Abstract
Background: Bicycle trauma is a common cause of recreational death and disability and helmets have been shown to reduce fatal and non-fatal head and face injuries. This study evaluated the effect of mandatory bicycle helmet legislation for all ages in St. Albert, Alberta.
Methods: We observed bicyclists from June to September of 2006 in St. Albert, a community subject to both provincial (<18 years old) and municipal (all ages) helmet legislation, and compared our results with observations taken in 2000 when no legislation existed. Helmet wearing and rider characteristics were recorded by trained observers. Poisson regression analysis was used to obtain helmet prevalence (HP) and prevalence ratio (PR) estimates.
Results: HP increased from 45% to 92% (PR=2.03; 95% CI: 1.72–2.39) post-legislation. Controlling for other covariates, children were 53% (PR=1.53; 95% CI: 1.34–1.74) and adolescents greater than 6 times (PR=6.57; 95% CI: 1.39–31.0) more likely to wear helmets; however, adults (PR=1.26; 95% CI: 0.96–1.66) did not show a statistically significant change post-legislation. Restricting the analysis to high socio-economic status areas, adult helmet prevalence increased in St. Albert from 58% to 73% post-legislation compared with a 52% to 57% change across the province; this effect was not statistically significant.
Conclusions: Helmet legislation in St. Albert was associated with a significant increase in helmet use among child and adolescent cyclists. A larger increase in HP was observed for adults in St. Albert than in other areas of the province; however, this difference was not statistically significant, which may reflect the small sample size or insufficient time passage after bylaw enactment.
Key Words: Bicycling, head protective device, legislation, prevalence
Résumé
Contexte: Les traumatismes dus aux accidents de bicyclette sont une cause courante de mortalité et d’invalidité survenues dans le cadre d’activités de loisirs, et l’on sait que le port du casque réduit les blessures mortelles et non mortelles à la tête et au visage. Nous avons évalué l’effet des lois sur le port obligatoire du casque de cycliste à tout âge à St. Albert, en Alberta.
Méthode: De juin à septembre 2006, nous avons observé des cyclistes à St. Albert, une municipalité assujettie à la fois à la loi provinciale (<18 ans) et à un règlement municipal (tous les âges) sur le port du casque, et nous avons comparé nos résultats aux observations effectuées en 2000, quand il n’existait encore aucune loi. Le port du casque et les caractéristiques des cyclistes ont été notés par des observateurs formés. Au moyen d’analyses de régression de Poisson, nous avons estimé la prévalence du port du casque (PPC) et les ratios de prévalence (RP).
Résultats: La PPC est passée de 45 % à 92 % (RP=2,03; IC de 95 % = 1,72-2,39) après l’adoption des mesures législatives. Si l’on tient compte des effets d’autres covariables, les enfants étaient plus susceptibles dans une proportion de 53 % (RP=1,53; IC de 95 % = 1,34-1,74), et les adolescents plus de 6 fois plus susceptibles (RP=6,57; IC de 95 % = 1,39-31,0) de porter un casque; cependant, la loi ne semble pas avoir eu d’effet significatif sur le port du casque chez les adultes (RP=1,26; IC de 95 % = 0,96-1,66). En limitant notre analyse aux quartiers de statut socioéconomique élevé, la prévalence du port du casque chez les adultes a augmenté à St. Albert, passant de 58 % à 73 % après les mesures législatives; à l’échelle de la province, elle est passée de 52 % à 57 %; cet effet n’était pas statistiquement significatif.
Conclusion: À St. Albert, les mesures législatives sur le port du casque étaient associées à une hausse significative du port du casque de cycliste chez les enfants et les adolescents. Une plus forte hausse de la PPC a été observée chez les adultes de St. Albert que dans d’autres parties de la province, mais cet écart n’était pas significatif, ce qui peut s’expliquer par la petite taille de l’échantillon ou par le fait qu’il ne s’était pas écoulé suffisamment de temps après l’adoption du règlement municipal.
Mots Clés: cyclisme, dispositifs de protection de la tête, législation, prevalence
Footnotes
Conflict of Interest: None to declare.
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