Bicycle Helmet Safety Institute

Consumer-funded, volunteer staff

Helmets Children Promotions Statistics Search

Some Helmet Program Evaluations

Summary: The material below is old, but reliable.

Harborview Injury Prevention Center
Rivara, Thompson, Patterson, Thompson

PREVENTION OF BICYCLE-RELATED INJURIES: Helmets, Education, and Legislation

Annual Review of Public Health, Vol. 19:293-318 (Volume publication date May 1998) Frederick P. Rivara, Diane C. Thompson, Matthew Q. Patterson, and Robert S. Thompson.

Portion of the abstract: "Helmets have been shown to reduce bicycle-related head injuries for cyclists of all ages involved in all types of crashes including those with motor vehicles. Helmet use has been promoted using educational campaigns, helmet subsidies, and legislation. Careful evaluation of these strategies has shown that these interventions increase helmet use and decrease the incidence of bicycle injuries."

Centers for Disease Control
Evaluation of Legislation and Community Programs
to Increase the use of Bicycle Helmets - Selected Locations

Helmet-use rates are for children except for
Victoria, Australia, which included adults.

                                               Helmet use Rates
                                               Pre-        Post-
Location    Years          Program type      Program      Program

Victoria,   March 1983-    Community        6 percent  36 percent
Australia   March 1990     campaign   

            Comments: Included education, mass media publicity, 
            support by professional associations and community
            groups, involvement of bicycling groups, and $10
            government rebate for helmet purchases.

Victoria,   March 1990     Helmet         36 percent  73 percent
            March 1991     legislation

            Comments: Hospitalizations for bicycle-related 
            head injuries also decreased by 37 per cent,

Howard      1990-1991      Helmet           4 percent  47 percent
County,                    legislation,
Maryland                   community campaign 
             Comments: Activity prompted by bicycling deaths of
             two children. Use determined by observation. A
             school-based survey showed 11 percent and 37 per

Montgomery  1990-1991      Community   8 percent  19 percent    
County,                    campaign 

              Comments: Use determined by observation. Use
              determined by school-based survey was 8 per cent
              and 13 per cent

Baltimore   1990-1991     No specific   19 percent 4 percent 
County,                   helmet promotion  
Maryland                  activities

            Comments: Served as control county. Use determined 
            by observation. Use determined by a school-based
            survey was 7 percent and 11 percent.

Seattle,    1987-1988      Community    5 percent  14 percent   
Washington                 campaign

            Comments: Included education of parents by
            physicians; advertising in newspapers, on 
            television, and on radio; school presentations; 
            and discount coupons for helmets.

Seattle,    1980-1990      Community   14 percent 33 percent
Washington                 campaign 

            Comments: Follow-up evaluation of bicycle helmet

Seattle,       1990-1993      Community   33 percent 60 percent
Washington                    campaign 

            Comments: Follow-up evaluation of bicycle helmet
            campaign. Bicycle-related head injuries decreased
            approximately 67 per cent among children 5-14 years
            of age who were members of a health maintenance

Portland,   1987-1988      No specific   1 percent  4 percent
Oregon                     helmet 

            Comments: Control community, use determined by

Barrie,     1988-1989      Educational  0 percent  0 percent
Ontario                    program

            Comments: Use determined by a limited number of

Barrie,     1980-1989      Educational   0 percent  22 percent
Ontario                    program and
Canada                     helmet subsidy

            Comments: Use determined by a limited number of


Injury-Control Recommendations: Bicycle Helmets
Morbidity and Mortality Weekly Report, Vol 44, No. RR-l February 17, 1995
Centers for Disease Control and Prevention (CDC)
U. S. Public Health Service, Department of Health and Human Services

This chart is part of the source document. The rest is available from CDC.

Swedish Study

Swedish authorities published a paper in 2003 evaluating helmet campaign strategies. The overall conclusion is that a considerable increase in helmet use by cyclists could be achieved by noncompulsory measures, but the use levels are not as high as those achieved by legislation. We have some more details and a link to the original study.

Dutch Study

A similar study in the Netherlands turned up some different conclusions about helmet use. We have the abstract and a link to the original study in Dutch.