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Ditching bike helmets laws better for health

With epidemics of diabetes and obesity threatening to bankrupt state health budgets, governments need to broaden their strategies to encourage physical activity. Allowing cyclists to ride without a helmet…

The life expectancy gained from cycling to work outweighs the risks of ill health from pollution and injury.

With epidemics of diabetes and obesity threatening to bankrupt state health budgets, governments need to broaden their strategies to encourage physical activity.

Allowing cyclists to ride without a helmet would remove one common barrier to cycling and encourage more Australians to get on a bike. Even if there is a small risk involved.

The story of mandatory bicycle helmet legislation in Australia really starts in the 1970s. After WWII the urban transport landscape was overrun by private motor vehicles and by the 1970s road trauma was at an all-time high.

Through the 1980s a range of road safety measures were introduced in Australia and other developing countries. Lower speed limits, traffic calming, random breath testing and substantial road safety media campaigns led to significant reductions in injury rates for all road users, including cyclists.

In those glory days of road safety, attention was then turned to cyclists. Motorcyclists had already faced legislation requiring them to wear helmets, with some success in reducing head injuries, so there is an understandable logic that cyclists might benefit from helmets too.

In 1991 Australia introduced mandatory bicycle helmet laws requiring all adults and children to wear a helmet at all times when riding a bike, despite opposition from cycling groups.

The legislation increased helmet use - from about 30 to 80% - but was coupled with a 30 to 40% decline in the number of people cycling.

Rates of head injuries among cyclists, which had been dropping through the 1980s, continued to fall before levelling out in 1993. We didn’t see the kind of marked reduction in head injury rates that would be expected with the rapid increase in helmet use. In fact, any reductions in injuries may simply have been the result of having fewer cyclists on the road and therefore fewer people exposed to the risk of head injuries.

One researcher noted that after mandatory helmet laws were introduced there was a bigger decrease in head injuries among pedestrians than there was among cyclists. The improvements in the general road safety environment introduced in the 1980s are likely to have contributed far more to cyclist safety than helmet legislation.

This poses a puzzle – if bicycle helmets protect the head from injury, surely if all cyclists wore one there would be fewer head injuries?

Helmet design standards ensure that helmets sold in Australia are able to absorb the impact of a blow equivalent to a direct impact at about 19.5km/hour. Commuter cyclists typically average 20-25km/hour, with sports cyclists often averaging over 30km/hour.

To be effective helmets can’t be too old (they become brittle and cracked), and need to fit correctly and be worn properly. This can be a problem for infrequent riders. There is also a serious likelihood that modern (soft shell) helmets have actually increased the risk of some types of brain injury (for example diffuse axonal injury), with standards only changing in 2010 to try to take this problem into account.

One early helmet study in the late 1980s reported that helmets reduced the risk of head injury by a whopping 85%. Despite criticism of the methodology at the time, this figure has been frequently repeated by road safety authorities.

But a recent re-analysis of all the major studies examining the efficacy of helmets found a substantial publication bias in previous assessments. Most helmets reduced the risk of head injury by up to 15%, if worn properly.

So helmets offer a little protection, but the road environment is far more important.

The biggest pitfall of helmet legislation is that it discourages people from cycling.

In safety terms there is a phenomenon called safety in numbers. As more people cycle, our roads become safer for these cyclists. Drivers become used to seeing cyclists and adjust their behaviour, and infrastructure tends to be improved to better cater for cycling. Even if cyclist wear helmets they are less safe with fewer cyclists on the road than they would be with more cyclists about.

Helmets are a barrier to new riders, particularly for occasional and non-regular riders. The need to wear a helmet reinforces the message that cycling is dangerous - with perceptions of danger a major reason people give for not cycling.

All levels of Australian governments now have policies or plans to increase the population levels of cycling. The benefits are clear: increased levels of physical activity, less air pollution and reduced congestion.

The health benefits of physical activity are particularly important. A large study in Denmark found that commuter cycling for just three hours a week led to 39% fewer deaths (from any cause, including heart disease) compared with non cyclists, taking into account other leisure time physical activities and other explanatory factors.

A recent analysis compared the risks and benefits of leaving the car at home and commuting by bike. It found the life expectancy gained from physical activity was much higher than the risks of pollution and injury from cycling.

Increased physical activity added 3 to 14 months to a person’s life expectancy, while the life expectancy lost from air pollution was 0.8 to 40 days. Increased traffic accidents wiped 5-9 days off the life expectancy.

It is clear that the benefits of cycling outweigh the risks, with helmet legislation actually costing society more from lost health gains than saved from injury prevention. With Australia and New Zealand the only countries with mandatory helmet laws for cyclists, we have a lot to learn from our international cousins.

Background

The legislation increased helmet use – from about 30 to 80% – but was coupled with a 30 to 40% decline in the number of people cycling:

Gillham C. Bike numbers in Western Australia: government surveys.

