Observational Evaluation of Compliance With Traffic Regulations Among Helmeted and Nonhelmeted Bicyclists,☆☆,

Presented at the Society for Academic Emergency Medicine Annual Meeting, Denver, May 1996.
https://doi.org/10.1016/S0196-0644(97)70251-8Get rights and content

Abstract

See related editorial p 643.

Study objective: To evaluate whether helmeted bicyclists are more compliant with traffic regulations than nonhelmeted bicyclists. Methods: This prospective observational study, using a convenience sample, was conducted during daylight hours at three separate intersections, marked with legal stop signs, near the campus of a major university. Data collected included helmet use, legal hand signal use to indicate a turn or stop, and whether the bicyclist came to a complete stop before proceeding through the intersection. Results: A total of 1,793 bicyclists were evaluated. Only 8.8% of the bicycle riders were wearing helmets. Helmeted bicyclists were 2.6 times more likely than nonhelmeted bicyclists to make legal stops (P<.000001; odds ratio [OR], 3.1; 95% confidence interval [CI], 2.1 to 4.6). They were also 7.1 times more likely to use hand signals (P<.000001; OR, 7.2; 95% CI, 2.8 to 18.2). Conclusion: Helmeted bicycle riders showed a significantly greater compliance with two traffic laws than nonhelmeted bicyclists. They were 2.6 times more likely to stop at stop signs and 7.1 times more likely to use legal hand signals. This very strong association of helmet use with safer riding habits has implications for injury-control efforts aimed at preventing bicycle-related injuries. [Farris C, Spaite DW, Criss EA, Valenzuela TD, Meislin HW: Observational evaluation of compliance with traffic regulations among helmeted and nonhelmeted bicyclists. Ann Emerg Med May 1997; 29:625-629.]

Section snippets

INTRODUCTION

Bicycling, both as a sport and a mode of transportation, is becoming increasingly popular. It is estimated that there are more than 100 million bicycles in the United States1, and more than 45% of the population ride at least on an occasional basis.2 According to the Consumer Product Safety Commission, more than 600,000 emergency department visits are made annually as a result of bicycle-related injuries, a figure that probably represents only one third of actual incidents.3

The most common

MATERIALS AND METHODS

Data were collected during a total of 27 daylight hours on four separate days in March 1995, near the campus of a major university with an enrollment of more than 35,000 full-time students. A convenience sample of consecutive bicyclists was taken at three separate intersections marked with legal stop signs and located within a half mile of the campus. For each rider, the investigator (CF) recorded whether a helmet was in use, whether the bicyclist signaled a turn or a stop, and whether the

RESULTS

Data were recorded for 1,793 bicyclists during the study period; 157 (8.8%) were wearing helmets, and 1,636 (91.2%) were not. Fifty-one (32.5%) of the helmeted riders came to a complete stop, and 9 (5.7%) signaled a turn or stop on approach to the intersection. In the nonhelmeted group, 205 (12.2%) came to a complete stop, and 13 (.8%) used standard hand signals to indicate a turn or stop (Table).

Table. Compliance of bicycle riders with two traffic regulations.

ActionHelmet (%) [n=157] No. (%)

DISCUSSION

Bicycle crashes are a major cause of morbidity and mortality in many countries, including the United States.5, 6, 7, 8, 10, 19, 20, 26, 27, 28, 29, 30 Many investigators have evaluated the epidemiology and demographics of bicycle-related trauma and demonstrated lower incidence and severity of head injuries among bicyclists who wear protective helmets.2, 7, 11, 20, 21, 23, 31, 32, 33, 34, 35, 36 These studies were focused mainly on patients who presented to EDs after bicycle crashes. Little is

References (48)

  • MMWR Morb Mortal Wkly Rep...
  • D Cohen

    Bicycle accidents

    Med J Aust

    (1986)
  • D Fife et al.

    Fatal injuries to bicyclists: The experience of Dade County, Florida

    J Trauma

    (1983)
  • M Bader

    Helmets for child bicyclists

    JAMA

    (1990)
  • E Belongia et al.

    Severity and types of head trauma among adult bicycle riders

    Wis Med J

    (1988)
  • DT Cass et al.

    Paediatric bicycle injuries

    Aust N Z J Surg

    (1989)
  • D Kiburz et al.

