Helmet efficacy in the prevention of bicyclist head injuries: Royal Australasian College of Surgeons initiatives in the introduction of compulsory safety helmet wearing in Victoria, Australia.

The results of a comparative study of the injury profiles of Victorian motorcyclist and bicyclist casualties were used by the Royal Australasian College of Surgeons in initiating a state-wide campaign to promote the wearing of approved safety helmets by Victorian bicyclists and to obtain the necessary legislation whereby such wearing would become compulsory. Bicyclist casualties had sustained more frequent and severe head injuries than motorcyclist casualties although the latter had sustained overall more severe body injuries. Increases in voluntary helmet wearing rates and reductions in costs preceded the introduction in July, 1990 in Victoria of compulsory safety helmet wearing by bicyclists. Sixty-four helmets obtained during a study of more than 1,700 Victorian bicyclists wearing and not wearing helmets were evaluated for performance by impact severity testing and findings related to head injury occurrence. Sixteen helmets sustained more than one impact during the accident. All casualties who sustained a severe head injury (Abbreviated Injury Scale greater than or equal to 4) were involved in a collision with a motor vehicle and subjected to more than one impact to the head/helmet and/or the helmet had come off during the accident. Most impacts occurred below the current test lines of Australian and United States standards. Ten percent of impacts were more severe than required in performance standards. Recommendations are made for improvements in the current standard.