A Systematic Review of Bicycle Helmet Laws Enacted Worldwide

Article (PDF Available) · August 2018with 693 Reads
Cite this publication
Abstract
A systematic review was undertaken to summarise bicycle helmet laws (BHL) enacted around the world, when they were introduced, available information regarding enforcement fines and whether they were later repealed. Jurisdictions with some form of BHL were identified using several sources including European Commission, Bicycle Helmet Safety Institute, government websites, and news articles. Wikipedia and advocacy group websites were also searched, but material was included only if verified from other sources. Road safety organisations in countries with existing BHL were also contacted. Information regarding date BHL was introduced, age of riders required to wear a helmet, what fines apply, and where and when BHL was modified or repealed, were gathered. There are currently 28 countries in total that have a helmet bicycle law. When the data is broken down in terms of countries, states, and cities, there have been at least 273 bicycle helmet laws enacted all over the world. Nine countries have bicycle helmet laws that apply to all ages as well as half of Canadian provinces, some US cities, urban travel in Chile and Slovakia, and interurban travel in Israel and Spain. To date, seventeen jurisdictions have modified their laws and only two laws have been fully repealed (Mexico City and Bosnia and Herzegovina). Although often presented as unique to cycling in Australia or New Zealand, bicycle helmet legislation has been enacted in many locations around the world. These laws are also robust with less than 1% of these laws (two instances) being fully repealed.
Vol 29 No 3, 2018
Journal of
the Australasian College of Road Safety
Formerly RoadWise – Australia’s First Road Safety Journal
Peer-reviewed papers
Original Road Safety Research
• Recordingofalcoholinocialcrashstatistics:underreportingandprocedurestoimprovestatistics
• AnalysisoftrendsinthecompositionofAustralasianvehicleeetsassociatedwithpedestrianinjuryseverity
• ASystematicReviewofBicycleHelmetLawsEnactedWorldwide
• SafeRoadsforCyclists:AnInvestigationofAustralianandDutchApproaches
• DevelopmentofapedestrianinjurypredictionmodelforpotentialuseinanAdvancedAutomatedCrashNotication
 (AACN)system
Contributed articles
Road Safety Policy & Practice
•TheAgeofLightVehiclesInvolvedinRoadFatalities
PerspectiveonRoadSafety
•SafeSpeedsPart1:PoliticalDecisionsandtheLimitedAdoptionofSpeedManagementforRoadSafety
Journal of the Australasian College of Road Safety – Volume 29 No. 3, 2018
30
A Systematic Review of Bicycle Helmet Laws Enacted
Worldwide
Mahsa Esmaeilikia1,2, Raphael Grzebieta2 and Jake Olivier1
1School of Mathematics and Statistics, UNSW Sydney, Australia
2Transport and Road Safety (TARS) Research Centre, UNSW Sydney, Australia
Corresponding Author: Jake Olivier, School of Mathematics and Statistics, The Red Centre, UNSW Sydney, Australia
2052, j.olivier@unsw.edu.au, +61 2 9385 6656.
Key Findings
Twenty-eight countries around the world have some form of bicycle helmet legislation;
Current laws vary by maximum applicable age, the presence and amount of nes;
All-ages helmet laws exist in nine countries, half of Canadian provinces, some US cities, urban travel in Chile and
Slovakia, and interurban travel in Israel and Spain;
There have been 273 laws enacted worldwide with only two being fully repealed
Abstract
A systematic review was undertaken to summarise bicycle helmet laws (BHL) enacted around the world, when they were
introduced, available information regarding enforcement nes and whether they were later repealed. Jurisdictions with
some form of BHL were identied using several sources including European Commission, Bicycle Helmet Safety Institute,
government websites, and news articles. Wikipedia and advocacy group websites were also searched, but material was
included only if veried from other sources. Road safety organisations in countries with existing BHL were also contacted.
