Lifting the lid on the helmet debate

The debate about wearing helmets has been raging for as long as we can remember, but whatever your stance it pays to arm yourself with the hard facts and be aware of some flimsy fallacies…

‘Helmets encourage a false sense of security.’ ‘They’re only useful for children falling off bikes.’ ‘Helmets put people off bikes.’ These aren’t the outbursts of Twitter trolls; each statement is backed up by studies over almost three decades of ongoing discussion of the pros and cons of cycle helmets.

It was the publication of one such academic paper that started it all. A case-control study of the effectiveness of bicycle safety helmets, from 1989, is said by some to have been the catalyst for mandatory helmet law in Australia in 1990.

Its findings continue to influence debate and divide opinion. Mandatory cycle helmet laws have been introduced and enforced — and even repealed in countries such as Mexico — ever since. The findings of that 1989 study — from Seattle — have been pulled apart as frequently as new and contradictory papers have been released.

Do you really want to live and ride in a place where you need to wear body armour to remain safe?

“The report’s been cited time and again by campaigners for compulsory helmets,” says Tony Upfold, spokesman for Cycling UK, who is against blanket legislation. “But we’ve seen studies since that question the merits of imposing helmets.”

Australia continues to review the impact of the law change 26 years on — with several states set to trial ‘helmet-free’ low-speed cycle zones. Seattle introduced compulsory helmets in 2003, but in December 2016 its city council expressed fears that its mandatory helmet law was hampering the $5 million upgrade of its bike share scheme.

Do I need to wear an Australian standards helmet?

One of the more recent surveys, from the Universities of Toronto and British Columbia, measured five years’ cycle accidents in different Canadian districts. It found that compulsory helmet laws had no impact on hospitalisation rates for brain, head, face or neck injuries. ‘Policy makers should concentrate on investing in infrastructure rather than creating helmet enforcement laws,’ suggested the research.

In contrast, a number of high profile fatalities on British roads recently have led to renewed calls for legislation requiring riders to wear a helmet.

Compulsory helmet laws split opinion, and a characteristic of the debate is that both sides regularly resort to smacking each other with malleable statistics extracted from the reams of ongoing research.

Perhaps the strongest argument against mandatory helmets is one proffered by former Olympic champ Chris Boardman, among others, whereby too much focus on helmets detracts from the real safety issues. While many defenders of ‘choice’ cite Dutch and Danish cities as examples of places where helmets are rarely worn and head injuries rarely recorded, those cities look different to most British ones.

Boardman, a policy advisor to British Cycling, believes riders need to look into why they feel the need to wear helmets and while he’s adamant there’s nothing wrong with them, he feels they detract from the bigger picture. “Do you really want to live and ride in a place where you need to wear body armour to remain safe?”

Boardman has called for attitudinal change to how we view cycling and how it’s integrated. On the subject of why other European cities have much lower helmet usage and yet aren’t overwhelmed by head injuries he’s clear. “You are as safe riding a bike as you are walking, statistically. 0.5 percent of people in the Netherlands wear a helmet, and yet it’s the safest country in the world. Places such as Utrecht in the Netherlands have looked at the real dangers cyclists could face. In Britain we need to look at making the space for cycling, there are greater safety priorities to address.”

Debate: making a case for...

Choice

Nick Hussey, creator of cycling brand Vulpine.cc — the cynic might expect him to see uniform wearing of cycle helmets as a must but…

“Social media and the immediacy of information make it look like cyclists are dying in huge numbers but they’re not. When it comes to helmets I’m ‘pro choice’. I’d find it very strange for anyone not to wear one mountain biking, and definitely downhill. I’m in favour of compulsory helmets for track and racing, but not hill climbs, who crashes in a hill climb?

“It’s speed that creates risk. Crashes happen often in road races or mountain biking, not pottering through Hyde Park. I’ve been wearing a helmet most of the time for 30 years, my mum said I could only race if I did. I hated it, but I got it. Cycling is safer than driving, without even taking into account the health benefits. Sadly people will always die tragically on bikes, just as they do on building sites, in cars, and even their own gardens.”

Compulsory

Former Olympic rower James Cracknell, suffered life-changing injuries when hit by a petrol tanker while cycling in the USA…

“I got into the habit of wearing a helmet when cycling in Australia where it was against the law not to. I would be dead if I hadn’t worn a helmet when a wing mirror smashed into my skull at 70mph. In an ideal world wearing a helmet would be compulsory; if the approach was more joined-up with legislators, manufacturers and retailers, and cyclists ‘policing’ it themselves, then it could work.

“I don’t buy into the resistance to wearing them; ‘having a hotter head’ or ‘your hair will be messed up’. It’s really no price to pay at all when you consider the possible outcome of not wearing one. Also there’s no point saying, ‘Wear a helmet, it’s the law’ and that’s it. It has to fit, stay in position and not impair your hearing, sight or peripheral vision.”

Q&A: Should We Bin the Lids?

Tony Upfold, of Cycling UK, and Luke Griggs, from Headway, the brain injury association highlight how the debate rages on...

Compulsory helmets, what’s your stance?

Luke Griggs: “At Headway we encourage cyclists of all ages to wear helmets and campaign for compulsory helmets among vulnerable groups, especially children. We also support wider calls for better protection for cyclists through changes to infrastructure, for example.”

