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12 May 2011, 6.58am EST

Don’t be fooled, keeping bike helmets is best for health

Convincing more Australians to get on a bike would undoubtedly deliver health improvements that come with reduced waistlines. But ditching bike helmets isn’t the answer. The health benefits of more cycling would need to be multiplied countless times before they could offset the loss of life and health…

Flickr_tejvanphotos_ — If helmets protect against brain injury, why not wear them?

Convincing more Australians to get on a bike would undoubtedly deliver health improvements that come with reduced waistlines. But ditching bike helmets isn’t the answer.

The health benefits of more cycling would need to be multiplied countless times before they could offset the loss of life and health harms caused by serious head injury.

Benefits of helmets

Bicycle helmets have long been recognised as the best protection against head injury. As far back as 1977, Standards Australia approved a helmet design for cyclists to reduce their risk of head injury.

Throughout the 1980s the Victorian Government promoted cycling and encouraged the use of helmets with a bulk-purchase subsidy scheme, compulsory helmets for the schools Bike Ed program, a television and radio campaign, and a $10 per helmet rebate on purchases each December from 1984 to 1988.

Observational surveys show that the campaigns worked and helmet use grew each year in the 1980s, mostly among primary school children and also in teen and adult commuting cyclist groups.

As helmet use grew, the risk of head injuries reduced. The number of cyclists killed or hospitalised with head injuries reduced by about a third in the 1980s.

The number of other injuries actually increased, though it’s not surprising given there were greater numbers of cyclists on the road.

When the Victorian compulsory helmet laws passed on 1 July 1990, helmet wearing rates more than doubled — from around a third to three quarters — by March 1991. The increase was smaller for primary school children, who were already avid helmet-wearers.

Rates of cyclist head injury fell by 48% and 70% during the first and second years of the law.

It’s been suggested that helmet laws contributed little to the reduced injury rate, and that Victorian cyclists benefited most from road safety improvements, such as random breath testing, speed camera enforcement and supporting mass-media campaigns.

These initiatives may explain some of the reduction in the total number of cyclists killed and hospitalised during the early 1990s.

But the additional reduction in head injuries in the first two years of the law was consistent with the rise of helmet-wearing in those years.

Cyclist rates

So, there’s no doubt that mandatory helmet laws reduced head injury and improved cyclist safety. The problem is that it also reduced rates of cycling in some groups.

Teenage cycling decreased by 43% and 46% in the first and second years of the law. Rates of primary school student cyclists also dropped slightly.

But it wasn’t all bad news.

More adults began cycling after the introduction of mandatory helmet laws. Adult bicycle use increased by 88% from 1987/1988 to 1991, and doubled by 1992.

Overall bicycle use had increased by 9% in 1991 and by a further 3% in 1992.

So focusing on reduced bicycle use by teenagers, and to a lesser extent by younger children, gives a misleading impression of the overall impact of the helmet law on bicycle use.

New generations of cyclists

It’s interesting to speculate on what would happen if helmet laws were repealed.

Because the bicycle-use surveys weren’t repeated throughout the 1990s, we won’t ever know if helmet laws continued to discourage cycling.

If they did, we would have to ask whether repealing the law would increase cycling and bring about sufficient health improvements to offset the increased risk of head injury.

Valuing the benefits of exercise through cycling is outside my area of expertise. And I am yet to see a full analysis of these benefits comparable to an objective analysis of the costs of increased cyclist trauma, especially head injuries.

But failing to prevent serious trauma on our roads isn’t just a transport problem or even a public health issue — it’s both an ethical and economic dilemma.

Investment in preventing a road death is now valued at about $6 million in the National Road Safety Strategy. A serious head injury resulting in permanent brain damage, which a bicycle helmet can often prevent, could cost our health system a lot more.

More than two decades after they came into effect, it is likely that cyclists — and parents of child cyclists — have accepted that helmet wearing is a normal part of cycling.

Only those who are ideologically opposed to their legal obligation to protect themselves would choose not to wear a helmet.

What’s clear is that our community values preventing road deaths and serious injuries much higher than it did in the past.

Ultimately, the health benefits of increased bicycle exercise have a long way to go before they can offset the increased costs of cyclist death and serious head injury.

Chris Rissel from the University of Sydney kicked off The Conversation’s debate about mandatory bike helmet laws in March, when he said ditching helmets would encourage more people to get on a bike and get to fit. Read his article here

Continue the conversation in the comments field below: Should mandatory helmet laws be maintained to protect cyclists against serious head injury?

References:

Cameron, MH, Vulcan, AP, Finch, CF, and Newstead, SV. Mandatory bicycle helmet use following a decade of helmet promotion in Victoria, Australia – An evaluation. Accident Analysis and Prevention, 1994, 26(3), 325-337.

Wood, T, and Milne, P. Head injuries to pedal cyclists and the promotion of helmet use in Victoria, Australia. Accident Analysis and Prevention, 1988, 20(3), 177-185.

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46 Comments sorted by

Werner Hammerstingl

logged in via LinkedIn

I find the use of percentages without a baseline number a significant hindrance to a full evaluation of the arguments. After all a 50% decrease can describe a change from 2 to 1 or 150 to 75....

about 2 years ago report
1. Troy Barry
  
  Postgraduate student
  
  In reply to Werner Hammerstingl
  
  Helmet laws could be relaxed without being entirely rescinded. For example, helmet use could be optional on bike paths and on streets where the traffic speed limit does not exceed the suburban speed limit. Selecting the cut-off point would require a closer look at the statistics and an ideological compromise from both sides of the discussion.
  
  about 2 years ago report
2. Peter Robinson
  
  logged in via email @nex.net.au
  
  In reply to Troy Barry
  
  Troy, this is a good approach and I have written many emails and letters to polititians over this very question. Why are there no common-sense exemptions when there are for every other safety intervention? There is an infuriating vacuum where there should be an answer to this question. They WILL NOT ANSWER this question. Instead we have a situation where one is actually breaking the law if one straddles a bike in any public space without a helmet. This is puerile beyond belief in a purported free country.
  
  about 2 years ago report
3. Dave Kinkead
  
  logged in via Facebook
  
  In reply to Troy Barry
  
  Troy - in the NT, it is legal to ride on a foot/bike path without a helmet. Interestingly, despite having a per capita road toll 3 times higher than the rest of the country, their cycling fatality rates are identical to southern states. The NT has not suffered for relaxing the laws.
  
  All states have some, rather strange exemptions. Often, unicycles aren't defined as bikes and therefore not covered by the laws. Pedicabs are normally exempted (for paying passengers only - it seems that when money changes hands, people become safer. But not the riders, they always have to wear one).
  
  Finally in QLD, you can get an exemption from your GP. As the skin cancer capital of the world, we have around 2000 deaths annually from skin cancer, but less than 40 from cycling. Given that you can't wear a wide brim hat with a helmet, most GPs are willing to write an exemption on these grounds if you ask.
  
  about 2 years ago report
Bob Bobsson

Mr

You make a compelling argument, and are obviously significantly more aware of the studies around this than I. But what about the fact that more people on bikes results in greater awareness of them by motorists? This should result in motorists being more careful around those cyclists than they are now.

If you compare the rates of cycling deaths by the Dutch (who have no mandatory helmet laws and who cycle *much* more frequently) with those of Australians, you'll see that the Dutch cyclists are…
Read more

You make a compelling argument, and are obviously significantly more aware of the studies around this than I. But what about the fact that more people on bikes results in greater awareness of them by motorists? This should result in motorists being more careful around those cyclists than they are now.

If you compare the rates of cycling deaths by the Dutch (who have no mandatory helmet laws and who cycle *much* more frequently) with those of Australians, you'll see that the Dutch cyclists are the safest in the world. Surely this shows us that there is at least some evidential basis to claims that health benefits of more people cycling would be gained by ditching mandatory helmet laws if safety was enforced through other road safety laws?

I haven't been able to find data on injury rates, however, and that may be something of a tipping point. But based solely on deaths, it looks like there are other, better ways of improve cyclist safety *and* get more people improving their health by cycling.

Ref:
http://www.tobysterling.net/2007/12/bike-accident-deaths-in-amsterdam-and.html
http://www.bakfiets-en-meer.nl/2008/10/16/bicycle-death-statistics-in-amsterdam-and-the-netherlands/
http://hembrow.blogspot.com/2011/04/netherlands-traffic-deaths-down-again.html
http://www.infrastructure.gov.au/roads/safety/publications/2006/pdf/death_cyclists_road.pdf

about 2 years ago report
This is a highly recommended comment.

Peter Robinson

logged in via email @nex.net.au

Back in the late '60s the Danish had a high cyclist road toll. Like anywhere in Australia, Copenhagen was car-clogged.
They were loosing 300 cyclists a year.
What they then did brought the toll down to 19 by last year.
It was not helmet law.
They did it with advanced infrustructure and laws that favour cyclists.
A few years ago the issue of helmets came up.
But, citing the "Australian Effect", they voted 90 to 20 not to have a helmet law.
They could see that it had not worked in Australia.
What happened…
Read more

Back in the late '60s the Danish had a high cyclist road toll. Like anywhere in Australia, Copenhagen was car-clogged.
They were loosing 300 cyclists a year.
What they then did brought the toll down to 19 by last year.
It was not helmet law.
They did it with advanced infrustructure and laws that favour cyclists.
A few years ago the issue of helmets came up.
But, citing the "Australian Effect", they voted 90 to 20 not to have a helmet law.
They could see that it had not worked in Australia.
What happened after mandatory helmet law in Australia is that most forms of bicycle use other than purely sport completely died out. What was left was cyclists who only use the bike head down, bum up, to raise a sweat and go fast.
Believing their helmets keep them safe, they behave less safely and have more accidents.
Believing the cyclist is safe with his helmet drivers are more complacent around them and actually drive closer to them.
But most importantly, believing they have done enough for cyclists with a helmet law, governments and other authorities then do nothing else.
We once had a bicycle using culture here where many people used bikes just to get around. We could have had something like Denmark, Amsterdam or Stockholm does now has where ordinary people use bicycles just to go somewhere and at a safe steady pace with a tiny fraction of the accident rate we experience but we chose a paternalistic law that marginalized those that use bicycles and put them back into cars.

about 2 years ago report
This is a highly recommended comment.

