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Policy statement

Published evidence supportive of helmet effectiveness or promotion

Case-control studies

The case-control studies below are those that have been selected by meta analyses as representing the strongest evidence in favour of cycle helmet effectiveness.

A case control study of the effectiveness of bicycle safety helmets

Thompson RS, Rivara FP, Thompson DC. New England Journal of Medicine, 1989 v320 n21 p1361-7. 1989.

A case-control study on the effectiveness of bicycle safety helmets in preventing facial injury

Thompson DC, Thompson RS, Rivara FP, Wolf ME. American Journal of Public Health, 1990; 80(12):1471-1474. 1990.

A prospective analysis of injury severity among helmeted and non helmeted bicyclists involved in collisions with motor vehicles

Spaite DW, Murphy M, Criss EA, Valenzuela TD, Meislin HW. Journal of Trauma, 1991 Nov;31(11):1510-6.. 1991.

Bicycle injuries: road trauma is not the only concern

Jacobson GA, Blizzard L, Dwyer T. Austr NZ J Public Health, 1998 Jun;22(4):451-5.. 1998.

Bicyclists, helmets and head injuries: a rider-based study of helmet use and effectiveness

Wasserman RC, Waller JA, Monty MJ, Emery AB, Robinson DR. American Journal of Public Health, 1988 Sep;78(9):1220-1. 1988.

Usually cited as a pro-helmet paper, nevertheless helmet wearers were 7 times more likely to have hit their heads than non-wearers.

Do bicycle safety helmets reduce severity of head injury in real crashes?

Dorsch MM, Woodward AJ, Somers RL. Accident Analysis and Prevention, 1987 Jun;19(3):183-90. 1987.

Effectiveness of bicycle helmets in preventing head injury in children: case-control study

Thomas S, Acton CH, Nixon J, Battistutta D, Pitt WR, Clark R. BMJ, 1994;308:173-176. 1994.

Effectiveness of bicycle safety helmets in preventing head injuries: a case-control study

Thompson DC, Rivara FP, Thompson RS.. JAMA, 1996 Dec 25;276(24):1968-73. 1996.

Effectiveness of bicycle safety helmets in preventing serious facial injury

Thompson DC, Nunn ME, Thompson RS, Rivara FP. JAMA, 1996a;276(24):1974-1975. 1996.

Epidemiology of bicycle injuries and risk factors for serious injury

Rivara FP, Thompson DC, Thompson RS. Injury Prevention, 1997 3: 110-114. 1997.

Epidemiology of bicycle injury, head injury, and helmet use among children in British Columbia: a five year descriptive study

Linn S, Smith D, Sheps S. Injury Prevention, 1998;4:122-125. 1998.

Helmet protection from head injuries among recreational bicyclists

Wasserman RC, Buccini RV. American Journal of Sports Medicine, 1990 Jan-Feb;18(1):96-7. 1990.

Impact of bicycle helmet safety legislation on children admitted to a regional trauma center

Shafi S, Gilbert JC, Loghmanee F, Allen JE, Caty MG, Glick PL, Carden S, Azizhan RG. J Paediatric Surgery, 1998 Feb;33(2):317-21. 1998.

Injury patterns in cyclists attending an accident and emergency department: a comparison of helmet wearers and non-wearers

Maimaris C, Summers CL, Browning C, Palmer CR. BMJ, 1994 Jun 11;308(6943):1537-40. 1994.

The effectiveness of bicycle helmets: a study of 1710 casualties

McDermott FT, Lane JC, Brazenore GA, Debney EA. Journal of Trauma, 1993; 34(6):834-845. 1993.

The effects of bicycling helmets in preventing significant bicycle-related injuries in children

Finvers KA, Strother RT, Mohtadi N. Clinical Journal of Sports Medicine, 1996 Apr;6(2):102-7. 1996.

The impact of compulsory cycle helmet legislation on cyclist head injuries in New South Wales

Walter SR, Olivier J, Churches T, Grzebieta R.. Accident Analysis & Prevention, 2011 Nov;43(6):2064-71. 2011.

This study claims to be the last word in showing that helmet laws are beneficial.

Meta analyses

The meta analyses that follow are not research papers in their own right, but reviews of other papers. The first two meta analyses examine the same 16 case-control studies. The Cochrane Review examines a subset of 7 of the same studies. None of the meta analyses considers any papers not supportive of helmet use.

Bicycle helmet efficacy: a meta-analysis

Attewell RG, Glase K, McFadden M. Accident Analysis & Prevention, 2001;33(3):345-352

Bicycle helmets - a review of their effectiveness: a critical review of the literature

Towner, Dowswell, Burkes, Dickinson & Hayes. Department for Transport, London, November 2002.

Cochrane Review: Helmets for preventing head and facial injuries in bicyclists

Thompson RS, Rivara FP & Thompson DC. Cochrane Database of Systematic Reviews, The Cochrane Library.

This review is not independent, being dominated by the authors' own research.

See also