As a mode of transportation, the bicycle is a remarkably simple and satisfying machine. In fact, bicycling is so addictively pleasant that it is synonymous with fun, exercise, and good times. However, head injuries on a bicycle are not fun. It is very serious, and the challenge to an individual to find his way again is enormous. There was a man who was thirty-eight years old when his bicycle was hit by a pickup truck on the outskirts of Boulder, Colorado. He landed directly on his head, fractured his skull, survived two emergency brain surgeries, spent nineteen anxious days in intensive care, six weeks in a coma, and four long months in Boulder Memorial Hospital's rehabilitative unit. Almost two years post-injury, this man lives at home and continues treatment as an outpatient. He goes to "work" three days a week. He is unable to drive a car and he struggles to read and to write. His speech, his gait, his memory, his judgment, his confidence, his competence have all been affected. Jim was not wearing a bicycle helmet.
             In all studies reviewed, there are consistent data indicating that wearing an industry-approved bicycle helmet significantly reduces the risk of head injury during a crash or collision. The reduction in risk is somewhat dependent on whether the controls originate from the emergency department or the population at large. However, population-based controls provide the best estimate of helmet effectiveness and allow it greatest generalizability. Overall, helmets decrease the risk of head and brain injury by 70 to 88 percent and facial injury to the upper and mid face by 65 percent. Wearing a helmet substantially reduces the risk of head injury to a cyclist in a crash.
             Because of the predominant importance of head injury, from the earliest stages of accident analysis attention was concentrated on head protection. Early standards for bicycle safety helmets complied with the requirements of safety advocates, but failed the ...