Information regarding date BHL was introduced, age of riders required to wear a helmet, what nes apply, and where
and when BHL was modied or repealed, were gathered. There are currently 28 countries in total that have a helmet
bicycle law. When the data is broken down in terms of countries, states, and cities, there have been at least 273 bicycle
helmet laws enacted all over the world. Nine countries have bicycle helmet laws that apply to all ages as well as half of
Canadian provinces, some US cities, urban travel in Chile and Slovakia, and interurban travel in Israel and Spain. To date,
seventeen jurisdictions have modied their laws and only two laws have been fully repealed (Mexico City and Bosnia and
Herzegovina). Although often presented as unique to cycling in Australia or New Zealand, bicycle helmet legislation has
been enacted in many locations around the world. These laws are also robust with less than 1% of these laws (two instances)
being fully repealed.
Keywords
Bicycle; helmet legislation; transport policy; cycling safety; systematic review
Introduction
There is no current, comprehensive list of bicycle helmet
laws that exist around the world. Bicycle helmet legislation
is an often-debated topic and these discussions should be
informed by factual information. According to the Bicycle
Helmet Safety Institute (2017), the U.S. state of California
was the rst place to introduce bicycle helmet legislation
for passengers under 5 years of age in 1987, followed by
the states of New York and Massachusetts in 1989 and 1990
respectively. In July 1990, the Australian state of Victoria
became the rst jurisdiction to introduce BHL for riders
of all ages (Carr et al, 1995). The remaining Australian
states and territories introduced similar legislation by 1992
(Australian Transport Safety Bureau, 2006).
Opponents of BHL often claim that only two countries
(Australia and New Zealand) have bicycle helmet legislation
(Rissel & Wen, 2011; Turner, 2012; Guy, 2015; Greaves,
2016), which is then used to argue for the repeal of such
legislation in Australia and to argue against the introduction
of BHL in other countries. This is despite numerous
research articles that have assessed the impact of BHL in
other countries (Karkhaneh et al, 2013; Dennis et al, 2010;
Bonander et al, 2014; Kett et al, 2016; Bauer et al, 2016).
Although it is clear multiple jurisdictions have introduced
BHL and despite the ongoing arguments for and against the
effectiveness of BHL, there has been no systematic review to
identify or summarise these laws. A summary of all bicycle
helmet laws will greatly improve identifying relevant data
which in turn will improve our knowledge of the potential
effects of BHL.
This study aims to summarise bicycle helmet laws enacted
worldwide. The data collected includes date of legislation,
the maximum age the law applies, whether the law is
enforced via nes or not, and whether the law was later
modied or repealed.
Journal of the Australasian College of Road Safety – Volume 29 No. 3, 2018
31
Methods
A Google desktop search was conducted in January 2017
to identify jurisdictions with BHL. Several sources were
identied including reports from the European Commission
(2015,2016), the Bicycle Helmet Safety Institute (2017), the
International Transport Forum (2017), government websites,
journal articles, technical reports, dissertations, and news
articles.
Information regarding BHL effective date, age of
enforcement, and nes, were gathered using the
aforementioned sources, searching government websites,
and contacting road safety organisations in countries
with existing BHL. Wikipedia and websites sponsored by
advocacy groups such as the Bicycle Helmet Research
Foundation were also searched for relevant data; however,
information was included only when veried by another
source. Non-English sources were translated to English
using Google Translate.
Results
Our search identied 28 countries around the world with
some form of bicycle helmet legislation (see Figure 1). This
includes legislation adopted in Argentina, Australia, Austria,
parts of Canada, Chile, Croatia, Czech Republic, Estonia,
Finland, France, Iceland, Israel, Japan, Jersey, Latvia,
Lithuania, Malta, Namibia, New Zealand, Nigeria, Slovakia,
Slovenia, South Africa, South Korea, Spain, Sweden, United
Arab Emirates and parts of the United States. These laws
differ in terms of enforcement and many apply only to
children below a certain age. Nine countries have bicycle
helmet laws that apply to all ages (Argentina, Australia,
Finland, Malta, Namibia, New Zealand, Nigeria, South
Africa, and United Arab Emirates). Additionally, ve out of
ten Canadian provinces and some US cities have all-ages
BHL, while all cyclists must wear helmets while travelling
in urban areas in Chile and Slovakia, and between urban
areas in Israel and Spain.
In Australia, Canada and the United States, road rules are
often created at state, provincial, territorial or city levels.
Therefore, these countries are discussed separately.
