Health Promotion International Advance Access originally published online on January 24, 2005
Health Promotion International 2005 20(1):33-40; doi:10.1093/heapro/dah505
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Bicycle helmet use in Sweden during the 1990s and in the future
1Swedish Road and Transport Research Institute (VTI), Linköping, Sweden, 2Linköping University, Department of Health and Society, Division of Social Medicine and Public Health Science, Linköping, Sweden, 3Karolinska Institutet, Department of Public Health Sciences, Division of Social Medicine, Stockholm, Sweden and 4Swedish Rescue Services Agency, National Centre for Learning from Accidents (NCO), Karlskoga, Sweden
Address for correspondence: Sixten Nolén, Swedish Road and Transport Research Institute (VTI), SE-581 95 Linköping, Sweden E-mail: sixten.nolen{at}vti.se
This paper describes how the use of bicycle helmets in Sweden has changed for different categories of cyclists from 1988 to 2002, and it also estimates future trends in voluntary wearing of bicycle helmets up to the year 2010. Observational studies of the use of bicycle helmets were conducted once a year from 1988 to 2002 at 157 sites in 21 cities. The subjects observed were children cycling to school (average n = 5471/year) and in their free time (average n = 2191/year), and adults cycling to workplaces and on public bike paths (average n = 29 368/year). The general trend in helmet use from 1988 to 2002 was determined by linear regression analysis, and the results were also employed to estimate future helmet wearing for the period 2003–2010. Differences in helmet use according to gender and size of city were analysed by chi-square tests. From 1988 to 2002, all categories of cyclists showed an upward trend in helmet use (p < 0.01, p < 0.001). Helmet wearing increased from about 20 to 35% among children (
10 years) cycling during free time, from approximately 5 to 33% among school children, and from around 2 to 14% in adults. Total average helmet use rose from about 4 to 17%. However, during the last 5 years of the study period (1998–2002), none of the categories of cyclists studied showed an upward trend in helmet wearing. It is estimated that 
30% of cyclists will wear helmets voluntarily by the year 2010, if helmet promotion activities are continued at the same level as previously. The results suggest that Sweden will probably not reach its official goal of 80% helmet use unless a national bicycle helmet law is passed.
Key words: bicycle helmet; observational study; safety promotion
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