Bicycle Helmet Laws Research Articles

Cycle safe or cycle cool? Adolescents’ views on bicycle helmet use and injury prevention campaigns in Belgium

ObjectivesAlthough cycling is a healthy, ecological and practical way of transportation, it is not without risk. The effect of bicycle helmets to prevent head injuries on crashing has been extensively...

To helmet or not to helmet: a global perspective on the bicycle compulsory protective helmet law.

Child injury from bike accidents is a significant component of morbidity, mortality and health expenditure in many countries. Universal use of bicycle helmets by children could prevent between 135 and 155 deaths, and between 39,000 and 45,000 head injuries annually. Surprisingly, epidemiologic data indicate a worldwide low prevalence of helmet use. A global view on the law on the compulsory use of safety helmets involving 58 different countries is provided in order to bring this critical debate back to the table. A broad search using "bicycle-related injuries," "bicycle helmet," "bicycle helmet legislation" and "compulsory bicycle helmet law by countries" was performed in order to identify and select the most pertinent information on the issue as well as all the information available on bicycle helmet law by countries. The papers identified permitted us to assess the main topics related to the use of bicycle helmets discussed over the years which are still relevant and without consensus even today, as well as alphabetically enlist the approach of 58 countries to the compulsory helmet law. Our review on the many faces of the bicycle helmet use (pros and cons), personal aspects, head injuries, legislation, promotion, socioeconomic influence, and finally a global view on the law on the compulsory use of safety helmets allowed us to bring here many suggestions and a few conclusions, mainly because "to helmet or not to helmet" should not be a question anymore. A universal consensus on their compulsory use has to be achieved in order to improve children's safety.

Legal Studies: Bicycle helmet laws: More harm than good?

Legal Studies: Bicycle helmet laws: More harm than good?

To helmet or not to helmet: a global perspective on the bicycle compulsory protective helmet law.

Objective Child injury from bike accidents is a significant component of morbidity, mortality, and health expenditure in many countries. Universal use of helmets by children could prevent between 135 and 155 deaths, and between 39,000 and 45,000 head injuries annually. Surprisingly, epidemiologic data indicate a worldwide low prevalence of use. A global view on the law on the use of safety helmets involving 58 different is provided in order bring this critical debate back the table. Methods A broad search using bicycle-related bicycle helmet, bicycle legislation and compulsory law by countries was performed in order identify and select the most pertinent information on the issue as well as all the information available on law by countries. Results The papers identified permitted us assess the main topics related the use of helmets discussed over the years and that still relevant and without consensus even today, as well as alphabetically enlist the approach of 58 the law. Conclusions Our review on the many faces of the use (pros and cons), personal aspects, head injuries, legislation, promotion, socioeconomic influence, and finally a global view on the law on the use of safety helmets allowed us bring here many suggestions and a few conclusions, mainly that to or not helmet should not be a question anymore. A universal consensus on their use has be achieved in order improve children's safety.

Mandatory Bicycle Helmet Laws in the United States: Origins, Context, and Controversies.

This article examines the origins and context of mandatory bicycle helmet laws in the United States. Localities began to enact such laws in the early 1990s, having experimented with helmet laws for motorcycles previously. As cycling became increasingly popular in the 1970s and 1980s because of a variety of historical trends, from improved cycle technology to growing environmental consciousness, cycling-related injuries also increased. Bicycle safety advocates and researchers alike were particularly troubled by head injuries. National injury surveillance systems and a growing body of medical literature on bicycle-related injuries motivated a number of physicians, cyclists, children, and other community members to advocate helmet laws, which they argued would save lives. Controversy over these laws, particularly over whether they should apply universally or only to children, raised public health ethics concerns that persist in contemporary debates over bicycle helmet policies. (Am J Public Health. 2020;110:1198-1204. doi: 10.2105/AJPH.2020.305718).

The perspectives of young people on barriers to and facilitators of bicycle helmet and booster seat use.

