Despite some criticism of bike helmets for not being protective enough, they do cut the risk of severe traumatic brain injury (TBI) by half when riders suffer a head injury, a U.S. study suggests.\r\nRiders with helmets were also less likely to die from their injuries, and less likely to break facial bones, than those not wearing a helmet, researchers report in American Journal of Surgery.\r\n\u201cIt\u2019s similar to wearing a seat belt, said Dr. Jerri Rose, a pediatric emergency physician at University Hospitals\u2019 Rainbow Babies and Children\u2019s Hospital in Cleveland, Ohio, who was not involved in the study. \u201cWearing one doesn\u2019t ensure that you\u2019re not going to get in a car accident, but it lowers the risk of injury and of dying in a car accident.\u201d\r\nMillions of Americans ride bicycles, but less than half wear bicycle helmets, according to the Centers for Disease Control and Prevention.\r\nIn the U.S., there were 900 deaths and an estimated 494,000 emergency room visits due to bicycle-related injuries in 2013, the study authors write.\r\nUsing the American College of Surgeons\u2019 National Trauma Data Bank, the researchers analyzed records of 6,267 people treated in 2012 for bleeding inside the skull after a bicycle accident.\r\nOne quarter of patients had been wearing a bicycle helmet at the time of their accident. Just over half of the patients had severe traumatic brain injuries and 3 percent died.\r\nResearchers found that people wearing helmets had 52 percent lower risk of severe TBI, compared to unhelmeted riders, and a 44 percent lower risk of death.\r\nRiders with helmets also had 31 percent lower odds of facial fractures. The upper part of the face, particularly around the eyes, was most protected. Helmets offered less protection against fractures to the lower part of the face, such as the nose and jaw.\r\nMoreover, people who wore helmets reduced their likelihood of having brain surgery, further confirming a certain level of protection with helmet use, the study team writes.\r\n\u201cUsing helmets has always been controversial,\u201d said study coauthor Dr. Asad Azim, a research fellow in the department of Surgery at the University of Arizona in Tucson. \u201cCritics argue that due to its incomplete design bicycle helmets are of no use and do not protect riders when it comes to severe injuries.\u201d\r\nBut \u201cthe results of the study say different,\u201d he told Reuters Health by email.\r\nHelmeted riders were more likely to be white, female and insured compared to non-helmeted riders. Riders aged 10 to 20 were among the least likely to wear a helmet, while those aged 60 to 70 were most likely to wear one.\r\n\u201cAbout 75 percent of people in this study weren\u2019t wearing helmets so we have a long way to go in terms of making sure that people wear helmets when cycling,\u201d Rose said.\r\n\u201cEspecially teens,\u201d she added, \u201cthey perceive it as not cool.\u201d\r\nThe key is to start them early, Rose said. \u201cStarting early is really important. As soon as they start riding their bikes, they should be taught to wear a helmet. It has to become a routine.\u201d\r\nReuters.