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news
White cycle helmetCanadian doctors call for mandatory cycle helmets for all 'to reduce head injury'
Paediatricians in Canada are putting pressure on the government to legislate for mandatory cycle helmets, saying that forcing adults to wear them could protect children who copy their behaviour.
Currently only currently only four of thirteen Canadian provinces and territories have full helmet legislation, but the Canadian Paediatric Society is calling for them to be made mandatory for all ages.
In a paper entitled Bicycle helmet use in Canada: The need for legislation to reduce the risk of head injury, the CPS argues:
Bicycling is a popular activity and a healthy, environmentally friendly form of transportation. However, it is also a leading cause of sport and recreational injury in children and adolescents. Head injuries are among the most severe injuries sustained while bicycling, justifying the implementation of bicycle helmet legislation by many provinces. There is evidence that bicycle helmet legislation increases helmet use and reduces head injury risk. Evidence for unintended consequences of helmet legislation, such as reduced bicycling and greater risk-taking, is weak and conflicting. Both research evidence to date and recognition of the substantial impact of traumatic brain injuries support the recommendation for all-ages bicycle helmet legislation.
"Bicycle helmets reduce the risk of head and brain injuries significantly and studies show that legislation increases the use of helmets," said Dr. Brent Hagel, statement co-author and member of the CPS Injury Prevention Committee.
"Everyone is at risk for head injury, regardless of age group.
"Children see adults and often adopt similar behaviours, so if we can get helmets on adults then children and adolescents will be more likely to wear them too."
Six provinces and territories currently have no legislation at all on bike helmets:
- Saskatchewan
- Quebec
- Newfoundland and Labrador
- Yukon
- Northwest Territories
- Nunavut
-
Three provinces have bike helmet legislation that only applies to children:
- Alberta
- Ontario
- Manitoba
Four provinces meet CPS recommendations for all ages bike helmet legislation:
- British Columbia
- New Brunswick
- Nova Scotia
- Prince Edward Island
The report found that in those places that had legislated, helmet use had gone up.
“Systematic reviews have... demonstrated that legislation increases the use of helmets in children and youth.
“One review showed that bicycle helmet use increased postlegislation, with more than one-half of the included studies demonstrating an increase of at least 30%.
“One Ontario study noted a 20% increase in helmet use among children five to 14 years of age two years after passage of helmet legislation covering riders younger than 18 years of age, demonstrating larger increases in low- and middle-income areas.”
Despite evidence from countries including Australia, showing that helmet legislation reduces the number of people riding bikes, Dr Hagel insists that this is not necessarily proven.
“We definitely don’t want to stop people from cycling, we want to increase cycling,” he said.
“If there’s more education that needs to be done and perhaps more environmental changes to increase cycling, I think that’s where we need to look next rather than target legislation for mixed evidence.”
The report added: “While some individuals may avoid bicycling due to helmet legislation, it would need to be shown that they do not replace it with other physical activities for helmet legislation to be considered to have a negative effect on overall health.”
The report said: “There is... ample research indicating that legislation reduces risk of bicycle-related head injury. Evidence of the potential negative effects of bicycle helmet legislation, such as reduced bicycling, is mixed, and a direct cause-and-effect relationship has not been demonstrated.
“Head injuries rank among the most severe injuries in bicyclists, representing 20% to 40% of all bicycling injuries.
“Overall death rates in Canada are estimated to be 0.27 per 100,000 population.”
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74 comments
Head injuries are also no doubt contributing to motorist and pedestrian deaths.
If cyclist MUST wear helmets, surely car drivers and pedestrians should too?
And what about people who live near coconut trees?
Golf... All those small white missiles. A nice tweed or argyle golf helmet will make that game safer
I'm mocking a serious subject here, but it illustrates some sort of point..
Cinelli Dave, I wish you a speedy recovery. I also have a crashed helmet in my garage that is used to scare kids into wearing one, but I still don't think that helmets should be compulsory. If you're tearing round roads on skinny-tyres then wearing a helmet makes sense. If you're rolling down to the shops at 6mph on a dutch-bike the likelihood of hitting your head is tiny and a helmet makes no more sense than full downhill body armour.