Sue Abbott

logged in via email @virtualgypsies.com.au

Your references are archaic, and have been well & truly refuted.

Standards Australia is an agent for SAI-Global, a company in the business of manufacturing and trading in standards. The amended standard, AS/NZ2063 still has not incorporated a test for an oblique impact for various reasons; ethics, lack of equipment, lack of biomechanical knowledge, funding constraints, time constraints.

Given that Australian academics are still squabbling on this issue, it ought to be a matter that is left to the realm of personal choice. The rest of the world (New Zealand being an unfortunate exception) manages very safely without mandatory helmet laws to the point where they have more cyclists sharing the roads with considerably more motorised vehicles than we have here in Australia.

It's time for us to grow up and acknowledge what the world already knows - bicycle helmet laws are dangerous for our health!

about 2 years ago report
1. Linda Ward
  
  Biostatistician
  
  In reply to Sue Abbott
  
  Sue
  Contrary to your claim that Prof Cameron's references have been well and truly refuted, numerous (more recent) studies have shown that helmets substantially reduce the risk of fatal, brain and head injuries . . .
  A 1999 study by Hendrie et al (An economic evaluation of the mandatory bicycle helmet legislation in Western Australia) found that after the helmet law there was
  - a 20% reduction in the ratio of the proportion of cyclists with a serious head injury, compared to the proportion of…
  Read more
  
  Sue
  Contrary to your claim that Prof Cameron's references have been well and truly refuted, numerous (more recent) studies have shown that helmets substantially reduce the risk of fatal, brain and head injuries . . .
  A 1999 study by Hendrie et al (An economic evaluation of the mandatory bicycle helmet legislation in Western Australia) found that after the helmet law there was
  - a 20% reduction in the ratio of the proportion of cyclists with a serious head injury, compared to the proportion of pedestrians with a serious head injury (p<0.001)
  A 2010 study by Dinh et al ("Trends in head injuries and helmet use in cyclists at an inner-city major trauma centre, 1991-2010." Med J Aust 193(10): 619-620) found that wearing a helmet
  - reduced the risk of intracranial bleeding or skull fracture by 81% (p=0.005)
  A 2011 study by Walter et al ("The impact of compulsory cycle helmet legislation on cyclist head injuries in New South Wales, Australia." Accid Anal Prev 43(6): 2064-2071) found that the helmet legislation
  - reduced cyclist head injuries (serious enough to require a hospital admission) by between 25% and 29% (p=0.03)
  A 2011 meta-analysis by Elvik ( "Publication bias and time-trend bias in meta-analysis of bicycle helmet efficacy: a re-analysis of Attewell, Glase and McFadden, 2001." Accid Anal Prev 43(3): 1245-1251.) found that wearing a helmet reduced
  - fatal injuries by 77%
  - brain injuries by more than 60%
  - head injuries by more than 40%
  On what evidence do you base your claim that Prof Cameron's references have been well and truly refuted?
  
  7 months ago report
2. Dorothy L Robinson
  
  logged in via email @gmail.com
  
  In reply to Linda Ward
  
  Linda seems to have confused risk of injury with the odds ratio of head vs other injuries for cyclists who crash.
  
  The distinction is important because the Australian population aged nine years and over grew by 58.4% between 1986 and 2010 but the daily average number of bicycle trips grew by only 20.9%, representing a per capita decline in cycling - http://cyclehelmets.org/1207.html?NKey=95
  
  Census data on cycling to work is also substantially less:
  1986: NSW: 1.09%; Aust: 1.68%.
  2006…
  Read more
  
  Linda seems to have confused risk of injury with the odds ratio of head vs other injuries for cyclists who crash.
  
  The distinction is important because the Australian population aged nine years and over grew by 58.4% between 1986 and 2010 but the daily average number of bicycle trips grew by only 20.9%, representing a per capita decline in cycling - http://cyclehelmets.org/1207.html?NKey=95
  
  Census data on cycling to work is also substantially less:
  1986: NSW: 1.09%; Aust: 1.68%.
  2006: NSW: 0.84%; Aust 1.24%
  
  Despite these apparent decreases, per capita cycling injuries have increased. With more crashes, fewer cyclists and no reduction in total head injuries per capita, the inevitable conclusion is that the risk of head injury has increased.
  
  There are several explanations for the above, including risk compensation and reduced safety in numbers. One peer-reviewed paper showed that cyclists accustomed to wearing helmets cycle faster when they wear helmets. Dr Ian Walker, measured the distance left by overtaking motorists, and found that he was given significantly less room when he wore a helmet. He was hit twice when conducting this research - by a truck and a bus - both times when wearing a helmet http://www.eurekalert.org/pub_releases/2006-09/uob-wah091106.php
  
  Discussion about helmet laws and health must, however, consider the lost health and environmental benefits from reduced cycling because of helmet laws. The NZ cost-benefit analysis found that the reduction in head injuries was somewhere between zero (if trends were fitted in a model) to a maximum of 13 cents per helmet per year.
  
  Yet an economic analysis by PriceWaterhouseCoopers (Evaluation of the costs and benefits to the community of financial investment in cycling programs and projects in New South Wales ) estimated the benefits of cycling at $0.48 per km.
  
  The methodology developed by the World Health Organization (WTO) in its Health Economics Assessment Tool (HEAT) provides an even greater estimate of the health benefits of cycling, worth about $0.6 per km cycled.
  
  So if the head injury reduction is about 13 cents per helmet per year, but WHO estimates the benefits at 60 cents per km cycled, laws that discourage cycling and reducing safety in numbers appear to make no sense whatsoever because they will increase health costs.
  
  On the other hand, one group of Australian researchers concluded that bicycle style helmets would reduce injuries to vehicle occupants: “”The total benefits associated with headwear in the form of a soft shell bicycle helmet were estimated to be $380 million (assuming a fully airbag equipped fleet), or $476 per car ($626 for cars without airbags).” McLean, A., B. Fildes, et al. (1997). Prevention of Head Injuries to Car Occupants An Investigation of Interior Padding Options, Federal Office of Road Safety: Rpt CR160. Available at http://www.monash.edu.au/muarc/reports/atsb160.html.
  
  7 months ago report
3. Sue Abbott
  
  logged in via email @virtualgypsies.com.au
  
  In reply to Linda Ward
  
  How interesting we can both use Rune Elvik's meta-analysis to support our different positions! To me Elvik's paper 'indicated no net protective effect' of bicycle helmets, a position I mentioned in my submissions to the ACCC last year. In fact I recall that Elvik highlighted in his paper at the section headed "5. Discussion" that 'these findings raise a number of issues':
  
  - 'In the first place, why do recent studies show a smaller protective effect of bicycle helmets than older studies…
  Read more
  
  How interesting we can both use Rune Elvik's meta-analysis to support our different positions! To me Elvik's paper 'indicated no net protective effect' of bicycle helmets, a position I mentioned in my submissions to the ACCC last year. In fact I recall that Elvik highlighted in his paper at the section headed "5. Discussion" that 'these findings raise a number of issues':
  
  - 'In the first place, why do recent studies show a smaller protective effect of bicycle helmets than older studies?'
  
  - 'In the second place, should a meta-analysis include all studies or just studies that satisfy certain selection criteria, like those applied in the Cochrane review of bicycle helmets (Thompson et al., 2009)?'
  
  - 'In the third place, why are the findings of some studies that have evaluated the effects of laws mandating the use of bicycle helmets apparently inconsistent with the findings of studies of the protective effect of bicycle helmets of each user?'
  
  Elvik's paper was well worth reading, and I particularly found his conclusion useful:
  
  "Based on the studies reviewed in this paper, the following conclusions can be drawn:"
  
  "1. A re-analysis has been performed of a meta-analysis of the protectiveeffects of bicycle helmets reported in Accident Analysis and Prevention (Attewell etal.,2001). The original analysis was found to be influenced by publication bias and time-trend bias that were not controlled for."
  
  "2. When these sources of bias are controlled for, the protective effects attributed to bicycle helmets become smaller than originally estimated."
  
  "3. When the analysis is updated by adding four new studies, the protective effects attributed to bicycle helmets are further reduced. According to the new studies, no overall effect of bicycle helmets could be found when injuries to head, face or neck are considered as a whole."
  
  "4. The findings of this study are inconsistent with other meta-analyses, in particular a Cochrane review published in 2009. However, the study inclusion criteria applied in the Cochrane review are debatable."
  
  Furthermore, even last year's study from Scott R Walter, Jake Olivier, Tim Churches & Raphael Grzebieta, ‘The impact of compulsory cycle helmet legislation on cyclist head injuries in New South Wales, Australia’ (2011) Accident Analysis and Prevention (Article in Press), 7, supporting helmet legislation admitted that the ‘lack of population level exposure and helmet wearing data for cyclists mean that several assumptions were necessary for an analysis to be possible.' This sounds a little too shaky for me to have confidence in a mandatory law requirement.
  
  The claims of helmet promoters are unsubstantiated and unfounded, and can be said to remain in scientific dispute. Given this state of affairs there should be no mandatory compulsion to wear helmets. Rather it should be a matter where we survey all the existing data collected over the last 21 years and either wear one with our informed consent or not wear one with our informed refusal.
  