    Bicycle accidents and injuries among adult cyclists

    Am J Sports Med

    (1986)
  • C Lindvist et al.

    Maxillofacial fractures sustained in bicycle accidents

    Int J Oral Maxillofac Surg

    (1986)
  • FT McDermott et al.

    Injury profile of pedal and motor cyclist casualties in Victoria

    Aust N Z J Surg

    (1985)
  • FT McDermott et al.

    Differences in head injuries of pedal cyclists and motorcyclist casualties in Victoria

    Med J Aust

    (1982)
  • FT McDermott et al.

    Head injury predominance: Pedal-cyclists vs motor-cyclists

    Med J Aust

    (1985)
  • AJ McLean

    Neurotrauma on two wheels

    Aust N Z J Surg

    (1985)
  • AH Simpson et al.

    Head injuries, helmets, cycle lanes and cyclists

    Br Med J

    (1988)
  • RS Thompson et al.

    A case-controlled study of the effectiveness of bicycle safety helmets

    N Engl J Med

    (1989)
  • Cited by (24)

    • The impact of implementing a public bicycle share program on the likelihood of collisions and near misses in Montreal, Canada

      2013, Preventive Medicine
      Citation Excerpt :

      We propose that helmet wearing is related to differential reporting of near misses or reverse causality. Helmet wearing cyclists, a group with higher income and education (Teschke et al., 2012), who also tend to have better compliance with traffic regulations (Farris et al., 1997; Lardelli-Claret et al., 2003), may overreport near misses, or alternately, non-helmet wearers may under report near misses. In the case of reverse causality, a near miss may frighten a cyclist into wearing a helmet.

    • The effectiveness of helmets in bicycle collisions with motor vehicles: A case-control study

      2013, Accident Analysis and Prevention
      Citation Excerpt :

      Prior studies of cyclist use of helmets and head injury have not regularly examined proxies for risky cycling behaviour, which could introduce an element of confounding into case–control studies. It has been suggested that helmet wearers are more likely to obey traffic laws, wear fluorescent clothing and use lights at night (Robinson, 2007; Farris et al., 1997; McGuire and Smith, 2000), which may result in them being involved in less severe crashes than non-helmet wearers. Indeed, Lardelli-Claret et al. (2003) found that committing a traffic violation was significantly associated with a lower frequency of helmet use.

    • Bicycle-related injuries requiring hospitalization in the United Arab Emirates

      2012, Injury
      Citation Excerpt :

      A cost-benefit ratio of 29 for bicycle helmets has been reported.30 Helmet use in our community is extremely low when compared with others.10,17 In an observational study about the behaviour of bicyclists in Al-Ain city, only 0.5% of bicyclists were helmeted.2

    • Drivers overtaking bicyclists: Objective data on the effects of riding position, helmet use, vehicle type and apparent gender

      2007, Accident Analysis and Prevention
      Citation Excerpt :

      If, on the other hand, drivers believe helmeted bicyclists are less likely to do something unexpected during overtaking, there is some justification for this. American surveys found a trend towards regular bicyclists wearing helmets more than casual riders (Rodgers, 2000), and that people who wear helmets are generally more likely to be interested in acting safely (Bolen et al., 1998; see also Farris et al., 1997; Walker, 2006). Findings from Spain tend also to concur (Lardelli-Claret et al., 2003).

    • Bicycle helmet legislation: Can we reach a consensus?

      2007, Accident Analysis and Prevention
      Citation Excerpt :

      Evidence suggests that cyclists who choose to wear helmets may differ substantially from those who do not. Helmet wearers are more likely to ride in parks, playgrounds or bicycle paths than city streets (DiGuisseppi et al., 1989), obey traffic laws (Farris et al., 1997), wear fluorescent clothing and use lights at night (McGuire and Smith, 2000). These factors affect both the risk of colliding with motor vehicles, and impact speed when collisions occur.

    View all citing articles on Scopus

    From the Arizona Emergency Medicine Research Center, Health Services Research Program, Department of Surgery, University of Arizona College of Medicine, Tucson, AZ.

    ☆☆

    Reprint no.47/1/80264

    Address for reprints: Daniel W Spaite, MD Emergency Medicine 1501 North Campbell Avenue Tucson, AZ 87724 520-626-7957 Fax 520-626-2480

    View full text