Smith NC and Milthorpe FW. An Observational Survey of Law Compliance and Helmet Wearing by Bicyclists in New South Wales – 1993, Sydney: NSW Roads and Traffic Authority; 1993. (not available on-line, but many on-line references to it)

Finch CF, Heiman L, Neiger D. Bicycle use and helmet wearing rates in Melbourne, 1987 to 1992: the influence of the helmet wearing law. Melbourne: Monash University Accident Research Centre; 1993.

Finch CF, Newstead SV, Cameron MH, Vulcan AP. Head injury reductions in Victoria two years after introduction of mandatory bicycle helmet use. Melbourne: Monash University Accident Research Centre; 1993.

The same thing happened in New Zealand when helmet legislation was introduced there:

Land Transport New Zealand. Sustainable and safe land transport – trends and indicators.

Rates of head injuries among cyclists, which had been dropping through the 1980s, continued to fall before levelling out in 1993:

Hendrie D, Legge M, Rosman D, Kirov C. An economic evaluation of the mandatory bicycle helmet legislation in Western Australia. Road Accident Prevention Research Unit, 1999.

Finch CF, Newstead SV, Cameron MH, Vulcan AP. Head injury reductions in Victoria two years after introduction of mandatory bicycle helmet use. Monash University Accident Research Centre. Report No. 53, 1993 p10

Mortality rates parallel that of head injuries:

Australian Transport Safety Bureau. Monograph 17 Cycle Safety. 2004.

It is very important to note that the statement in this document “An ATSB study which reviewed numerous epidemiological studies published during the period 1987 to 1998, found ‘overwhelming evidence in support of helmets for preventing head injury and fatal injury.’ refers to a study now discredited for publication bias in a recent re-analysis.

Elvik R. Publication bias and time-trend bias in meta-analysis of bicycle helmet efficacy: A re-analysis of Attewell, Glase and McFadden, 2001. Accident Analysis and Prevention 2011;43(3):1245-51.

There is no question that cycling has many health benefits:

The classic Danish study that found commuter cycling for just three hours a week led to 39% fewer deaths: Andersen LB, Schnohr P, Schroll M, Hein HO. All-cause mortality associated with physical activity during leisure time, work, sports and cycling to work. Archives of Internal Medicine 2000,160:1621-1628.

It is clear that the benefits of cycling outweigh the risks:

de Hartog, J. J., Boogaard, H., Nijland, H., and Hoek, G. Do the Health Benefits of Cycling Outweigh the Risks? Environmental Health Perspectives 2010: 118: 1109-1116.

Helmet legislation actually costs society more from lost health gains than saved from injury prevention:

De Jong P. The health impact of mandatory bicycle helmet laws. (February 24, 2010).

Join the conversation

67 Comments sorted by

  1. Mat Holroyd

    logged in via Twitter

    As a bike rider in Melbourne, who has also lived in China and Germany, I can certain testify to what Chris Rissel is saying- it certainly feels safer riding when there are more bikes on the road.

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  2. Darren Christensen

    logged in via Facebook

    I'm not sure the benefits are clear, and the costs of not wearing a safety helmet can be life ending or extremely tragic. It will be hard to persuade a government to compromise public safety when the same health gains you speak of can be achieved through less riskier means (e.g. like banning smoking in public places).

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  3. Mishy Lane

    logged in via Twitter

    I recently had an accident with my front wheel getting stuck in a slippery tram track. My head hit the ground and my helmet probably saved me from a very bad injury. I think safety is really important and I would wear a helmet if it was the law or not.

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  4. Bob Constable

    logged in via Facebook

    I think the large study in Denmark that found that commuter cycling for just three hours a week led to 39% fewer deaths is as suspect as the 1980s report that helmets reduced the risk of head injury by a whopping 85%, for exactly yhe same reason.
    The Denmark study was undertaken by those advocating cycling. They were biased.
    To qualify the Denmark findings by "taking into account other leisure time physical activities and other explanatory factors." surely shows the bias.

    I think maybe not wearing a helmet would be a little like not wearing a seatbelt because if the car caught fire you want to get out quicker.

    I am biased because I was mandated to wear a helmet against my will and subsequently had a cycling accident which if not for my helmet would probably lead to very serious head injury

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  5. Josh Bassett

    logged in via Twitter

    The law has nothing to do with why I choose to wear a helmet while I commute to/from work every day in Melbourne. I used to feel indifferently but that all changed after I was car doored while riding home one evening. I was knocked unconscious after I supermanned into the back of another car.

    There's no doubt that my helmet saved me from much more serious head injuries that day and I hope other people don't have to learn that lesson the hard way.

