In 2023, 20,400 people lost their lives in road crashes in the EU (more information is available here). Although this represents a reduction of 10% compared with 2019, the downward trend is slowing (-1% compared with 2022) and is a long way off the expected annual reduction of 4.5% needed to achieve the EU's objective of halving the number of road deaths by 2030. The safety of road users is an essential part of the safe system approach adopted by EU. The development of protective equipment is, among others, a major component of measures to improve road user safety. Helmets, seatbelts, and child restraint systems are all examples of protective equipment whose effectiveness has been widely demonstrated. Considered to be passive or secondary safety devices because they do not help to prevent crashes, they can nevertheless prevent deaths and serious injuries. However, their (correct) use is far from universally widespread.
For this reason, the Charter will devote increased attention over the coming months to the use of safety equipment and, in particular how road safety campaigns can help educate and improve their use — and most importantly, save lives.
We hosted an online event on Wednesday 4th December where attendees discovered the latest insights into protective equipment and innovative promotional campaigns that make a difference from across Europe (Watch the recording here). We are also developing a video case study and resources which will help our members to run effective and efficient road safety campaigns.
In this article we look at the latest statistics from across Europe for helmet use and seatbelt/child restraint systems, two of the most widespread safety equipment. We also explore success stories, which we hope you find inspiring.
Helmet use
Helmets for cyclists and motorcyclists protect against head injuries and brain trauma.
- When cycling, helmet use reduces the risk of serious head injury by 60% and fatal head injury by 71%.
- According to the WHO, wearing a quality motorbike helmet reduces the risk of death by over six times and the risk of brain injury by up to 74%.
While motorbike helmets are compulsory in all EU countries, cycle helmets are only compulsory in a few countries and often only for children. In Europe, the motorbike helmet use frequency varies from 79% in Greece to 100% in Latvia, while bicycle helmet use ranges from 18% in Latvia to 81% in Malta (Figure 1).
There can be various reasons for not wearing a helmet. A lack of comfort or conviction about their usefulness (particularly for low-speed journeys and especially for bicycles), or it may be too expensive. An additional concern is that helmets can also be used incorrectly. Most often, the helmet is not fastened properly, or not fastened at all, or it is not adjusted in a proper way. In all cases, misuse considerably reduces the helmet's protective effectiveness.
While we are observing an increasing popularity of personal mobility devices (including bikes), there remains a considerable margin for improvement in helmet use. One way of doing this is to make helmets compulsory. According to scientific literature, mandatory helmet could lead to a 20% reduction in head injuries and a reduction of more than half of serious head injury (-55%) among cyclists . However, this approach is often the subject of much debate. Another approach is to promote helmet use on a voluntary basis through road safety education, campaigns to change behaviour and inform users about the importance of wearing a helmet, or measures to make helmets more attractive and affordable. Several countries have adopted this approach, including Denmark, where the use of bicycle helmets in towns and cities has risen from 6% in 2004 to 50% by 2022.
Increasing helmet uptake in practice
In Denmark , helmets gained increased popularity between 2015 and 2019, but this increase has stalled in recent years. In 2021, the Danish Road Safety Council launched a campaign, “Helmet has always been a good idea”, to raise awareness of the importance of wearing a helmet. The campaign features Vikings wearing helmets to ride safely. Using humour and irony, the aim is to highlight that in medieval times, Vikings did not refuse to wear a helmet on the pretext that ‘it ruins my hair’. The ultimate message of this campaign is that the excuses we sometimes put forward for not wearing a helmet when cycling can be insufficient when you consider the consequences of falling and hitting your head.
Seatbelts and child restraint systems
Created in the 1950s, the three-point seatbelt has undergone numerous improvements, including retractors and pre-tensioners. In addition, the effectiveness of the seatbelt is enhanced when combined with two other passive protection systems, the airbag and the headrest. However, as it did not fit children’s small size, specific child restraint systems were developed. The models of these devices vary according to the weight and size of the child. To be effective, the child restraint must be attached to the vehicle, either by the seatbelt or by a specific attachment system.
Seatbelts and child restraint systems remain among the most effective means of protection in road accidents, for both drivers and passengers. 
Five reasons to use seatbelts:
- Reduce the risk of colliding with the vehicle's interior or reduce the severity of injuries if it happens.
- Ensure that, if any accident occurs, the most resistant parts of the body will absorb its force.
- Ensure that the occupant is not ejected from the vehicle on impact.
- Prevent occupants from hurting each other (unbelted occupants can become projectiles that can hit other occupants).
How to use a seatbelt correctly:
- It should pass over the shoulder and chest, with minimal slack.
- The lower part should pass over the pelvic bones.
- The headrest should be at the same height as the top of the head.
