Increased bicycle helmet use in the absence of mandatory bicycle helmet legislation: Prevalence and trends from longitudinal observational studies on the use of bicycle helmets among cyclists in Denmark 2004-2022

INTRODUCTION

Using a bicycle helmet reduces the risk of serious head injuries among cyclists substantially. This makes it highly relevant to increase the use of helmets and to measure the prevalence of bicycle helmet use over time and across different groups.

METHOD

Since 2004, the use of bicycle helmets in Denmark has been measured observationally in two nationwide time series: one among cyclists in city traffic across all age groups, and one among cycling school children (aged 6-16) around schools. The observations have been conducted on a regular basis in different parts of the country following the same methodology over the years.

RESULTS

Bicycle helmet use among cyclists in city traffic in Denmark has increased from 6% in 2004 to 50% in 2022. Among cycling school children, helmet use has increased from 33% in 2004 to 79% in 2022. Throughout the years, helmet wearing rates have been highest among young children and lowest among young adults. Since 2015, female cyclists in city traffic have had a slightly higher helmet use than male cyclists.

DISCUSSION

Several factors might have affected bicycle helmet use in Denmark. One possible factor is a nationwide focus on traffic safety education and behavior change campaigns to encourage helmet wearing. Furthermore, among stakeholders on cycling safety there has been consensus on recommending bicycle helmet use and supporting the promotion of helmets while not recommending or promoting helmet legislation. Finally, more safety-oriented behavior in road traffic in general, and self-reinforcing effects of increased helmet use have plausibly been important factors.

PRACTICAL APPLICATIONS

Increasing bicycle helmet use in a country where cycling is popular is possible in the absence of mandatory bicycle helmet legislation. Persistent behavior change campaigning and education, stakeholder consensus, higher levels of road safety-oriented behaviors, and self-reinforcing processes could potentially be important factors.

Attitudinal segmentaion of drivers in Pakistan: The potential for effective road safety campaigns

Deviant driving behaviors are considered as the main cause of Road Traffic Accidents in Pakistan. This research is founded on the premise that driving behaviors are mediated by attitudinal and motivational factors. It advocates that rather than simply aggregating drivers' responses or a-priori classification of them based on their personal characteristics, adoption of segmentation technique is more useful to look at multiple factors provoking aberrant driving behavior in combination and not just in isolation. For this, the study generated an Attitudinal Questionnaire, inspired by the Ajzen's Theory of Planned Behavior (TPB: Ajzen, 1991), and extended violation-scale of modified Driver Behavior Questionnaire (DBQ: Lawton et al., 1997). Attitudinal and behavioral items are first factor analyzed. Then, cluster analysis is performed on extracted attitudinal factors which classified sample driving population into four relatively homogenous and distinct groups of drivers. The results demonstrated the explanatory utility of the market segmentation approach to systematically relate the interaction between attitudes, behaviors and socio-demographic characteristics of drivers. It is concluded that the approach is successful in distinguishing safe drivers from unsafe driver and therefore, can legitimately form the basis of road safety interventions. Finally, the findings are used to recommend targeted information-based road safety solutions with a focus on the diverse characteristics of each of the identified segments.