  7 months ago report
4. Linda Ward
  
  Biostatistician
  
  In reply to Sue Abbott
  
  You seem to have overlooked the results presented in Elvik's paper with respect to fatal and brain injury, and misinterpreted what Elvik said in the conclusion. The results presented in section 4 of the paper showed that, compared to non-helmeted cyclists, in helmeted cyclists the risk of
  - fatal injury was reduced by 77% (table 1, 6 studies, random-effects model)
  - brain injury was reduced by 53% (table 1, 8 studies, random-effects model)
  - head injury was reduced by 53% in older studies, by…
  Read more
  
  You seem to have overlooked the results presented in Elvik's paper with respect to fatal and brain injury, and misinterpreted what Elvik said in the conclusion. The results presented in section 4 of the paper showed that, compared to non-helmeted cyclists, in helmeted cyclists the risk of
  - fatal injury was reduced by 77% (table 1, 6 studies, random-effects model)
  - brain injury was reduced by 53% (table 1, 8 studies, random-effects model)
  - head injury was reduced by 53% in older studies, by 44% in new studies, 42% across all studies (table 2, 18 studies, random-effects model)
  - head/face/neck injuries combined was reduced by 33% in older studies, there was no effect in new studies, and reduced by 15% across all studies (table 2, random-effects model)
  In the study by Walter et al, helmet wearing increased from about 25% to 80%, and the study found that among cyclists in a crash, the risk of a head injury was reduced by 29%. Applying the change in helmet wearing results in a reduction in the risk of head injury of about 53% among cyclists who crash. This figure is consistent with the reduced risk of head injury reported in Elvik's table 2, indicating that the assumptions used by Walter et al were appropriate.
  Elvik opens the discussion section by saying: 'Do bicycle helmets reduce the risk of injury to the head, face or neck? With respect to head injury, the answer is clearly yes, and the re-analysis of the meta-analysis reported by Attewell et al. (2001) in this paper has not changed this answer.' The results section shows that the reanalysis found that, among cyclists who crash, the risk of a fatal injury was reduced by 77%, the risk of a brain injury was reduced by 53%, and the risk of a head injury was reduced by 42%. The evidence of the protective effect of helmets is far from 'shaky', there is strong evidence that helmets provide considerable protection against fatal, brain and head injuries.
  
  7 months ago report
5. Linda Ward
  
  Biostatistician
  
  In reply to Dorothy L Robinson
  
  Re the claim that the Australian population aged nine years and over grew by 58% between 1986 and 2010 and there was a per capita decline in cycling . . .
  
  58% is considerably more than the 42% I calculated (using ABS population counts):
  - in 1986, the Australian population was 16,018,350 with 2,387,973 aged 0-9 years
  - in 2010, the population was 22,328,847 with 2,826,476 aged 0-9
  - this represents a growth in population between 1986 and 2010 of (19,502,371-13,630,377)/13,630,377=43%
  
  Figures…
  Read more
  
  Re the claim that the Australian population aged nine years and over grew by 58% between 1986 and 2010 and there was a per capita decline in cycling . . .
  
  58% is considerably more than the 42% I calculated (using ABS population counts):
  - in 1986, the Australian population was 16,018,350 with 2,387,973 aged 0-9 years
  - in 2010, the population was 22,328,847 with 2,826,476 aged 0-9
  - this represents a growth in population between 1986 and 2010 of (19,502,371-13,630,377)/13,630,377=43%
  
  Figures in numerous publications indicate that there has been a considerable increase in cycling participation, not a decrease
  - the ABS' Participation in Sport and Physical Recreation reports (http://www.abs.gov.au/AUSSTATS/abs@.nsf/second+level+view?ReadForm&prodno=4177.0&viewtitle=Participation%20in%20Sport%20and%20Physical%20Recreation,%20Australia~2009-10~Latest~21/12/2010&&tabname=Past%20Future%20Issues&prodno=4177.0&issue=2009-10&num=&view=&<http://www.abs.gov.au/AUSSTATS/abs@.nsf/second+level+view?ReadForm&prodno=4177.0&viewtitle=Participation%20in%20Sport%20and%20Physical%20Recreation,%20Australia%7E2009-10%7ELatest%7E21/12/2010&&tabname=Past%20Future%20Issues&prodno=4177.0&issue=2009-10&num=&view=&>;;)
  - the Australian Sport and Recreation Commission's Exercise, Recreation and Sport surveys (http://www.ausport.gov.au/information/casro/ERASS)
  - Cycling Promotion Fund's 2009/10 Annual Report (http://www.cyclingpromotion.com.au/content/view/506/145/)
  - an Australian Cyclist article (http://www.australiancyclist.com.au/article.aspx?aeid=5871)
  - the NSW RTA's Cycling in Sydney: Bicycle Ownership and Use report (http://www.rta.nsw.gov.au/usingroads/downloads/cyclinginsydney_bicycleownershipanduse.pdf)
  Participation rates published in the ABS' Participation in Sport and Physical Recreation reports indicate there was a 38% increase in cycling participation between 1997/8 and 2009/10.
  Participation rates published in the ERASS reports point to a 17% increase in cycling participation between 2001 and 2009.
  According to the CPF 2009/10 Annual report, there was 32% increase in the number of people cycling in Australia between 2000 and 2009/10.
  The Australian Cyclist article stated that
  - the number of adult cyclists increased by 17% between 2001 and 2006
  - cycling trips to work grew at an average of 22% across Australian capital cities, with Melbourne soaring 42% between 2001 and 2006 According to the RTA report, between 2001 and 2005, cycling for
  - transport on weekdays increased by 23%
  - transport on weekends increased by 58%
  - social/recreational reasons on weekends grew by 67%
  
  7 months ago report
6. Linda Ward
  
  Biostatistician
  
  In reply to Dorothy L Robinson
  
  Re your description of the Walker study as showing the author was given 'significantly less room' when wearing a helmet . . .
  For a non-helmeted cyclist, the average overtaking proximity varied from about 1.2m to 1.45m, depending on the cyclist's distance from the road edge. For a helmeted cyclist, the average overtaking proximity was about 5 cm less. Your description of this difference as 'significantly less' appears to be referring to statistical significance. In health research, such a trivial difference (less than 0.5%) would be described as clinically insignificant, ie. the 5cm difference in overtaking proximity (in the context of an average overtaking proximity of about 1.3m) is unlikely to have any effect on the outcome of being hit by a car.
  
  7 months ago report
7. Linda Ward
  
  Biostatistician
  
  In reply to Dorothy L Robinson
  
  Re cycling to work between 1986 and 2006 reducing from 1.1% to 0.8% in NSW, and from 1.7% to 1.2% nationally . . .
  A study by Mees et al (Travel to work in Australian capital cities,1976-2006: An Analysis of Census Data) provides some insight into possible reasons for the decrease in cycling to work. According to the census data presented in Mees' paper
  - in Melbourne, there was no difference in the proportion of people cycling to work in between the censuses immediately before (1986) and after…
  Read more
  
  Re cycling to work between 1986 and 2006 reducing from 1.1% to 0.8% in NSW, and from 1.7% to 1.2% nationally . . .
  A study by Mees et al (Travel to work in Australian capital cities,1976-2006: An Analysis of Census Data) provides some insight into possible reasons for the decrease in cycling to work. According to the census data presented in Mees' paper
  - in Melbourne, there was no difference in the proportion of people cycling to work in between the censuses immediately before (1986) and after (1991) the law (the law came into effect in July 1990, the 1991 census was in August)
  - in Sydney, travel to work by bicycle was 0.7% in the 1986 census, and 0.6% in the 1991 census (the law came into effect for adults in January 1991)
  - in Adelaide, cycling to work had been falling well before the helmet law, from 2.4% in 1981, to 2.2% in 1986, then to 2.0% in 1991 (the law came into effect on 1 July 91)
  - in Perth, cycling to work decreased from 1.6% in 1991 to 1.0% in 1996 (the law came into effect on 1 July 1992)
  - in Canberra, travel to work by bicycle was 2.0% in the (1991) census immediately before the law, and increased to 2.2% in the (1996) census immediately after the law (the law came into effect on 1 July 1992)
  Mees et al noted that Perth's public transport system was significantly upgraded between 1983 and 1993: 'The revitalisation of Perth’s public transport system began in 1983 . . . and continued with the 1987 decision to electrify the three suburban rail lines, and accelerated with the construction of the new northern suburbs railway, which opened with a supporting feeder bus network in 1993.'
  According to the census data in Mees' report, between 1991 and 1996, in Perth
  - travel to work by bicycle dropped by 38% (from 1.6% to 1.0%)
  - travel to work by bus reduced by 41% (from 7.6% to 4.5%)
  - travel to work by train increased by 137% (from 1.9% to 4.5%)
  In describing increases in car travel to work in Adelaide (co-inciding with decreases in cycling to work for several years before the helmet law), Mees et al indicated that 'This poor trend is a result of the reversal of the 1970s Dunstan Government’s transport policies, which favoured public transport and restrained urban road building.'
  Attributing the considerable decrease in the proportion of people cycling to work is a good example of ecological fallacy (case-control studies are not subject to this type of bias).
  An analysis of cyclist counts in NSW before and after the helmet law by Dr Alan Davies (http://blogs.crikey.com.au/theurbanist/2012/04/02/did-mandatory-helmets-kill-cycling-in-nsw/) found that 'there appears to be no correlation between the law and the level of on-road cycling by adults in Sydney, or the level of recreational cycling by children. Moreover, recreational cycling by adults rose sharply in the years following the new law'. This conclusion is consistent with the data presented in the SA study by Marshall and White, showing that there was no reduction in frequency of cycling amongst adults, and that an approximately 40% reduction in cycling to school was replaced by an increase in recreational/other cycling in under 16 year-olds. The study by Finch et al found that, in Melbourne, there was no reduction in cycling among adults after the law, but a reduction of about 40% in cycling among teenagers.
  
  7 months ago report
8. Linda Ward
  
  Biostatistician
  
  In reply to Dorothy L Robinson
  
  Re the NZ cost-benefit analysis found that the reduction in head injuries was somewhere between zero (if trends were fitted in a model) to a maximum of 13 cents per helmet per year . . .
  The 2nd sentence of the 2nd paragraph of the Taylor and Scuffham paper states that the evolution does not include the cost savings in preventing death, and is limited to evaluating costs with respect to hospital admissions averted. (The claim of an 'absence of evidence on the effectiveness of the HWL in preventing…
  Read more
  
  Re the NZ cost-benefit analysis found that the reduction in head injuries was somewhere between zero (if trends were fitted in a model) to a maximum of 13 cents per helmet per year . . .
  The 2nd sentence of the 2nd paragraph of the Taylor and Scuffham paper states that the evolution does not include the cost savings in preventing death, and is limited to evaluating costs with respect to hospital admissions averted. (The claim of an 'absence of evidence on the effectiveness of the HWL in preventing death' is odd, given that the paper was published in 2002, and the 7 fatal injury studies in Attewell's meta-analysis were from between 1989 and 1998.) With respect to fatal and severe head/brain injury
  - the (random-effects) odds ratios reported in Elvik's meta-analysis were
  - 0.23 (95% CI 0.08-0.66) for fatal injury (6 studies)
  - 0.47 (95% CI 0.29-0.75) for brain injury (8 studies)
  - the OR reported by Dinh for severe head injury (AIS>=3) was 1/5.3=0.2 (95% CI 0.1-0.6), the authors noted that the lifetime costs associated with such injuries had been 'estimated to be around $4.8 million per incident case')
  http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6123a1.htm estimates that the costs saved in preventing a fatality is $1,212,800.
  A study by Williams ('Research Note 17/94 - Evaluation of the NSW Introduction of Compulsory Bicycle Helmet Legislation', NSW RTA, 1995, available via http://www.bicycleinfo.nsw.gov.au/tools_and_resources/cycling_research.html) attributed 'a saving of $47,863,820 to the NSW community in reported road serious casualty since the introduction of helmet legislation'.
  The above evidence suggests that the savings associated with the helmet law would be considerably more than 13 cents per helmet per year.
  
