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.