Cochrane Summaries

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Bicycle helmet legislation for the uptake of helmet use and prevention of head injuries

Macpherson A, Spinks A
Published Online: 
16 June 2010

Cycling is a popular past-time among children and adults and is highly beneficial as a means of transport and obtaining exercise. However, cycling related injuries are common and can be severe, particularly injuries to the head.

Bicycle helmets have been advocated as a means of reducing the severity of head injuries, however voluntary use of helmets is low among the general population. Bicycle helmet laws mandating their use have thus been implemented in a number of jurisdictions word-wide in order to increase helmet use. These laws have proved to be controversial with opponents arguing that the laws may dissuade people from cycling or may result in greater injury rates among cyclists due to risk compensation. This review searched for the best evidence to investigate what effect bicycle helmet laws have had. There were no randomised controlled trials found, however five studies with a contemporary control were located that looked at bicycle related head injury or bicycle helmet use. The results of these studies indicated a positive effect of bicycle helmet laws for increasing helmet use and reducing head injuries in the target population compared to controls (either jurisdictions without helmet laws or non-target populations). None of the included studies measured actual bicycle use so it was not possible to evaluate the claim that fewer individuals were cycling due to the implementation of the helmet laws. Although the results of the review support bicycle helmet legislation for reducing head injuries, the evidence is currently insufficient to either support or negate the claims of bicycle helmet opponents that helmet laws may discourage cycling.