  7 months ago report
9. Linda Ward
  
  Biostatistician
  
  In reply to Dorothy L Robinson
  
  Re ' . . . per capita cycling injuries have increased . . . the risk of head injury has increased' . . .
  ABS travel to work data and ATSB road fatality data indicate that, nationally, between 1986-1990 and 1992-1996 there was a (considerable) decrease in cyclist per capita risk (of death), not an increase:
  - cycling to work reduced by 13%
  - cyclist road fatalities reduced by 41% (annual cyclist road fatalities averaged 84 between 1986 and 1990, and 40 between 1992 and 1996, there were 41 fatalities…
  Read more
  
  Re ' . . . per capita cycling injuries have increased . . . the risk of head injury has increased' . . .
  ABS travel to work data and ATSB road fatality data indicate that, nationally, between 1986-1990 and 1992-1996 there was a (considerable) decrease in cyclist per capita risk (of death), not an increase:
  - cycling to work reduced by 13%
  - cyclist road fatalities reduced by 41% (annual cyclist road fatalities averaged 84 between 1986 and 1990, and 40 between 1992 and 1996, there were 41 fatalities in 1992)
  A recent study by Walter et al found that per capita head injuries in NSW have decreased: 'between 1991 and 2010, the NSW population increased by 22%. In that time, arm injuries rose by 145%, yet head injuries rose by just 20% (and in the past decade alone, cycling participants increased by 51%)' (http://www.med.unsw.edu.au/medweb.nsf/page/shownewsstory?OpenDocument&LinkID=920022F16B).
  With a population increase of 22% between 1991 and 2010, even assuming that cycling participants had increased by only 51% (the increase in cycling participants 'in the past the past decade alone'), the head injuries would be expected to increase by 62%. Head injuries only increased by 20%, this suggests a considerable decrease in per capita head injuries (in NSW), not an increase.
  With respect to the 145% increase in arm injuries, data presented in the Carr and Meuleners studies provides a possible explanation as to what at first glance appears to be an increase in per capita risk of injury.
  The data presented in the Meuleners (WA) study shows that in 1992-1996, compared to 1989-1991
  - there was a 5.9% decrease in cycling to work, and a 63% decrease in the number of cyclist road fatalities (during the same period, there was an increase of 5.9% in the WA population and a 19% increase in the number of pedestrian fatalities)
  - the number cyclist hospital admissions where the head was the most severely injured part of the body decreased by 23%
  - the number of cyclist hospital admssions where an upper limb fracture was the most severely injured part of the body increased by 32%
  - the total number of cyclist hospital admissions reduced by 5%
  The data presented in the Carr (Victoria) study showed that
  - the number of AIS severity 3 head injuries decreased from an average of 30 per year in the 3 years before the law, to 13 per year in the 3 years after the law
  - the number of AIS severity 4 head injuries decreased from an average of 42 per year in the 3 years before the law, to 26 per year in the 3 years after the law
  - these reductions in serious and severe head injuries in cyclists was about 3 times the reductions in the corresponding cyclist non-head and pedestrian head injuries
  This suggests 2 mechanisms that may cause the reduction in risk of (serious and severe) head injuries not to be proportional to the reduction in hospital admissions
  - cyclists in crashes that without a helmet would have resulted in head/brain injuries AIS 4 (severe) and AIS 3 (serious), but with a helmet were reduced to AIS 3 or AIS 2 (moderate) would (likely) still require a hospital admission for the head injury
  - cyclists in crashes that without a helmet would have resulted in a head/brain injury severe enough to require a hospital admission (eg. AIS 2 or AIS3), but with a helmet were reduced to AIS1 may have required a hospital admission due the severity of injury to body parts other than the head/brain
  On what evidence do you base your claim/s that capita cycling injuries, and the risk of head injury, have increased?
  
  7 months ago report
10. Colin Clarke
  
  logged in via email @vood.freeserve.co.uk
  
  In reply to Linda Ward
  
  The RTA detailed the drop in cycling by 1992;
  · road intersections in Sydney down 41%
  · number of high school children cycling in Sydney down 53% and 42% in rural locations
  · rural recreational areas and primary schools, both down by 37%.
  
  From the above information for children and also adults it is obvious that a main effect of the helmet legislation was to discourage cycling.
  
  The 1990 survey was conducted in the spring and poor Sydney weather conditions. Walker reported, “As it turns…
  Read more
  
  The RTA detailed the drop in cycling by 1992;
  · road intersections in Sydney down 41%
  · number of high school children cycling in Sydney down 53% and 42% in rural locations
  · rural recreational areas and primary schools, both down by 37%.
  
  From the above information for children and also adults it is obvious that a main effect of the helmet legislation was to discourage cycling.
  
  The 1990 survey was conducted in the spring and poor Sydney weather conditions. Walker reported, “As it turns out, the first survey was conducted in overcast conditions in Sydney and, in some areas, was interrupted by rain whereas the second survey was conducted in sunny conditions.
  
  Robinson 1996 report shows data for children in NSW. The equivalent number of injuries for pre law level of number of cyclists increased from 1310 (384 head + 926 other injuries) in 1991 to 2083 (488 head + 1595 other injuries) in 1993. The increased injury rate was 59%, from 1310 to 2083. This information showed that children’s safety had been reduced substantially compared to the level of cycling activity.
  see Robinson DL; Head injuries and bicycle helmet laws; Accid Anal Prev, 28, 4: p 463-475, 1996
  http://www.cycle-helmets.com/robinson-head-injuries.pdf
  
  Police figures show that in 2005 almost 10,000 cyclists were fined for not wearing a helmet but that numbers has dropped to 6537.
  see SMH http://www.smh.com.au/nsw/cyclists-getting-an-easy-ride-20101208-18px7.html
  
  The helmet law discouraged cycling and reduced children's health and safety. It also resulted in thousands of cyclists being fined. Why has the truth been covered up the the press?
  
  7 months ago report
11. Colin Clarke
  
  logged in via email @vood.freeserve.co.uk
  
  In reply to Colin Clarke
  
  Correction
  Should have stated;
  The RTA detailed the drop in cycling by 1992;
  There was a 14% decline in the number of adults cycling and a 36% decline for children. The largest children declines recorded were:
  · road intersections in Sydney down 41%
  · number of high school children cycling in Sydney down 53% and 42% in rural locations
  · rural recreational areas and primary schools, both down by 37%.
  
  7 months ago report
12. Doug Rand
  
  logged in via Facebook
  
  In reply to Linda Ward
  
  These tiresome statistics tell us nothing about the real risk of cycling on an individual basis. A reduction of a very tiny, tiny risk, is still a tiny, tiny risk.
  
  I wonder if you or Cameron have any cycling experience at all. I've ridden on roadways in traffic for over six decades. In my lifetime, I've accumulated in excess of 300,000km without suffering a head injury
  
  Helmets don't reduce accident risk and may even increase it. Cycling experience and logic tells me they offer the false sense of security that could increase risk taking. Behaviour is critical.
  
  The most effective means, estimated as high as 80%, of reducing a cyclist's risk is lawful and competent cycling.
  
  Here in Canada, of all serious head injuries 49% involve motor vehicles, 1% involve bicycles. The question arises as to who should wear helmets.
  
  ... is this just an academic exercise in order for you to interfere in the life style of a group of which you are not a member?
  
  7 months ago report
Gary MacDonald

logged in via Facebook

You state that "Valuing the benefits of exercise through cycling is outside my area of expertise". I would argue that writing articles promoting helmet use is also outside your area of expertise. With all of your "statistics" above you seen to have forgotten to substantiate these claims with actual research data. There are numerus study which suggest that the health benefits from cycling (with or without a helmet) outweigh the risks by 20:1 (see Hillman M, Cycling and the promotion of health., PTRC…
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You state that "Valuing the benefits of exercise through cycling is outside my area of expertise". I would argue that writing articles promoting helmet use is also outside your area of expertise. With all of your "statistics" above you seen to have forgotten to substantiate these claims with actual research data. There are numerus study which suggest that the health benefits from cycling (with or without a helmet) outweigh the risks by 20:1 (see Hillman M, Cycling and the promotion of health., PTRC 20th Summer Annual Meeting, Proceedings of Seminar B, pp 25-36, 1992 or British Medical Journal 1999).

The fact of the matter is that the evidence for and against helmets is conflicting and as such people should have the right to make their own decisions. The other fact is that 20 years after it's introduction, mandatory helmets laws (MHLs) are only in force in Australia and New Zealand (and some provinces in Canada) and these countries have the lowest cycling participation rates in the world. Other countries which did have MHLs have since repealed them due to the adverse affects they had on cycling rates (Isreal & Mexico).

Deaths from cycling are rare as opposed to deaths from sedentary lifestyle diseases, motor vehicle accidents and smoking which are amongst the biggest killers in western society. Anything that can be done to promote cycling should be done.

For more information on the effect of helmet laws check out http://wrongheaded.org.uk/

about 2 years ago report
Will Ross

Medical Officer at Victorian Infectious Diseases Reference Laboratory

I'm not sure how statements like "Only those who are ideologically opposed to their legal obligation to protect themselves would choose not to wear a helmet." fit in a respectable piece about public health.

Not only is it a logical non sequitur, it is also empirically false. Large numbers of Australians ride bikes in Europe, and when they do, they will tend to conform with the prevailing norm and law. When I ride a bike in Copenhagen, I'm not choosing to ride without a helmet due to some ideological disagreement with you! I suspect, however, that if you *did* wear a helmet, that in itself may be a more ideological act.

about 2 years ago report
This is a highly recommended comment.