This is where Wiggins and Trott's pro-helmet views come from too. The kind of cycling they do means they have crashed many times and been glad to be wearing a helmet. When that is your experience it's hard to imagine why anyone wouldn't wear a helmet. It's also why if you see a cyclist in the Cheshire lanes they are probably wearing a helmet. But their cycling is abnormal, and the kind of cycling anyone who follows this site does is probably abnormal (when compared against the total population of people who ride bikes).
As has been said previously, the problem with helmet laws is that they reduce cycling, which produces more risk for the remaining cyclists, and a cost to society from increased car use (congestion and pollution), increased diabetes etc etc.
Round and around and around we go.
Interesting to read reactions to this article. I am writing this post having crashed on Monday morning. I have a fractured pelvis, dislocated and broken collar bone, cracked ribs and multiple lascerations. What I don't have is a fractured skull because my Kask Mojito took the impact of my head on the road. Most of the right frontal lobe area has collapsed inside the helmet as it absorbed the impact. I was travelling at over 20mph when I crashed on black ice. The ambulance crew,doctors and specialists agree that I was saved from serious head trauma and possibly brain damage or even death by that helmet. Anyone who argues that the protection of a helmet is not necessary should stop and think about those around them. If I had not had a helmet on I may have orphaned my 5 year old boy, widowed my wife and caused more distress for my widowed mother. We have a responsibility to set standards for all and be a good example to younger people. If wearing a helmet became the norm then it would not be an issue. My brother in law has been trying for ages to ensure my nephew wears a cycle helmet. He has shown him pictures of my Kask to show the benefit of wearing one. It is accepted that if you ride a motor bike you must wear a helmet. Why should it not be the same for us on two wheels sharing the roads as well?
A month or two ago I was going down a hill. It had rained that morning, after a dry period, and the road was greasy. The lights at the bottom of the hill went red and I braked a bit too hard. The front wheel locked and folded up. I was going about 45 km/h. I had a bad gash to my elbow, and problems moving it, and went to hospital for X-rays. Luckily nothing more than severe road rash and a bruised nerve. I wasn't wearing a helmet. The natural human instinct to lift the head away from a fall prevented mine from hitting the ground (note: helmets sometimes can defeat this instinct, their extra weight and width turning what would be no-contact or a glancing blow into a heavy blow).
Aside: For every anecdote there is an opposite anecdote. Which is why we should let our views be guided by the output of science instead. E.g.: http://www.sciencedirect.com/science/article/pii/S000145751100008X (a meta-analysis, so systematically analysing a number of primary studies).
1. E.g. as demonstrated by some of the cyclists in https://www.youtube.com/watch?v=Lqo4hwnJt6Y
With such responsibilities in your life, I'm surprised that it didn't occur to you not to take risks such as cycling at 20+mph on black ice.
No one was to blame for your crash but you, but you seem to want everyone else to pay the price.
I've been a member of this forum for just over a year, quite long enough to realise that the helmet debate is road.cc's answer to Groundhog Day.
The debate generates a lot of heat every time, but is there actually any serious possibility that a mandatory helmet law will be introduced in this country? I can't help feeling that the topic is a good excuse for people to mount their favourite hobby horse.
Most of my riding is in a rural setting and at this time of year especially lots of things fall out of trees, so I wouldn't go out without a lid. It saves me from being bruised by conkers and stray branches, but I'm under no illusion that it would prevent serious injury if I was hit by one of Cheshire's 4 x 4's.
I'm sceptical about some of the arguments presented earlier. There was a claim that helmet wearing put teenage girls off cycling, but the fact is that once compulsory school sport ends most teenage give up physical exercise.
Then there was the assertion that riders who went helmetless would be a target for police, but the police routinely ignore riding without lights after dark and riding on pavements so I'm not sure why they would choose to enforce a helmet law while ignoring other infractions.
Anyway, I'm looking forward to the next lengthy thread on this subject which should be due shortly after Christmas.
There was talk some years ago of a pledge by one UK party or another to introduce mandatory helmet laws once the base rate of wearing exceeded a particular percentage (not sure which party or what percentage). And now Sir Bradley Wiggins has joined a helmet law campaign (which sadly trots out the discredited 88 per cent figure).
Helmet wearing rates in central London are already quite high. Some years ago I did my own tiny survey (one commute to work about 5 miles in length on one route on one morning). Of 100 people on bikes I counted, 82 were wearing a helmet (I stopped at 100 because it's not easy to concentrate on traffic when you're juggling numbers). With no other evidence to back it up, I'd guess that figure is on the rise, thanks to the continual drip feed of pro-helmet propaganda and regular scare stories carried in the press. I think the spectre of helmet laws is going to be with us for a long time to come.
