Effects of the compulsory bicycle helmet wearing law in Victoria during its first three years.

On 1 July 1990, a law requiring wearing of an approved safety helmet by all bicyclists (unless exempted) came into effect in Victoria. Some of the more important steps that paved the way for this significant initiative (believed to be the first State-wide legislation of its type in the world) are described and its effects analysed. here was an immediate increase in average helmet wearing rates from 31 per cent in March 1990 to 75 per cent in March 1991, although teenagers continued to show lower rates than younger children or adults. he number of insurance claims from bicyclists killed or admitted to hospital after sustaining a head injury decreased by 69 per cent in the two years following introduction of the law, but has risen in the third year post-law to only 54 per cent below the pre-law level. In contrast, the number of bicyclists killed or admitted to hospital who did not sustain head injuries fell by 22 per cent two years after the introduction of the law and has continued to fall to 40 per cent below the pre-law level in the third year. logistic regression model relating the proportion of head injuries to helmet wearing rates showed the proportion of all seriously injured cyclists with a head injury in the second year post-law was significantly less than that projected on the basis of continuing pre-law helmet wearing rate trends. n the third year post-law, the model showed the proportion of head injured cases had returned to the level expected based on pre-law trends. The mechanisms by which the reductions m the proportion head injured were achieved in the first two years post-law seem to be twofold: a reduction in the number of bicyclists involved in crashes resulting in severe injury and a reduction in the risk of head injury for bicyclists who were severely injured. The increase in the number of head injured cyclists in the third year suggests that the risk of head injury has increased again and emphasises the continuing need for efforts in maintaining the reductions seen in the first two post-law years. (A)