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  6. Paul Schofield

    logged in via Facebook

    This is one of the more vague articles on this topic written recently. I don't consider a 15% reduction in head injury risk to be "little protection". And there is no mention in the reduction of severity of head injury. Having quoted "recent re-analysis" of some factors, there should also be a recent analysis of evidence supporting cycling participation being reduced by helmet laws, the quoted evidence is almost 20 years old, surely there should be investigation into whether helmets are an accepted part of cycling now, like seatbelts in cars or helmets on Motorcycles.
    to quote the metal cowboy "if you don't think your're head's worth spending $50 to save, neither do I"

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    1. Luke Turner

      logged in via Facebook

      In reply to Paul Schofield

      Personally I don't consider a 15% improvement in safety to be particularly significant. I think of it in the context of the absolute level of risk. For example, if you go for a short ride, your chance of getting killed or a severe injury is pretty low, probably somewhere around 1 in 5 million. So if you wear a helmet you improve your odds to 1 in 5.75 million. When you look at it like this, is the improvement worth the inconvenience of wearing a helmet if you don't want to? It isn't to me, but you may be a very risk averse or cautious person, so each to their own. For me the probability in either case is so remote, it's hardly worth worrying about. Add to this that there are other things you can do to improve you safety on a bike that dwarf the safety improvement that helmets provide (like riding on quieter roads or bike paths, observing all road rules, being alert while riding) I believe that wearing a helmet should be a matter of choice.

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  7. Dave Kinkead

    logged in via Facebook

    Studies for both sides of the argument are lacking because they are observational and don't measure exposure when determining risk.

    That said, the claim that helmet laws make cycling safer just don't correspond with reality. The safest places in the world to cycle (eg most euro cities) have very low rates of helmet usage. Clearly, other factors have a much bigger influence on cycling safety than helmets.

    As an example riding in Copenhagen (low helmet usage) is almost 20 times safer than than in NSW ( high helmet usage)

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  8. Dean Harris

    logged in via Twitter

    I'm a fan of rolling back the mandatory helmet laws for a number of reasons. But, as Paul Schofield mentions, this is a rather vague article, with no links to any of the research used to support the points made, which hurts the credibility.

    This is a divisive issue, with a lot of anecdotal evidence supplied by both sides as "indisputable proof-positive" that their side is in the right. Anecdotal evidence is fantastic if you want to provoke an emotional reaction, but doesn't actually prove any points.

    Clearly, though, the safety of cyclists is a more nuanced issue, as is evidenced by the lower head injury rates in places with low helmet usage.

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    1. Jason Kerr

      logged in via Facebook

      In reply to Dean Harris

      There's some good strong arguments in this article for winding-back the mandatory helmet laws.

      Brisbane (like other cities in Australia) has had a 'city cycle' scheme for a number of months now. Rows and rows of bikes ready for tourists and infrequent cyclists to set-off on an adventure of discovery.

      Sadly you need a helmet to ride one. The tourists I saw at lunchtime today sunbathing in the botanic gardens in their bikinis - didn't seem the type to pack a cycle hemet in their backpack.

      Councils should start with an exemption from helmets in certain circumstances (such as for city cycles and off-road bikeways).

      That could make a good trial. A good piece of research as well. Oh to see a piece of nanny-state over-regulation rescinded - now that would be, as the article suggests, a victory for common sense.

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    2. Dean Harris

      logged in via Twitter

      In reply to Jason Kerr

      Oh, I agree that there are some strong arguments, but without supplying evidence, they are little more than conjecture. My reference to anecdotal evidence was not aimed at this article, but rather at other examples I have seen, including in this very comments thread.

      And as a current Brisbane resident (newly transported back from Melbourne) I have seen both city cycle schemes struggle due to helmet laws. In fact, since returning to Brisbane, I'm yet to see a single city cycle bike in use.

      And I agree that exempting these schemes from helmet laws would be a great experiment, but would also be specific to the major cities, where dedicated cycling infrastructure exists, and mitigates to some extent the "dangers" of riding in traffic.

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    3. Barry Calderbank

      logged in via Facebook

      In reply to Jason Kerr

      I was fortunate enough to spend some time in Paris earlier this year. Their are bikes galore that you can simply take from one of the many bike stations and ride to wherever you want to go and leave the bike at the nearest bike station. A brilliant scheme and very well patronised. I can't see how the scheme would work if they had compulsory helmets over there. I doubt many would enthuse about using a helmet that the "general public" has used. And it's impractical for men and women in their smart city clothes to carry their own helmet around with them.

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  9. brightcarvings

    logged in via Twitter

    One thing I never see covered properly in articles like this is the impact of driver attitude in this debate. There's a brief mention of safety in numbers, but nowhere is it mentioned just how incredibly *aggressive* many Australian drivers are towards bikes (especially Sydney). I've ridden in many cities around the world and have felt safe in a lot of them without a helmet but I wouldn't spend 5 minutes on a Sydney city street without one.

    Trying to extrapolate data gained from rider-conscious European cities into highly aggressive environment like Sydney I think is a poor treatment of the subject.

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  10. Liv Morgenstern

    logged in via Facebook

    i am in australia for almost 1 1/2 by now. before i lived in europe all my life.
    when i moved to australia I also shipped over my bike. which I do not wanted to use in the first year at all. why? australian street especially car drivers are horrible. i really rare occasions i came across a car driver who was paying attention to cyclists. no shoulder view, no security distance when they over take, bike lanes are a nice way of taking over the slow car in front of them, opening doors without checking…

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    1. Liv Morgenstern

      logged in via Facebook

      In reply to Liv Morgenstern

      And sorry for all my spelling mistakes. I should have checked them, but this topic is driving me crazy.

