Introduction: Patients presenting to emergency departments ( ED ) for injuries resulting from recreational activities represent a unique source of information on important directions for injury prevention efforts. We describe the epidemiology of non-motorized wheeled activity-related injury in pediatric patients presenting to Canadian ED s as well as patients' helmet use.

Methods: Data for the years 2004 to 2009 were abstracted from the Canadian Hospitals Injury Reporting and Prevention Program ( CHIRPP ), a national ED injury surveillance program in fifteen hospitals.

Results: Most of the 28 618 children aged 1 to 16 years injured during non-motorized wheeled activities were injured while cycling, followed by skateboarding. Most injuries occurred among boys. Children injured on scooters tended to be younger whereas skateboarders were the oldest. On average, the number of all injuries decreased by 6% over the time period. Falls were the most common mechanism of injury; 8.3% of patients had head injuries, which were seen more often among cyclists than other wheeled-activity users. Helmet use was greatest among cyclists (62.2%) and lowest among skateboarders (32.9%). Injured patients presenting to ED s in jurisdictions with legislation mandating helmet use had 2.12 greater odds of helmet use and 0.86 lesser odds of head injury compared with those presenting in jurisdictions without helmet laws.

Conclusion: These results provide further evidence that legislation mandating helmet use may be an effective way of reducing injury among all wheeled-activity users. The small number of patients who presented with helmet use and protective gear (59.4% overall) suggests that this remains an area for intervention.