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Politics trumps hard-headed reason on bicycle helmets

johnboy 4 December 2013 103

bicycle helmet

By Chris Rissel, University of Sydney

For a few hours, late last week, it looked like Queensland could become the first Australian state to start relaxing its strict bicycle helmet laws.

After months of careful review of the evidence, a state parliamentary committee backed the need for A new direction for cycling in Queensland, releasing a 200-page report that recommended, among other things, letting cyclists over 16 ride helmet-free in certain conditions.

Yet within hours of that report being released, the state Transport Minister Scott Emerson called a press conference to reject relaxed bicycle helmet laws, in what I would argue was a clear example of personal views and politics trumping science and evidence.

While the minister will support many of the report’s 68 other recommendations, such as safe passing distance rules for motorists and increased penalties for breaking road rules, he declared that:

Personally I’m a big believer in the benefits of helmets and I believe the evidence shows helmets reduce the risk of serious injury.

That statement sums up well the confusion around this issue.

While on the one hand helmets can protect against some head injuries, particularly minor scrapes and contusions, making them compulsory at all times does not automatically reduce rates of serious injury at a population level.

Clashing heads over helmets

The evidence on the effectiveness of mandatory helmet legislation is highly contested, with many analyses reporting negative effects on cycling participation.

There is compelling evidence that cycling head injury rates were consistently declining before the introduction of helmet legislation (see figure 1, p4 of this report), with any reductions in head injuries attributed to the legislation actually due to a marked reduction in the number of people cycling.

After examining the evidence, the Queensland parliamentary committee summed this up well:

The report notes Australia is one of the few countries in the world that has compulsory helmet laws and the committee was not convinced there was sufficient worldwide evidence of the safety outcomes of compulsory helmet wearing to justify the mandating of helmet wearing for all cyclists.

In other words, the committee was not against encouraging helmet use; instead it was a recognition that, in some circumstances, a helmet may not always be required when cycling.

Making adult decisions

The committee’s recommendation (number 15) was to have a two-year trial, exempting cyclists aged 16 years and over from the mandatory helmet road rule when riding in parks, on footpaths and shared/cycle paths and on roads with a speed limit of 60 km/hr or less.

Those people who want to wear a helmet can certainly continue to do so. The focus on adults is important, as 50% of cycling injuries are among children.

Further, the conditions of the trial are those scenarios where the risk of a cycling crash, or the even less likely event of a head injury, is very, very low. In the conditions where the risk of cycling is high, such as road racing or mountain biking, helmets are still required.

An important aspect of this recommended trial was to evaluate it carefully, with baseline measurements and data collection on injury and cycling participation. This trial could have established the evidence, either for or against this helmet law reform, and finally lay to rest the debate over the value of helmet legislation.

What a sensible idea! We could have had real world evidence to inform policy, but instead we have seen one politician and his advisers who know better.

Is this another example of politicians being out of touch with the majority views of the public? Consider the views on increasing spending of taxpayers’ money on public transport in Sydney (supported by the public) versus investment in motorways (supported by the government).

On this issue, many local councils around the country, including Brisbane, Fremantle, and the lord mayors of Adelaide and Sydney have publicly expressed their support of reviews of helmet laws, seeing them as one barrier to increasing cycling participation.

The negative effect of helmet legislation on the bicycle share schemes in Brisbane and Melbourne has also been well-documented.

Queensland has missed a good opportunity to start bringing Australia back to parity with the rest of the world.

It is worth remembering that the Northern Territory already has legislation, which allows helmet-free cycling on footpaths and cyclepaths. They have one of the highest rates of cycling participation by women, and cycling mode share for journey to work in the country. Their cycling injury rates are no different to the rest of the country.

Despite this lack of political leadership on bicycle helmet law reform, if the other recommendations of the Queensland parliamentary committee are implemented, there should be significant improvements in cycling. These are to be applauded.

If the Queensland transport minister can’t be persuaded to change his mind, then perhaps it will be up to another state now to do what needs to be done to trial and evaluate what happens when you relax bicycle helmet laws.

Chris Rissel receives funding from the Australian Research Council for the a project to evaluate cycling infrastructure in Sydney. He is a member of the Australian Cyclists Party and Bicycle NSW.

The Conversation

This article was originally published at The Conversation.
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103 Responses to Politics trumps hard-headed reason on bicycle helmets
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thatsnotme 11:04 pm 18 Dec 13

gooterz said :

Don’t like it? Then invent a better safety device, maybe airbags for bicycles.

Already done

http://www.hovding.com/en/

FWIW, I had a mountain bike accident a couple of months back. Wasn’t going fast, or doing anything extreme by any measure, but things went wrong, I was pitched over the handlebars, and I now have a whole lot of metal in my left shoulder. It could just as easily happened on my road bike, and when I eventually get back to riding I’ll need a new helmet, cause mine took a decent blow when I came off.

My helmet is possibly the reason I’m now just having to do physio to get movement back in my left shoulder, rather than having to learn to talk again. I get all the arguments about participation, and see how they apply to Amsterdam or Denmark. Canberra though? I can easily see how my stack (which was at jogging pace, at most) could have happened just as quickly off the dirt, on our roads or cycle paths.

