Journal of Community Health

, Volume 41, Issue 6, pp 1160–1166 | Cite as

The Effect of an All-Ages Bicycle Helmet Law on Bicycle-Related Trauma

  • Paula Kett
  • Frederick Rivara
  • Anthony Gomez
  • Annie Phare Kirk
  • Christina Yantsides
Original Paper


In 2003, Seattle implemented an all-ages bicycle helmet law; King County outside of Seattle had implemented a similar law since 1994. For the period 2000–2010, the effect of the helmet legislation on helmet use, helmet-preventable injuries, and bicycle-related fatalities was examined, comparing Seattle to the rest of King County. Data was retrieved from the Washington State Trauma Registry and the King County Medical Examiner. Results comparing the proportions of bicycle related head injuries before (2000–2002) and after (2004–2010) the law show no significant change in the proportion of bicyclists admitted to the hospital and treated for head injuries in either Seattle (37.9 vs 40.2 % p = 0.75) nor in the rest of King County (30.7 vs 31.4 %, p = 0.84) with the extension of the helmet law to Seattle in 2003. However, bicycle-related major head trauma as a proportion of all bicycle-related head trauma did decrease significantly in Seattle (83.9 vs 64.9 %, p = 0.04), while there was no significant change in King County (64.4 vs 57.6 %, p = 0.41). While the results do not show an overall decrease in head injuries, they do reveal a decrease in the severity of head injuries, as well as bicycle-related fatalities, suggesting that the helmet legislation was effective in reducing severe disability and death, contributing to injury prevention in Seattle and King County. The promotion of helmet use through an all ages helmet law is a vital preventative strategy for reducing major bicycle-related head trauma.


Bicycle injury Head injury Major head injury Helmet Legislation 



We would like to thank the following individuals for their contributions to this paper: Kathy Schmidt, Zeynep Shorter, Wren Haaland, and Nick Zajchowski.

Statement of Contributorship

Paula Kett acquired and analyzed the data and produced the manuscript. Frederick Rivara, Tony Gomez, Annie Phare Kirk and Christina Yantsides assisted in the conception and design of the manuscript. All authors read, revised, and gave final approval of the manuscript.

Compliance with Ethical Standards

Conflict of interest

The authors declare they have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Paula Kett
    • 1
  • Frederick Rivara
    • 2
  • Anthony Gomez
    • 1
  • Annie Phare Kirk
    • 1
  • Christina Yantsides
    • 1
  1. 1.Public Health – Seattle & King CountySeattleUSA
  2. 2.Department of Pediatrics and Harborview Injury Prevention and Research CenterUniversity of WashingtonSeattleUSA

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