Cyclist safety: Why bicycle helmets are important and whether they should be mandatory in Québec

In Québec, head injuries are a major cause of death and hospital admissions among cyclists.

Helmets are very effective for preventing head injuries in all cyclists, whether falling off a bike or having a collision with a motor vehicle.

Promotion campaigns targeting children under 18 are effective for increasing use of bike helmets, especially when they are community-wide and accompanied by a free helmet distribution program.

In Québec, bike helmet use has increased considerably since 2010, reaching an average of 53% in 2014. In some regions, this proportion was around 70%, which is close to the maximum 80% achievable with a law making it mandatory to wear a bicycle helmet. Seventy-eight percent of children aged 5-9 years were wearing helmets.

Studies on the effect of laws making bicycle helmets mandatory suggest that this type of law can help reduce the number of deaths and hospital admissions among cyclists, but their limitations and sometimes contradictory results make it difficult to conclude with certainty how protective its effect is.

The possibility that this type of law might reduce how widespread bike-riding is cannot be ruled out, in particular among youth, which is worrying because:

• it is difficult to replace bike riding with another physical activity;
• a decrease in physical activity, including cycling, has a negative impact on health;
• doing physical activity at an early age is a good predictor of physical activity in adulthood.

There are measures other than bicycle helmets for promoting cyclist safety, including developing safe cyclable infrastructures that not only prevent potential biking injuries, but also promote bike riding.

Since bike helmet use has risen since 2010 to reach an average of 53% in 2014, a regional rate of at least 70% can be reached voluntarily, bike helmet use seldom exceeds 80% when it is mandatory and since the possibility that this type of law might have a negative effect on bike riding, and therefore public health, cannot be ruled out, INSPQ believes that it is justified in being cautious, i.e., not making bicycle helmet use mandatory in Québec, especially since there are alternatives. For these reasons, to promote cyclist safety in Québec, INSPQ recommends:

• continuing to promote voluntary wearing of bike helmets by intensifying promotion efforts and making use of other types of activities, including free helmet distribution, particularly for socioeconomically disadvantaged groups;
• focusing efforts on implementing safe cyclable infrastructures.