Recommend or mandate? A systematic review and meta-analysis of the effects of mandatory bicycle helmet legislation

Accident; Analysis and Prevention
Alena Hoye

Abstract

If all cyclistswere wearing helmets, significant numbers of head injuries might theoretically be prevented. Mandatory bicycle helmet legislation increases helmet use but is a controversial measure. Results from 21 studies of the effects of mandatory bicycle helmet legislation on injuries among crash involved cyclists were investigated by means of meta-analysis and the effects of several potential biases were investigated. The summary effect of mandatory bicycle helmet legislation for all cyclists on head injuries is a statistically significant reduction by 20% (95% confidence interval [-27; -13]). Larger effects were found for serious head injury (-55%; 95% confidence interval; [-78; -8]). Among children, larger effects were found when legislation applies to all cyclists than when it applies to children only. There is no clear indication of the results being affected by publication bias. Publication bias may exist, but any existing biases seem to more or less outweigh each other. Results from meta-analysis do not indicate that the results are systematically affected by a lack of control for time trend bias, choice of comparison group or study design (before-after vs. case control). Summary effects may be somewhat overestimated ...Continue Reading

Citations

Feb 7, 2019·International Journal of Epidemiology·Jake OlivierRaphael Grzebieta
Jul 21, 2020·Brain Injury : [BI]·Maureen O'ReillyAlice Theadom
Sep 13, 2018·International Journal of Adolescent Medicine and Health·Ronald ChowRaissa Dzulynsky
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