In general, bicycle helmets are not a familiar sight in Dutch streets. Objective data about bicycle helmet use in the Netherlands are not available. On the basis of the preliminary results of an international questionnaire study in 2015 among a – possibly not entirely representative – group of adult cyclists in 17 countries, some indications may be given [7]. Of more than seven hundred Dutch respondents 34% claim to own a helmet. However, only a small group (2%) always wears a helmet; the majority (70%) never wears a helmet. And if helmets are worn, they are often worn during sports activities [7]. That helmet use during sports activities has become commonplace in the Netherlands, is also shown by the results of a questionnaire study among Dutch touring and sports cyclists; almost all (96%) reported wearing a helmet at all times [8]. The Cycling Union NTFU stimulates helmet use and advises its members to make helmet use mandatory for all tours. As early as 2003, the International Cycling Union UCI introduced mandatory helmet use for all road cycling races.
How often helmets are worn abroad varies by age group and country and, obviously, largely depends on legal requirements [9] [10] [11] [12]. In New Zealand [13] helmets are mandatory for all age groups. The rate of helmet use has been higher than 90% for several years. This also goes for Australia (Queensland), where the rate is higher than 98% [10].In Finland, where helmet use has been mandatory since 2003 (incidentally without active enforcement), the rate for Helsinki is 64% and nationwide 42% [14]. In European countries where they are not mandatory, helmets are also worn. In Switzerland, almost half the population and three quarters of the children up to age 14 wear helmets [15]. In Germany, the helmet use rate is 19% across all age groups [16].