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    2. Suzanne Gatz

      logged in via Facebook

      In reply to Liv Morgenstern

      Thanks Liv - not to worry about your spelling - your reply holds many, many good points that the licensing system could take on board; like including safe driving around cyclists as part of driver testing. I learned to drive in the USA and shoulder check was very important. I agree that is seems non-existant here. I'm not sure why. You also raise a good point about driver's training. In the USA it is part of the secondary school curriculum. There is a Driver's Education teacher (I never knew where they find them!). Thanks for providing another perspective.

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  11. Peter Willis

    logged in via Facebook

    How is this even a law? Shouldn't we have the right to decide for ourselves whether to wear a bike helmet or not?

    Yes, it's more dangerous to not wear a helmet, but that's the risk we take and that decision should be ours.

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    1. Suzanne Gatz

      logged in via Facebook

      In reply to Peter Willis

      Hi Peter, I think that because the government, through TAC, provide for our care if we are injured, so they exercise the right to put some restrictions on our "freedom." In the USA you don't have to wear a helmet on a motorcycle or push bike, but if you are injured you are on your own. There is no support from the TAC as there is here. Possibly that is why?

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  12. Chris Lloyd

    logged in via Facebook

    Facinating article Chris. Would you have a link to teh Denmark study?

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  13. Sven Feldmann

    logged in via Facebook

    Several of the commentators remark that wearing a helmet increases a rider's safety. Many of us may even know people whose life was saved (or could have been saved) by wearing a helmet.
    These observations, while true, don't address the problem of mandatory helmet laws as raised in the article. Citizens and researchers who object to mandatory helmet laws generally don't object to cyclists *wearing* a helmet. They object to the *requirement* of wearing a helmet. If, as the article suggests, this…

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  14. Kathy Mellett

    logged in via Facebook

    I am a physiotherapist having previously worked in head injury departments of major rehabilitation hospitals. I am also a casual bike rider who enjoys exercise. I must note that I have not completed any research into this topic however I would like to comment on some questions I have. From my experience bike helmets may not decrease the incidence of head injuries but they most certainly can decrease the severity of a injury and subsequent cost to society and the individual. Any study looking at…

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  15. Crido

    logged in via Twitter

    Love the copy. Pity we cant have this sort of debate (comments included) at a local and state government level.

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  16. Mike Rubbo

    logged in via Facebook

    I became aware of the issue due to Sue Abbott's fight in court for the right not to wear a helmet, and ended up making two films about her. That was about two years ago. Since then, I've come to think choice is important because helmet freedom usually goes with a cluster of other good things. The most important is that in enables bike share.

    And even though the MBS (Melb Bike Share) people twist and turn , searching for ways to make helmetseasily available, vending machines in a couple of…

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    1. Suzanne Gatz

      logged in via Facebook

      In reply to Mike Rubbo

      If a helmet were provided with the bike share, are we assuming that they would disappear? Who wants a MBS bike helmet? Probably MBS bike riders. Could a helmet not be locked onto the bike? We trust them with the bike but not the helmet? I don't get it.

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  17. Gary MacDonald

    logged in via Facebook

    I know from personal experience that helmet laws put people off cycling. I gave up for 9 yrs because of the law until I gained 10 kgs of fat. I have been cycle commuting for the past year & am in the best shape of my life. The Hillman report for the British Medical Association, compared the exercise benefit of cycling to accident risks. The report concluded “ ... even in the current hostile traffic environment, the benefits gained from regular cycling outweigh the loss of life years in cycling fatalities by a factor of around 20 to 1.” Why do people find this so difficult to accept? Smoking, obesity & motor vehicle incidents kill 1,000's every year & yet this law targets those who are making a healthy & green choice. People should have the right to choose.

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  18. David McDonald

    logged in via Twitter

    At the 2010 annual conference of the Public Health Assoc of Aust Lynda Norton and colleagues from the Research Centre for Injury Studies presented a paper on trends in cycling injuries. They pointed out that the incidence of such injuries has increased markedly over the last decade, and will probably continue to increase if health authorities are successful in getting more people onto bikes.

    The increase in cycle-related injury hospitalisation has been especially seen in cyclists aged 45-64 years, they reported.

    Perhaps a public policy conclusion from that study is that, if the incidence continues to increase, the gains from exercise on bike will be heavily off-set by the losses from injuries.

    Perhaps the helmets issue should be seen in this broader public health/injury control context?

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  19. Alan Todd

    logged in via Facebook

    Nice article, giving a fair overview of the issue to date. People are often surprised when I express opposition to compulsory helmets, as they have perhaps unconsiously taken on board twenty years of official propaganda, normalising cycling as a somehow risky activity requiring body armour. I have, in part to stimulate thought and discussion, developed a set of ten questions which I put to those in favour of compelling cyclists to wear helmets. I will put them up for this discussion:
    1 Why are…

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  20. Greg d'Arville

    logged in via Twitter

    Speaking as a pedestrian, I note that as well as increasing the number of cyclists the absence of helmet laws tends to promote a more relaxed and healthy attitude among the cyclists themselves. I'm sure Melbourne cyclists have many reasons (some of them rational) for their flagrant disregard of all laws except the helmet law and their attitude of entitlement when powering with ringing bell through a clump of pedestrians on a shared pathway. But their Copenhagen counterparts show, and therefore receive, much more respect.

