The impact of compulsory helmet legislation on cyclist head injuries in New South Wales, Australia: A response

This article responds to criticisms made in a rejoinder (Accident Analysis and Prevention 2012, 45: 107–109) questioning the validity of a study on the impact of mandatory helmet legislation (MHL) for cyclists in New South Wales, Australia. We systematically address the criticisms through clarification of our methods, extension of the original analysis and discussion of new evidence on the population-level effects of MHL. Extensions of our analysis confirm the original conclusions that MHL had a beneficial effect on head injury rates over and above background trends and changes in cycling participation. The ongoing debate around MHL draws attention away from important ways in which both safety and participation can be improved through investment in well-connected cycling infrastructure, fostering consideration between road users, and adequate legal protection for vulnerable road users. These are the essential elements for providing a cycling environment that encourages participation, with all its health, economic and environmental benefits, while maximising safety.

► We respond to criticisms of our original study on mandatory cycle helmet laws.
► We demonstrate that the original analysis is robust to these criticisms.
► The beneficial effect of helmet laws in New South Wales, Australia is confirmed.
► Future cycling improvements need to focus on creating a safe cycling environment.