Trends in bicycle helmet use in Ottawa from 1988 to 1991.

OBJECTIVE To determine the prevalence rates of helmet use by cyclists in Ottawa in September 1991 and to compare them with the rates in a baseline survey conducted in September 1988. DESIGN Observational survey. SUBJECTS A total of 3252 cyclists (commuters, recreational cyclists and students in primary, secondary and postsecondary schools) were observed. In the baseline study 1963 such cyclists had been surveyed. RESULTS In 1991, 1056 (32.5%) of the cyclists were observed wearing helmets. After the samples were standardized for varying size across the cyclist groups the total helmet use was found to have increased from 10.7% in 1988 to 32.2% in 1991. The highest increase in the rate of helmet use was found among the commuters (from 17.9% in 1988 to 44.6% in 1991); the rate had increased from 14.3% to 31.1% among the recreational cyclists and from 1.9% to 21.0% among the students. All of the trends were statistically significant (p less than 0.0001). When the student population was subdivided the rate of helmet use was found to be 25% among the elementary school children, 17% among the secondary school students and 20.2% among the postsecondary school students. CONCLUSIONS The use of bicycle helmets in Ottawa has increased dramatically. Our experience, as well as evidence from other centres, indicates that specific interventions such as media coverage, bulk-buying projects in schools and discount coupons can accelerate the rate of helmet adoption. Although less than half of cyclists are wearing helmets the trend has acquired considerable momentum, and major gains are expected in the next few years. Nevertheless, resistance among young adults and the cost of helmets for low-income groups may be problems. These challenges call for the refinement of future promotional strategies.