(Off topic, but if you’re ever after a practical demonstration of how our ageing population is going to blow out health funding, first get admitted through A&E, then spend a few days in the osteo ward. Sheesh…)

gooterz 8:46 pm 18 Dec 13

Its Pascal’s wager:
Don’t wear a helmet and nothing happens your fine.
Don’t wear a helmet and you die.
Wear a helmet and be fine even if something happens.

When doing a survey do they include those that aren’t around anymore to do the survey?

Given you can die from falling over without a helmet on a helmet is a good choice.
I’m all for people having the right to cycle without a helmet ad long as when they become a cripple or die they don’t then become a drain on my tax money and hospitals.

Don’t like it? Then invent a better safety device, maybe airbags for bicycles.

desertdreaming 8:06 pm 18 Dec 13

This is not hard bicycle users. Read on:

– where a helmet. If you fall off and hit your head, it will not hurt as much.

– where bright colours, even hi-viz. Where it over your dark grey office clothes as you are hard to see

– stop at pedestrian crossings, check that the driver has elected to give way when otherwise not obligated, and proceed across mounted or dismounted – your choice. But just stop and check please.

– when you are riding in groups and packs on the weekend, think about how motorists might react when encountering your pack coming around a blind corner at speed. Probably best thin out and keep to verge,

dtc 5:43 pm 18 Dec 13

davo101 said :

Here’s a good editorial on the subject by Ben Goldacre.

Having thought about this a bit more over the past few days, it seems to me that benefit of increased health through cycling participation – as is alleged will occur if there are no helmet laws – is over done.

This is because the people who refuse to ride at all due to a helmet are, I think, highly unlikely to be people who will be regular long distance riders. People who want to ride (commute, for enjoyment etc) will be very unlikely to not do it because of a helmet. After all, there are plenty of other difficulties associated with riding (eg getting organised to change into work clothes etc) that create much greater issues than a helmet. There may be some people who would commute if there were no helmet laws, but I just find it hard to imagine someone wanting to cycle but choosing to pay $12 for parking or $6 for a bus (and hanging around for the wandering bus route) per day just because of a helmet.

Rather, the people who wont ride due to a helmet are the people who might (if there were no helmet laws), one fine Saturday spring morning think ‘I’ll ride to get my morning coffee today rather than drive’ and potter down to the cafe (but will drive if its cold or too hot); or who might hop on a bike to ride 500m to the shops every now and then to get a loaf of bread rather than drive just to do something different.

While any exercise is better than none, infrequent slow and short exercise is hardly going to make any serious blip in societal health. Increased cycling participation rates, on their own, do not necessarily result in increased health benefits (after all, to take an extreme example, I suspect the proportion of Thai people who participate in ‘sporting activities’ is far lower than the USA but it doesnt mean there are more obese Thai people).

So to point to reduced participation rates does not prove that the negative health impact of helmet laws outweights the health benefits (associated with accidents). Indeed, it could be argued that less riders means less accidents, so in fact overall there is a benefit.

Statistics, 99% of them can be interpreted to prove 4 contradictory arguments at once.

davo101 3:41 pm 18 Dec 13

Here’s a good editorial on the subject by Ben Goldacre.

snoopydoc 3:09 pm 12 Dec 13

howeph said :

snoopydoc said :

The purpose of a bicycle helmet is to reduce the severity of head injury in cyclists involved in crashes. I was discussing that, as the most relevant aspect of the “issues at hand”.

On what basis have you determined that this is the most relevant aspect of the issues at hand?

snoopydoc said :

The wider issue is the cost to the individual’s family, and society at large, for ongoing care for severe head injuries that may have been preventable.

The OP repeatedly mentions the helmet laws effect on participation. Why do want to ignore this aspect?

I haven’t ignored it. I’ve considered it in some detail and decided that it is of little relevance when the outcome measure of interest is the risk of serious head injuries to cyclists.

If you insist on remaining excited about the reduced participation of “borderline” cyclists, then you could even view mandatory helmet laws as doubly beneficial… fewer people are exposed to the risks of head injury from cycling, and those that still cycle have a lower risk than they otherwise would have. 😉

Anyway, cheer up, move on… maybe go for a ride in the fresh air… Sitting at a computer’s not good for you… even if you wear a helmet… 🙂

snoopydoc 3:01 pm 12 Dec 13

Aeek said :

snoopydoc said :

I’m more concerned with the relative risk reduction to people who are already going to be cycling anyway, and for those people (such as myself) there is a clear benefit in using a helmet.

There’s also risk compensation, helmet wearing encouraging higher speeds and riskier choices, offsetting any risk reduction benefits obtained from wearing helmets.

It’s a plausible supposition, but there is no good quality evidence demonstrating that it actually happens.

howeph 1:19 pm 10 Dec 13

snoopydoc said :

The purpose of a bicycle helmet is to reduce the severity of head injury in cyclists involved in crashes. I was discussing that, as the most relevant aspect of the “issues at hand”.

