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Head Injuries Increase without Bike Share Program Helmet Requirements

head injuryLast month during Bike to Work day, many cycling activists renewed the simple question of why all the wonderful bike sharing programs popping up across the U.S. don’t provide helmets as well as wheels. Of course there are a number of predictable reasons — cost, hygiene, liability — but one of the most common justifications is that bike share programs are supposed to be extremely safe. Much safer, in fact, that cruising around on your own bicycle. The evidence cities offer here is generally anecdotal, based on the small number of personal injury reports from cyclists who have taken millions of rides using these growing bike share programs.

Well, it turns out those claims are wrong.

In the first comprehensive study to tackle this question, researchers from Washington State University discovered a head injury risk of 15% higher in cities with bike share programs. In fact, when they took head injury data for cyclists in 5 cities before and after the implementation of bike share programs and looked at it side-by-side, researchers saw an 8% rise in bicycle-related head injury incidents.

Meanwhile, data for five cities without bike share programs has shown a slight decrease in head injuries over the past few years (down by about 2.3%).

“I would personally suggest folks err on the side of caution and use safety devices like bike helmets,” said Janessa Graves, an assistant professor at Washington State’s College of Nursing, who led the study, published online in the American Journal of Public Health.

“Crashes can happen to anyone — tourists visiting the city, children, seasoned cyclists who ride 200 miles a week,” Graves added.

Despite the overwhelming evidence that bike helmets prevent head injuries, no existing bike share operations in the U.S. provide riders with helmets. However, Seattle — where the law requires helmets for all cyclists — and Boston are planning to implement them soon. Both will use credit card operated vending machines that let riders take a helmet from a box and return it when done. Helmets will be cleaned and inspected for damage after each use before being re-inserted in the kiosks.

Yet all other cities where bike share programs have been a hit – New York, Washington, Minneapolis, Austin and others – have no plans to provide helmets. While all encourage riders to use their own helmets, none require it.  In fact, the Dallas City Council recently eliminated helmet laws for adults, stating that the move would boost participation in their bike share program.

“The conclusion of our study — that [bike share] implementation is associated with increased odds that a person admitted for a bicycling-related injury would have a head injury — is likely attributable to the low propensity of [bike share] cyclists to use helmets,” the researchers wrote.

As Lenny Bernstein wrote in the Washington Post: “The limitations of the study design prevent the researchers from saying outright that bike share programs have caused an increase in head injuries (emphasis mine). For one thing, their data come from trauma centers, so they are biased toward severe injuries. And because the researchers did not get patient-by-patient information, it was impossible to determine which individual was a bike share rider and which one wasn’t.  But Graves said the strong correlation makes it very clear that bike share programs should provide helmets from the outset. “You rent a car [and] there are seatbelts in the car,” she said. “You don’t have to advocate for them. They should be part and parcel of the program. I can definitely stand on the soapbox and say every bike share [program] should have helmets available.”

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