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  21. Bill Nelson

    logged in via Twitter

    I think you've er, hit the nail on the head. But only about improving saftey though numbers. More cyclists on the road, means more awareness from drivers and this makes everyone safer. However, removing helmet safety laws is only one, and it seems a bad, way to go about this. Why not have driver education programs, brightly painted cycles lanes, that are actually built for that purpose rather than a bit of paint slapped on some crumbly tarmac on the side. There are multiple other ways to promote cycling, encouraging cyclists to ride around with their thin little skulls in the wind seems like a last resort.

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  22. Reinhard Dekter

    logged in via Facebook

    Quite apart from the benefits to cyclist safety by increasing road user awareness and increasing the number of cyclists, and the benefits to public health and the environment, there is substantial evidence that protective equipment causes people to to behave more recklessly. As a case in point, the NY Times recently reported on the resistance of women's lacrosse in adopting more safety gear. Read about it here: http://www.nytimes.com/2011/02/17/sports/17lacrosse.html?_r=1

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  23. Mal Booth

    University Librarian

    Sorry, but my life or my neck has been twice saved by an approved helmet. Once on the road and once on a dedicated bike path in Canberra. On both occasions I was not at fault, but had no time to react and landed on my head. I see bike helmets as being much the same as seat belts in cars. Even a low impact crash from a bike can do major damage to a head. I think there needs to be some public encouragement to wear helmets and as the law has been around for so long now in Australia I don't think it is the barrier to cycling that you imply here. Maybe people just use it as a convenient excuse?

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  24. Michael McGrath

    logged in via Facebook

    Thanks Chris for a fair and balanced article. Like many of the others leaving comments, I too lived overseas and rode a bicycle almost exclusively since my childhood, until I came to Australia in the 1980s and discovered true car supremacy. I didn't stop riding altogether, but certainly don't ride everywhere for every purpose as I once did. It just isn't feasible for so many reasons, mostly lack of safe routes, secure bike parking or end of trip facilities.
    I have no qualms wearing a helmet, however, but feel this should be a personal choice, encouraged by evidence-based education.
    As in so many things, it is the hypocrisy of mandatory laws for some, but not others that sticks in the throat. Why are cyclists forced to wear helmets but not skateboarders or rollerbladers? From my own anecdotal evidence skateboarders suffer a very high rate of head injury, but I've not once heard anyone suggest that helmets be made mandatory skating, even on ramps.

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  25. Michael Block

    logged in via Facebook

    A 15% reduction in head injuries is both a worthwhile public and personal health measure. If the author feels that helmet use is a barrier to cycling then perhaps we need more research into what else can help to remove that barrier. There certainly is safety in riding in numbers although this introduces risks of it's own with a variety of skill levels amongst riders.

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  26. Hal Rikard-Bell

    logged in via Facebook

    Horses for courses? I wouldnt dream of going out for a group ride without my helmet on but I'd love to be able to just pop down the street without it. I live in Bathurst and we've been consulting with the council about improving cycling facilities and encouraging more people to commute by bike. There has been a noticeable jump in the number of people commuting this year, some wiwthout helmets I notice so good on them.
    The group that is missing though is the university students from CSU - almost none of them cycle - they are a very big and fast! presence on our streets in their cars. I suspect that they wouldnt be seen dead in anything quite so uncool as a bicycle helmet.
    My suggestion is that, if we want to do a trial of non compulsory helmets in certain places, we allow those university students to cycle around the university without helmets and also along the cycleway into town. If we could get that group onto their bikes that would be a great thing for all of us.

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    1. Chris Rissel

      Professor of Public Health at University of Sydney

      In reply to Hal Rikard-Bell

      A number of comments have asked for more information to support the points made in the article. There is plenty! Here are some documents and web-sites that underpin this story.

      http://www.cycle-helmets.com/
      http://www.cyclehelmets.org/
      http://freedomcyclist.blogspot.com/

      The legislation increased helmet use – from about 30 to 80% – but was coupled with a 30 to 40% decline in the number of people cycling.

      Gillham C. Bike numbers in Western Australia: government surveys.
      http://www.cycle-helmets.com/bicycle_numbers.html

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  27. Simon Batterbury

    Associate Professor at University of Melbourne

    Excellent summary of the issues, Chris. Like some of the readers I was stunned when I moved to Australia, got cautioned, and had to wear a lid even in the most ridiculous places - on riverside paths for example. That is after 40 years of no accidents in Europe, Africa, and USA.
    The policymakers who instituted compulsory helmets were working in a different environment, had inadequate cycling knowledge, and their ideas are now terribly out of date (look at the apathetic uptake of compulsory helmet…

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  28. Richard Burton

    logged in via Facebook

    Pretty good article Chris, and the fact that helmet laws have failed to provide any benefit would now appear to be conclusively proved, but this doesn't appear to stop the helmet proponents, or to convince politicians to withdraw a useless law.