Paul Martin

logged in via email @me.com

"If helmets protect against brain injury, why not wear them?"

If this is something which you firmly believe then you must insist, given the greater benefit, that helmets should be mandatory for all car occupants too. If not, why insist that ALL bicycle riders, under ALL conditions, must wear them? The reason is that it is a minority and utility cycling (ie. not cycle sport) a minority yet again.

You might want to update your old references too... 1994 & 1988? Good grief.

about 2 years ago report
1. Will Ross
  
  Medical Officer at Victorian Infectious Diseases Reference Laboratory
  
  In reply to Paul Martin
  
  Excellent point. Helmet wearing is ultimately a security measure; it protects against a harm. All security measures involve tradeoffs, which is why we don't adopt even very effective ones.
  
  For example, bullet-proof vests reduce the risk of being shot and killed. I choose not to wear one, however, because of the low risk, it is expensive, heavy, and makes me look stupid.
  
  Why can't A/Prof Cameron write a piece that honestly addresses the issue of the security tradeoffs rather than thinking the argument is proved when he can establish that a countermeasure reduces a harm?
  
  about 2 years ago report
BicycleTim Stredwick

logged in via Facebook

If there is a positive health case for compulsory helmet wearing, then there is a greater case for compulsory wearing of helmets in cars. There are far more people killed and injured due to head injuries in car crashes than cycling accidents.

about 2 years ago report
Peter Teow

logged in via email @yahoo.com

Firstly, removal of the Mandatory Helmet law is very, very different from 'ditching bike helmets' - if people who ride bikes, skateboards or even drive their cars, can still choose to wear helmets, just like in the many countries of the world with better cycling safety without MHL.

Secondly, Standards Australia AS/NZ 2063 legislation is another classic enforcement shoved down the throat of the Australian public. A purported $20,000 to test a helmet so that you get a silver sticker for the helmet…
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Firstly, removal of the Mandatory Helmet law is very, very different from 'ditching bike helmets' - if people who ride bikes, skateboards or even drive their cars, can still choose to wear helmets, just like in the many countries of the world with better cycling safety without MHL.

Secondly, Standards Australia AS/NZ 2063 legislation is another classic enforcement shoved down the throat of the Australian public. A purported $20,000 to test a helmet so that you get a silver sticker for the helmet to be deemed 'safer' then the same helmet approved in other countries but cannot legally be sold here. - RRPs of silver stickered helmets in Australia can be 100% more expensive then the same helmet sold (at RRP) elsewhere - when UCI competitions are run in Australia, the riders are granted exemption from the AS/NZ 2063 standards so long as they have an approved helmet AND for good measure, NZ legislation actually allows their citizens to use a helmet with international standards which says a lot about the 1977 scam that is still ongoing.

The next thing is that helmets CAN serve a purpose, they are used , for example in Rally motor racing, but you don't see them enforced on ALL motorists, say for example the 85% of single occupant cars doing their daily runarounds.

IF 'saving lives and reducing head injuries' were so much of a concern, then the young and elderly should also have mandatory helmet laws enforced.
IF 'preventing ROAD deaths' are the main consideration then lets contrast the fatalities CAUSED by cars on every other road user vs the deaths CAUSED by cyclist with a lack of helmet. (as opposed to a helmeted or un-helmeted cyclist killed by a car, I assure you , AS/NZ2063 standards does not include this test)
Add in the number of unhelmeted pedestrians killed cars and with the same rationale, these class of road users should also wear helmets
In fact, it's probably worth doing an article on the number of ROAD deaths vs GUN deaths annually.
To address the economic rationale, it would be pertinent if a study contrasts the nett cost of unhelmeted cyclists vs the cost of (legal) alcohol, (legal) smoking and (legal) unprotected sex.

Wearing a helmet increases your head mass by 40% , the laws of probability tells you this means there is a 40% higher chance of hitting your head with a helmet, thus increasing the dangers and falsifying the true value of the 'a helmet saved my life' stories.

The bottom-line is Mandatory Helmet Laws have turned a safe, utility activity into a dangerous sporting activity. It has reduced the absolute number of cyclists. It has turned citizens who choose to use a bicycle into criminals and become an additional revenue stream for Australia Standards / SAI global and distracting the police forces forces from far more important activities.
It has done nothing for overall cycling safety compared with the rest of the non-MHL countries.

Back to your first point, no one is saying that with the removal of Mandatory Helmet Laws, cyclists who invested in the color coordinated helmets can't use them during their weekend rides.
And if a person prefers a helmet, they are entitled to, just like I am may choose to use padded gloves, hi-vis clothing and covered footwear.

about 2 years ago report
Colin Clarke

logged in via email @vood.freeserve.co.uk

It says
"helmet wearing rates more than doubled — from around a third to three quarters — by March 1991"
In 1990 Melbourne surveys had 3121 cyclists with 1006 wearing helmets, by 1991, 2011 cyclists with 1303 wearing them. About 10% extra wore helmets, 297 in number, compared with 1110 fewer cyclists. Injury data suggest a larger reduction in cycling in regional areas of Victoria.

Robinson DL; Head injuries and bicycle helmet laws; Accid Anal Prev, 28, 4: p 463-475, 1996 http://www.cycle-helmets…
Read more

It says
"helmet wearing rates more than doubled — from around a third to three quarters — by March 1991"
In 1990 Melbourne surveys had 3121 cyclists with 1006 wearing helmets, by 1991, 2011 cyclists with 1303 wearing them. About 10% extra wore helmets, 297 in number, compared with 1110 fewer cyclists. Injury data suggest a larger reduction in cycling in regional areas of Victoria.

Robinson DL; Head injuries and bicycle helmet laws; Accid Anal Prev, 28, 4: p 463-475, 1996 http://www.cycle-helmets.com/robinson-head-injuries.pdf

Survey data from NSW found it discouraged cycling, e.g. child cycle use fell 44% by the second year of the helmet law.

Smith NC, Milnthorpe FW. An observational survey of law compliance and helmet wearing by bicyclists in NSW. Roads and Traffic Authority of NSW. 1993.

Erke and Elvik (Norwegian researchers) 2007 stated: "There is evidence of increased accident risk per cycling-km for cyclists wearing a helmet. In Australia and New Zealand, the increase is estimated to be around 14 per cent."

Erke A, Elvik R, Making Vision Zero real: Preventing Pedestrian Accidents And Making Them Less Severe, Oslo June 2007. page 28
http://www.toi.no/getfile.php/Publikasj ... 7-nett.pdf

see, Assessment of Australia's Bicycle Helmet Laws, refer 'Mandatory' can have unanticipated consequences – Civil Liberties Australia web site, 25 Nov. 2008. Providing details of the effects of the legal requirement to wear cycle helmets. http://www.cla.asn.au/Article/081125BikesHelmetPolicy.pdf

The article by Max is not providing a full picture.

about 2 years ago report
Etienne de Briquenel

logged in via Twitter

You are quite correct in claiming that "cyclists have accepted that helmet wearing is a normal part of cycling". The problem, however, is that we are talking about most established cyclists here; you know, the ones that make up around 1-2% of the population. The huge number of potential cyclists who have been turned off by the enormously exagerrated "dangers" of cycling certainly do not share this view, nor do a considerable number of established cyclists who either do not comply with the law or…
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You are quite correct in claiming that "cyclists have accepted that helmet wearing is a normal part of cycling". The problem, however, is that we are talking about most established cyclists here; you know, the ones that make up around 1-2% of the population. The huge number of potential cyclists who have been turned off by the enormously exagerrated "dangers" of cycling certainly do not share this view, nor do a considerable number of established cyclists who either do not comply with the law or only do so to avoid a fine. Helmet advocates have a habit of using misleading stastistics to claim that cycling numbers have not suffered as a result of these laws, but simple empirical evidence proves that this is simply not the case. I would treat their arguments for mandatory helmet use more seriously if they refrained from insulting my intelligence with this "cycling is booming" nonsense.
Furthermore, the assertion that I choose to not wear a helmet because I am "ideologically opposed to the legal requirement to protect myself" is an utterly ridiculous statement. I choose not to wear a helmet because I feel perfectly safe without one, as has been the case for the past 20 years of my life since the helmet laws were first established. My ideological opposition to the law can be best summed up by the rows of unused bikes sitting at bike share stations in the Melbourne CBD, while similar schemes in cities around the world have seen incredible success. This is the cost of these ridiculous, paternalistic laws.

about 2 years ago report
Dave Kinkead

logged in via Facebook

Wow Max - is this really the standard of logic and analysis we can expect from C-MARC?

It seems from your article that you are confusing two issues: the efficacy of helmet usage with the effectiveness of mandatory helmet laws. I would expect most people, especially those with experience in accident research, would be able to tell the difference between the two but you have proven me wrong.

On the issue of helmet effectiveness, the jury is out. Clearly, there are a number of situations where wearing…
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Wow Max - is this really the standard of logic and analysis we can expect from C-MARC?

It seems from your article that you are confusing two issues: the efficacy of helmet usage with the effectiveness of mandatory helmet laws. I would expect most people, especially those with experience in accident research, would be able to tell the difference between the two but you have proven me wrong.

On the issue of helmet effectiveness, the jury is out. Clearly, there are a number of situations where wearing a bike helmet in the event of an accident would be a good thing. Yet, as European Commission notes in its analysis of motorcycle injuries (1), rotational injuries (which helmets often cause and/or exacerbate) account for 60% of serious head trauma while linear impacts account for only 30%.

As to your claim that "there’s no doubt that mandatory helmet laws reduced head injury and improved cyclist safety", after extensive research I cannot find a single peer reviewed article that supports a link between mandatory helmet laws and improved cyclists safety and that has controlled for even the most obvious confounders such as reduced cycling levels. If you are aware of such research, please let me know in a reply to this comment.

You also claim that preventing serious road trauma is also an ethical and economic issue. On this I totally agree but am at a loss why you claim that mandatory helmet laws for cyclists are a solution when in terms of both rate and absolute numbers, motorists and pedestrians are at a greater risk of head injury. Even if helmet laws worked as you claim, then on ethical and economic grounds, you should be arguing for helmet laws for motorists before cyclists.

Max, I would really like to hear your response to the issues I have raised. Especially, links to any research linking helmet laws to improved cyclist safety.

