Head injuries to pedal cyclists and the promotion of helmet use in Victoria, Australia

doi:10.1016/0001-4575(88)90002-4

Accident Analysis & Prevention

Volume 20, Issue 3, June 1988, Pages 177-185

https://doi.org/10.1016/0001-4575(88)90002-4 Get rights and content

Abstract

Bicycle accidents account for approximately 1,200 reported injuries and 30 deaths each year in the State of Victoria, Australia. Head injuries constitute 33% of reported injuries and cause 80% of fatalities. Helmet wearing promotion campaigns conducted by the Victorian Road Traffic Authority and involving substantial contributions from many voluntary and commercial groups in the community have resulted in significant increases in the wearing rates of approved bicycle helmets. These increases in helmet wearing rates have been accompanied by significant reductions in the rate of head injuries among bicycle accident victims. The promotion program is outlined and the changes in helmet wearing rates detailed.

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Cited by (81)

Modeling helmet usage behavior of motorized two-wheeler riders in developing countries
2020, Transportation Research Procedia
Motorcycle crashes make up a large proportion of road casualties in all over the world, particularly in developing countries like India, where motorcycle ownership is high. Wearing helmet decreases the risk and severity of injuries. To increase helmet usage, government has introduced a mandatory helmet usage law for two-wheeler driver and pillion riders in Mumbai, India from April 2016 onwards. Thus, the study objectives are to examine the various factors affecting helmet usage behavior and develop the model for estimating helmet usage behavior of motorcycle rider’s in cities. The data were collected in two different time frames, such as before and after helmet mandatory law at randomly selected ten study locations in Mumbai, India. From field survey, 28,209 and 37,245 samples were collected during 2015 and 2016 respectively. This study was performed the statistical analysis of the impact of the state strict law on helmet usage and it was found that helmet usage was increased from 62.81% to 83.53%. Further, Pearson’s R, Kendall’s tau, Spearman’s rho correlation and analysis of variance tests were conducted for identifying the impact of each variable with helmet wearing behavior of motorcyclists. Finally, binary logistic regression model was developed to estimate helmet usage behavior of the motorcycle rider. The model was validated, and their statistical performance results denote that developed model predicts helmet usage behavior more preciously. These study findings and model outcomes can be useful for policy makers to understand about the actual conditions of helmet usage behavior in cities and increase helmet usage rate, and also create policy level decision making on reduction in traffic crashes in India.
Mass media health communication campaigns combined with health-related product distribution: A community guide systematic review
2014, American Journal of Preventive Medicine
Citation Excerpt :
Although a search was performed for studies of additional health-related products that assessed effectiveness or measured the outcome of interest, none were found. In the 17 studies (20 study arms)24–27,30,33,42–46,48–53 shown in Figure 3, data on intervention effects on the proportion of people engaging in a healthy behavior are shown as pct pt changes. Data points to the right of the zero line are in the favorable direction.
Health communication campaigns including mass media and health-related product distribution have been used to reduce mortality and morbidity through behavior change. The intervention is defined as having two core components reflecting two social marketing principles: (1) promoting behavior change through multiple communication channels, one being mass media, and (2) distributing a free or reduced-price product that facilitates adoption and maintenance of healthy behavior change, sustains cessation of harmful behaviors, or protects against behavior-related disease or injury.
Using methods previously developed for the Community Guide, a systematic review (search period, January 1980–December 2009) was conducted to evaluate the effectiveness of health communication campaigns that use multiple channels, including mass media, and distribute health-related products. The primary outcome of interest was use of distributed health-related products.
Twenty-two studies that met Community Guide quality criteria were analyzed in 2010. Most studies showed favorable behavior change effects on health-related product use (a median increase of 8.4 percentage points). By product category, median increases in desired behaviors ranged from 4.0 percentage points for condom promotion and distribution campaigns to 10.0 percentage points for smoking-cessation campaigns.
Health communication campaigns that combine mass media and other communication channels with distribution of free or reduced-price health-related products are effective in improving healthy behaviors. This intervention is expected to be applicable across U.S. demographic groups, with appropriate population targeting. The ability to draw more specific conclusions about other important social marketing practices is constrained by limited reporting of intervention components and characteristics.
Economics of mass media health campaigns with health-related product distribution: A community guide systematic review
2014, American Journal of Preventive Medicine
Citation Excerpt :
Based on the grant amount, the per capita cost was about $116 for this 5-month intervention. The other study21 evaluated a helmet promotion campaign implemented in Victoria, Australia, that offered purchase rebates. Partial program cost was provided as $294,286 for TV and radio campaigns and $745,200 for rebates over the approximate 1-year duration of the intervention (the rebate was calculated as an approximate value by the present reviewers).
The objective of this systematic review was to determine the costs, benefits, and overall economic value of communication campaigns that included mass media and distribution of specified health-related products at reduced price or free of charge.