    Here in the UK, we have suffered a twenty year long propaganda campaign aimed at making helmets compulsory, and merely pointing out that the helmet laws haven't reduced the risk to cyclists anywhere doesn't stop some of our politicians demanding a law…

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  29. Fron Jackson-Webb

    Section Editor at The Conversation

    Thanks for your comments - you've raised some interesting points (and some scary cycling anecdotes!). Chris has provided some extra background info and sources. I’ve added these references as hyperlinks at the end of the article.

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  30. jedro74

    logged in via Twitter

    The helmet 'barrier' is a convenient excuse from people who are too lazy to ride.

    Sure, you can poke holes in some of the studies supporting the efficacy of helmets, but it swings both ways. The science downplaying the efficacy of helmets is hardly squeaky clean - http://blogs.crikey.com.au/croakey/2010/12/08/cycling-helmet-laws-what-does-the-evidence-really-say/

    I find the following article to be a more balanced discussion of the issue:

    http://www.theage.com.au/sport/cycling/blogs/cycling-tips/not-another-helmet-debate-20101215-18xa7.html

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  31. Paul Schofield

    logged in via Twitter

    We don't live in Copenhagen. In most cases we have to deal with sharing space with cars or pedestrians, poor road surfaces, inconsiderate drivers, unreastrained dogs, clumps of pedestrians and hills. And all of these can occur on a "short ride to the shops". When all of these causes can be eliminated, the need for helmets to reduce the may effects may decrease.

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    1. Luke Turner

      logged in via Facebook

      In reply to Paul Schofield

      There's really only one way of getting killed or seriously injured on a bike and that's getting hit by a motor vehicle. Dogs and hills? Come on mate, get real. I don't need to wear a helmet most of the time when I ride around my area because there are few cars. Yes a random accident could still happen, but it could happen walking on the street or sitting at a cafe as well. You can't eliminate all risk in life.

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    2. Paul Schofield

      logged in via Twitter

      In reply to Luke Turner

      As I was pointing out, we can't all live in Utopia like you think you do. Around here all of the factors mentioned ARE REAL risks, where serious injuries have occurred. If you seriously injuries are only caused by cars you are fooling yourself and probaly not aware enough of your surroundings. On our local shared path a man died when he left the path to avoid some pedestrians, hit an open drain hole, was thrown from his bike and died a few days later in Hospital. A friend of a work colleague was hospitalised last week when he was hit by an oncoming cyclist, on a path within 2km of his home. I don't see the likelihood of being involved in a similar incident as these as been great, but it's not the same as sitting in a cafe and I am not in control of all the factors involved. And there are always cars around here, and even on a quiet street, the drivers aren't always looking for cyclists.

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    3. Paul Smith

      Australian National University

      In reply to Paul Schofield

      Agreed with Paul Schofield. The likelihood of an accident on a bike is not necessarily dependent on being on a road with motor traffic. A most recent event points this out. A Senior Administrator was riding on an ACT Bike path around one of Canberra's lakes and had a front wheel stick in a poorly maintained bridge, between the wooden planks of the surface. He was pivoted over the front wheel and driven head first into the ground. Without his helmet, we would likely not have survived. These things…

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  32. Ruth Steinbring

    logged in via Facebook

    I lived in Japan and cycled to work every day with no helmet and had no problems. I now live in Canberra and only cycle to work once or twice a week - because I have to wear a helmet and I feel less safe on the road here than I did in Japan. I reckon the cycling 'culture' here needs to change, as a lot of cyclists I see here wear their lycra and seem to be in a race to get to the office, rather than another approach to cycling as being a form of transport with no need to wear lycra or helmets, but just the same clothes I wear to work/

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  33. Anony Mous

    Having lived in London for 15 years and just returned to Sydney, I can see that cycling will be a less enjoyable experience for me. The compulsory helmet laws are a deterrent to cycling - no wonder there is a low cycling rate in this country. Being forced to wear a helmet gives cycling a dangerous image, in addition they are cumbersome and uncomfortable which further turn people off wanting to cycle. Its no coincidence that one of the first things I noticed when back in Australia was the number of…

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  34. Jason Henwood

    logged in via Facebook

    Chris, it seems the most important conclusion that you could make here is that it is difficult to compare arguments of differing types, ie the right to wear whatever one wants to wear (helmet) with medical or cost benefits. It is erroneous to attribute associations of diminished cycle use with the introduction of compulsory helmet use, considering the evidence that you have produced. Equally, reductions in harm (either incidence or more importantly severity of head or neck injury) could easily be attributed to many of the other factors that determine safety on the bicycle. Perhaps one could compare motor vehicle engine size difference between Europe and Australia, and conclude that their is an association between the petrol-fueled motorhead frequency and the dangers of being a cyclist in Australia. Either way, those of us who choose to ride two wheeled transport options and wear helmets seem to be subsidising the health care of others who choose to do neither.