1) http://ec.europa.eu/transport/roadsafety_library/publications/cost327_final_report.pdf

about 2 years ago report
Alan Todd

logged in via Facebook

The debate about bike helmets has been dogged by belief based on little or no evidence. It is disappointing to find that Max Cameron's latest contribution is in this category. Take just the opening sentences:

"The health benefits of more cycling would need to be multiplied countless times before they could offset the loss of life and health harms caused by serious head injury."

"Bicycle helmets have long been recognised as the best protection against head injury."

In 2010 Piet De Jong published…
Read more

The debate about bike helmets has been dogged by belief based on little or no evidence. It is disappointing to find that Max Cameron's latest contribution is in this category. Take just the opening sentences:

"The health benefits of more cycling would need to be multiplied countless times before they could offset the loss of life and health harms caused by serious head injury."

"Bicycle helmets have long been recognised as the best protection against head injury."

In 2010 Piet De Jong published an exhaustive actuarial cost benefit analysis clearly demonstrating that the "benefits" of widespread compulsory helmet wearing in Australia were far outweighed by the disbenefits. The second statement is merely an assertion.

The most up to date meta analysis of data from Rune Elvik (Norwegian road safety expert) found that helmet wearing in the event of an accident was associated with a reduction in the severity and extent of head and face injury of 15%, with later data showing a reduced effect. This follows from an earlier study co-authored by Elvik showing helmeted cyclists as being 14% more likely to be involved in a crash than non helmeted cyclists. This is hardly a ringing endorsement for compelling all cyclists to wear a helmet. Further to this, population wide studies in Australia and New Zealand have shown the overall effect of compelling a population to wear helmets led to no statistically significant reduction in the rate of head and other injuries to cyclists.

I know of no other area of public health where such an intervention would not only be promoted but actually forced upon a population. An intervention which has not only been unsuccessful by its own terms of reference (reducing pro rata the extent and severity of head injuries) but has led to unintended but quite predictable (and therefore inexcusable) consequences, namely the absolute hobbling of our nascent bike culture. It has been particularly damaging in discouraging adolescents and women from cycling. The statistics Max Cameron quotes from Victoria in the late eighties and 1991 are not only "selective" but were based on small observational samplings, and included in one instance a weekend cycle touring event which happened to pass through an observation point.

An unfortunate side effect of the legislation is that the non conformity of individual cyclists seems to attract special attention from the police - to the extent that it is, per trip, the most heavily enforced of all traffic infringements (yes,including speeding and drink driving) in the State of Victoria.

The only thing we can salvage from this sorry fiasco is the comfort we may draw from the example we have shown the rest of the world of how not to promote cycling or make it safe. Twenty years on, most of the world has taken note of this. Small comfort I know when you are pulled over, fined and lectured by the police, and you realize that if you had driven instead, you would have been a normal law abiding citizen.

about 2 years ago report
1. Linda Ward
  
  Biostatistician
  
  In reply to Alan Todd
  
  Alan
  Re your claim that the Elvik meta-analysis showed a 'reduction in the severity and extent of head and face injury of 15%, with later data showing a reduced effect' . . .
  The paper reported odds ratios
  - for brain injuries of 0.42 using a fixed-effects model, and 0.47 using a random-effects model (table 1)
  - for fatal injuries of 0.23 with both models (table 1)
  - for head, face and neck injuries combined of 0.73 in the fixed-effects model, and 0.85 in the random-effects model (table 2…
  Read more
  
  Alan
  Re your claim that the Elvik meta-analysis showed a 'reduction in the severity and extent of head and face injury of 15%, with later data showing a reduced effect' . . .
  The paper reported odds ratios
  - for brain injuries of 0.42 using a fixed-effects model, and 0.47 using a random-effects model (table 1)
  - for fatal injuries of 0.23 with both models (table 1)
  - for head, face and neck injuries combined of 0.73 in the fixed-effects model, and 0.85 in the random-effects model (table 2)
  Why did you not mention the more than 50% reduction in brain injuries, and more than 75% reduction in fatal injuries?
  In saying that in that helmets reduced the severity and extent of head and face injury by '15%, with later data showing a reduced effect', you appear to be referring to the odds ratio of 0.85 obtained by combining head, face and neck injuries using a fixed-effects model (table 2 in the paper).
  If the 15% you quoted was in relation to the fixed-effects odds ratio in table 2 of the paper
  - why did you quote the 15% reduction from the random-effects model instead of the 27% reduction from the fixed-effects model?
  - what did you mean by 'with later data showing a reduced effect'?
  If the 15% was not in relation to the fixed-effects odds ratio in table 2 of the paper, how did you arrive at this number?
  
  8 months ago report
2. Colin Clarke
  
  logged in via email @vood.freeserve.co.uk
  
  In reply to Linda Ward
  
  Hi Linda
  
  I think the evidence for allowing people a choice in helmet use is substantial.
  
  eg
  NSW survey data shows a reduction in children cycling following legislation from 1991 to 1993, 6788 to 3798 counted, a 44% reduction. With 44% fewer cycling but only 9% extra wearing helmets the main outcome was to discourage cycling. Survey counts of students riding to/from NSW schools: 1991 – 3107, 1993 – 1648, a drop of 47%.
  
  Australian data
  The 1985-86 Day to Day travel report details for…
  Read more
  
  Hi Linda
  
  I think the evidence for allowing people a choice in helmet use is substantial.
  
  eg
  NSW survey data shows a reduction in children cycling following legislation from 1991 to 1993, 6788 to 3798 counted, a 44% reduction. With 44% fewer cycling but only 9% extra wearing helmets the main outcome was to discourage cycling. Survey counts of students riding to/from NSW schools: 1991 – 3107, 1993 – 1648, a drop of 47%.
  
  Australian data
  The 1985-86 Day to Day travel report details for the 9-15 age group with a daily average of about 6.5 minutes. For 2010 the ABS reported that the average time children spent bike riding decreased from 6 hours in 2000 to 5 hours in 2009. The 6 hour figure equates to about 1 minute per day and indicates a massive drop, about 80%, in cycling for children.
  My report, Clarke, CF, Evaluation of New Zealand’s bicycle law, NZMJ 10 February 2012, Vol 125 No 1349;
  http://journal.nzma.org.nz/journal/125-1349/5046/
  refers to a 75% reduction for children in NZ
  
  Fatality rate comparison, cyclist v pedestrian
  In NSW from 1986 to 1990 there were 114 cyclist and 924 pedestrian deaths, cyclists 12% of pedestrians in number. Table below shows the trend from 1986 to 2010.
  
  .....1886-90 91-95 96-2000 01-05 06-10
  Cyclists ......114 .....58 56 64 54
  Pedes ......924 ....616 564 457 312
  C/P% ...12.3% ...9.4% 9.9% 14.0% 17.3%
  
  O’Rourke 1987 detailed information on head injury to children cycling in Brisbane. From 150 admitted, 135 incurred minor head injuries.
  
  Dr Hillman from the UK's Policy Studies Institute calculated that life years gained by cycling outweighed life years lost in accidents, by a factor of 20 to 1.
  
  Balancing all the available evidence suggests that the mandatory cycle helmet requirement has not been the best approach to promoting health and safety.
  
  7 months ago report
3. Alan Todd
  
  logged in via Facebook
  
  In reply to Linda Ward
  
  Hi Linda,
  Sorry to take so long to respond - I had to dig around for the original paper by Elvik. I think Dorothy Robinson has probably answered your question, or at least highlighted a source of misunderstanding in the confusion of risk of injury with the odds ratio of head vs other injuries for cyclists who crash.
  
  But dealing specifically with your question of how I arrived at the 15%. I didn't arrive at it by way of fixed-effects odds ratios quoted in table 2. It is taken directly from…
  Read more
  
  Hi Linda,
  Sorry to take so long to respond - I had to dig around for the original paper by Elvik. I think Dorothy Robinson has probably answered your question, or at least highlighted a source of misunderstanding in the confusion of risk of injury with the odds ratio of head vs other injuries for cyclists who crash.
  
  But dealing specifically with your question of how I arrived at the 15%. I didn't arrive at it by way of fixed-effects odds ratios quoted in table 2. It is taken directly from the body of the report, where Elvik states (Publication bias and time-trend bias in meta-analysis of bicycle helmet efficacy: A re-analysis of Attewell, Glase and McFadden, 2001. page 4)
  
  " For all studies, based on a random-effects model adjusted for publication bias, the best estimate is a 15% reduction of the risk of injury to the head, the face or the neck if a bicycle helmet is worn."
  
  He goes on in the discussion section (op cit p4) to state:
  
  "When the risk of injury to head, face or neck is viewed as a whole, bicycle helmets do provide a small protective effect. This effect is evident only in older studies. New studies, summarised by a random-effects model of analysis, indicate no net protective effect"
  
  I hope this clears up any misunderstanding.
  
  7 months ago report
This is a highly recommended comment.

Dan

logged in via Twitter

What an extraordinary article! I note the this website promises 'academic rigour'; it is a shame that Mr Cameron seems entirely unable to provide it.

His second sentence, for example, can be refuted with a simple literature search. There are a number of studies that have been done that conclude that the negative health benefits of helmet laws (because people stop riding) outweigh the positive benefits form head injury reduction. One of the most pertinent was conducted by Professor Piet de Jong at…
Read more

What an extraordinary article! I note the this website promises 'academic rigour'; it is a shame that Mr Cameron seems entirely unable to provide it.

His second sentence, for example, can be refuted with a simple literature search. There are a number of studies that have been done that conclude that the negative health benefits of helmet laws (because people stop riding) outweigh the positive benefits form head injury reduction. One of the most pertinent was conducted by Professor Piet de Jong at Macquarie University. As an actuary he is an expert at assessing risk / benefit ratios, and he concluded in his paper 'The Health Impact of Mandatory Bicycle Helmet Laws' that even under the most extreme assumptions there is a negligible health benefit to helmet laws, and that under more realistic assumptions helmet laws actually cost society in terms of overall health outcomes.

The next sentence that 'helmets are the best protection against head injuries' again is something that is utter nonsense. The best protection against head injury is delivered by providing safe infrastructure, as demonstrated by the low injury rates in places where such infrastructure has been invested in. Still, even if we forgive the sloppy language and take the meaning to be 'in the event of a blow to the head occurring, helmets are the best protection against head injuries' the statement is still debatable, with research conducted by Curnow in 2003 indicating that in certain circumstances wearing a helmet can actually increase the risk of brain injury.

