In der Schweiz führten Velounfälle 1998 zu rund 10.000 Kopfverletzungen, die in 35 Fällen tödlich endeten. Mit einer Steigerung des Helmtrageverhaltens auf 100 Prozent könnten jährlich rund 7.700 Verletzungen und 30 Todesfälle vermieden werden. Eine detaillierte Erhebung des Tragverhaltens sowie eine Befragung zu den Gründen des Nichttragens geben Hinweise auf eine mögliche Strategie zur Förderung des Helms. Erfahrungen mit verschiedenen Strategien zur Förderung des Helmtragens zeigen, dass psychologisch-pädagogische Methoden (Aktionen, Verkehrserziehung, Anreize, Gemeindekampagnen) vor allem dann zu einer Steigerung der Tragquote führen, wenn es sich um aufwändige, mehrere Elemente enthaltende Kampagnen handelt. Die schweizerischen Bemühungen im Laufe der 90er Jahre dürften dafür verantwortlich sein, dass die Helmtragquote von unter 4 Prozent auf 18 Prozent gestiegen ist. Diese Ergebnisse zeigen, dass die bisherigen Anstrengungen weiterzuführen, zu intensivieren und in einzelnen Punkten leicht zu modifizieren sind. Abschliessend wird ein Aktionsplan zur Förderung der Helmtragquote in der Schweiz vorgeschlagen. Titel in Französisch: Enquête sur les casques cyclistes : comportements et raisons de le porter. Titel in Englisch: Cycling helmets : survey of wearing behaviour and reasons. English summary: In 1998 cycling accidents led to 10,000 head injuries, which in 35 cases proved to be fatal. Evidence for the effectiveness of the cycling helmet has been provided by studies in various countries as well as by surveys carried out by the Swiss Council for Accident Prevention bfu. If every cyclist were to wear a helmet, 7,700 injuries and 30 deaths could be prevented every year. Furthermore, some CHF 700m in social accident costs could be saved annually. Considering the often serious and cost-intensive nature of head injuries, it is therefore imperative that a preventive strategy based on encouraging the wearing of a helmet should be evolved. However, the prevention options depend on the actual behaviour of cyclists, their behavioural motives and their attitudes towards a possible legal requirement to wear a helmet. Experience gained from various strategies shows that psycho-pedagogic methods (advertising campaigns, road safety training, incentives, local initiatives) can lead to an increase in the wearing rate by up to about 30% when costly campaigns containing several elements are involved. Swiss efforts during the 1990s are probably responsible for the fact that the helmet-wearing rate has risen from below 4% to 18%. Most of the campaigns throughout the world are aimed at children or, more precisely, at their parents. In this case the direct communication with the parents seems to be an important factor for success; concerned parents tend to be more easily influenced. On the other hand it doesn’t make any difference to what extent the parents are convinced of the benefit of wearing a helmet. The few experiences of behavioural legislation concerning helmet wearing suggest that this measure should only be introduced if the extent of negative side effects, like young cyclists switching to the more dangerous moped, is negligible. This condition is not satisfied if the wearing rate prior to introduction of the legislation is below 50%. In the first part of this Swiss study a survey of the wearing rate was carried out, which took into account the bicycle type, the purpose of the journey and the age of the cyclist. In all there were 6,828 observations, which were weighted on the basis of the actual journey purpose. The resulting wearing rate for the whole of Switzerland was 14%. There were differences relating to the purpose of the journey: helmets are worn most frequently (17%) for leisure journeys, followed by commuting (12%), school (10%) and shopping (9%). In this random sample the helmet-wearing rate also varied considerably according to the type of bicycle used. In Switzerland 46 % of the cyclists riding a racing bicycle wore a helmet, in the case of children's bicycles the rate was 36 %, for mountain bikes 17% and only 7% in the case of normal bicycles. On average, the wearing rate of approx. 10% for cyclists aged 15 and older was considerably lower than the rate for those under the age of 14 (30%). Across all of the country's linguistic regions the wearing rate was much higher for men than for women (for example: whole country 17% vs. 10%). Afterwards, 650 of the monitored cyclists were interviewed by telephone about their cycling and helmet wearing habits, their attitudes to wearing a helmet, their cognition of risk and their socio-demographic background. The interviewees, who had to be at least 15 years of age, were divided according to their self-reported behaviour into helmet wearers and non-wearers. Based on the comparison with actually observed selective behaviour, this division proved to be valid. The differences between these two groups are especially relevant for the prevention strategy. The univariate comparisons showed that the groups differed in the areas socio-demography, bicycle riding behaviour and psychology although not with regard to all the questions asked. A more complex method (logistic regression) was used to discover which socio-demographic and psychological variables influence helmet wearing and in what form. The following proved to be significant predictors for the wearing of a cycling helmet (in order of significance): (i) rejection of the assertion `A helmet takes away the feeling of freedom’ (factor 4.3 to 1, i.e. the probability that those who reject this assertion are helmet-wearers is 4.3 times greater than those who say that a helmet restricts freedom); (ii) high perceived risk of sustaining a head injury, i.e. perceived susceptibility (factor 2.6); (iii) sporting bicycle (racing bike, mountain bike) is the mainly used bicycle type (factor 1.9); (iv) rejection of the statement ‘cycling helmets are not attractive’ (factor 1.9); and (v) cycling for health reasons (factor 1.7). On the other hand, the following variables had no influence on helmet-wearing behaviour: sex, purpose of journey, the cycling motives `fun' and `environment', three of the five counterarguments checked (loss of time, inadequate protection, practical problems associated with leaving a bicycle unattended), the perceived benefit of a helmet in preventing head injuries – i.e. the perceived effectiveness of the action – the social norms and the cyclist’s attitude to possible legislation making it compulsory to wear a helmet. The existing campaign should be continued and, if possible, intensified. Slightly different emphases should be set concerning the contents of public relations work in order to take the survey results into account. In particular, the emotional components of the perceived restriction of freedom should be taken as a theme. Furthermore, the target groups’ awareness of personal, objective accident and injury risk should be heightened. This probably applies especially to people who use the bicycle as part of their everyday life, rather than for sporting purposes. However, other aspects, such as arguing that a helmet is effective in the event of an accident, that wearing a helmet is considered normal by the majority, and practical problems in connection with helmet wearing can be disregarded. To improve the helmet-wearing rate in Switzerland an action plan containing the following focal points was proposed: (i) Immediate introduction of a monitoring system (permanent accident study, annual survey of helmet-wearing rate); (ii) Use of campaigns to increase the helmet-wearing rate to 60% among children and sportspeople by the year 2005 and to 40% in the case of adults riding a normal bicycle. Wherever possible, the campaigns should contain several elements that include personal contact. The campaigns should be aimed in the first place at children, their parents and users of everyday bicycles. The message should deal primarily with individual awareness of risk; the anticipated loss of freedom must be a topic, but it should not be denied; the protective effect of a helmet and practical arguments against wearing one should not be taken up; (iii) Introduction at the appropriate time of legislation making it compulsory for cyclists to wear a helmet; and (iv) Using controls and accompanying public relations work to increase wearing rates to 95% among children and sportspeople by the year 2010 and to 80% in the case of adults riding a normal bicycle. (A)
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