Citation

Nolen S. Proc. Road Saf. Four Continents Conf. 2005; 13: 13p.

Copyright

(Copyright © 2005, Conference Sponsor)

DOI

unavailable

PMID

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Abstract

Injuries among cyclists constitute a traffic safety problem in many countries. For instance, the fatality rate among cyclists per 100,000 population year 2000 were about 1.00 in both Japan, the Netherlands, Denmark and Finland. In Sweden the fatality rate was about 0.5 the same year. If the amount of exposure to bicycling is considered, the fatality rate is somewhat lower in the Netherlands than in Sweden, but on the other hand the fatality rate per exposure is more than twice as high in United Kingdom compared to Sweden. In the context of hospital care in Sweden, injured bicyclists are of major concern. About one third of all road user inpatients are bicyclists, which is about 4,000 cyclists each year and roughly the same number that is seen for car drivers and passengers. Among bicyclists, the majority of the fatalities and about one third of the casualties have sustained head injuries. There is empirical evidence that head injuries among bicyclists could be reduced by the use of helmets. A meta-analysis of 16 peer reviewed studies has shown that, on average, bicycle helmets decrease the risk of fatalities by 73%, head injuries and brain injuries by 60%, and face injuries by 47%. The overall conclusion of the meta-analysis is also confirmed in a Cochrane Review that show that bicycle helmets decrease the risk of both mild and severe brain injuries and of head injuries in general by 63 88%; these results applied to cyclists of all ages and to both single and collision accidents. A majority of bicycle-associated head injuries that require hospital care are caused by single accidents, witch indicate that the safety problem among cyclists is not solved only by separating cyclists from motor vehicles. It is indeed important to improve the traffic environment for cyclists, but it is also important to increase cyclists helmet wearing. The average use of bicycle helmets varies among countries, from a very low helmet wearing (for instance in the Netherlands) to a wearing rate of about 20-25% (Finland, Sweden, United Kingdom), and up to about 80% (Australia, New Zealand). To increase helmet wearing among cyclists different barriers and facilitators of helmet wearing could be addressed, both related to the individual factors (demographic variables, attitudes and beliefs) and to external factors (design, pricing and regulations). At an individual level, it is reasonable to believe that cyclists helmet wearing behavior are a process spanning over different phases, from never having reflected over using a helmet to using a helmet every time by routine . According to the stage of change model the process of changing behavior could be described in five or six phases, from pre-contemplation, contemplation, preparation and action to maintenance and, in some cases, even termination. According to this model some people could be motivated to change their behavior, for instance by general helmet information, but they might not take the final step into the action-phase. The optimal scenario is to find measures that motivate people to use helmets by influencing their intentions but also that triggers the actions-phase to reach a change in actual behavior.