A 12-year study (1999 to 2010) analyzed fatality reductions in bicycle-car collisions to determine the effect of mandatory helmet laws. 16 states had bike helmet laws in the beginning or the study. The researchers identified all relevant fatalities, totaling 1612, in states with and without bike helmet laws.
Relevance was determined by adjusting for factors previously associated with rates of motor vehicle fatalities (elderly driver licensure laws, legal blood alcohol limit and household income) and, among those, they found that the adjusted fatality rate was significantly lower in states with helmet laws. On average, 900 people die annually in bicycle-motor vehicle collisions — three quarters of those are from head injuries.