Mandatory bicycle helmet and booster seat laws for children are now common across Canada and the United States. Previous research has found that despite legislation, child compliance is often low. Our objectives were to identify and compare children's perspectives on barriers to and facilitators of their use of bicycle helmets and booster seats. Eleven focus groups were conducted with a total of 76 children; five groups of children between the ages of 4 and 8 years discussed booster seats and bicycle helmets, and six groups of children between the ages of 9 and 13 years discussed bicycle helmets. Efforts were made to include diverse participants from a variety of ethno-cultural and socioeconomic backgrounds. Poor fit and physical discomfort were most often described as barriers to bicycle helmet use. Helmet appearance was a barrier for some children but acted as a facilitator for others. Booster seat facilitators included convenient features such as drink cup holders and being able to sit higher up in order to have a better view, while barriers included fear of being teased, and wanting to feel and be seen as more mature by wearing a seatbelt only. The main barriers to usage of bicycle helmets and booster seats identified by young people were modifiable and fit within a theory of planned behaviour framework that includes subjective norms, child attitudes towards safety equipment and perceived behavioural control of its usage. Recommendations were made regarding how these elements can be utilized in future injury prevention campaigns.

Policing mandatory bicycle helmet laws in NSW: Fair cop or unjust gouge?

Australia was the first country to introduce laws mandating the wearing of helmets by bicyclists with the aim of enhancing road safety for cyclists. Examining the law and its administration in NSW, we point to some serious problems and anomalies with the law. We argue safety concerns have been relegated and the fine for the offence has lost any sense of proportionality with offending, parity with penalties imposed in other states and with penalties for other road safety offences in NSW. We also discuss concern over potential police misuse of the law and of its collateral consequences for the vulnerable.

Legal Studies: Mandatory bicycle helmet laws and the disabled

Legal Studies: Mandatory bicycle helmet laws and the disabled

As easy as riding a bike? How mandatory bicycle helmet laws may harm those who can least afford it

This work takes compulsory helmet laws in Victoria and considers them from a new angle – namely that of someone living with a disability. While much has been written on mandatory helmet laws in terms of their broader societal implications, little has been done on their impact on society’s most vulnerable such as the disabled, the impecunious and the mentally impaired. Drawing on the author’s time at the Melbourne Magistrates’ Court as a framework, this article analyses the existing state of the law and provides a critique of its shortcomings – prosecuting the argument that existing legislation can have an unexpected impact upon the marginalised in our community, particularly those with a cognitive impairment.

The impact of bicycle helmet legislation on cycling fatalities in Australia.

Australian bicycle helmet laws were first introduced in Victoria in July 1990 and the remaining Australian states, Australian Capital Territory and Northern Territory by July 1992. Previous research on helmet legislation has focused on changes in helmet wearing and bicycle-related head injury. Although it is generally accepted that bicycle helmets can reduce the risk of fatality due to head injury, there has been little research assessing the impact of helmet legislation on cycling fatalities. An interrupted time series approach was used to assess the impact of bicycle helmet legislation on yearly-aggregated rates of bicycle-related fatalities per population from 1971 to 2016. Immediately following bicycle helmet legislation, the rate of bicycle fatalities per 1 000 000 population reduced by 46% relative to the pre-legislation trend [95% confidence interval (CI): 31, 58]. For the period 1990-2016, we estimate 1332 fewer cycling fatalities (95% CI: 1201, 1463) or an average of 49.4 per year (95% CI: 44.5, 54.2). Reductions were also observed for pedestrian fatalities; however, bicycle fatalities declined by 36% relative to pedestrian fatalities (95% CI: 12, 54). In the absence of robust evidence showing a decline in cycling exposure following helmet legislation or other confounding factors, the reduction in Australian bicycle-related fatality appears to be primarily due to increased helmet use and not other factors.

