Cycling has been shown to have health and environmental benefits, but there are also inherent risks including serious and fatal injury. Head injuries are common among cycling hospitalisations and fatalities, and bicycle helmets have been designed to mitigate head injuries in a crash or fall. Biomechanical and epidemiological evidence suggests wearing a bicycle helmet substantially reduces the risk and odds of head and face injury of any severity, serious head injury, and fatal head injury. Bicycle helmet legislation (BHL) has been introduced in many jurisdictions to increase helmet wearing among cyclists. Past studies indicate BHL is associated with increased helmet wearing and reductions in cycling head injury. Critics of bicycle helmet legislation argue BHL deters people from cycling. Several sources claim the reduction due to BHL is approximately of 30-40% which is often used as a reason against the creation of new helmet laws or to repeal current ones. However, there are other studies that have found no reductions in cycling following helmet legislation. Those critical of helmet use argue the use of protective equipment such as a helmet are counterproductive due to risk compensation. This hypothesis posits that wearing a helmet might lead cyclists to engage in riskier behaviours. There is a lack of consensus in this area with supportive and non-supportive studies in the literature, and previous calls for a systematic review on bicycle helmets and risk compensation have gone unanswered. The objectives of this study were (1) to systematically identify and describe bicycle helmet laws worldwide, (2) to systematically review the evidence bicycle helmet legislation is associated with reductions in cycling, and (3) to systematically review the evidence wearing a bicycle helmet will increase a cyclist’s risky behaviour. (Author/publisher)
Samenvatting