Australia
The state of Victoria was the rst jurisdiction in the world to
introduce bicycle helmet legislation for bicycle riders with
effect from July 1990 for all ages and in all areas (Cameron
et al, 1994). The remaining Australian states and territories
followed with similar legislation by July 1992 (see Table 1).
New South Wales enacted a law for adults (16+ years of age,
1 January 1991) which was modied six months later (1 July
1991) to apply to all ages (Smith & Milthorpe, 1993). The
Northern Territory (NT) rst introduced legislation for adults
(17+ years of age) on January 1992 and all ages by July 1992
(van Zyl, 1993). The NT law was further modied from 31
March 1994 to no longer apply to cyclists over the age of 17
who ride along footpaths or on cycle paths. Bicycle helmet
legislation in the states of Queensland (July 1991) and
Western Australia (January 1992) was initially introduced
without enforcement, then with enforcement from January
1993 for Queensland and in July 1992 for Western Australia
(King & Fraine, 1995; Healy & Maisey, 1992).
Note that although nes were not issued for the rst six
months in Western Australia, the police issued over 3,000
cautions during this time (Healy & Maisey, 1992), and
nes of $25 could be withdrawn during the rst six months
of enforcement if the cyclist provided proof of a helmet
purchase within 14 days of being ned.
3of14
and some US cities have all-ages BHL, while all cyclists must wear helmets while travelling in 94
urban areas in Chile and Slovakia, and between urban areas in Israel and Spain. 95
96
In Australia, Canada and the United States, road rules are often created at state, provincial, 97
territorial or city levels. Therefore, these countries are discussed separately. 98
99
100
Figure 1. Map of Jurisdictions with Bicycle Helmet Legislation (*Canada and the United States do not have 101
legislation for all provinces or states) 102
103
Australia 104
105
The state of Victoria was the first jurisdiction in the world to introduce bicycle helmet legislation 106
for bicycle riders with effect from July 1990 for all ages and in all areas (Cameron et al, 1994). The 107
remaining Australian states and territories followed with similar legislation by July 1992 (see 108
Table 1). 109
110
New South Wales enacted a law for adults (16+ years of age, 1 January 1991) which was modified 111
six months later (1 July 1991) to apply to all ages (Smith & Milthorpe, 1993). The Northern 112
Territory (NT) first introduced legislation for adults (17+ years of age) on January 1992 and all ages 113
by July 1992 (van Zyl, 1993). The NT law was further modified from 31 March 1994 to no longer 114
apply to cyclists over the age of 17 who ride along footpaths or on cycle paths. Bicycle helmet 115
legislation in the states of Queensland (July 1991) and Western Australia (January 1992) was 116
initially introduced without enforcement, then with enforcement from January 1993 for Queensland 117
and in July 1992 for Western Australia (King & Fraine, 1995; Healy & Maisey, 1992). 118
119
Note that although fines were not issued for the first six months in Western Australia, the police 120
issued over 3,000 cautions during this time (Healy & Maisey, 1992), and fines of $25 could be 121
withdrawn during the first six months of enforcement if the cyclist provided proof of a helmet 122
purchase within 14 days of being fined. 123
124
Table 1. Bicycle helmet legislation, Australia 125
126
Effective date
Current fine
Figure 1. Map of Jurisdictions with Bicycle Helmet Legislation (*Canada and the United States do not have legislation for all
provinces or states)
Journal of the Australasian College of Road Safety – Volume 29 No. 3, 2018
32
Canada
Eight out of ten Canadian provinces have some form of
bicycle helmet legislation (Dennis et al, 2010; Bicycle
Helmet Safety Institute, 2017). Ontario was the rst
province to enact BHL in October 1995, followed by seven
other provinces by 2015 (see Table 2). The all-ages helmet
law in Newfoundland and Labrador is applied to all cyclists
riding on the province’s roadways. A provincial map of
Canadian helmet laws is given in Figure 2.
Quebec and Saskatchewan do not have bicycle helmet
legislation although Yorkton, Saskatchewan has its own
bicycle helmet bylaw and there are some municipal
bylaws in Québec. None of the three territories of Canada
(Northwest Territories (NWT), Nunavut and Yukon) has a
bicycle helmet law. However, the town of Inuvik, NWT, and
the city of Whitehorse, Yukon, have enacted all-ages helmet
bylaws.