WHAT DO BICYCLE HELMET LAWS DO? EVIDENCE FROM CANADA

Twenty‐one states and the District of Columbia require youths to wear helmets when riding a bicycle, and there has been a push to extend such laws to adults. We provide new evidence on helmet laws by studying Canada using difference‐in‐differences models and restricted area‐identified public health survey data with information on cycling and helmet use for nearly 800,000 individuals from 1994 to 2014. We first confirm prior patterns from the United States that laws requiring youths to wear helmets significantly increased youth helmet use. We then provide the literature's first comprehensive evidence that “all‐age” bicycle helmet laws significantly increased both adult and youth helmet use by 50%–190% relative to pre‐reform levels, with larger effects for younger adults and less‐educated adults. All‐age helmet laws had modest effects at reducing cycling and increasing in‐home exercise during winter months among adults but did not meaningfully affect weight. Overall, our findings confirm that all‐age helmet laws can be effective at increasing population helmet use without significant unintended adverse health consequences. (JEL I18, I12, K32)

Bicycle helmet law does not deter cyclists in Finland

Bicycle helmet legislation (BHL) in Finland went into effect in January 2003 and applies to cyclists of all ages. There are no mechanisms to fine cyclists riding without a helmet; however, helmet wearing rates are 64% in Helsinki and 42% across Finland. Our aim was to discuss possible effects of BHL on cycling in Finland. We used data from the 1998/1999, 2004/2005 and 2010/2011 Finnish National Travel Surveys. Data across three surveys suggest cycling has declined from before to after BHL. In a 2004/2005 survey, however, only 0.063% (95% CI: 0.02–0.10%) of responders identified helmet use as their most important obstacle to cycling. It is unlikely BHL is a causal factor in the downward trend in Finnish cycling. Lack of cycling infrastructure and concerns for safety are much more common reasons given.

Prevention diaries by Larry Cohen

Larry Cohen is well known to the injury prevention community (eg, American Public Health Assocition (APHA)'s Injury Control and Emergency Health Services section has awarded him the Public Service Award). Larry has fought for bicycle and motorcycle helmet laws and for strengthening child and adult passenger restraint regulations. He has been a leader in helping define violence as a preventable public health issue. In Prevention Diaries , Larry has written an inspiring and very personal book. He writes about public health and his work in promoting prevention and also provides many personal recollections and anecdotes from both his work and personal life. When he was 9 years old, a neighbourhood friend died in a biking incident; it was so difficult for Larry when he would see the mom in the grocery store—and he began to recognise both the permanence and poignancy of death. As …

Helmet Wars - or Can We Stop Banging Our Heads into the Wall and Have a Healthy Dialog about Bicycle Helmets?

The subject of bicycle helmets and helmet laws has been a widely discussed topic for years among health care specialists, cycling advocates and politicians. Who can be against protecting someone's head? If a simple device can save someone's life, why shouldn't everyone be using it? Numerous studies have attempted to quantify the safety benefits of helmet usage, but this still remains a highly contentious topic. More recently, linkages have been made between mandatory helmet laws and lack of success for bike share programs. As a cycling advocate representing the Montreal cycling community I am frequently asked to express my opinion on this topic. The discussion will focus on bicycle helmets as detrimental to the wider subject of cyclist safety. Helmet discussions implicitly place the blame on victims while allowing us to ignore more important safety topics which might require political will and necessitate a reallocation of space to favor active transportation. In the media, we frequently hear from trauma experts or first responders (with a chorus of cyclists who have been 'saved by their helmet' responding in the comments), yet we rarely hear from public-health advocates who are able to put the cyclist injuries into a larger context. Cyclist and pedestrian deaths may make for sensationalist reporting, but diseases associated with our sedentary lifestyles are a far larger public health challenge. In this presentation I would like to engage with the audience to explore strategies that might help to shift the safety conversation to more constructive areas.

