Helmet use in BIXI cyclists in Toronto, Canada: an observational study

OBJECTIVE: To investigate the use of helmets for cyclists choosing to use BIXI bikes in comparison to personal bike riders in the City of Toronto. DESIGN: Cross-sectional study design. SETTING: Cyclists were observed in Toronto, Canada. PARTICIPANTS: Of the 6732 sample size, 306 cyclists on BIXI bikes and 6426 personal bike riders were observed. OUTCOME MEASURE: The outcome of interest was helmet use. RESULTS: Overall, 50.3% of cyclists wore helmets. The proportion of BIXI bike riders using helmets was significantly lower than the proportion of helmet users on personal bikes (20.9% vs 51.7%, respectively, p<0.0001). CONCLUSIONS: Although the BIXI bike programme has provided an alternate means for Torontonians to use a bicycle, cyclists using BIXI bikes are much less likely to wear a helmet. Since the prevalence of helmet use in cyclists in general is already low, helmet use should be especially promoted in BIXI bike riders in order to promote a safe and healthy environment for cyclists.