Spotters have gone out to 20 Utah schools for more than a decade, intent on measuring child safety on bicycles. What's they've found is cause for concern.

Utah ranks 10th highest nationally for bike deaths, with use of helmets often a deciding factor in whether someone survives. Bicycle helmets are designed to protect against head and brain injuries. Studies say they reduce the risk of head injury and death by 85 percent.

And though the numbers are improving, it's still bad news in what are largely preventable serious injuries, according to Gary Mower, bicycle safety coordinator in the injury prevention arena at the Utah Department of Health.

On average, 940 Utah bicyclists are hit by automobiles every year. About seven of them die. And one of the determining factors is whether a helmet was used — and whether it was used correctly, which is a big problem.

In each of the 20 selected locations statewide, the department picked an elementary school and the area surrounding it, some rural, some urban. They observed the children as they left school, watching and marking on a form what they were seeing , starting in 1994. They checked off an age group, then checked to see if helmets were worn correctly or even at all. They also noted the gender of the bike rider.

A couple of hours later, to avoid getting the same kids again, they drove through the neighborhoods and again assessed the bike riders they saw, from helmet use to how well they used it and more.

"The good news is improvement," said Mower. "Helmet use is improving." But there's a long way to go.

When they started, only 3 percent of elementary-age students wore helmets, a number now up to 20 percent "but still pretty low."

Adult helmet usage has consistently been better than that of children, Mower said, hovering around 38 percent the whole time. In secondary schools, numbers were 0.2 percent and have climbed to 5 percent, meaning 95 percent of those youths on bikes don't wear helmets.

"Once you get to be an adult, you start wearing a helmet. Maybe you get smarter with age and know the risk of danger is more without it." Parents are powerful role models. If parents wear a helmet when they ride, so do kids. And parents should have a rule that a child cannot ride a bicycle anywhere without a helmet, Mower said.

They also found that children were more apt to wear a helmet when riding the bike to school than just around the neighborhood. "A lot of people think they won't get hurt in the neighborhood," Mower said.

But fully 30 percent of those who wear bike helmets wear them wrong. The helmet should be worn level on the head, with the chin strap tightened below the chin. "We saw helmets tilted so far they exposed half the head," Mower said. The pointy part of the helmet belongs in back. Newer helmets, he noted, are harder to put on backwards.

"We saw people with no chin strap buckled at all. If you fall off the bike, the helmet will go flying. And some were so loose they were hanging below the chin."

School-age children and teens are involved in about two-thirds of all bicycle crashes with motor vehicles. Those age groups account for 41 percent of all bicycle deaths. Three-fourths of those injured are male, but males are also more apt to wear helmets.

The study suggests that if everyone wore a helmet on every ride, Utah emergency rooms would treat 920 fewer people every year and that would save at least $19 million in medical costs.

The entire report is available online at