Bicycle helmet use among persons 5 years and older in the United States, 2012

IntroductionIn 2013, injuries to bicyclists accounted for 925 fatalities and 493,884 nonfatal, emergency department-treated injuries in the United States. Bicyclist deaths increased by 19% from 2010 to 2013. The greatest risk of death and disability to bicyclists is head injuries. The objective of this study was to provide estimates of prevalence and associated factors of bicycle riding and helmet use among children and adults in the United States. MethodCDC analyzed self-reported data from the 2012 Summer ConsumerStyles survey. Adult respondents (18+years) were asked about bicycle riding and helmet use in the last 30days for themselves and their children (5 to 17years). For bicycle riders, CDC estimated the prevalence of helmet use and conducted multivariable regression analyses to identify factors associated with helmet use. ResultsAmong adults, 21% rode bicycles within the past 30days and 29% always wore helmets. Respondents reported that, of the 61% of children who rode bicycles within the past 30days, 42% always wore helmets. Children were more likely to always wear helmets (90%) when their adult respondents always wore helmets than when their adult respondents did not always wear helmets (38%). Children who lived in states with a child bicycle helmet law were more likely to always wear helmets (47%) than those in states without a law (39%). ConclusionsDespite the fact that bicycle helmets are highly effective at reducing the risk for head injuries, including severe brain injuries and death, less than half of children and adults always wore bicycle helmets while riding. Practical applicationStates and communities should consider interventions that improve the safety of riding such as policies to promote helmet use, modeling of helmet wearing by adults, and focusing on high risk groups, including Hispanic cyclists, occasional riders, adults, and children ages 10 to 14.

Observational study of compliance with Queensland bicycle helmet laws

Mandatory bicycle helmet laws have been found to increase helmet wearing rates in Australia and internationally. However, much of the research on factors influencing compliance with the Australian helmet laws is dated or focuses on commuters and city areas only. To address this gap, video recordings of bicycle riders were undertaken at 17 sites across Queensland, Australia, representing a mixture of on- and off-road locations, speed limits and regions. Helmet status was able to be determined for 98% of riders observed. The level of compliance with the laws was very high, with 98.3% of the more than 27,000 riders observed wearing helmets. Riders riding on roads were less compliant than those riding on bicycle paths, but no significant differences were observed between the school-holiday and school-term periods. Among the on-road riders, boys were less compliant than girls and overall children were less compliant than adults. Higher compliance levels were found for group riders, road bike riders, lycra-clad riders, during morning hours, and on 50km/h or lower speed limit roads. While the overall level of compliance was very high, certain subgroups were identified as a possible focus for interventions to further improve the compliance level, for example children (particularly boys) riding mountain bikes away from groups during the afternoon hours on 60km/h roads.

Bicycle helmet laws and persistent racial and ethnic helmet use disparities among urban high school students: a repeated cross-sectional analysis.

BackgroundBicycle helmet laws generally increase helmet usage, but few studies assess whether helmet laws reduce disparities. The objective of this study is to assess changes in racial/ethnic disparities in helmet use among high school students in urban jurisdictions where laws were previously determined to increase overall helmet use.MethodsLog-binomial models were fit to four districts’ 1991–2013 Youth Risk Behavior Survey (YRBS) data. Post-regression predictive margins were used to calculate adjusted bicycle helmet use proportions, assess before-to-after changes in race/ethnicity specific helmet use, and estimate changes in disparities from jurisdictions’ white subpopulations.ResultsHelmet use among white students increased by 10.2 percentage points in two Florida counties (p < 0.001), 20.1 points in Dallas (p < 0.001), and 24.4 points in San Diego (p < 0.001). Increases among African Americans were 6.1 percentage points in the Florida counties (p < 0.001), 8.2 points in Dallas (p < 0.001), and 6.3 points in San Diego (p = 0.070). Use increased among Latino students in the Florida counties (4.3 percentage points, p = 0.016) and Dallas (6.2, p = 0.002), but not significantly in San Diego. San Diego helmet use among Asian students increased by 12.8 percentage points (p < 0.001). Because helmet use increased more for white students, helmet laws were associated with increased disparities. In the Florida counties, disparities increased significantly by 5.9 percentage points for Latino students (p = 0.045). San Diego disparities worsened by 18.1 (p < 0.001), 21.3 (p < 0.001), and 11.6 (p = 0.013) percentage points among African American, Latino, and Asian students respectively. Dallas disparities increased by 11.9 (p = 0.015) and 14.0 (p = 0.003) percentage points among African American and Latino students. Increased disparities generally persisted for follow-up time of at least a decade. Main study limitations include the possibility of helmet use reporting error and limited socioeconomic variables in YRBS datasets.ConclusionsHelmet use increased across racial/ethnic subpopulations, but greater increases among white students increased disparities. Policymakers should couple laws with other approaches to reduce helmet disparities and cycling injuries.Electronic supplementary materialThe online version of this article (doi:10.1186/s40621-016-0086-3) contains supplementary material, which is available to authorized users.

