title: Bicycle helmet size, adjustment, and stability.
abstract: OBJECTIVE
  One of the main requirements of a protective bicycle helmet is to provide and maintain adequate coverage to the head. A poorly fitting or fastened helmet may be displaced during normal use or even ejected during a crash. The aims of the current study were to identify factors that influence the size of helmet worn, identify factors that influence helmet position and adjustment, and examine the effects of helmet size worn and adjustment on helmet stability.
  
  
  METHODS
  Recreational and commuter cyclists in Sydney were surveyed to determine how helmet size and/or adjustment affected helmet stability in the real world. Anthropometric characteristics of the head were measured and, to assess helmet stability, a test analogous to the requirements of the Australian bicycle helmet standard was undertaken.
  
  
  RESULTS
  Two hundred sixty-seven cyclists were recruited across all age groups and 91% wore an AS/NZS 2063-compliant helmet. The main ethnic group was Europeans (71%) followed by Asians (18%). The circumferences of the cyclists' heads matched well the circumference of the relevant ISO headform for the chosen helmet size, but the head shapes differed with respect to ISO headforms. Age and gender were associated with wearing an incorrectly sized helmet and helmet adjustment. Older males (>55 years) were most likely to wear an incorrectly sized helmet. Adult males in the 35-54 year age group were most likely to wear a correctly adjusted helmet. Using quasistatic helmet stability tests, it was found that the correctness of adjustment, rather than size, head dimensions, or shape, significantly affected helmet stability in all test directions.
  
  
  CONCLUSIONS
  Bicycle helmets worn by recreational and commuter cyclists are often the wrong size and are often worn and adjusted incorrectly, especially in children and young people. Cyclists need to be encouraged to adjust their helmets correctly. Current headforms used in standards testing may not be representative of cyclists' head shapes. This may create challenges to helmet suppliers if on one hand they optimize the helmet to meet tests on ISO-related headforms while on the other seeking to offer greater range of sizes.
authors.affiliation: a School of Aviation , University of New South Wales , Sydney , Australia.
authors.forename: Kim T
authors.initials: KT
authors.lastname: Thai
authors.forename: Andrew S
authors.initials: AS
authors.lastname: McIntosh
authors.forename: Toh Yen
authors.initials: TY
authors.lastname: Pang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000886:Anthropometry; D001315:Australia; D001642:Bicycling; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D004867:Equipment Design; D005260:Female; D006257:Head / Q000033:anatomy & histology; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011998:Recreation; D014186:Transportation; D055815:Young Adult
keywords: bicycle helmets; head anthropometry; stability testing