Bicycle helmets are mandatory in parts of Canada but not in others. This created an opportunity for Researcher Kay Teschke and associates "to calculate exposure-based bicycling hospitalisation rates in Canadian jurisdictions with different helmet legislation and bicycling mode shares, and to examine whether the rates were related to these differences." The results were released today in a study, Bicycling injury hospitalisation rates in Canadian jurisdictions: analyses examining associations with helmet legislation and mode share.

It's an interesting study because it is all within one relatively homogenous country with small cultural and transportation policy differences, and it tried to look beyond just helmets but also at cycling infrastructure and cycling mode shares.

© Kay Teschke studyNow let it be said right up front that we are not discussing whether you should wear a helmet or not. That is a matter of personal choice, and if you are like me you can make the choice to wear one. And lots of people do; note how in British Columbia, where helmets are mandatory, 71.3 percent of adults over 18 wear helmets while in Ontario, where adults over 18 do not have to wear them, 41.2 percent do. However many studies have shown that helmet laws keep people off bikes, both by the inconvenience and discomfort and by scaring possible riders. That's why I keep saying that the debate should be about building safe infrastructure, not arguing about helmets. And now I have proof.

Among the more surprising findings is how much safer women riders are:

We found that females had lower bicycling hospitalisation rates than males in analyses of all injury causes, consistent with results found else- where and for other travel modes, an effect often attributed to conservative risk choices.

The study also found a relationship between the number of people cycling and the rate of injuries; there really is safety in numbers.

In our view, the most important implication of our results is that factors other than helmet legislation influenced bicycling hospitalisation rates, whereas helmet legislation did not. Females had lower rates in our study and they have been shown to cycle more slowly, and to choose routes on quiet streets and with bike-specific infrastructure. We also found lower traffic-related hospitalisation rates with higher cycling mode shares. Here too there is a reasonable link to safer bicycling infrastructure, since it has been shown to draw more people to bicycling.

The ultimate conclusion is that other factors are more important that mandatory helmet legislation.

In our study comparing exposure-based injury rates in 11 Canadian jurisdictions, we found that females had lower hospitalisation rates than males. This difference in injury rates is consistent with other bicycling studies and studies of other transportation modes. We found that lower rates of traffic-related injuries were associated with higher cycling mode shares, a finding also reported else- where. We did not find a relationship between injury rates and helmet legislation.

These results suggest that transportation and health policymakers who aim to reduce bicycling injury rates in the population should focus on factors related to increased cycling mode share and female cycling choices. Bicycling routes designed to be physically separated from traffic or along quiet streets fit both these criteria and are associated with lower relative risks of injury.

Basically the path to safer cycling is pretty clear: Instead of scaring people off the road with helmet rules and high-visibility campaigns, why not just build the safe infrastructure needed to attract all kinds of people onto bikes. As the study shows, it is a lot more effective and has so many other benefits for society.