title: The effects of provincial bicycle helmet legislation on helmet use and bicycle ridership in Canada.
abstract: BACKGROUND
  Bicycle helmet legislation has been variably implemented in six of 10 Canadian provinces. The objectives of this study were to determine the association between the comprehensiveness of helmet legislation and both helmet use and bicycle ridership.
  
  
  METHODS
  Analysis of helmet use was based on data from the 2005 Canadian Community Health Survey (CCHS) and included respondents from three Canadian provinces (Saskatchewan, Ontario, and Nova Scotia). Analysis of bicycle use was based on data from the 2000-01, 2003, 2005, and 2007 cycles of the CCHS and included respondents from all provinces. In the time between the 2000-01 and 2007 cycles, two provinces (Prince Edward Island (PEI) and Alberta) implemented helmet legislation.
  
  
  RESULTS
  Helmets were reportedly worn by 73.2% (95% CI 69.3% to 77.0%) of respondents in Nova Scotia, where legislation applies to all ages, by 40.6% (95% CI 39.2% to 42.0%) of respondents in Ontario, where legislation applies to those less than 18 years of age, and by 26.9% (95% CI 23.9% to 29.9%) of respondents in Saskatchewan, where no legislation exists. Though legislation applied to youth in both Ontario and Nova Scotia, helmet use was lower among youth in Ontario than among youth in Nova Scotia (46.7% (95% CI 44.1% to 49.4%) vs 77.5% (95% CI 70.9% to 84.1%)). Following the implementation of legislation in PEI and Alberta, recreational and commuting bicycle use remained unchanged among youth and adults.
  
  
  CONCLUSIONS
  Canadian youth and adults are significantly more likely to wear helmets as the comprehensiveness of helmet legislation increases. Helmet legislation is not associated with changes in ridership.
authors.affiliation: Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada. dennis.jessica@gmail.com
authors.forename: Jessica
authors.initials: J
authors.lastname: Dennis
authors.forename: Beth
authors.initials: B
authors.lastname: Potter
authors.forename: Tim
authors.initials: T
authors.lastname: Ramsay
authors.forename: Ryan
authors.initials: R
authors.lastname: Zarychanski
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001642:Bicycling / Q000293:injuries / Q000331:legislation & jurisprudence*; D002170:Canada / Q000453:epidemiology; D002648:Child; D006259:Craniocerebral Trauma / Q000453:epidemiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D055815:Young Adult