I could go on, perhaps pointing to research that shows that the injury reduction benefits Mr Cameron attributes to helmets apparently also applied to pedestrians over the same period this making it highly questionable that helmets were the prime factor in those reductions.
I could point out that, far from not knowing what might happen if helmet laws were repealed we can in fact look to the NT, where they have been partially repealed. Not only does the NT have one of the best cycling safety records in Australia (despite having the most dangerous roads), it also has the highest modal bicycle share.
I could point out the tone of the piece, painting cycling as some sort of uniquely risky activity, is erroneous; Australian injury statistics show that, on a per-hour basis, riding a bicycle is much safer than playing netball, for example

And so on.

Interesting though all these data are (and Mr Cameron would do himself a service to actually read and understand them), it is really a sideshow.

The real point is this. Riding a bicycle without a helmet is an activity that benefits society. It benefits the individual in terms of their health (for whatever the risks, riding a bicycle is offers a net gain in terms of life expectancy). Cycling - with or without a helmet - reduces traffic congestion thus delivering direct economic benefits to society. Riding a bicycle also reduces the risks to other road users; you are twenty times less likely to cause a fatality whilst riding a bicycle as you are when driving a car.

Now, it may be that wearing a helmet is a good idea as it maximises these benefits (although the research findings can be described, at best, as ‘mixed’).

However, the result of mandatory helmet laws is that it criminalises an activity that is safe, and that delivers benefits to society. It penalises the very behaviour that we should be trying to encourage.

By all means suggest that people should wear helmets to minimise the risk of head injury. But don’t make me a criminal for doing something that has only positive consequences.

about 2 years ago report
Paul Richards

Paul Richards is a Friend of The Conversation.

The UCI - Union Cycliste Internationale have adopted helmets for protection.
Their model carries the weight of superior experience, knowledge, and wisdom regarding cycling.
No amount of logical argument, statistics, supposition and dare I say cognitive bias will ever compete with their insurers actuarial data.
Yes, insurers carry a bias, toward reducing risking their profit. Insured riders are killed, injured permanently disabled in and out of competition, but they are insurable. The underwriter…
Read more

The UCI - Union Cycliste Internationale have adopted helmets for protection.
Their model carries the weight of superior experience, knowledge, and wisdom regarding cycling.
No amount of logical argument, statistics, supposition and dare I say cognitive bias will ever compete with their insurers actuarial data.
Yes, insurers carry a bias, toward reducing risking their profit. Insured riders are killed, injured permanently disabled in and out of competition, but they are insurable. The underwriter expects compliance for the insured to benefit, one area of compliance is that of wearing a helmet. Business is business, the insurer is profitable if they pay-out less and make more profit.

UCI CYCLING REGULATIONS - 13.1.001
"Each cyclist shall take care of his physical condition and be attentive to health and safety risks."

That sums up all the issues for the sport at competition level, but it applies to all cycling.
Helmet on or not, every cyclist is responsible for their own risk. When cyclist choose to ride, what they choose to cycle, how they choose to ride and the risks they take are all their own. Even choosing to comply with any helmet law are all their own risk.
Arguing if helmet use is redundant here and there, is irrelevant.
It's no different to arguing smoking cigarettes is safe.

about 2 years ago report
1. Harvey C
  
  Cyclist
  
  In reply to Paul Richards
  
  The UCI adoption of helmets wouldn’t have anything to do with the sponsorship income earned from helmet manufacturers?
  
  This authoritative and uncompromising argument is ridiculous, dismissing any form of rational discussion. You could use the same argument to claim that, since racing car drivers wear helmets, every car driver must wear an helmet.
  
  about 2 years ago report
Dorothy L Robinson

logged in via email @gmail.com

In the first and second years of Victoria’s bicycle helmet law, the numbers of *pedestrians* with concussion fell by 29% and 75%.

Pedestrians weren’t forced to wear helmets. So other factors, e.g. safer roads, probably had a much greater effect than helmet laws. 93 pedestrians were killed in Victoria the year helmet laws were introduced (1990), compared to 159 the previous year. Comparing the 24 months before and after Victoria’s helmet law, pedestrians and cyclists had identical changes in…
Read more

In the first and second years of Victoria’s bicycle helmet law, the numbers of *pedestrians* with concussion fell by 29% and 75%.

Pedestrians weren’t forced to wear helmets. So other factors, e.g. safer roads, probably had a much greater effect than helmet laws. 93 pedestrians were killed in Victoria the year helmet laws were introduced (1990), compared to 159 the previous year. Comparing the 24 months before and after Victoria’s helmet law, pedestrians and cyclists had identical changes in the ratio of deaths and serious head injuries to other serious injuries – there was no additional improvement for cyclists.

Graphs of percent head injury over time for all road users in several Australian states before and after helmet laws are at http://www.cyclehelmets.org/papers/c2022.pdf I encourage everyone to look at the data. Is it likely that the claimed benefits were due to helmets, instead of other road safety initiatives?

With fewer cyclists, we’d expect fewer bicycle crashes, especially bike-only crashes. This is reflected in the hospital admissions data. Despite the safer roads, and the fall in pedestrian head injuries, the dominant effect for cyclists is a similar drop in both *non* head injuries and head injuries. Helmets don’t prevent injuries to other parts of the body, and the drop starts the same month as the helmet law, so there must have been a big drop in cycling.

This was confirmed by the surveys. 1567 adult cyclists were counted in May 1990, compared to 1106 adults in an identical post-law survey – same sites, same observation periods, same time of year. The most logical conclusion is that helmet laws reduced adult cycling by about 29%. Max Cameron’s claim that “More adults began cycling after the introduction of mandatory helmet laws” seems nonsensical.

Although surveys in Melbourne were discontinued, census data on cycling to work indicate that helmet laws continue to discourage cycling - http://www.cyclehelmets.org/1194.html
1976: 1.12%
1981: 1.56
1986: 1.68
1991: 1.56
1996: 1.24
2001: 1.21
2006: 1.24
Splitting 1991 data into states with and without enforced helmet laws show a dramatic effect of just how much helmet laws discouraged cycling.

Dublin’s City Bike Scheme is a roaring success – its 450 bikes are used about 2720 times per day. Compare this with just 140 uses per day for Melbourne’s 600 City Bikes. With over 2 million hirings in Dublin, only 2 injuries required hospitalisation and both cyclists were out of hospital within 24 hours.

Because of reduced Safety in Numbers it’s probably more dangerous to cycle in Melbourne with a helmet than without one in Dublin!

The increased risk of injury from reduced Safety in Numbers and risk compensation is real. UK researcher, Dr Ian Walker, measured the amount of room left by passing drivers, and found they passed closer when he was wearing a helmet. Dr Walker what hit twice when carrying out his research, both times when wearing a helmet. A recent study has also shown that cyclists who are used to wearing helmets ride faster and presumably take more risks when wearing a helmet.

Rather than preventing injuries, relative to the amount of cycling, injury rates in Australia appear to be higher than would have been expected without helmet laws.

Cyclists who have accepted helmets will continue to wear them even if the laws are repealed. But, especially with the advent of City Bike Schemes, repealing the laws would allow more and more people to start enjoying the health and environmental benefits of cycling.

Research in Denmark, where very few cyclists wear helmets, showed that *not* cycling to work increased mortality by 39%. So whatever the risks of cycling without a helmet, they pale into insignificance compared to health benefits of cycling to work.

about 2 years ago report
timgummer

logged in via Twitter

Helmets are a sign of a failed cycle culture. Like flouro hi-viz [nice idea.. give riders road worker status.. that’ll be a big sell…) they send a very clear and unambiguous message that cycling is unsafe that turns off potential new cycle riders, thereby ensuring less cycle riders on the roads, and a more dangerous environment. As has been pointed out, successful cycle cultures are lidless, and their accident rates are far lower. UK research (bath university.. check it out) has shown that car drivers…
Read more

Helmets are a sign of a failed cycle culture. Like flouro hi-viz [nice idea.. give riders road worker status.. that’ll be a big sell…) they send a very clear and unambiguous message that cycling is unsafe that turns off potential new cycle riders, thereby ensuring less cycle riders on the roads, and a more dangerous environment. As has been pointed out, successful cycle cultures are lidless, and their accident rates are far lower. UK research (bath university.. check it out) has shown that car drivers drive substantially closer to people wearing helmets than those who don’t.

I don’t know about you, but my main safety concern is to avoid being hit. Speaking more anecdotally: in car crazy New Zealand where I live, and with Australia is one of the few countries to adopt compulsory helmets (- an instant precursor to a massive drop in cycling of course) I now ride upright, un-lidded, comfortable and confident, just like most in the more civilized non-english speaking world, only I’m breaking the law. Drivers give me a much wider berth and I have never felt safer, and happier, on a bike in my life.

about 2 years ago report
This is a highly recommended comment.

Harvey C

Cyclist

"A serious head injury resulting in permanent brain damage, which a bicycle helmet can often prevent"

That is not true. The cause of serious head injury resulting in permanent brain damage is diffuse axonal injury (DAI). The main cause of DAI is rotational acceleration. Not only helmets cannot protect against rotational acceleration but they can increase it. In other words, helmets can CAUSE permanent brain damage, or make it worse.

Here is a well-researched article that covers helmets effectiveness…
Read more

"A serious head injury resulting in permanent brain damage, which a bicycle helmet can often prevent"

That is not true. The cause of serious head injury resulting in permanent brain damage is diffuse axonal injury (DAI). The main cause of DAI is rotational acceleration. Not only helmets cannot protect against rotational acceleration but they can increase it. In other words, helmets can CAUSE permanent brain damage, or make it worse.

Here is a well-researched article that covers helmets effectiveness, with some further links on this topic
http://www.smh.com.au/lifestyle/wellbeing/bicycle-helmet-dos-and-donts-20100915-15cs8.html
http://books.google.com.au/books?id=IlRychZFYwQC&lpg=PA139&ots=9q_leuiSd4&dq=curnow%202008%20scientific&pg=PA138#v=onepage&q=curnow%202008%20scientific
http://www.bhsi.org/chinstrp.pdf

"there’s no doubt that mandatory helmet laws reduced head injury and improved cyclist safety"

Perhaps the disclosure statement could have mentioned that the author has published several studies that exaggerate the benefits of helmets, funded by the Victorian government. Isn't it odd how such "studies" fail to mention that a similar drop in head injuries occurred for pedestrians? Obviously this can't be attributed to helmets. Taking into account the decline in the number of cyclist, the risk of injury per cyclist (relative to pedestrians) increased significantly after the helmet law.

