Bicycle helmet prevalence two years after the introduction of mandatory use legislation for under 18 year olds in Alberta, Canada

Objective: To determine changes in helmet use in cyclists following the introduction of a bicycle helmet law for children under age 18. Methods: Cyclists were observed by two independent observers from July to August 2004 (post-legislation) in Edmonton, Alberta. The data were compared with a similar survey completed at the same locations and days in July to August 2000 (pre-legislation). Data were collected for 271 cyclists in 2004 and 699 cyclists in 2000. Results: The overall prevalence of helmet use increased from 43% (95% CI 39 to 47%) in 2000 to 53% (95% CI 47 to 59%) in 2004. Helmet use increased in those under 18, but did not change in those 18 and older. In the cluster adjusted multivariate Poisson regression model, the prevalence of helmet use significantly increased for those under age 18 (adjusted prevalence ratio (APR) 3.69, 95% CI 2.65 to 5.14), but not for those 18 years and older (APR 1.17, 95% CI 0.95 to 1.43). Conclusion: Extension of legislation to all age groups should be considered.

[1]  D J Beirness,et al.  Bicycle helmet use in British Columbia : effects of the helmet use law , 2000 .

[2]  W. Rogers Regression standard errors in clustered samples , 1994 .

[3]  Patricia C Parkin,et al.  Peer and Adult Companion Helmet Use Is Associated With Bicycle Helmet Use by Children , 2005, Pediatrics.

[4]  D. Thompson,et al.  Cochrane Review : Helmets for preventing head and facial injuries in bicyclists , 2017 .

[5]  R G Attewell,et al.  Bicycle helmet efficacy: a meta-analysis. , 2001, Accident; analysis and prevention.

[6]  A. Dannenberg,et al.  Bicycle helmet use among Maryland children: effect of legislation and education. , 1992, Pediatrics.

[7]  Sander Greenland,et al.  Model-based estimation of relative risks and other epidemiologic measures in studies of common outcomes and in case-control studies. , 2004, American journal of epidemiology.

[8]  J. Leblanc,et al.  Effect of legislation on the use of bicycle helmets. , 2002, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[9]  K D Liller,et al.  Children's bicycle helmet use and injuries in Hillsborough County, Florida before and after helmet legislation , 2003, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[10]  A. Delamater,et al.  Bicycle Helmet Wearing in Children: A Seven-Year, Observational Study in Broward County, Florida , 2003 .

[11]  K. Belton,et al.  The use of bicycle helmets in a western Canadian province without legislation. , 2003, Canadian journal of public health = Revue canadienne de sante publique.

[12]  D. Thompson,et al.  Effectiveness of bicycle safety helmets in preventing head injuries. A case-control study. , 1996, JAMA.

[13]  A P Vulcan,et al.  Mandatory bicycle helmet use following a decade of helmet promotion in Victoria, Australia--an evaluation. , 1994, Accident; analysis and prevention.

[14]  J Gilchrist,et al.  Police Enforcement as Part of a Comprehensive Bicycle Helmet Program , 2000, Pediatrics.

[15]  Colin Macarthur,et al.  Influence of socioeconomic status on the effectiveness of bicycle helmet legislation for children: a prospective observational study. , 2003, Pediatrics.

[16]  H. Ni,et al.  Evaluation of a statewide bicycle helmet law via multiple measures of helmet use. , 1997, Archives of pediatrics & adolescent medicine.

[17]  B. Rowe,et al.  Bicyclist and environmental factors associated with fatal bicycle-related trauma in Ontario. , 1995, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[18]  M. Kresnow,et al.  Effectiveness of a state law mandating use of bicycle helmets among children: an observational evaluation. , 2001, American journal of epidemiology.