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Helmet laws: Ontario

Introduction and scope
The Ontario helmet law came into effect from 1st October 1995. Although originally intended to apply to all ages, it was amended by regulation before enactment to exempt adults (18 years of age and over). The penalty for failing to wear a helmet is CAD 105 and applied directly to 16/17 year-olds and to the parents of those under 16.

Compliance and enforcement
From 1995 to 1996, child helmet use increased from an average of 46% to 68%, the increase being greater in lower income households than in higher. Observations were in one Toronto Borough and were not necessarily typical of Ontario [7].
Surveys in Ottawa in 1994 showed that on average 56% of cyclists (all ages) wore helmets, up from 45% in 1992. However helmet use was more common in suburban areas than urban. Of males under 18 years old, 32% wore helmets [4].
The legislation has not been enforced [1] and there is no evidence that any penalties have been imposed. By 1999, helmet wearing levels had fallen back to the levels prior to legislation, with about the same level again in 2001.

Effect on casualties
The percentage of child cyclists admitted to hospital with head injury pre and post law was as follows [2] [6]:

Most cycling in the 1995-96 fiscal year would have taken place before enactment of the law as Ontario winters are not conducive to cycling as a popular activity. The greatest falls in % head injury took place before legislation and more than one year after legislation. The year following introduction of the helmet law was associated with the smallest reduction in head injuries. It seems likely, therefore, that on-going trends rather than the helmet law was responsible for the changes over time. [3]
A subsequent analysis from 1997-98 to 2001-02 showed a 12.5% decrease in all hospital admissions for child cyclists and a 26% reduction in head injuries [6]. During most of this period the helmet wearing rate was similar to that pre-legislation. At the beginning of this period (1997-98) % head injuries were declining similarly in all provinces, with and without helmet laws [2].

Effect on cycle use
Cycle use among children observed in one Toronto Borough (but not necessarily typical of the rest of Ontario) declined following introduction of the helmet law but subsequently recovered, probably because the law was not enforced.

Cost benefit
Not analysed.

References and related studies
[1] Burdett AJ. Butting heads over bicycle helmets. CMAJ, Elec Letters 27 Aug 2002.
[2] Macpherson AK, To TM, Macarthur C, Chipman ML, Wright JG, Parkin PC. Impact of mandatory helmet legislation on bicycle-related head injuries in children: a population-based study. 2002. Pediatrics: 2002; 110(5):e60.
[3] Robinson DL. Confusing trends with the effect of helmet laws. Pediatrics, Post Publication Peer Review 7 Jul 2003.
[4] Analysis of cycling and helmet use in Ottawa, Ontario, OCBC, October 1994.
[5] Macpherson AK, Parkin PC, To TM. Mandatory helmet legislation and children's exposure to cycling, 2001. Injury Prevention 2001;7:228-230
[6] Ontario Trauma Registry 2003 Report: Injury Hospitalizations. Canadian Institute for Health Information, 2003.
[7] Parkin PC, Khambalia A, Kmet L, Macarthur C. Influence of socioeconomic status on the effectiveness of bicycle helmet legislation for children: a prospective observational study. Pediatrics, Pediatrics 2003;112:192-196.
[-] Rowe BH, Rowe AM, Bota GW. Bicyclist and environmental factors associated with fatal bicycle-related trauma in Ontario. Canadian Medical Association Journal, 1995;152(10:45-53.