Graduate Thesis Or Dissertation
 

Evaluation of the Oregon bicycle helmet use law on bicycle helmet usage and bicycle-related head injuries

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  • The objectives of this study were to 1) assess the effectiveness of the law in increasing helmet use and compare methods of measuring helmet use, and 2) determine the impact of the law on bicycle-related head injury and fatalities. To measure changes in helmet use by children under 16 years of age, we conducted three statewide pre- and post-law surveys: direct observations, telephone surveys of parents, and classroom surveys of students. We identified bicycle-related head injury cases during July 1989 -, June 1995 through the Oregon Trauma Registry and Vital Statistical Department. Time series analysis was employed to determine if the secular trend and intervention were actual effects rather than random noise. Observed helmet use increased from 24.5% pre-law to 49.3% post-law (P<0.01). Classroom survey self-reported "always" use of helmets increased from 14.7% to 39.4% afterwards (P₍₂₎<0.01). Younger girls were more likely to comply the law. Helmet ownership increased from 5 1.5% pre-law to 75.5% afterwards on the student surveys (P₍₂₎<0.01) and from 67.4% to 83.9% on the parent surveys (P₍₂₎<0.01). The increase in helmet ownership was greater among children with low household-income. The results obtained from classroom surveys and direct observations were correlated (r=0.76, P<0.0l). The majority of students (87.8%) and parents (95.4%) knew about the Oregon bicycle helmet law, but only half of the students thought the law was a "good idea." One year after the law was effective, the incidence rate of statewide bicycle-related head injury decreased from 3.9 per 100,000 person-years pre-law to 2.9 per 100,000 person-years (P₍₂₎<0.001). The decrease was most profound in children under 16 years of age. For children under 16 years of age, the decreasing trend of bicycle-related head injuries appeared to mirror the increasing trend of helmet usage. We conclude that 1) the law increased helmet use; 2) the law helped reduce the bicycle-related severe head injuries; and 3) although use estimates differ, all helmet surveys showed similar degrees of pre- and post-law change. Our results suggest that the laws may be an effective approach to increase helmet use and reduce head injury in other states.
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