Canada’s current population is around 37 million with
Quebec at 8.4 million (23%), Saskatchewan at 1.2 million
(3%) and the three territories of NWT, Nunavut and Yukon
totalling around 0.12 million (0.3%) (Statistics Canada,
2018). This means that around 73.7% (27.2 million) of
Canada’s population is subject to some form of BHL where
20% (7.2 million) is an all ages BHL. For provinces with
child only laws (Alberta, British Columbia, and Manitoba),
the population 14 years and younger was an estimated 3.2
million on 1 July 2017 (Statistics Canada, 2017).
Effective date Current fine (AUD) Maximum age
Australian Capital Territory Jul 1992 $118 All
New South Wales Jan 1991/Jul 1991 $330 All
Northern Territory Jan 1992/Jul 1992/Mar 1994 $25 All
Queensland Jul 1991 $121 All
South Australia Jul 1991 $153 All
Tasmania Jan 1991 $260 All
Victoria Jul 1990 $194 All
Western Australia Jan 1992 $50 All
Table 1. Bicycle helmet legislation, Australia
4of14
(AUD)
Australian Capital Territory
Jul 1992
$118
All
New South Wales
Jan 1991/Jul 1991
$330
All
Northern Territory
Jan 1992/Jul 1992/Mar
1994
$25
All
Queensland
Jul 1991
$121
All
South Australia
Jul 1991
$153
All
Tasmania
Jan 1991
$260
All
Victoria
Jul 1990
$194
All
Western Australia
Jan 1992
$50
All
127
128
Canada 129
130
Eight out of ten Canadian provinces have some form of bicycle helmet legislation (Dennis et al, 131
2010; Bicycle Helmet Safety Institute, 2017). Ontario was the first province to enact BHL in 132
October 1995, followed by seven other provinces by 2015 (see Table 2). The all-ages helmet law in 133
Newfoundland and Labrador is applied to all cyclists riding on the province's roadways. A 134
provincial map of Canadian helmet laws is given in Figure 2. 135
136
137
138
Figure 2. Map of Canadian Provinces with Bicycle Helmet Legislation
4of14
(AUD)
Australian Capital Territory
Jul 1992
$118
All
New South Wales
Jan 1991/Jul 1991
$330
All
Northern Territory
Jan 1992/Jul 1992/Mar
1994
$25
All
Queensland
Jul 1991
$121
All
South Australia
Jul 1991
$153
All
Tasmania
Jan 1991
$260
All
Victoria
Jul 1990
$194
All
Western Australia
Jan 1992
$50
All
127
128
Canada 129
130
Eight out of ten Canadian provinces have some form of bicycle helmet legislation (Dennis et al, 131
2010; Bicycle Helmet Safety Institute, 2017). Ontario was the first province to enact BHL in 132
October 1995, followed by seven other provinces by 2015 (see Table 2). The all-ages helmet law in 133
Newfoundland and Labrador is applied to all cyclists riding on the province's roadways. A 134
provincial map of Canadian helmet laws is given in Figure 2. 135
136
137
138
Journal of the Australasian College of Road Safety – Volume 29 No. 3, 2018
33
United States
The state of California was the rst jurisdiction in the
world to introduce bicycle helmet legislation, although it
applied only to passengers under 5 years of age. By 2007, an
additional 36 states and the District of Columbia (DC) had
enacted some form of bicycle helmet legislation (see Table
3). Sixteen states have only city-wide laws and 13 other
states do not follow any form of bicycle helmet legislation
including Arkansas, Colorado, Idaho, Indiana, Iowa,
Minnesota, Nebraska, North Dakota, South Carolina, South
Dakota, Utah, Vermont, and Wyoming. In total, 21 states,
the District of Columbia, and 203 cities, have some form of
bicycle helmet legislation. Note that all state-level helmet
laws in the US relate to children.
