As a physician and chief executive officer for Hawaii’s only rehabilitation hospital, I am an advocate for patients.
Having spent nearly 25 years caring for people who have suffered serious illnesses and injuries, including traumatic brain injury (TBI), I believe it is critical to the welfare of Hawaii’s youth that the Honolulu City Council pass Bill 62 requiring skateboard helmets for children 16 years and younger.
A recent Star-Advertiser story highlighted some of the difficulties this bill has encountered in trying to protect children from serious harm (“Skateboard helmet bill confronts rough ride as liability issue rises,” Star-Advertiser, Oct. 8).
There will always be issues when considering new laws. But this bill is for the safety of our children.
It is our responsibility as adults and parents to try to protect our children from bodily harm. If the government won’t mandate it, then we must do our best to make sure every child has a helmet when skateboarding, riding a moped, roller or in-line skating, bicycling or any other activity that has potential for injury.
Each year in Hawaii, emergency rooms treat more than 2,600 children under the age of 14 for TBI. That is a frightening statistic. Sometimes the injury comes from something as simple as an incorrect helmet fit, let alone no helmet.
The U.S. Centers for Disease Control and Prevention reports that 1,482 Hawaii residents were hospitalized with TBI in 2006 (the latest year with available data). This equates to a rate of TBI of 109 injuries per 100,000 residents, the second highest rate in the U.S. Eighty-seven percent of these injuries were non-fatal, resulting in significant residual physical and cognitive disabilities. Survivors of TBI require comprehensive and coordinated care, including cognitive, neurobehavioral and neuropsychological therapies to maximize their recovery and allow them to return to the community.
The Hawaii Department of Health reported that between 2006-2010, patients under 16 years of age made up half (2,218) of all those (4,416) who were treated in hospitals for injuries from skateboarding.
Fractures were the most common type of principal diagnosis, both at the emergency depart
ment and hospitalization levels, specifically fractures of the lower arm or hand. Skull fractures were also prevalent (24 percent) among patients admitted to hospitals. TBI, which includes skull fractures, was the principal diagnosis for 41 percent of the inpatients.
A review of the National Trauma Databank showed that 66 percent of persons seriously injured by skateboarding were 16 years of age or younger. Of those who were injured, the incidence of TBI was as high as 45.5 percent. There is a strong consensus in the medical literature that proper helmets can greatly reduce the incidence of sports-related head injury, with reductions in the incidence of serious injury of 50 percent to 80 percent in sports such as bicycling and skiing. The American Academy of Pediatrics strongly recommends that all skateboarders wear a helmet and other protective gear.
In spite of the benefits of helmet use while skateboarding, it is estimated that only 20 percent of skateboarders typically wear helmets in the absence of a helmet law. Ironically, helmet use is lower for less experienced skateboarders despite their increased risk for injury. Helmet laws can be very effective in increasing helmet use.
Hawaii is even more at risk than many other states for keiki injuries since our weather allows for outdoor activities 365 days a year. Is there really a need for more discussion and delay knowing the statistics and the kind of fatal or serious injuries that are happening? The data on this matter is compelling, and has led to many states and municipalities passing mandatory helmet laws.
While our lawmakers continue discussions, I encourage everyone to take advantage of community resources that offer classes on helmet safety and helmet giveaways for families that may need assistance. I encourage Hawaii residents to write a letter or call their City Council representative to ensure that our government mandates the protection of Hawaii’s keiki.
