Purpose To describe the epidemiology of bicycle-related injuries among children 5–17 years of age treated in US emergency departments (EDs).

Methods/Approach A retrospective analysis was conducted with data from the National Electronic Injury Surveillance System (NEISS) for children 5–17 years of age who were treated in EDs (from 2006 through 2015) for a bicycle-related injury. Bivariate comparisons were conducted by using chi-square tests, and relative risks (RR) and odds ratios (ORs) assessed strength of association with 95% confidence intervals (CIs). Rates of injuries over time were analysed by using linear regression.

Results An estimated 2,219,742 (95% CI: 1,871,120–2,568,363) bicycle-related injuries to children 5–17 years of age were treated in EDs over the 10 year study period, an average of 608 cases daily. Most injuries involved children 10–14 years of age (45.7%). The rate of bicycle-related injuries significantly decreased from 447.4 per 1 00 000 children in 2006 to 321.1 per 1 00 000 children in 2015 (p<0.001). Helmet use at the time of injury was significantly associated with lower likelihood of head and neck injuries (OR: 0.52 [95% CI: 0.40–0.59]) and hospitalizations (OR: 0.71 [95% CI: 0.54–0.94]), but there was no significant change in the rate of injury among helmet users (p=0.224). Motor vehicle involvement increased the risk of traumatic brain injury (RR: 1.76 [95% CI: 1.74–1.78]) and the odds of hospitalisation (OR: 4.03 [95% CI: 3.33–4.89]).

Conclusions Despite decreasing injury rates, bicycles remain an important source of injury for children. Greater efforts are needed to promote helmet use, promote use of safe routes to reduce the possibility of motor vehicle involvement.

Significance and Contribution to the Field It is critical to understand patterns of bicycle-related injuries as bicycling remains a leading cause of unintentional injury among children. Continued surveillance and research are necessary to identify strategies to improve bicycle safety for children.