Further information related to the laws for each state/city
of the United States can be found on the Bicycle Helmet
Effective date Current ne Maximum age
(CAD) (AUD)c
Alberta May 2002 $69 $70 17
British Columbia Sep 1996 $100 $102 All
Manitoba May 2013 Up to $50aUp to $51 17
New Brunswick Dec 1995 $21 $21 All
Newfoundland & Labrador Apr 2015 $25-$180 $26-$184 All
Nova ScotiabJul 1997 $128 $131 All
Ontario Oct 1995 $60 $61 17
Prince Edward Island Jul 2003 $100 $102 All
Table 2. Bicycle helmet legislation, Canada
a Fine can be dismissed if the cyclist takes the Manitoba Bike Helmet Safety Course.
b Fine is replaced with a 2-hour education program delivered by police, health professionals and injury survivors
c Conversion rate based on 10th April 2018 exchange rate rounded to nearest dollar value
6of14
175
176
Figure 3. Map of US States with Bicycle Helmet Legislation 177
178
In 1994, Tennessee passed a law requiring the use of helmets for cyclists under the age of 16. There 179
was a move to repeal the law, but it was reconfirmed in 2000. Following a referendum in the City of 180
Seymour, Connecticut, the all-ages helmet law was repealed in September 1998, two months after 181
its introduction in July 1998. However, helmet legislation still applies to children up to 16 years of 182
age due to a state-wide law in Connecticut. In Dallas, Texas, all-ages bicycle helmet legislation was 183
enacted in 1996 and was relaxed in 2014, which then applied to children under 18 years. In 184
Snohomish, Washington, an all-ages law was repealed in 2002; however, an existing law still 185
applies to skate parks. 186
187
The original 1987 California helmet law was later modified in 1994 to apply to child riders under 188
18 years of age. Similarly, the Massachusetts’ 1990 law was modified in 1994 and 2004, which 189
applied to children under 12 and 17, respectively. Bicycle helmet legislation was also modified in 190
the state of New York. The 1989 law was modified in 1994 to apply to children under 14 years. 191
Pennsylvania introduced legislation in 1991 for children under 5 years, which was modified in 1995 192
to apply to children under 12 years. Rhode Island also modified the applicable age in their 1996 law 193
for children under 9 years to children under 16 years in 1998. 194
195
Figure 3. Map of US States with Bicycle Helmet Legislation
6of14
175
176
Figure 3. Map of US States with Bicycle Helmet Legislation 177
178
In 1994, Tennessee passed a law requiring the use of helmets for cyclists under the age of 16. There 179
was a move to repeal the law, but it was reconfirmed in 2000. Following a referendum in the City of 180
Seymour, Connecticut, the all-ages helmet law was repealed in September 1998, two months after 181
its introduction in July 1998. However, helmet legislation still applies to children up to 16 years of 182
age due to a state-wide law in Connecticut. In Dallas, Texas, all-ages bicycle helmet legislation was 183
enacted in 1996 and was relaxed in 2014, which then applied to children under 18 years. In 184
Snohomish, Washington, an all-ages law was repealed in 2002; however, an existing law still 185
applies to skate parks. 186
187
The original 1987 California helmet law was later modified in 1994 to apply to child riders under 188
18 years of age. Similarly, the Massachusetts’ 1990 law was modified in 1994 and 2004, which 189
applied to children under 12 and 17, respectively. Bicycle helmet legislation was also modified in 190
the state of New York. The 1989 law was modified in 1994 to apply to children under 14 years. 191
Pennsylvania introduced legislation in 1991 for children under 5 years, which was modified in 1995 192
to apply to children under 12 years. Rhode Island also modified the applicable age in their 1996 law 193
for children under 9 years to children under 16 years in 1998. 194
195
  • Article
    Background 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. Methods 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. Results 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). Conclusions 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.
  • Article
    Background In Austria, bicycle helmets have been mandatory on public roads for children under 12 years of age since May 31, 2011 (23rd amendment to the road safety act). The regulation was introduced as an awareness measure and is primarily designed to protect children from head injuries. Thus, there are no consequences for violation of the regulation. Methods Post hoc evaluation of the effect of the helmet wearing legislation comprised the use of existing data sources about helmet wearing and the rate of head injuries. The main data source used for the analysis, the Injury Databases (IDB Austria), is quite unique for this purpose as it provides information on both the type of road user and the type of injury. The results on helmet wearing are based on regularly conducted counts, performed bi-annually since 2005. Results After the introduction of the regulation a significant increase of the helmet wearing rate was observed in the target group: before the introduction about 65% of children under 12 wore a helmet, by 2014 the rate was 87%. This trend in helmet wearing was mirrored also in the development of the rate of head injuries of child bicyclists who were treated in hospital after an accident: before the helmets became mandatory 47% of the children under 12 years had head injuries, by 2014 the rate was 38%. Conclusions As intended by the regulation, an increase in the proportion of children wearing a helmet and a decrease in the rate of head injuries was observed. However, both trends need to be further observed in order to evaluate the supposed effect of the legislation in the long run. By the time of the Safety2016 taking place, the most recent data on both indicators will be presented in addition to results given above.
