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Policies and campaigns that promote helmet use should decrease cycling deaths for people of all ages, a doctor says. (Adrian Wyld/Canadian Press)

Cyclists who died of a head injury were three times as likely to not be wearing a helmet compared with those who died of other injuries, according to a review of data from Ontario's chief coroner.

Wearing a bike helmet is associated with preventing nonfatal head injuries. To find out more about fatal head injuries, researchers compared cycling deaths from head injuries to deaths from other injuries.

"While legislating helmet use is controversial and inconsistent in Canada, our study shows that wearing helmets saves lives," said the study's lead author, Dr. Navindra Persaud of the family and community medicine department at St. Michael's Hospital in Toronto. 

"Policies and campaigns that promote helmet use should decrease cycling deaths for people of all ages," he added in a release.

For the study, researchers reviewed data from coroner and police reports as well as accident reconstructions for 129 cycling deaths in the province between 2006 and 2010.

Not wearing a helmet while riding was associated with 3.1 times higher risk of dying from a head injury, the researchers said in Monday's issue of the Canadian Medical Association Journal.

The relationship was the same when those under the age of 18 were excluded.

Cyclist ages ranged from 10 to 83 years and 86 per cent were boys or men.

The study's authors said their analysis assumed that the investigators reported helmet use similarly regardless of the cause of death.

It's also possible that helmets weren’t working properly or were worn improperly at the time of the collision.

To support their call to enact legislation to promote helmet use, the researchers gave the example of Victoria, Australia.

Helmet use in the city increased from 31 per cent to 75 per cent and cycling fatalities decreased by 48 per cent after the introduction of mandatory helmet laws, despite an increase in cycling among adults, they said.