Do you or your children bike to work or school? Here in Beijing, a lot of us are fortunate to live close enough to their schools and offices that walking or biking could be an option. I bike to my hospital every day and I love it. But many others choose not to, for various reasons. Hopefully some readers can be inspired by the annual May 7th Walk and Bike To School Day and reconsider their commuting options, at least for one day of the year.  This public health promotion, sponsored by the US Department of Transportation, has two main goals: to encourage healthy exercise as well as to educate about proper bike safety. Walking and biking are great ways to keep kids in shape, especially amidst our modern world’s worsening epidemics of obesity and diabetes. In China, childhood obesity and diabetes is increasing at an alarming rate.

Many parents are worried about road safety and air pollution, and your kids certainly need to know the bike “rules of the road”, especially if you are riding in the street and not in a bike lane. These include:

• Ride single file and in the same direction as cars.
• Ride to the right side of the road, but far enough from parked cars to avoid any car doors that suddenly open.
• Obey traffic laws. Follow all traffic signs, signals, and lane markings.
• Be predictable. Ride in a straight line, not in and out of cars. Use hand signals.

Regarding air pollution and biking, a handful of studies have directly compared health benefits of biking versus driving to school or work, and found much greater health benefits than any risks from air pollution or road accidents. The largest study followed 67,000 Shanghai women for five years and showed clear benefits from bicycling, leading to less heart disease, cancers and deaths. Other studies from Europe have also shown this, but as Shanghai’s air pollution is more relevant for us here in China, it’s very encouraging that local research shows that exercise and bicycling still have clear health benefits.

Besides road safety, a proper bike helmet is crucial for protecting yourself in an accident, especially with car collisions. The foam padding in a helmet can absorb most of the impact in a collision, minimizing potential injuries especially to the brain. Compared to helmeted cyclists, unhelmeted cyclists are twice as likely to sustain a brain injury or head injury; and four times more likely to die from their injury. Helmet use is recommended by all the major health organizations, including the World Health Organization, the American Academy of Pediatrics and the American Medical Association.

The other key to this puzzle is proper fit of a bike helmet, as yet another quick glance around tell us shows many people, including kids, with helmets perched up too high, or worse — not even strapped down. Make sure your kids know the basics of a proper fit:

• Put your helmet flat on your head. If it moves when you shake your head, you need to tighten your helmet or get a smaller one.
• Eyes: The helmet should sit low on your forehead – two finger widths above your eyebrows.
• Ears: With the helmet buckled, the straps should meet just below the ears.
• Mouth: When buckled, you should be able to fit no more than two fingers between the buckle and chin.
• Finally, take the yawn test: a big yawn should tighten the mask down. If it doesn’t, it’s not tight enough.

I’ve bought a few brands of helmets for myself and now also for my one year old son, and I know how confusing it is to buy a safe brand with a good reputation. In the USA, every helmet must have safety approval by the Consumer Product Safety Commission, and every helmet must have this CPSC sticker inside as proof. You may also see other certification stickers inside your helmet, including EN 1078 or EN 1080, which are the European Union safety standard. For more research, you can find specifics on safe brands at websites including the Bicycle Helmet Safety Institute and ConsumerSearch. You should resist the urge to buy the most expensive helmets, assuming they are safer: the BHSI performed their own tests and found that a $10 helmet and a $200 helmet achieved the same safety results.

We all know from a quick glance around our streets that a distressingly small amount of riders actually wear helmets, including children. It’s such a tragedy to have any child die from a preventable bike accident! What can we do to increase the use of bike helmets in our communities? Firstly, I believe we all need to be role models for others, especially our children. That means we adults always wear a bike helmet, and our children will model our good example. Secondly, a Cochrane review of studies has shown that public health campaigns in communities can help increase awareness, and giving away helmets or providing coupons can greatly help increase the percentage of people wearing them.

My Alex is still too young even to go to school, but I’m already teaching him safety habits with his own bike helmet as he rides with us. He initially hates it, but once he sees mommy and daddy wearing one as well, he eventually calms down and we all have a lovely time exploring our local hutongs via bike. Very soon, he will be walking or biking to his local school, escorted by his daddy. I already know that will be much harder on me than on him.