C. Juhra, U. Weiss, B. Wieskötter, M.J. Raschke

• An increased use of bicycles comes along with an increased number of bicycle accidents. Bicycle accidents are more frequent than recorded by the police. To evaluate the real number of bicycle accidents during 12 months in Münster, Germany, injuries were collected by the Police and in each emergency unit anonymously. 2,153 patients had to be treated in a hospital, nearly triple the number of accidents that were registered by the police. Beside fractures of the upper extremities with major surgery, traumatic brain injuries were the leading cause for hospital admission. Bicycle helmet use can reduce traumatic brain injuries and the related number of deaths and hospital admissions. Laws on bicycle helmet might decrease the use of bicycles and therefore the reduction of positive health benefits. Other methods of accident prevention may lead to positive effects as helmet legislation as well, while having no reduction in bicycle use.