School of Mathematics and Statistics, University of New South Wales, Sydney NSW, Australia.
Transport and Road Safety Research Centre, School of Aviation, University of New South Wales, Sydney, NSW, Australia.
Int J Epidemiol. 2019 Aug 1;48(4):1197-1203. doi: 10.1093/ije/dyz003.
Australian bicycle helmet laws were first introduced in Victoria in July 1990 and the remaining Australian states, Australian Capital Territory and Northern Territory by July 1992. Previous research on helmet legislation has focused on changes in helmet wearing and bicycle-related head injury. Although it is generally accepted that bicycle helmets can reduce the risk of fatality due to head injury, there has been little research assessing the impact of helmet legislation on cycling fatalities.
An interrupted time series approach was used to assess the impact of bicycle helmet legislation on yearly-aggregated rates of bicycle-related fatalities per population from 1971 to 2016.
Immediately following bicycle helmet legislation, the rate of bicycle fatalities per 1 000 000 population reduced by 46% relative to the pre-legislation trend [95% confidence interval (CI): 31, 58]. For the period 1990-2016, we estimate 1332 fewer cycling fatalities (95% CI: 1201, 1463) or an average of 49.4 per year (95% CI: 44.5, 54.2). Reductions were also observed for pedestrian fatalities; however, bicycle fatalities declined by 36% relative to pedestrian fatalities (95% CI: 12, 54).
In the absence of robust evidence showing a decline in cycling exposure following helmet legislation or other confounding factors, the reduction in Australian bicycle-related fatality appears to be primarily due to increased helmet use and not other factors.
澳大利亚自行车头盔法于 1990 年 7 月首先在维多利亚州实施，其余澳大利亚州、澳大利亚首都领地和北领地于 1992 年 7 月实施。先前关于头盔立法的研究主要集中在头盔佩戴和与自行车相关的头部受伤的变化上。尽管普遍认为自行车头盔可以降低因头部受伤而导致死亡的风险，但几乎没有研究评估头盔立法对自行车死亡的影响。
采用中断时间序列方法评估 1971 年至 2016 年期间每年自行车相关死亡人数的人口归因率与自行车头盔立法的关系。
在自行车头盔法实施后，自行车死亡率相对于立法前的趋势降低了 46%（95%置信区间：31, 58）。对于 1990-2016 年期间，我们估计有 1332 例自行车死亡人数减少（95%置信区间：1201, 1463），或平均每年减少 49.4 例（95%置信区间：44.5, 54.2）。行人死亡人数也有所减少；然而，自行车死亡人数相对于行人死亡人数下降了 36%（95%置信区间：12, 54）。
在没有强有力的证据表明头盔立法后骑自行车的暴露量下降或其他混杂因素的情况下，澳大利亚与自行车相关的死亡人数的减少似乎主要归因于头盔使用率的增加，而不是其他因素。