Incorrect use of seatbelts and child restraint systems can reduce or even eliminate the safety effect. Child restraint systems are often used incorrectly, whether for comfort reasons or difficulties understanding how to install them in the car and/or the child in them. Sometimes, the system is not adapted to the child's height or weight.
The effectiveness of seat belts and child restraint systems in public health has been widely documented. Wearing a seatbelt reduces the risk of death and injury by around 60% for drivers and 44% for rear-seat passengers. Correct use of a child restraint system reduces the risk of being killed or injured by around 55% to 60% compared with children who are not buckled up.
European regulation stipulates that seatbelt use in all vehicles and on all seats and the use of adapted child restraint systems are compulsory in all Member States. A recent European study showed that wearing seatbelts in the front seats of cars was widely adopted in European countries, although there were variations (from 70.6% in Greece to 99.0% in Germany). Wearing seatbelts in the rear was less widespread, ranging from 24.2% in Bulgaria to 96.1% in Germany (Figure 2).
Recent data on child restraint systems highlight major disparities within the EU and indicate that, whether through observational studies or in-car inspections, there is still considerable room for improvement (Figure 3).
Increasing seatbelt and child restraint systems in practice
In 2021, the key role played by seatbelts and restraint systems in ensuring the safety of children in cars was not yet fully recognised by Bulgarian institutions and society. In this context, the ‘Kids on Board’ foundation developed an awareness campaign to promote using these safety devices in cars. The primary target group was parents (of children under the age of 12) or expectant parents. However, the campaign was also aimed at institutions and organisations involved in child safety in vehicles (including professionals such as medical staff, nursery staff, etc.) and the public. The foundation developed several activities, including creating an online platform (www.kidsonboard.bg ) providing accessible, reliable and comprehensive information (articles and videos) on all subjects related to the child's safety in the car, offering one-to-one consultations to help parents choose the most suitable restraint system for their child, and installing and using the system correctly, providing information and answering parents‘ questions about child safety in the car by taking part in Bulgaria's largest online parents’ forum (‘BG-Mamma’), promoting the importance of child safety in vehicles through all the different media, by organising online educational sessions and training courses for parents (including practical training). Training is also offered to companies for their staff.
The foundation's activities help to improve knowledge and change attitudes and behaviour not only among parents but also among families and the community.
Conclusion
Protective equipment use still has considerable growth potential, and we are very pleased to focus our attention on this in the coming months here at the European Road Safety Charter. Our up-and-coming webinar will be an opportunity to bring together experts to report on the situation in European countries, and also to talk about good practices or success stories that have been found to have a positive impact on the use of protective equipment. Book your place here - https://road-safety-charter.ec.europa.eu/content/european-road-safety-c…
We strongly encourage all our members to take action to promote the use of protective equipment, to share their experience and to submit their best practices.
References
1. European Commission (2024). Road safety thematic report – Road safety protective equipment. European Road Safety Observatory. Brussels, European Commission, Directorate General for Transport.
2. Høye, A., & Elvik, R. (2013). Seat belts, belt reminders and belt locks in light vehicles. In The Handbook of Road Safety Measures, Norwegian (online) version.
3. Høye, A. (2016). How would increasing seat belt use affect the number of killed or seriously injured light vehicle occupants? Accident Analysis and Prevention, 88, 175–186. https://doi.org/10.1016/j.aap.2015.12.022
4. Høye, A. (2018). Bicycle helmets – To wear or not to wear? A meta-analyses of the effects of bicycle helmets on injuries. Accident Analysis & Prevention, 117, 85–97. doi.org/10.1016/j.aap.2018.03.026.
5. Hoye A. Recommend or mandate? A systematic review and meta-analysis of the effects of mandatory bicycle helmet legislation. Accid Anal Prev. 2018 Nov;120:239-249. doi: 10.1016/j.aap.2018.08.001.
6. Liu, B. C., Ivers, R., Norton, R., Boufous, S., Blows, S., & Lo, S. K. (2008). Helmets for preventing injury in motorcycle riders. Cochrane database of systematic reviews, 1. doi:https://doi.org/10.1002/14651858.CD004333.PUB3
7. Olsson B. Increased bicycle helmet use in the absence of mandatory bicycle helmet legislation: Prevalence and trends from longitudinal observational studies on the use of bicycle helmets among cyclists in Denmark 2004-2022. J Safety Res. 2023 Dec;87:54-63. doi: 10.1016/j.jsr.2023.09.003.
8. Van den Broek B., Aarts, L. & Silverans, P. (2022). Baseline report on the KPI Safety belt and Child restraint systems. Baseline project, Brussels: Vias institute”
9. WHO (2023). Global status report on road safety 2023. Geneva: World Health Organization. Licence: CC BY-NC-SA 3.0 IGO..
10. Yannis, G., Folla K. (2022). Baseline report on the KPI Helmet use among Cyclists and Powered two wheelers (PTWs). Baseline project, Brussels: Vias institute