I prefer to see it as refining and sharing the argument against bike helmet laws.
Instead of making cycling safer by introducing continuous, dedicated and segregated infrastructure, which requires investment (investment which will eventually be recouped) and time, politicians prefer to seek out a fast, cheap fix, and helmet laws are it.
Those of us who love to cycle are far from convinced, and would prefer not to go down the path taken by countries which have enacted helmet laws, but made no other provision for safe cycling. As a result, cycling rates drop and remain low, bike hire schemes languish and the few people who dare take their bikes on the roads are no safer than before the laws were made.
Is it safe to assume that when you go for a walk at this time of the year you don a safety helmet???
Fair point, but I don't walk in the country and I can't walk at 15/20mph.
Also, I generally wear my trilby when I'm out and about at this time of year. (I am an OAP)
If you could walk that fast would expect to see you in the next Olympics
my preferred walking head wear is a duncher. I think it is better known as a flat cap down your way!
In other news:
Police in Kentucky the place with the highest levels of firearms ownership have called for body armour to be compulsory. They claim that when people are recklessly shot, it prevents some but not all of the injuries and that this was a sensible measure to prevent injuries. Asked why they didn't seek to stop the reckless use of guns that caused the problem in the first place the spokesman for the Kentucky State Police merely looked puzzled.
I have lived in Nova Scotia, one of the Canadian provinces that has complusory helmet laws and it has (or had - I lived there 14 years ago) a very different cycle culture to here in the UK and I don't know if the results of reduced injuries would be replicated here.
I moved to Halifax (the provincial capital) and bought my bike from Cyclesmith on Quinpool and I was told firmly that I needed a helmet but I was surprised when I asked for some lights and they said - "oh you don't need those - it's not a legal requirement"
Cycling was very much a leisure pursuit. I and some of my colleagues (from the Netherlands) used bicycles as utility transport and we were seen as a bit odd, though treated with respect. I once asked at a sailing club I cycled too ( I crewed on a yacht) if there was somewhere I could leave my bike and was told "people don't normally cycle" and a couple of drivers drove beside me and asked how easy it was to cycle round Halifax, they seemed genuinely surprised somebody would cycle just to get from one place to another.
Gavin
It's not just emulating our heroes. Cyclists both old hands and new comers are under huge peer pressure to adopt the wearing of helmets and hi viz because of the 'perceived risk' on the roads. It comes from chain stores with the you will need this to friends and family saying I really wish you would wear one.
Dr. Hagel suggests that cycling might be replaced as healthy exercise by other sports.
The beauty of transport cycling is that it keeps you fit as a byproduct of getting around.
I can't see anyone swimming to school, not many of us could row to work, working out in the gym does not get you to the shops.
The real cost of helmet legislation is an opportunity cost. Theres only a finite amount of time and money available. Goverment, police and law courts would save far more lives putting their time into reducing the liklihood of being run over people in the first place, rather than ensuring those who are hit have a helmet on.
The question isn't "Would a helmet law save lives?", its "Could we save more lives by doing something else with the time & money it would take to implement and enforce a helmet law?"
Watch this video and count the helmets:
www.youtube.com/watch?v=cWf5fbSUNAg
This video totally makes the point that many are trying to make: it's not about helmets, it's about making a road culture that promotes, expects, and above all respects people on bicycles. A helmet law would not help this cultural shift at all, and in my opinion would actually make it worse.
Like many others here I frequently choose to wear a helmet, but usually don't when I'm 'utility cycling' (normal clothes, short journeys of a few miles). As a society it is this kind of cycling that needs to increase. The lycra and strava fuelled obsessives of this site are not relevant, it's your neighbours, your parents and grandparents, and your colleagues at work who don't cycle in the UK because there is such a car-bias that would be helped by a Danish/Dutch cycling attitude and structure. I've cycled in both countries, and seen that rate of helmet use is almost non-existent in both, and the odd person in HiViz is looked upon as though they're an alien. Yet they seem happy and healthy and the streets aren't littered with bodies.
The solution, is to make it easier to bike to the shops, station, work, school etc, helmets are at best a distraction from this.
Excellent comment, 3cylinder.
