Review Article: Correct bicycle helmet wearing

Although bicycle helmets effectively help prevent injuries and reduce morbidity and mortality, they must fit correctly to work. A properly fitted helmet meets these criteria:

• It sits straight and horizontal on the head, not too forward to cover the eyebrows or too far back so that the forehead is exposed.
• Without the buckle or straps fastened, the helmet  should fit comfortably on the head, not be too loose.
• When the buckle is fastened, there should be no more than one finger width between the chin and the straps.
• It should be stationary on the head when the buckle is fastened.

But in practice, are helmets really fitted correctly? Hagel and his colleagues searched the medical literature for evidence that helmet fit was considered during studies. In the more than 2,200 studies they examined, only 11 met their criteria of providing enough detail to evaluate helmet fit.

Their closer examination of these 11 articles, 10 of which were peer-reviewed, revealed that correct helmet fit was reported to be between 43% and 100% of the time, depending on the study. Studies involving females and adults tended to have a higher prevalence of correct fit, as did studies that reported on school-based campaigns to promote helmets.

Editor’s note: Helmet fit is an important element to promoting helmets. This study emphasizes the need for researchers – as well as community promotion programmes – to stress more fully the need to correctly fit a helmet.

Lee RS, Hagel BE, Karkhaneh M, Rowe BH. A systematic review of correct bicycle helmet use: how varying definitions and study quality influence the results. Inj Prev 2009;15(2):125-31.

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