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  35. Michael Leask

    logged in via Facebook

    As an cycling competitor and official with over 25 years experience I would certainly not be going back to no helmet even if the law allowed it.

    In 1991, the man who was to be best man at my wedding (a state champion cyclist) died at 21 years of age from head trauma less than a week after what appeared to be a very minor fall from his bike while not wearing a helmet.

    More recently I fell due to an equipment failure (a product recall later occurred) and even with years of competitive experience I landed quite heavily on my head and shoulder. The helmet performed as it should, compressing the foam to about 1/3 of its original thickness, no doubt saving my skull and brain from significant damage.

    Change the laws if you wish but my family and friends will still be preached the benefits and Darwin's Law will prevail.

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  36. Brian ThatiscalledBrian

    logged in via Facebook

    Thank you for a great article. I have refused to wear a helmet for the last year or so after travelling overseas and realizing that the fear we create with comments like "where's your helmet" are actually stigmatizing bicycles as dangerous to ride. In Germany and Japan, where I hired bicycles, people thought I was very strange to say such a thing. I refuse to wear helmets as I commute to work every day, but I do ride slowly and find the lack of a helmet improves my hearing and vision as I am able to turn my head easier. I appreciate that many people swear by helmets and have a personal story to justify their view, but with respect, this is a far cry from a conclusive scientific study and I think that the helmet laws are unnecessary.

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  37. Hen Ryh

    logged in via Facebook

    What a wonderful idea. No helmets. I am all for this idea and I would like as many (preferably young) people to take it up as possible. This would be a great service for me and others who are in my phase of life (old) as we will be needing as many organ transplants a are available. (I notice that kidneys are in short supply ATM.)

    If the ventilators had a maximum application time of, say, 1 week before thay had to be disconnected, this would solve the current organ shortage and provide a reserve for when mine fail and I need 'a spare part'.

    How about extending the logic to taxing helmet wearing to increase the number of donors and thus reducing the overall costs to the health service?

    [As someone who has 'used' a helmet I JUST DON'T GET IT. What IS the problem with just chucking on a skid-lid? Yes, it's another thing to do, like getting the bike out etc... but argueing that it gets in the way of riding... are you expecting anyone to take that seriously?]

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    1. Stephen Humble

      logged in via Facebook

      In reply to Hen Ryh

      Where will this one size fits everyone perfectly helmet magically appear from may i ask ? imagine you want to use a hire bike ?
      What if you already have a hat or turban or a hair style other than shaved or crew cut or it's cold and you need to wear a beanie. ?
      What about when your helmet causes you to suffer rotational injury in a fall or collision and makes your injury worse or fatal ?
      Or you collide at faster than the 20Kmph the helmet is tested to - fact is they don't save lives they only good for minor bumps and statistics back that up we are WORSE off than many countries without such counterproductive laws.

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  38. Erik Bower

    logged in via Facebook

    I used to ride a lot before moving from the UK to Sydney.
    I sympathise with all the posters below who said they would wear a helmet regardless. I think we'd have better results if it were made compulsory for all car drivers to ride a bike across town once a year - there might be a bit more awareness then. Obviously that's not going to happen. Having learnt to drive in London, which to be fair has the same
    cyclist vs motorist war as anywhere, I was totally shocked at the sub standard driving ability…

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  39. Bob Constable

    logged in via Facebook

    Would those people that say they want to be able to "pop down the local shops" without a helmet also "jump in the car" for a short trip without a seatbelt ? Doesn't make sense, considering that studies on car accidents show most happen close to home. Can't see why there would be less risk for cyclists.

    Also why do Cyclists say they would wear a helmet in a large group on a long trip, how does that stand up to the "safety in numbers" argument ?

    Not using Helmets with bikeshare is asking for trouble…

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  40. Harvey C

    Cyclist

    I find it rather amusing that many people deride this article as ‘conjecture’ and ‘anecdotes’ when it has so many references. Has anybody bothered to checked them?

    Helmet believers don’t seem to realise that their own side of the argument is the one full of anecdotes and conjecture. The stories “I believe a helmet saved my life” being the classic one. There is no solid data showing that the helmet law has improved safety. This side of the argument is largely based on blind faith in helmets…

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  41. Rolf Schmidt

    Palaeontologist

    You can't compare cycling in Australian cities with cycling in European cities: European city roads are vastly more bike friendly and thus safer to ride without a helmet. Australian roads are a joke; narrow bike lanes that you can park on, so cyclists have to swerve into traffic constantly? Fix that first and then we'll revisit helmet laws.

