Skip to main content
PMC home page
Injury Prevention logoLink to Injury Prevention
. 1999 Sep;5(3):183–188. doi: 10.1136/ip.5.3.183

Urban and rural patterns of bicycle helmet use: factors predicting usage

S Harlos 1, L Warda 1, N Buchan 1, T Klassen 1, V Koop 1, M Moffatt 1
PMCID: PMC1730514  PMID: 10518264

Abstract

Objectives—To document current bicycle helmet use in Winnipeg, Manitoba and nearby rural communities, and to identify target groups for a helmet promotion campaign.

Methods—Cyclist helmet use was observed between 28 May and 20 August 1996 at a sample of urban and rural locations. Age, gender, helmet use, riding companion(s), location type, correct helmet use, and use of headphones were recorded. Univariate and multivariate analyses were performed. Adjusted odds ratios with 95% confidence intervals were calculated from the final models.

Results—Altogether 2629 cyclists (70% male, 30% female) were observed: 2316 at 183 urban locations and 313 at 25 rural locations, with nearly equal numbers of children and adults observed. Overall helmet use was 21.3%, with lower use in males (18.9%) than females (26.3%), despite gender only being a significant variable on multivariate analysis for children under 8 years and adults. Urban helmet use was considerably higher (22.9%) than rural use (8.9%). Helmet use increased linearly as mean neighbourhood income increased, with a nearly fourfold difference in use between the highest and lowest income neighbourhoods. Children less than 8 years old and adults had the highest, and teenagers the lowest, use. Significant predictive variables were identified separately by age category to inform targeted programming.

Conclusions—We documented low helmet use in our region, emphasizing the need for a regional helmet promotion campaign as well as future helmet legislation. A marked urban-rural difference in helmet use that has not been previously reported was also identified. Target groups for a future campaign include adolescents, males, rural cyclists, and those in lower income neighbourhoods.

