Observational evaluation of compliance with traffic regulations among helmeted and nonhelmeted bicyclists

Study objective: To evaluate whether helmeted bicyclists are more compliant with traffic regulations than nonhelmeted bicyclists. Methods: This prospective observational study, using a convenience sample, was conducted during daylight hours at three separate intersections, marked with legal stop signs, near the campus of a major university. Data collected included helmet use, legal hand signal use to indicate a turn or stop, and whether the bicyclist came to a complete stop before proceeding through the intersection. Results: A total of 1,793 bicyclists were evaluated. Only 8.8% of the bicycle riders were wearing helmets. Helmeted bicyclists were 2.6 times more likely than nonhelmeted bicyclists to make legal stops (P<.000001; odds ratio [OR], 3.1; 95% confidence interval [CI], 2.1 to 4.6). They were also 7.1 times more likely to use hand signals (P<.000001; OR, 7.2; 95% CI, 2.8 to 18.2). Conclusion: Helmeted bicycle riders showed a significantly greater compliance with two traffic laws than nonhelmeted bicyclists. They were 2.6 times more likely to stop at stop signs and 7.1 times more likely to use legal hand signals. This very strong association of helmet use with safer riding habits has implications for injury-control efforts aimed at preventing bicycle-related injuries.