Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Inj Prev. 2012 Apr;18(2):94-7. doi: 10.1136/injuryprev-2011-040029. Epub 2011 Aug 26.
Legislation in the province of Ontario, Canada, mandates users under the age of 18 to wear a helmet when they ride a bicycle, and legislation has been shown to significantly increase rates of bicycle helmet use. Legislation does not exist in Ontario for older bicyclists or for users of other non-motorised modes of transportation, and there are no current data available regarding rates of helmet use in these categories. This study was designed to determine the prevalence of helmet use among users of bicycles, skateboards, push scooters and inline skates in Toronto, Ontario, and the surrounding area. Further analysis was performed to examine factors associated with helmet use.
We performed a cross-sectional, observational study. Three trained, stationary observers captured 6038 users of bicycles (5783), skateboards (77), inline skates (165) and push scooters (13) in the summer of 2009. Observations were separated into three time periods capturing commuters, midday users and recreational users. A general linear model was used to assess the factors associated with helmet use among bicyclists.
Helmets were worn by 48.9% of all users observed and 50.0% of all bicyclists. Among bicyclists, females were more likely to wear helmets than males (prevalence ratio 1.27, 95% CI 1.17 to 1.36), while children were significantly more likely to wear helmets than adults (prevalence ratio 1.17, 95% CI 1.37 to 2.15). Significant behavioural variation was observed among users during the three observation periods (p<0.001), with commuters being the most likely to wear a helmet.
In the absence of comprehensive legislation encompassing all ages of users, only half of users of non-motorised, wheeled transportation devices are choosing to wear a helmet to protect against traumatic brain injury. Implementation of evidence-based strategies to increase helmet use, such as the introduction of legislation encompassing all ages and all equipment, is required.
加拿大安大略省的立法规定，18 岁以下的自行车使用者必须戴头盔，这一立法显著提高了自行车头盔的使用率。安大略省没有针对年长自行车骑手或其他非机动交通方式使用者的立法，也没有关于这些类别中头盔使用率的当前数据。本研究旨在确定安大略省多伦多及其周边地区自行车、滑板、踏板车和直排轮滑使用者头盔使用率的流行率。进一步的分析是为了检查与头盔使用相关的因素。
我们进行了一项横断面观察研究。2009 年夏天，三名经过培训的固定观察员共观察了 6038 名自行车（5783 名）、滑板（77 名）、直排轮滑（165 名）和踏板车（13 名）使用者。观察分为三个时间段，分别为通勤者、中午使用者和休闲使用者。使用一般线性模型评估与自行车使用者头盔使用相关的因素。
所有观察到的使用者中有 48.9%戴头盔，所有自行车使用者中有 50.0%戴头盔。在自行车使用者中，女性戴头盔的可能性高于男性（流行率比 1.27，95%置信区间 1.17 至 1.36），而儿童戴头盔的可能性明显高于成年人（流行率比 1.17，95%置信区间 1.37 至 2.15）。在三个观察期间观察到使用者的行为存在显著差异（p<0.001），通勤者最有可能戴头盔。
在没有全面涵盖所有年龄段使用者的立法的情况下，只有一半的非机动、轮式交通方式使用者选择戴头盔来防止创伤性脑损伤。需要实施基于证据的策略来增加头盔使用率，例如引入涵盖所有年龄和所有设备的立法。