Tony Upfold: “At Cycling UK we’ve long campaigned against helmet laws. It should be a matter of informed personal choice, not compulsory. Laws in other countries that ban people from cycling without a helmet have reduced the number of cyclists. This undermines the health and environmental benefits of cycling and the ‘safety in numbers’ effect.”

How do you justify your position?

LG: “We believe there is enough evidence to show that wearing a helmet can prevent and reduce the chances of severe brain injury, and can save your life.”

TU: “Campaigners and politicians attempt to make their name by proposing legislation to force people to wear helmets. We aim to prevent these moves by explaining the damage such legislation could bring.”

Where’s your evidence?

LG: “The 2009 government-commissioned study by the independent Transport Research Laboratory (TRL), looked at the evidence around helmets and reported that they’re effective at reducing the risk of skull and brain injuries. We can cite numerous other studies and the opinions of neurosurgeons.”

TU: “By creating exaggerated perceptions of the risks of cycling, even voluntary helmet promotion campaigns have been found to deter some people from cycling. Given that the health benefits of cycling outweigh the risks, it can be shown that only a very small reduction in cycle use is needed for helmet promotion (let alone helmet laws) to shorten more lives than helmets could possibly save.”

LG: “We’ve contacted transport ministries in Australia where mandatory laws are often cited as being responsible for putting people off cycling — instead we’ve found that helmets there are not considered to be a barrier to cycling.”

Shouldn’t safety come ahead of numbers?

LG: “We don’t want to deter people from cycling — it plays a key role in keeping people fit and active and we support charity fundraisers taking part in cycling events. But we feel people should recognise that children especially don’t possess the same levels of road experience and have different ways of processing danger, making them more vulnerable on the road. Headway has helped so many cyclists rebuild their lives after coming off their bikes, and seen first-hand the impact of thinking ‘it’ll never happen to me.’”

TU: “There are better ways to make conditions safer for cycling. These include tackling bad driving; having widespread 20mph speed limits in towns and villages; developing high quality road infrastructure; and training adults and children to have the confidence to ride safely. Cycling should be promoted as an essentially safe, normal and enjoyable transport and leisure activity, which anyone can do in whatever clothes they prefer to wear, with or without helmets.”

Thanks to headway.org.uk and cyclinguk.org

Timeline of a tiff

1975: A by-product of motorcycle helmet manufacture — expanded polystyrene foams — used in the lining of ‘smack-hats’ first sold as bespoke bicycle helmets.
1987: Early mandatory bicycle helmet laws trialled in California in 1987 and New York in 1989 applied only to young children who were passengers on a bike.
1988: Analysis of data on all 8 million injuries to cyclists in the USA over 15 years concludes: ‘no evidence that hard shell helmets had reduced head injuries or fatalities, but moreover that fatalities were more likely among cyclists that wore helmets.’
1989: Seattle Study concludes: ‘cycle helmets reduce head injuries by 85% and brain injuries by 88%’. For many it was this study that kick-started the argument that’s raged ever since.
1990: Australia introduces national laws on helmet wearing for cyclists. New Zealand followed in 1993, regions of Canada in 1995 and South Africa in 2006.
1996: Researchers found that at least 50% of cyclist fatalities in Sheffield and Barnsley would not have been saved by helmets, and 13 times as many car occupants and pedestrians might benefit from helmets as cyclists.
2000: A Cochrane review considering five case-control studies from the UK, Australia and the USA illustrates a large and consistent protective effect from cycle helmets — reducing the risk of brain injury by up to 88% and injury to the upper and mid face by 65%.
2005: The House of Lords refuse a Road Safety Bill amendment that would have made helmets compulsory for cyclists under 16 because ‘mandatory helmets discourage healthy exercise, which would be a loss for the nation.'
2008: UK Department for Transport shows that overall bicycle helmet wearing in the UK was 34.3% — in line with a constant increase since 1994, when it was 16%. It remains approximately a third in 2016.
2009: Transport Research Laboratory review of over 100 police forensic reports into cycling fatalities showed that between 10 and 16% of those fatalities would have been avoided had the victim been wearing an “appropriate cycle helmet”.
2010: “Helmets are a barrier to new riders. The need to wear a helmet reinforces the message that cycling is dangerous — with perceptions of danger a major reason people give for not cycling," Chris Rissel, professor of public health at the University of Sydney.
2011: Review of the data used in a 2010 study finds a 29% reduction in bicycle-related head injury attributable to the introduction of the mandatory helmet law.
2012: Olympic champion and Tour de France winner Bradley Wiggins tweets that all cyclists should be forced by law to wear helmets on the road.
2014: “I see lots of people in bike accidents and these flimsy little helmets don’t help” — Henry Marsh, neurosurgeon at St George’s Hospital, Tooting, London. Helmets are compulsory (with limited exceptions) for children aged 13 years and under.
2015: “Humans adapt their risk-taking behaviour on the basis of perceptions of safety” — Dr Tim Gamble, traffic psychologist at the University of Bath, on the publication of a report suggesting cyclists take more risk when wearing helmets.
2016: “I went flying towards the concrete road. I was wearing a helmet that saved my life” — Sir Richard Branson. Helmet use is associated with odds reductions of 69% for serious head injury and 65% for fatal head injury, University of NSW review of 40 separate studies.