The bicycle: a developmental toy versus a vehicle.

This study was designed to compare bicycle-motor vehicle collisions involving those children using the bicycle for play vs those using it for transportation. Data were obtained from a multihospital-based monitoring system of traffic-related injuries among children aged 0 through 14 years, including the coroner's office, in a single urban county. The sample consisted of 289 children through 14 years of age; 123 (43%) were playing; 166 (57%) were on a purposeful trip. Those playing were younger; closer to home; on residential streets with fewer traffic lanes, lower posted speed limits, and lighter traffic; and more frequently with other children. Those using the bicycle for transportation or for a purposeful trip were more commonly 10 to 14 years of age, riding on multilane streets, and riding alone. Forty-five percent of these children were en route to/from school. There were no significant differences between the two groups with respect to number, severity, or distribution of injuries. Extremity and head injuries were predominant. This study demonstrates that motor vehicle-bicycle injuries among young children bicycling in their own neighborhood are just as severe as those in older children who are using the bicycle as a means of transportation. Recommendations for interventions include establishing an appropriate age at which children are permitted to bicycle in the street, separating bicyclists from traffic, teaching bicyclists the rules of the road, consideration of licensure, and use of helmets.