Here is an assessment of the helmet law done more objectively with comprehensive data.
http://www.cyclehelmets.org/papers/c2022.pdf

The report below indicates on page 465 that, after the helmet law, death and serious injuries (DSI) for child cyclists increased by 21%, compared to a decrease by 21% for child pedestrians. This indicates that the risk of DSI for child cyclists in NSW INCREASED SIGNIFICANTLY (by 50% according to this dataset) compared to what would have been expected without the helmet law.
Hospital data reports an increase in risk of non-head injuries above 70%, indicating a large increase in risk of accidents (and resulting injuries) after the helmet law. This is evidence that factors like 'safety in numbers' and 'risk compensation' are doing far more damage than helmets can protect against.
http://www.cycle-helmets.com/robinson-head-injuries.pdf

No doubt? Perhaps have should a closer look at the data.

The claim about an increase in the amount of adult cycling is deceptive, as shown by 30% decline in adult cycling after the helmet law, measured in both Sydney and Melbourne.
http://www.onestreet.org/images/stories/pdf/Helmet_law_outcomes_summary.pdf

"Ultimately, the health benefits of increased bicycle exercise have a long way to go before they can offset the increased costs of cyclist death and serious head injury."

An odd prophetic statement considering that the helmet law has failed to improve safety. Does this take into account the increased risk of death and serious injury after the helmet law?

European countries have not introduced a helmet law because they have done studies that demonstrate it would result in an increase in health care costs. Guess who has been the guinea pigs in that experiment?
http://www.ecf.com/3500_1

Don't be fooled by this misleading rhetoric. Check the underlying data to find out what had really happened after the helmet law.
The helmet law is a failed experiment.
That's why the rest of the world has not followed our blind lead.

about 2 years ago report
1. Harvey C
  
  Cyclist
  
  In reply to Harvey C
  
  It would also be worth checking out the AS/NZ 2063 standard for bicycle helmets, especially what they are tested for. The tests are low speed (19.5km/h), and only straight on. Not all sizes are tested (notably absent are small children’s helmets). There are no oblique test or test for rotational acceleration. Essentially, the most common helmet today (the soft-shell helmet) is a thin layer of polystyrene that crumbles very quickly on impact, and cannot absorb much energy at all. This crumbling…
  Read more
  
  It would also be worth checking out the AS/NZ 2063 standard for bicycle helmets, especially what they are tested for. The tests are low speed (19.5km/h), and only straight on. Not all sizes are tested (notably absent are small children’s helmets). There are no oblique test or test for rotational acceleration. Essentially, the most common helmet today (the soft-shell helmet) is a thin layer of polystyrene that crumbles very quickly on impact, and cannot absorb much energy at all. This crumbling is what ironically many people mistake for the helmet as having "saved their life".
  
  Helmets reduce lacerations and minor head (scalp, not facial) injuries in low speed falls. They DO NOT reduce the risk of serious head (ie. brain) injuries in significant impacts. They should have never been marketed as being effective at preventing serious head injury or "saving lives". Such statement give people an exaggerated perception of the protection provided by helmets, exacerbating the danger from risk compensation.
  http://www.damninteresting.com/the-balance-of-risk
  
  about 2 years ago report
2. Linda Ward
  
  Biostatistician
  
  In reply to Harvey C
  
  Re 'European countries have not introduced a helmet law because they have done studies that demonstrate it would result in an increase in health care costs', is this the article you are referring to:
  http://www.ecf.com/wp-content/uploads/2011/11/Cycle-helmets.pdf?
  
  7 months ago report
Frank Krygowski

At this point, joining the chorus of well-stated disagreement with this pro-helmet article may seem redundant. Yet there is one point I'd like to emphasize.

Almost all analyses of the effects of bicycle helmets are founded on an unspoken assumption: that bicycling is an unusually important source of serious head injury, and that therefore some form of protection is obviously necessary.

My study of available data shows this to be a myth.

As an example: John Pucher of Rutgers University has…
Read more

At this point, joining the chorus of well-stated disagreement with this pro-helmet article may seem redundant. Yet there is one point I'd like to emphasize.

Almost all analyses of the effects of bicycle helmets are founded on an unspoken assumption: that bicycling is an unusually important source of serious head injury, and that therefore some form of protection is obviously necessary.

My study of available data shows this to be a myth.

As an example: John Pucher of Rutgers University has staked his career on the danger of cycling, often noting that cycling in the U.S. is several times more dangerous, in fatalities per billion km traveled, than cycling in (for example) Germany. Yet in his paper _Making Walking and Cycling Safer..._, he perhaps inadvertently gives data showing American cycling is over three times safer than walking (362 pedestrian fatalities per billion km, vs. only 109 fatalities per billion km for cyclists).

Similar data is available for Australia. The Australian Transport Safety Bureau reported 1986 data (pre MHL for cyclists) showing 16.12 fatalities per hundred million km traveled for pedestrians, vs. only 4.24 for cyclists. And more such data exists for other countries.

Furthermore, cycling has never been an important source of head injury fatalities. In the U.S., cyclists make up fewer than 1% of the nation's head injury fatalities. Pedestrians, motorists and those simply falling around the home overwhelmingly outnumber cyclists in this regard. If "cost to society" is a concern, surely those groups are much more important targets!

Consider those absolute numbers: 23.5 million kilometers cycled between Australian cycling fatalities. Consider the relative numbers: Cycling is far safer, per km, than walking. Really, how safe does cycling need to be? Is there not some point - a point reached long before the invention of the foam helmet - where we should have said "Cycling is sufficiently safe" and stopped the fear mongering?

Any dispassionate evaluation will show that cycling - yes, even without a special hat - is a net benefit to the individual and to society. Several studies have made that point clearly, with benefit-to-risk estimates ranging from 7:1 (for the individual) to 20:1 (for society as a whole).

Helmet promotions, let alone mandates, are founded on the myth that bicycling is dangerous. But bicycling is NOT very dangerous. It does us no good to pretend it is.

almost 2 years ago report
1. Karl Stade
  
  logged in via Facebook
  
  In reply to Frank Krygowski
  
  Great comment Frank. I honestly am surprised that there is even such a debate about helmets for cyclists considering that such a debate does not seem to exist for other, higher risk actives such as walking or driving a car. It seems that helmets are an easy target, effectively placing further responsibility on cyclists for their own safety - rather than on motorists to drive slowly, safely and be aware of other road users. We need to stop blaming the victims - instead we should focus on making cycling a common activity like it is in places like Holland and Denmark. More cyclists on the streets/paths travelling at normal speeds, better quality and designed infrastructure, vulnerable road user laws, lower road speeds and reduced travel distances will do far for for the safety of cyclists and pedestrians than a helmet law ever will.
  
  over 1 year ago report
Anony Mous

Have just been back in Australia a few months after living in the UK for 15 years. Was a non-helmet wearer in the UK, cycling to work reguarly in London and on the occasional jaunt to Europe. I cycled about 30,000 km over this time - without a helmet and without any head injuries. Coming back here, I find it quite hard to adjust to having to wear a helmet. Firstly, I find them quite awkward and uncomfortable on my head. Also, you cannot fit a cap comfortably underneath - to provide some shade from…
Read more

Have just been back in Australia a few months after living in the UK for 15 years. Was a non-helmet wearer in the UK, cycling to work reguarly in London and on the occasional jaunt to Europe. I cycled about 30,000 km over this time - without a helmet and without any head injuries. Coming back here, I find it quite hard to adjust to having to wear a helmet. Firstly, I find them quite awkward and uncomfortable on my head. Also, you cannot fit a cap comfortably underneath - to provide some shade from the sun. In the local Sydney suburb I am currently in, the traffic seems quite faster than London and cars drive much closer to bikes. All this makes cycling less enjoyable here - I cannot see myself cycling as often in London - which was to work, to tennis, shopping, cafes, friends etc. I used it for most of my short incidental journeys. Here in Australia the car culture wants to push you into a car for every journey it seems. The introduction of the helmet law did nothing to prevent accidents from occurring in the first place - there was no effort to provide driver/cyclist education and cycling infrastructure akin to many of the European nations with a great cycling culture. There was a time in this country when bikes were a favourite activity for our youngsters - in the days of the BMX bikes in the early 80's - and back then hardly anyone was wearing a helmet. I feel the helmet law has led to a reduction in cycling and a more sedentary lifestyle for many people - using a car for almost every short journey. Its no surprise this country has a poor obesity record - up there with the USA. Also no surprise that European countries look to the Australian example of how the helmet law has discouraged cycling to the detriment of the nations health.

almost 2 years ago report
Justin Wood

logged in via Facebook

I have nothing to add other than to endorse the range of comments here pointing out the seriously questionable claims that bicycle helmets actually even represent a safety benefit.

I would challenge Max to respond directly to those points. It is telling that he in no way addressed the specific statements on the lack of protection from serious head injury raised by Chris Rissel in his original article.

almost 2 years ago report
SaveNaturefree Here

logged in via Facebook

I never use a bicycle helmet in daylight hours. I never pay bicycle helmet fines ether, haven't paid one for over 18 years. Cycle helmets are not recommended for outdoor use. Forcing a child to use one is unlawful,

(see s326 Queensland criminal code)

Exposing a child to harm outdoors or doing something that is likely to cause preventable exposure is unlawful.. This fact means the current Bicycle helmet legislation isn't worth the paper it's written on. It's back to the drawing board for the Government that wasted millions implementing this law and issuing fines to thousands of cyclist in error.

We have almost 5 deaths per day from Skin cancer in Australia. The highest rate of childhood obesity in the world and one of the worlds the highest rates of teenage suicide.

11 months ago report
1. Alan Todd
  
  logged in via Facebook
  
  In reply to SaveNaturefree Here
  
  If you want to sign a new petition opposing our infantile helmet laws, go to www.freestylecyclists.org
  
  11 months ago report

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