  • Article
    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.
  • Article
    Full-text available
    Electric bicycles (e-bikes) represent one of the fastest growing segments of the transport market. Over 31 million e-bikes were sold in 2012. Research has followed this growth and this paper provides a synthesis of the most pertinent themes emerging over the past on the burgeoning topic of e-bikes. The focus is transport rather than recreational e-bike research, as well as the most critical research gaps requiring attention. China leads the world in e-bike sales, followed by the Netherlands and Germany. E-bikes can maintain speed with less effort. E-bikes are found to increase bicycle usage. E-bikes have the potential to displace conventional motorised (internal combustion) modes, but there are open questions about their role in displacing traditional bicycles. E-bikes have been shown to provide health benefits and an order of magnitude less carbon dioxide than a car travelling the same distance. Safety issues have emerged as a policy issue in several jurisdictions and e-bike numbers are now approaching levels in which adequate safety data are able to be collected. Research on e-bikes is still in its infancy. As e-bike usage continues to grow, so too will the need for further research, in order to provide the necessary data to inform policy-makers and industry.
  • Article
    Full-text available
    The number of cities offering bikeshare has increased rapidly, from just a handful in the late 1990s to over 800 currently. This paper provides a review of recent bikeshare literature. Several themes have begun to emerge from studies examining bikeshare. Convenience is the major motivator for bikeshare use. Financial savings has been found to motivate those on a low income and the distance one lives from a docking station is an important predictor for bikeshare membership. In a range of countries, it has been found that just under 50% of bikeshare members use the system less than once a month. Men use bikeshare more than women, but the imbalance is not as dramatic as private bike riding (at least in low cycling countries). Commuting is the most common trip purpose for annual members. Users are less likely than private cyclists to wear helmets, but in countries with mandatory helmet legislation, usage levels have suffered. Bikeshare users appear less likely to be injured than private bike riders. Future directions include integration with e-bikes, GPS (global positioning system), dockless systems and improved public transport integration. Greater research is required to quantify the impacts of bikeshare, in terms of mode choice, emissions, congestion and health.
  • Article
    Background Previous population-based research has shown that bicycle helmet laws can reduce head injury rates among cyclists. According to deterrence theory, such laws are mainly effective if there is a high likelihood of being apprehended. In this study, we investigated the effect of the Swedish helmet law for children under the age of 15, a population that cannot be fined. Method An interrupted time series design was used. Monthly inpatient data on injured cyclists from 1998–2012, stratified by age (0–14, 15 +), sex, and injury diagnosis, was obtained from the National Patient Register. The main outcome measure was the proportion of head injury admissions per month. Intervention effect estimates were obtained using generalized autoregressive moving average (GARMA) models. Pre-legislation trend and seasonality was adjusted for, and differences-in-differences estimation was obtained using adults as a non-equivalent control group. Results There was a statistically significant intervention effect among male children, where the proportion of head injuries dropped by 7.8 percentage points. There was no evidence of an intervention effect on the proportion of head injuries among female children. Conclusion According to hospital admission data, the bicycle helmet law appears to have had an effect only on male children. Practical applications This study, while quasi-experimental and thus not strictly generalizable, can contribute to increased knowledge regarding the effects of bicycle helmet laws.
  • Article
    Full-text available
    How ought public officials address policy choices that entail trade-offs between desirable public health goods? Increasing cycling improves public health both by promoting physical activity and by decreasing vehicle use, thus reducing vehicular emissions. Proponents of bicycle helmets argue that, used properly, they protect individual cyclists; however, there is concern that mandating helmet use may result in a decrease in cycling. In 2012, New York City Mayor Michael Bloomberg opposed a bicycle helmet mandate, concerned that it would have a negative impact on the city's cycling rate, which he had sought to increase. The mayor did not explain his rationale, leaving constituents unsure why he opposed the proposal. This case study underscores the challenge of creating public policy in the context of competing public health goods.