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    1. Simon Batterbury

      Associate Professor at University of Melbourne

      In reply to Rolf Schmidt

      Sorry, not true. I have spent equal amounts of time in Australia, Europe and the US. The basic roadscape differs little - roads, kerbs, pavements, crossing points, junctions, and only a few dedicated cycle lanes. There is nothing inherently different about Australia that maked it more dangerous to ride a bike. Even the suburban hoons in turbos, and large trucks that are supposedly a great risk, exist equally in Denmark, France (where I am now), the UK etc. In general, I would say cycling in a planned…

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  42. Joel Cass

    logged in via Facebook

    Finally some common sense:
    http://www.heraldsun.com.au/news/breaking-news/helmets-reduce-head-injuries-for-cyclists/story-e6frf7jx-1226080291413

    Even falling off a bike at low speed I was glad to have the helmet on. I fell straight over the bars onto the helmet (a common fall in cycling) at around 20km/h. The helmet was ruined but my head was ok.

    Given that it only takes around 80 Newtons to fracture the skull, a 60kg rider going at 20km/h could experience over 300 newtons of force hitting an inanimate object (F=ma, m=60, a=20,000/(60^2)=5.5 = 333N)

    Worth thinging about.

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    1. Harvey C

      Cyclist

      In reply to Joel Cass

      Common sense is not so common in this emotional topic.

      This article misreports the underlying research by saying that head injuries fell by 29% after the helmet law. The analysis does not claim that head injury fell, only that there was a reduction in the ratio of head to arm injuries. It doesn't mean that there were fewer head injuries, it means that there were fewer head injuries relative to arm injuries.

      The claim that head injuries fell assumes that the risk of accidents did not increase…

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  43. dervelo

    logged in via Twitter

    If you think you need one wear it if not forget it they seem to be of little real value to skilled and experienced cyclists.
    To those down under stand up for your right to choose and don't be told what to do like and follow like sheep.

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    1. jamie wanda

      logged in via Twitter

      In reply to dervelo

      I agree that exempting these schemes from helmet laws would be a great experiment, but would also be specific to the major cities, where dedicated cycling infrastructure exists, and mitigates to some extent the "dangers" of riding in traffic.

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  44. Paul Richards
    Paul Richards is a Friend of The Conversation.

    Current helmet law is a product of an undeveloped human friendly cities. We need to solve the thought process, that protects car or truck drivers interests ahead of the pedestrian and cyclist. When we do this, there will be little need for every cyclist to wear helmets.

    Build cities with pedestrians and cyclists as the priority, retail businesses will thrive, cities will reinvigorate and thrive.

    We have cities like Copenhagen as models for best practice in developing people friendly cities and good cycling culture. We have no excuse not to adapt their model. Even Broadway in New York City has stopped multi lane car traffic, with great results.

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  45. John Harland

    bicycle technician

    The reason for helmet mandation, repeated many times over in this forum, is the risk of being hit or squeezed by cars.

    The logical solution is not to better the outcome of any impact by 15 - 25%, but to reduce the likelihood by a large factor through enforcing proper driver behaviour, including imposing European urban speed limits (commonly 20 km/h in towns)

    Another aspect totally overlooked is the scope of education. I was involved in helmet promotion before mandation. This included authoring…

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    1. Paul Richards
      Paul Richards is a Friend of The Conversation.

      In reply to John Harland

      You are so right John.
      Hopefully we will start to humanise cities and make it safer for us all.
      Then helmet laws will be utterly redundant for commuters, and recreational riders.

      Removing this useless helmet law could be a good start.

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  46. Baljeet Degun

    IT Consultant, Community Activist & Volunteer

    In addition to Chris's studies-based references, there's also a comprehensive & useful set of "Bicycle Helmet Articles" here http://www.copenhagenize.com/2008/03/bicycle-helmet-articles-cykelhjelm.html.

    We should all be familiar with Copenhagenize: arguably the best resource for cycling promotion:

    "Forty years ago Copenhagen was just as car-clogged as anywhere else but now 37% of commuters crossing the city boundary ride bicycles each day. That number rises to 55% in the city proper... Copenhagenizing is possible anywhere."

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  47. Citizen SG

    Citizen

    The concerns i have with this article are that it infers that:

    1. If MHLs were repealed tomorrow substantially more cyclists would cycle sufficently to increase population health

    2. Helmets are a significant deterrent to people cycling at a sufficient amount to improve their health.

    3.The fact that less people cycled subsequent to MHLs being enacted in the 90s does not infer that the same relative number of people will take up cycling now. This is a logical fallacy

    I'm actually fine with adults choosing whether or not to use a helmet, as the reduction in head injury presentations is around 10-20%, but i don't see any evidence that points 1&2 above have been demonstrated by either the author or by any other researcher.

    perhaps the answer to normalising cycling is showers at work, more/better bike lanes, education, role modelling etc.... perhaps helmets have nothing to do with it.

    .

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  48. Linda Ward

    Biostatistician

    Re the claims that Attewell's paper has been discredited due to 'substantial' publication bias, and that helmets reduce the risk of head injury 'by up to 15%' . . .
    According to table 1 in Elvik's re-analysis
    - the odds ratio (OR) for brain injury was 0.42 in Attewell's original study, after adjusting for publication bias it was 0.42 with fixed-effects (FE) model and 0.47 with a random-effects (RE) model, so 68% before adjusting for publication bias versus about 55% after adjustment
    - the OR for…

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