In anticipation of legislation, and to provide background information prior to this proposed legislation, the North Carolina Governor's Highway Safety Program sponsored a 1999 state-wide survey of bicycle helmet use. These data were used to estimate a baseline, pre-law helmet wearing rate as well as gather other information on bicyclist characteristics as they related to helmet use tendencies. In the spring and summer of 2002, approximately six months following the effective date of the mandatory helmet use law, the University of North Carolina Highway Safety Research Centre (HSRC) repeated the state-wide observational survey. We employed the same methodology and sampling locations used in 1999 in order to obtain comparable, post-law estimates of helmet use and again evaluate bicyclist characteristics related to use. We altered age groupings slightly for the 2002 survey to reflect the ages affected by the law as it was written. When we performed the survey in 1999, proposed legislation suggested that the law would affect those 13 years of age and under. When legislation was passed in 2001, the law mandated use by those ages 15 and under. Survey results indicate that helmet use has increased by a modest amount compared with use estimated from the 1999 survey. state-wide helmet use estimated from the probability sample of on-street locations was 24% for helmet use (includes correct and incorrect use) in 2002 compared to 18% in 1999. state-wide, correct use of helmets was estimated at 20% in 2002 compared to 14% in 1999. Helmet use was again lowest in the Coastal Plain, which showed no increase over the 1999 level (total use estimated at 9% from on-street locations), followed by the Piedmont region (25%), with highest use in the Mountain region (46%). As in 1999, observed helmet wearing rates were higher at greenways (55%) and mountain biking locations (89%) compared to on-road locations (30% on collector streets; 19% on local streets; unweighted data). Factors correlated positively with helmet use include use of gloves, use of road bikes, use of backpacks, riding in the mountain region, being female, and riding on weekends. Factors negatively correlated with helmet use include not using gloves or backpacks; use of child, or other adult bikes; riding in the coastal plain; being male; and riding on weekdays. As in the 1999 survey, adults had higher observed helmet use rates than children. Despite being covered by the state-wide helmet law, helmet use observed at on-street locations by those ages zero to 15 years was approximately 16% while that for ages 16 and up was nearly 30% (unweighted data for helmet use). School aged children (six to 15 years) had the lowest helmet use of any age group. Additionally, larger gains in helmet use were shown by adults than by children targeted by the law. Bicycle helmet use by children, zero to 18 years of age (combined for analyses due to the change in age groupings), increased from 12% during the 1999 survey to 16% during the 2002 survey (unweighted percentages from on-street locations). Adult (ages 19 years and up) helmet use increased from 27% in 1999 to 32% in 2002 (also unweighted values). As expected from the above comparisons, statistical analyses indicate that the law failed to generate a differential increase in helmet use by children ages zero to 15 years, mandated to wear helmets, compared with those ages 16 and above and not covered by the law. Although the difference in helmet use between surveys (1999 pre-law and 2002 post-law) was significant, it is clear that the helmet requirement has had little effect on increasing helmet use by children thus far. Increases in helmet use among both children and adults may simply be due to an upward trend over time unrelated to the law. It is also possible that the law has had a small effect in increasing helmet use among children, but that parents and other adults (perhaps to model good behaviour) are also wearing helmets at a higher rate in response to the law. An increase in adult use attributable to the law would be a positive benefit. But the relatively modest increases among both children and adults indicate that much greater effort in promoting proper helmet use and enforcement of the helmet law is needed to obtain the bicycling safety improvement among children desired from this law. The relationships of other bicyclist characteristics indicated by this study to be negatively correlated with helmet use provide insight for targeting helmet promotion and enforcement campaigns. Efforts should be focused particularly in the coastal plain and to a lesser extent, the Piedmont. An effort should be made to reach more casual adult riders, which may be reflected by those lacking specialised gear such as riding gloves, road bikes, and backpacks. Children and adults riding casually in neighbourhoods, where we saw the lowest helmet use among all the location types in both survey years, should also be a primary focus of helmet use campaigns. Additionally, male bicyclists appear to use helmets significantly less frequently than do females. Males also comprise nearly 80% of cyclists observed during both surveys, as well as more than 80% of bicyclists involved in reported crashes with motor vehicles in North Carolina from 1997 - 1999. These data suggest that an additional focus on persuading male bicyclists to use safety helmets is warranted. (Author/publisher)
Samenvatting