To investigate the use of helmets for cyclists choosing to use BIXI bikes in comparison to personal bike riders in the City of Toronto.
Cross-sectional study design.
Cyclists were observed in Toronto, Canada.
Of the 6732 sample size, 306 cyclists on BIXI bikes and 6426 personal bike riders were observed.
The outcome of interest was helmet use.
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).
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.
We investigated the use of helmets for cyclists choosing to use BIXI bikes in comparison to personal bike riders in the City of Toronto.
We hypothesised that the proportion of helmet users using BIXI bikes would be significantly lower than those on personal bikes.
Cyclists using BIXI bikes in Toronto are less likely to wear a helmet than cyclists riding their own bike; only 20.9% of all BIXI cyclists wear helmets compared with 51.7% of cyclists riding a personal bike.
More men than women ride bicycles in Toronto.
Women in Toronto were more likely to wear a helmet while cycling.
Strengths and limitations of this study
This is the first study (to our knowledge) investigating helmet use in a bike-sharing system. Additional strengths include the prospective study design, number of observations, randomly selected observation sites and stratified analyses by sex.
The data were collected by one of the observer not blinded to the study hypothesis; observations were limited to presumed commuter hours in the downtown core of Toronto and we were unable to account for variables previously associated with helmet use, including income, education and age.