There is a very strong association between helmet laws (and high rates of wearing and of pro helmet propaganda), low levels of cycling and high rates of casualties for cyclists.
USA, Canada, Australia, New Zealand, South Africa have dangerous roads, few cyclists and high helmet wearing rates (and/or laws).
Denmark and Netherlands have low casualty rates, low helmet rates and many cyclists.
We are somewhere between. Why on earth do we want to copy the foam hat wearers? They are more dangerous for cyclists even though they make us wear helmets.
I think helmets are an alibi or substitute for measures which might actually make the roads safer for cyclists.
+1
Now can we just move on? It gets boring reading the same old comments regarding cycle helmets.
Well don't read them then. But don't try to censor others.
I'm not trying to censor anyone. But the comments in this thread are going round and round and round in circles. And these are the same old circles we've seen in every other thread debating helmet use. There comes a point when you have to look back at all the comments in a thread and admit that the discussion has reached the point that it can't move on any further. Those in favour of wearing bits of plastic on their heads won't back down and those against won't back down either. It is pointless to continue.
You may not agree with some of the other news items or forum topics attracting comments right now, but at least they're taking discussions in a different direction for once. Vasectomies and cycling - well that hasn't been talked about here before that I remember. Is Jon Snow right or not? Also something that hasn't been looked into much, and the same is true as to whether or not a piece about an armed robber escaping by bike is or isn't a cycling story, or the discussion over the piece by Lucy Kellaway. But helmets? ZZZZZZZZZZZZ.
Carry on if you want. But it won't get you any further ahead. And in a few weeks, we'll have another news item kicking off another helmet debate and then pretty much the same string of comments. And then a few weeks after that...
I can tell you from experience that some people are open minded enough to change their minds when acquainted with evidence and arguments from a different viewpoint. They are usually scientists trained to look at statistics. I well remember discussing helmets on a newsgroup with a helmet believer who is now prominent on cyclehelmets.org.
Given the helmet propaganda and misinformation so widespread in the media there is a place for the other point of view. That this side of the argument needs putting is apparent from the number of ill informed cyclists who say, "I crashed and a helmet saved me."
Not everyone who reads these threads has read previous helmet threads. For some cyclists it may be news that there are people who don't believe in helmets, and that there is strong evidence they do not work.
There are indeed topics and forum discussions here which do not interest me. I do not read them. I don't bother to add my comment to say that the people who do find them interesting should shut up.
Of course some people are big enough to change their minds when they come across evidence that their previous assumptions were not correct (and indeed decent science is all about evidence based decisions and opinions).
Of course there are some who faced with evidence that previous assumptoins were not correct choose to disbeleive the evidence and try to discredit it or come up with contrary evidence. In the pro-helmet world that tends to involve quoting lots of frequently repeated "evidence" in the form of anecdotal information which is not actually "evidence" at all.
In the 1980s I became convinced that the helmet was a good idea - my opinion at that time wasn't evidence based but the modern type of helmets were appearing on the pro race scene and they seemed like a good idea.
Has anyone else noticed that the number of pro racers getting killed since helmet wearing was required hasn't reduced? (Note in most countries in Europe professionals could choose to wear helmets or not, and generally chose not to, until the UCI rules made them wear helmets in 1993)
Evidence since has indeen enabled me to change my mind and realise that no helmet, even a full motorcycle type offers nearly as much protection as changing the way people use the roads. I still tend to wear a helmet, it is a good place for my extra lights and it reduces the amount my wife worries (she's worked in casualty and has the usual anecdote based view on helmets and safety).
From now on I'm going to stick to one simple argument:
Pedestrians are in as much danger of head injuries per mile as cyclists, there are far more pedestrians so it makes sense to enforce mandatory helmets upon all pedestrians first.
There was a study I saw [Im trying to re-find it] about head injuries among pedestrians, cyclists and car passengers and cyclists actually come out having the slightly lower number of head injuries per km of the three.
If medical practitioners wish to make calls for mandatory helmets then they should base their calls on evidence and expand it to all people, all the time, in every environment.
Have you considered that the statistics in the study you reference don't include a large number of cyclists who DIDN'T have head injuries, because they were wearing a helmet when they had their accident? It would seem that most data is based on information from A&E departments etc, so it only includes those cases where a head injury occured. Hence, arguments in favour of helmets tend to be more anecdotal, as in "I fell off my bike last week and cracked my helmet, but my head was fine".