Helmet Laws, Helmet Use, and Bicycle Ridership

PurposeTo assess bicycle helmet laws' effect on helmet and bicycle use among U.S. high school students in urban jurisdictions. MethodsLog-binomial models were fit to Youth Risk Behavior Survey data from five jurisdictions. Adjusted helmet and bicycle use proportions were calculated with post-regression marginal effects. Difference-in-differences were estimated, comparing intervention to concurrent controls. A placebo outcome was used to falsify possible confounding or selection effects. ResultsIn San Diego and Dallas, helmet use increase increased 10.6 (95% confidence interval [CI] 6.5 to 14.7, p < .001) and 8.1 (95% CI 4.3 to 12.0, p < .001) percentage points more than out-of-jurisdiction controls. Increases in Florida counties were 5.0 (95% CI 1.8 to 8.2, p = .003) and 4.0 (95% CI −.7 to 8.8, p = .098) points against age-based and out-of-jurisdiction controls, respectively. Bicycle use fell 5.5 points in both San Diego (95% CI −9.8 to −1.1, p = .015) and the Florida counties (95% CI −11.5 to .5, p = .075) against out-of-jurisdiction controls, but other comparisons had no significant changes. The placebo outcome never changed significantly. ConclusionsLaws increased helmet use in all jurisdictions, with limited evidence of reduced cycling. Although sound health policy, laws should be coupled with physical activity promotion.

The Effect of an All-Ages Bicycle Helmet Law on Bicycle-Related Trauma.

In 2003, Seattle implemented an all-ages bicycle helmet law; King County outside of Seattle had implemented a similar law since 1994. For the period 2000-2010, the effect of the helmet legislation on helmet use, helmet-preventable injuries, and bicycle-related fatalities was examined, comparing Seattle to the rest of King County. Data was retrieved from the Washington State Trauma Registry and the King County Medical Examiner. Results comparing the proportions of bicycle related head injuries before (2000-2002) and after (2004-2010) the law show no significant change in the proportion of bicyclists admitted to the hospital and treated for head injuries in either Seattle (37.9 vs 40.2% p=0.75) nor in the rest of King County (30.7 vs 31.4%, p=0.84) with the extension of the helmet law to Seattle in 2003. However, bicycle-related major head trauma as a proportion of all bicycle-related head trauma did decrease significantly in Seattle (83.9 vs 64.9%, p=0.04), while there was no significant change in King County (64.4 vs 57.6%, p=0.41). While the results do not show an overall decrease in head injuries, they do reveal a decrease in the severity of head injuries, as well as bicycle-related fatalities, suggesting that the helmet legislation was effective in reducing severe disability and death, contributing to injury prevention in Seattle and King County. The promotion of helmet use through an all ages helmet law is a vital preventative strategy for reducing major bicycle-related head trauma.

Costs and benefits of a bicycle helmet law for Germany

This study presents a cost–benefit analysis of a law requiring cyclists to wear a helmet when riding a bicycle in Germany. The cost benefit-analysis takes into account the benefit of increased security when cyclists wear a helmet or use a transport mode that is less risky than cycling. The analysis also considers the cost of purchasing helmets, reduced fitness when cycling is replaced by a motorized transport mode, the discomfort of wearing helmets and environmental externalities. The benefits of a helmet law are estimated at about 0.7 of the costs. A bicycle helmet law for Germany is found to be a waste of resources.