Effect of helmet wearing regulation on electric bike riders: a case study of two cities in China

Abstract Objectives Electric bikes (e-bikes) are widely used for commuting and delivery in China. With the rapid increase in e-bikes on the road, related accidents have become crucial issues threatening the public. This research aims to explore the protection effect of helmet wearing regulation and investigate some factors influencing head injury with reference to two case cities in China, obtaining enlightment to protect e-bike riders. Methods The traffic police-reported crash data cover the periods before and after the implementation of helmet wearing regulations in Taizhou (with data from 2017 to 2019) and Nanning (with data in 2020) of China. Preliminary statistical analysis, logistic regression and chi-square test with a Bonferroni correction were applied in the research. Results Lack of helmets was common among victims in the context of high helmet wearing rate among general e-bike riders in Taizhou, indicating that fatality could be avoided to some extent by wearing helmets. Specifically, helmet wearing could reduce the probability of suffering fatal head injury by 6.4%. After the regulation implementation in Taizhou, the fraction of fatal head injury decreased from 89% to 79%, remaining at a high level, which indicates that other measures in addition to helmet wearing regulation should be taken. According to the results of Nanning, mandatory regulation worked more effectively than encouraged regulation in terms of reducing head injury. Conclusions Mandatory helmet wearing regulation is highly recommended to policymakers to reduce head injury among e-bike riders. Measures in addition to helmet wearing regulation, e.g., enhancing law-abiding awareness and improving road infrastructure, should be considered to further protect e-bike riders.