The Injuries and Helmet Use in Bike Share Programs: A Systematic Review.

To investigate the injury effects of bike share programs and the helmet usage status in bike share programs. We conducted a systematic review of peer reviewed scientific literature. Searches were conducted in three databases (Pubmed, Scopus, and Web of Science) on March 1 2020 to identify all articles on the injury incidence related to bike share programs and the helmet usage status in bike share programs. Titles, abstracts, and full-text articles were screened to identify all articles relevant to the themes by two authors independently, and discrepancies were resolved after discussion with the third author. Standardised data extraction and quality assessment (The Newcastle-Ottawa Scale) were implemented. A sum of 491 records after removing duplicates was identified, 181 fulltext articles were screened, and 13 studies were included in the review. The primary outcome are injuries of bike share users and unhelmeted rate among bike share users as well as the unhelmeted rate among personal bike users. Two studies evaluated the injuries related to bike share users, but have inconclusive results. A total of 11 studies reported the unhelmeted rates in bike share programs ranging from 36.0 to 88.9%. There is a significant change in bike injuries with the implementation of bike share programs. Moreover, the unhelmeted rate of bike share users was generally higher than that of personal bike users, which may result from helmets' accessibility and users' safety perception.