Since it became mandatory for cyclists to wear bicycle helmets in the state of Victoria, Australia in 1990, similar legislation now applies in all states of Australia, British Columbia, Canada, and in many other jurisdictions worldwide. There are probably several million cyclists in the world who do not wear a helmet, so that, each year, several tens of thousands of cyclists sustain head injuries in crashes. Although helmets often reduce the risk of head and brain injuries by much less than the quoted upper limits of 85% and 88%, they still offer worthwhile protection and greatly reduce cyclists' casualties where they are used. Upgrading helmet standards can take many years, but helmet wearing rates can be doubled much more quickly. Thus 'getting more helmets on heads' is more urgent, although improving helmet performance is also important and should be done. The previous article's criticisms of most existing standards and helmets are valid, and several further improvements can be suggested. Besides designing helmets to optimise energy absorption and force distribution, it is important to provide appropriate sizes and adjustments to ensure a good fit and proper retention in use. There is an urgent need to agree on a universal helmet standard.
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