Economic evaluation studies from a literature search from January 1980 to December 2009 were screened and abstracted following systematic economic review methods developed by The Community Guide. Data were analyzed in 2011.
The economic evidence was grouped and assessed by type of product distributed and health risk addressed. A total of 15 evaluation studies were included in the economic review, involving campaigns promoting the use of child car seats or booster seats, pedometers, condoms, recreational safety helmets, and nicotine replacement therapy.
Economic merits of the intervention could not be determined for health communication campaigns associated with use of recreational helmets, child car seats, and pedometers, primarily because available economic information and analyses were incomplete. There is some evidence that campaigns with free condom distribution to promote safer sex practices were cost-effective among high-risk populations and the cost per quit achieved in campaigns promoting tobacco cessation with nicotine replacement therapy products may translate to a cost per quality-adjusted life-year less than $50,000. Many interventions were publicly funded trials or programs, and the failure to properly evaluate their economic cost and benefit is a serious gap in the science and practice of public health.
Comparison of the serious injury pattern of adult bicyclists, between South-West Netherlands and the State of Victoria, Australia 2001-2009
2013, Injury
Head injury is the leading cause of death and long term disability from bicycle injuries and may be prevented by helmet wearing. We compared the pattern of injury in major trauma victims resulting from bicyclist injury admitted to hospitals in the State of Victoria, Australia and South-West Netherlands, with respective high and low prevalence of helmet use among bicyclists.
A cohort of bicycle injured patients with serious injury (defined as Injury Severity Score > 15) in South-West Netherlands, was compared to a cohort of serious injured bicyclists in the State of Victoria, Australia. Additionally, the cohorts of patients with serious injury admitted to a Dutch level 1 trauma centre in Rotterdam, the Netherlands and an Australian level 1 trauma centre in Melbourne, Australia were compared. Both cohorts included patients admitted between July 2001 and June 2009.
Primary outcome was in-hospital mortality and secondary outcome was prevalence of severe injury per body region. Outcome was compared using univariate analysis and mortality outcomes were also calculated using multivariable logistic regression models.
A total of 219 cases in South-West Netherlands and 500 cases in Victoria were analyzed. Further analyses comparing the major trauma centres in each region, showed the percentage of bicycle-related death was higher in the Dutch population than in the Australian (n = 45 (24%) vs n = 13(7%); P < 0.001). After adjusting for age, mechanism of injury, GCS and head injury severity in both hospitals, there was no significant difference in mortality (adjusted odds ratio 1.4; 95% confidence interval = 0.6, 3.5).
Patients in Netherlands trauma centre suffered from more serious head injuries (Abbreviated Injury Scale ≥ 3) than patients in the Australian trauma centre (n = 165 (88.2%) vs n = 121 (62.4%); P < 0.001). The other body regions demonstrated significant differences in the AIS scores with significantly more serious injuries (AIS ≥ 3) of the chest, abdominal and extremities regions in the Australian group.
Bicycle related major trauma admissions in the Netherlands trauma centre, and in South-West Netherlands had a higher mortality rate associated with a higher percentage of serious head injuries compared with that in the Australian trauma centre and the State of Victoria.
Quantification of local ventilation efficiency under bicycle helmets
2012, International Journal of Industrial Ergonomics
Citation Excerpt :
Head injury is reported as the direct cause of death in 69–86 percent of bicycle helmet fatalities (Fife et al., 1983; Wood and Milne, 1988).
Bicycle helmets can reduce the risk for head injuries in traffic accidents where cyclists are involved. Unfortunately, bicycle helmets are often unpopular due to the thermal discomfort that they may induce. Most bicycle helmets have therefore many large vents. These large vents can give helmet wearers the perception that helmets are well ventilated, but their efficiency on local airflow between head and helmet has not yet been quantified.
This research aimed at quantifying local ventilation efficiency of five bicycle helmets using a tracer gas measurement technique for 13 positions between a manikin head and a helmet. The 3D fresh air distributions that were quantified are a major parameter influencing thermal comfort of a bicycle helmet. Large variations in ventilation efficiency were seen for all helmets: from 0 × 10⁻³ s⁻¹ to 16 × 10⁻³ s⁻¹ or 20 × 10⁻³ s⁻¹. Highly ventilated zones were observed at the front of the manikin head, while low ventilated zones were monitored at the rear for all helmets.
This research suggests minimising the number of inlet vents, but to maximise the projected inlet area of each inlet vent to optimize the thermal characteristics of bicycle helmets. Furthermore, it is suggested that inlets in the front of a bicycle helmet should be connected with outlets at the rear using air channels. Vents on top of a bicycle helmet are not always useful during cycling.
Thermal discomfort is one of the major reasons why cyclists do not like to wear a helmet. The described method allows characterizing airflow between a helmet and a manikin head for real helmets that can be used on simple prototypes as well as final models.
Injury Prevention
2012, Pediatric Surgery, 2-Volume Set: Expert Consult - Online and Print

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Head injuries to pedal cyclists and the promotion of helmet use in Victoria, Australia

Abstract

Do Bicycle Safety Helmets Reduce Severity of Head Injury in Real Crashes?

Bicycle Helmet Research

Report to the Road Traffic Authority

The effect of compulsory safety helmets on motorcycle accident fatalities

Aust. Road Res.

Bicycle Accidents

Technical Bulletin 2

Trends in Helmet Usage Rates and Bicyclist Numbers Sustaining Head Injury—July 1981 to December 1985—Victoria

Differences in head injuries of pedal cyclist and motor cyclist casualties in Victoria

Med. J. Aust.