  • Article
    Full-text available
    This paper begins by providing an overview of bike share programs, followed by a critical examination of the growing body of literature on these programs. This synthesis of previous works, both peer-reviewed and gray, includes an identification of the current gaps in knowledge related to the impacts of bike sharing programs. This synthesis represents a critically needed evaluation of the current state of global bike share research, in order to better understand, and maximize the effectiveness of current and future programs. Several consistent themes have emerged within the growing body of research on bike share programs. Firstly, the importance bike share members place on convenience and value for money appears paramount in their motivation to sign up and use these programs. Secondly, and somewhat counter intuitively, scheme members are more likely to own and use private bicycles than nonmembers. Thirdly, users demonstrate a greater reluctance to wear helmets than private bicycle riders and helmets have acted as a deterrent in jurisdictions in which helmets are mandatory. Finally, and perhaps most importantly from a sustainable transport perspective, the majority of scheme users are substituting from sustainable modes of transport rather than the car.
  • Article
    Bicycling related head injuries (HIs) can be severe. Helmet use reduces head injury risk; however, there are few controlled studies of the effect of helmet legislation. We conducted this study to investigate changes in HIs after bicycle helmet legislation targeting those <18 in Alberta, Canada in 2002. Bicyclist and pedestrian (control) HI rates and HIs as a proportion of all injuries were compared for the three years (1999-2001) before and four years (2003-2006) after bicycle helmet legislation in three age groups (children: <13, adolescents: 13-17, and adults: 18+). There were 41,270 ED visits and 2782 hospitalizations for bicyclists and 9836 ED visits and 2029 hospitalizations for pedestrians (excluding the legislation year 2002). The rate of ED HIs declined for child bicyclists and child pedestrians, while the rate of non-HIs declined in adult bicyclists and child pedestrians. The rate of hospitalized HIs declined in child bicyclists and all ages of pedestrians while non-HI rates declined for child and adult pedestrians. Non-HI rates for adolescent and adult bicyclists increased. After adjusting for sex and location, the proportion of ED bicycle HIs declined by 9% (APR=0.91; 95% CI: 0.86, 0.95) in children, was unchanged among adolescents and increased in adults (APR=1.08; 95% CI: 1.01, 1.15). The proportion of bicycle HI related hospitalizations decreased by 30% (APR=0.70; 95% CI: 0.55, 0.90) in children, 36% (APR=0.64; 95% CI: 0.49, 0.84) in adolescents and 24% (APR=0.76; 95% CI: 0.63, 0.91) in adults. There were no observed changes in the proportion of pedestrian HIs resulting in ED visits or hospitalizations. Our data indicate significant declines in the proportion of child bicyclist ED HIs and child, adolescent and adult bicyclist HI hospitalizations. This is in contrast to no significant trends in the proportion of ED or hospitalized HIs among pedestrians and the unexpected increases in the proportion of ED HIs for adult bicyclists. Comparing bicyclist and pedestrian trends in the proportion of child and adolescent HIs suggests a bicycle helmet legislation effect.
  • Article
    We invoke a triple rationale to rebut Hooper and Spicer's argument against mandatory helmet laws. First, we use the laws of physics and empirical studies to show how bicycle helmets afford substantial protection to the user. We show that Hooper and Spicer erroneously downplay helmet utility and that, as a result, their attack on the utilitarian argument for mandatory helmet laws is weakened. Next, we refute their claim that helmet legislation comprises unjustified paternalism. We show the healthcare costs of bareheaded riding to pose significant third party harms. It follows, we argue, that a utilitarian case for helmet laws can be sustained by appeal to Mill's Harm Principle. Finally, we reject Hooper and Spicer's claim that helmet laws unjustly penalise cyclists for their own health-affecting behaviour. Rather, we show their argument to suffer by disanalogy with medical cases where injustice may be more evident, for example, denial of bypass surgery to smokers. We conclude that mandatory helmet laws offer substantial utility and are entirely defensible within the framework of a liberal democracy.