Most developed countries (including GB) publish annual figures for the amount of car, lorry, bicycle etc. miles ridden in the year. These have various inaccuracies no doubt, but as long as the method of collecting remains the same the figures will certainly capture trends.
Figures for cyclist head injuries treated in hospital are generally collected too. When helmets are made mandatory in a country the proportion of cyclists wearing them goes up suddenly, often to above 90% from 30 or 40%.
If the number of cyclists treated goes down (or up) but the number of miles or kilometres ridden remains the same when the rate of helmet wearing doubles or trebles we can deduce that helmets may have saved injuries and lives (or cost them).
In Oz, NZ and other mandatory helmet states the figures show no reduction in rates of injuries or deaths to cyclists. The number of casualties declined in proportion to the decline in miles cycled. This failure of helmets to reduce casualty rates has happened in all states where foam hats are mandatory. In states where helmets are not obligatory the figures seem to show the same, though because the increase in wearing is not so sudden it is more difficult to detect any effect or lack of effect.
As a control we can look at say pedestrian casualty rates and see whether they have moved in the same way as cyclists', in order to allow for other changes in the road environment.
The anecdotal evidence you mention is not very useful, but is often used by those in favour of compulsory helmets.
There is a large amount of information and discussion at
http://www.cyclehelmets.org/
The problem with comparisons to seatbelt and motorbike helmet laws, is that both of those items are designed and tested to protect you in higher speed motor vehicle collisions. Bicycle helmets are not. They're being proposed as a compulsory measure to protect you in an RTA, while there is not one helmet manufacturer who will claim that their product is designed to do that.
If cycle helmets are to made compulsory, they will almost certainly have to offer better protection to be considered fit for purpose. If cycle helmets become a compulsory safety measure for public road use, then both the manufacturers of the helmets, and the standards to which they have to conform will be subject to potential legal challenges, so they will need to make sure they measure up. This happened when motorbike helmets were made compulsory. New standards were set to define what constituted a legal safety level, and many of the helmets on sale at the time became illegal overnight. To pass the standards, motorcycle helmets had to become stronger, and heavier.
There's a good chance this will happen if bicycle helmets are made compulsory, because sooner or later there is going to be a court case. You legally compelled my father / son / daughter to wear a cycle helmet that did naff all to protect them from brain injuries when they were hit at 40mph. Who do I sue first? I'm a little surprised it hasn't happened already in one of the countries that has already adopted compulsion, and the fact that no one is addressing the issue of what level of protection that cycle helmets actually offer when mandating them just shows how little real thought is being put into the campaign to make them law. But as it spreads, and if it succeeds, I think it'll just be a matter of time. And at some point, cycle helmets will have to be stronger, heavier and less comfortable if they are to be considered suitable for road use, and that will deter people from getting on their bikes.
Then there's the political of effect of passing a mandatory helmet law. Forcing riders to wear helmets is easy. It's about the quickest, easiest, cheapest and most visible thing that any government can do to address cycle safety issues. Unfortunately, it's also way, way down the list of things that are going to make any real difference. Now, call me cynical if you like, but it seems that pretty much any government will take "quick, cheap, easy, visible and superficial" over "complicated, expensive but actually effective" (like providing better infrastructure, or changing driver attitudes and behaviour) every single time if they can get away with it. So what we have to look forward to if helmet use is made compulsory, is a day when we ask our politicians, "What are you going to do to make the roads safer for cyclists?", and their answer will be, "We've made it compulsory for them to wear helmets".
The helmet law is a distraction, it's a red herring. While it remains the focus of the cycle safety debate, it makes the chances of real effective change even more remote.
@GoingRoundInCycles
In general you seem to regard issues of right-or-wrong as 'irrelevant', and think that all that matters is power. So in your view its 'right' if someone of sufficient power tells you to do something? OK, I get where you are coming from. But we differ on that.
And you really don't argue in a coherent fashion. I realise you have gone off on a hypothetical tangent about the merits of obeying a helmet law should one be introduced. That's a different argument (I'd almost certainly just give up cycling, but I certainly would respect those who chose to openly defy such a bad law, just as I respected those who disobeyed racial segregation laws in the US civil rights era).
What we are actually arguing about is whether such a law is morally justifiable, not how to respond to it if it existed.
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