Full Text

The Full Text of this article is available as a PDF (95.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Armson C. J., Pollard C. W. Child cyclist injuries: a prospective study. Med J Aust. 1986 Feb 3;144(3):144–146. doi: 10.5694/j.1326-5377.1986.tb112244.x. [DOI] [PubMed] [Google Scholar]
  2. Cass D. T., Gray A. J. Paediatric bicycle injuries. Aust N Z J Surg. 1989 Sep;59(9):719–724. doi: 10.1111/j.1445-2197.1989.tb01664.x. [DOI] [PubMed] [Google Scholar]
  3. Coté T. R., Sacks J. J., Lambert-Huber D. A., Dannenberg A. L., Kresnow M. J., Lipsitz C. M., Schmidt E. R. Bicycle helmet use among Maryland children: effect of legislation and education. Pediatrics. 1992 Jun;89(6 Pt 2):1216–1220. [PubMed] [Google Scholar]
  4. Cushman R., Down J., MacMillan N., Waclawik H. Bicycle-related injuries: a survey in a pediatric emergency department. CMAJ. 1990 Jul 15;143(2):108–112. [PMC free article] [PubMed] [Google Scholar]
  5. Cushman R., Pless R., Hope D., Jenkins C. Trends in bicycle helmet use in Ottawa from 1988 to 1991. CMAJ. 1992 May 1;146(9):1581–1585. [PMC free article] [PubMed] [Google Scholar]
  6. DiGuiseppi C. G., Rivara F. P., Koepsell T. D., Polissar L. Bicycle helmet use by children. Evaluation of a community-wide helmet campaign. JAMA. 1989 Oct 27;262(16):2256–2261. [PubMed] [Google Scholar]
  7. Farley C., Haddad S., Brown B. The effects of a 4-year program promoting bicycle helmet use among children in Quebec. Am J Public Health. 1996 Jan;86(1):46–51. doi: 10.2105/ajph.86.1.46. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Friede A. M., Azzara C. V., Gallagher S. S., Guyer B. The epidemiology of injuries to bicycle riders. Pediatr Clin North Am. 1985 Feb;32(1):141–151. doi: 10.1016/s0031-3955(16)34762-9. [DOI] [PubMed] [Google Scholar]
  9. Howland J., Sargent J., Weitzman M., Mangione T., Ebert R., Mauceri M., Bond M. Barriers to bicycle helmet use among children. Results of focus groups with fourth, fifth, and sixth graders. Am J Dis Child. 1989 Jun;143(6):741–744. doi: 10.1001/archpedi.1989.02150180123033. [DOI] [PubMed] [Google Scholar]
  10. Illingworth C. M., Noble D., Bell D., Kemn I., Roche C., Pascoe J. 150 bicycle injuries in children: a comparison with accidents due to other causes. Injury. 1981 Jul;13(1):7–9. doi: 10.1016/0020-1383(81)90083-8. [DOI] [PubMed] [Google Scholar]
  11. McDermott F. T., Lane J. C., Brazenor G. A., Debney E. A. The effectiveness of bicyclist helmets: a study of 1710 casualties. J Trauma. 1993 Jun;34(6):834–845. doi: 10.1097/00005373-199306000-00015. [DOI] [PubMed] [Google Scholar]
  12. McKenna P. J., Welsh D. J., Martin L. W. Pediatric bicycle trauma. J Trauma. 1991 Mar;31(3):392–394. doi: 10.1097/00005373-199103000-00015. [DOI] [PubMed] [Google Scholar]
  13. Mock C. N., Maier R. V., Boyle E., Pilcher S., Rivara F. P. Injury prevention strategies to promote helmet use decrease severe head injuries at a level I trauma center. J Trauma. 1995 Jul;39(1):29–35. doi: 10.1097/00005373-199507000-00004. [DOI] [PubMed] [Google Scholar]
  14. Morris B. A., Trimble N. E., Fendley S. J. Increasing bicycle helmet use in the community. Measuring response to a wide-scale, 2-year effort. Can Fam Physician. 1994 Jun;40:1126–1131. [PMC free article] [PubMed] [Google Scholar]
  15. Moyes C. D., Tustin R. J., McCallum P. L., Pringle D. R., Eastwood J. G. Injuries to child cyclists in the Bay of Plenty. N Z Med J. 1990 Jul 25;103(894):343–345. [PubMed] [Google Scholar]
  16. Nakayama D. K., Gardner M. J., Rogers K. D. Disability from bicycle-related injuries in children. J Trauma. 1990 Nov;30(11):1390–1394. doi: 10.1097/00005373-199011000-00012. [DOI] [PubMed] [Google Scholar]
  17. Nakayama D. K., Pasieka K. B., Gardner M. J. How bicycle-related injuries change bicycling practices in children. Am J Dis Child. 1990 Aug;144(8):928–929. doi: 10.1001/archpedi.1990.02150320092035. [DOI] [PubMed] [Google Scholar]
  18. Parkin P. C., Spence L. J., Hu X., Kranz K. E., Shortt L. G., Wesson D. E. Evaluation of a promotional strategy to increase bicycle helmet use by children. Pediatrics. 1993 Apr;91(4):772–777. [PubMed] [Google Scholar]
  19. Rivara F. P., Thompson D. C., Thompson R. S., Rogers L. W., Alexander B., Felix D., Bergman A. B. The Seattle children's bicycle helmet campaign: changes in helmet use and head injury admissions. Pediatrics. 1994 Apr;93(4):567–569. [PubMed] [Google Scholar]
  20. Rourke L. L. Bicycle helmet use among schoolchildren. Impact of a community education program and a cycling fatality. Can Fam Physician. 1994 Jun;40:1116–1124. [PMC free article] [PubMed] [Google Scholar]
  21. Rowe B. H., Thorsteinson K., Bota G. W. Bicycle helmet use and compliance: a northeastern Ontario roadside survey. Can J Public Health. 1995 Jan-Feb;86(1):57–61. [PubMed] [Google Scholar]
  22. Selbst S. M., Alexander D., Ruddy R. Bicycle-related injuries. Am J Dis Child. 1987 Feb;141(2):140–144. doi: 10.1001/archpedi.1987.04460020030021. [DOI] [PubMed] [Google Scholar]
  23. Thompson D. C., Rivara F. P., Thompson R. S. Effectiveness of bicycle safety helmets in preventing head injuries. A case-control study. JAMA. 1996 Dec 25;276(24):1968–1973. [PubMed] [Google Scholar]
  24. Thompson D. C., Thompson R. S., Rivara F. P., Wolf M. E. A case-control study of the effectiveness of bicycle safety helmets in preventing facial injury. Am J Public Health. 1990 Dec;80(12):1471–1474. doi: 10.2105/ajph.80.12.1471. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Thompson R. S., Rivara F. P., Thompson D. C. A case-control study of the effectiveness of bicycle safety helmets. N Engl J Med. 1989 May 25;320(21):1361–1367. doi: 10.1056/NEJM198905253202101. [DOI] [PubMed] [Google Scholar]
  26. Thorson J. Pedal cycle accidents. Scand J Soc Med. 1974;2(3):121–128. doi: 10.1177/140349487400200303. [DOI] [PubMed] [Google Scholar]
  27. Vulcan A. P., Cameron M. H., Watson W. L. Mandatory bicycle helmet use: experience in Victoria, Australia. World J Surg. 1992 May-Jun;16(3):389–397. doi: 10.1007/BF02104437. [DOI] [PubMed] [Google Scholar]
  28. Warda L., Harlos S., Klassen T. P., Moffatt M. E., Buchan N., Koop V. L. An observational study of protective equipment use among in-line skaters. Inj Prev. 1998 Sep;4(3):198–202. doi: 10.1136/ip.4.3.198. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Weiss B. D. Trends in bicycle helmet use by children: 1985 to 1990. Pediatrics. 1992 Jan;89(1):78–80. [PubMed] [Google Scholar]

Articles from Injury Prevention are provided here courtesy of BMJ Publishing Group

RESOURCES