Reference, year | Country | Cyclist population | Design | Definition of correct helmet use |
Finch et al,14 1993 | Australia | All rider ages | Observational survey | Helmet’s chin strap fastened |
Forjuoh et al,9 2002 | USA | All children | Cross-sectional, direct observation | Positioned on head in a straight, horizontal line, strapped visibly below chin |
Hall et al,13 2004 | Australia | Elementary schools | Randomised controlled trial evaluating intervention | Fastened straps, positioned squarely on the head, cap not worn under helmet, correct helmet size |
Harlos et al,11 1999 | Canada | All rider ages | Observational survey | Visual assessment of fit, positioning on head, and appropriate strap use |
Nykolyshyn et al,1 2003 | Canada | All rider ages | Observational cohort survey | Sit level with rest of head, bottom of helmet ∼2 finger widths away from top of rider’s eyebrows, helmet straps fastened with ∼1 finger width space between chin and straps |
Parkinson et al,10 2003 | USA | All children | Questionnaire/helmet fit and condition assessment | Condition, room, strap, stability |
Rivara et al,7 1999 | USA | Helmeted subjects | Case–control (questionnaire, head/helmet measurement) | N/A |
Rowe et al,3 1995 | Canada | All rider ages who stopped and agreed to participate | Prospective roadside survey | Helmets should sit on forehead (not over eyebrow, should not expose forehead); straps should be “snug”; should remain in place when movement is attempted |
Thompson et al,15 1997 | USA | Injured cyclists | Case–control (self-report/expert evaluation) | Incorrect: poor fit, improper helmet placement because of style or fit, helmet failure when energy exceeds the threshold of ultimate protective capacity, impact occurring outside of covered head area |
Twomey et al,8 2001 | USA | All rider ages | Observational survey | Incorrect: helmet worn too far back on the head (forehead not covered) or without buckle fastened |
Van Houten et al,16 2007 | USA | Elementary school | Observational survey of baseline and treatment conditions | Helmet buckled snugly, level (forehead or back of head not exposed) |
N/A, not applicable.