On what basis have you determined that this is the most relevant aspect of the issues at hand?

snoopydoc said :

The wider issue is the cost to the individual’s family, and society at large, for ongoing care for severe head injuries that may have been preventable.

The OP repeatedly mentions the helmet laws effect on participation. Why do want to ignore this aspect?

Aeek 12:06 pm 10 Dec 13

snoopydoc said :

I’m more concerned with the relative risk reduction to people who are already going to be cycling anyway, and for those people (such as myself) there is a clear benefit in using a helmet.

There’s also risk compensation, helmet wearing encouraging higher speeds and riskier choices, offsetting any risk reduction benefits obtained from wearing helmets.

snoopydoc 11:18 am 10 Dec 13

howeph said :

snoopydoc said :

Again, really not fussed about the overall effect of absolute number of head injuries in society, or the people who get a bit fatter because they can’t cope with a helmet messing up their hair, etc.

So basically you’re not interested in discussing the issue at hand?

snoopydoc said :

I’m more concerned with the relative risk reduction to people who are already going to be cycling anyway, and for those people (such as myself) there is a clear benefit in using a helmet.

Then wear a helmet. No one is saying that you can’t.

The purpose of a bicycle helmet is to reduce the severity of head injury in cyclists involved in crashes. I was discussing that, as the most relevant aspect of the “issues at hand”.

And I will wear my helmet, thanks. 🙂

The wider issue is the cost to the individual’s family, and society at large, for ongoing care for severe head injuries that may have been preventable.

Watson 11:54 am 09 Dec 13

MrBigEars said :

Watson said :

MrBigEars said :

Watson said :

(2 per million versus 2.5 per million). ” Really, 0.5 per million is a significant decrease?

Or in other words a 20% reduction in fatalities/incapacitation injuries. In public health terms, that’s massive.

And a 20% reduction of SFA is still SFA. Meaningless numbers.

I don’t know that its meaningless. 0.5 child deaths per million children per year, roughly 75 million (from census graohs) children in the US, works out to be 37.5 children not dying from head injuries per year.

Like I said, I’m not really involved in this. I would, however, be cautious in overstating the role of mandatory helmet laws in people’s choice to exercise. I’m not convinced that people casually riding to the shops (which is the mode of transport most affected by helmet laws, apparently?) is going to have a particularly significant impact on an individuals health, but hey, by all means trial it. I’m all for evidence based decision making

We could save a lot more children and people by banning cars. Even with seatbelts and mandatory safety design standards, there are still heaps being killed each year just simply by getting into a car and onto the road. Yet we appear to think it an acceptable risk for the benefit it brings us.

howeph 9:19 am 09 Dec 13

snoopydoc said :

Again, really not fussed about the overall effect of absolute number of head injuries in society, or the people who get a bit fatter because they can’t cope with a helmet messing up their hair, etc.

So basically you’re not interested in discussing the issue at hand?

snoopydoc said :

I’m more concerned with the relative risk reduction to people who are already going to be cycling anyway, and for those people (such as myself) there is a clear benefit in using a helmet.

Then wear a helmet. No one is saying that you can’t.

KB1971 8:32 am 09 Dec 13

CraigT said :

Your use of “mute” was a malapropism.
“Moot” is the correct word, whether or not the argument in which you employed this standard expression makes any sense.

I will admit that I had to look that one up as I had not heard the term before.

But as before you are incorrect, I did not mistakenly replace a word with another. It was intentional, I explaind why I said it the way I did.

I could have used a number of words such as quiet, silent or soundless, but I didnt.

KB1971 8:22 am 09 Dec 13

CraigT said :

snoopydoc said :

No-one is being excluded from cycling.

Wrong. The introduction of mandatory helmets caused a 40% decrease in cycling participation rates.
They clearly are being excluded from bicycling by this law.

snoopydoc said :

They have a choice.

BWAHAHAHAHA. No they don’t. The law excludes choice.

No one is being excluded by helmet laws, the law isnt stopping you from doing it, you just need a helmet.

As snoopydoc says, you have a choice; if you want to ride you wear a helmet, if you dont want to wear a helmet, dont ride. No one is denying you the right to ride a bike.

CraigT 6:19 am 09 Dec 13

Postalgeek said :

The focus of the helmet law is reduction of head injury, not the promotion of cycling.

And that’s what’s wrong with it. The negative consequences of the law (40% reduction in cycling participation) are far more serious than the positive consequences it narrowly seeks to adress.

CraigT 6:16 am 09 Dec 13

snoopydoc said :

No-one is being excluded from cycling.

Wrong. The introduction of mandatory helmets caused a 40% decrease in cycling participation rates.
They clearly are being excluded from bicycling by this law.

snoopydoc said :

They have a choice.

BWAHAHAHAHA. No they don’t. The law excludes choice.

Postalgeek 8:06 pm 08 Dec 13

CraigT said :

Postalgeek said :

CraigT said :

Doesn’t seem anything like the equation we are talking about here, which is a sizeable chunk of the population being excluded from cycling due to a law which achieves very, very little.

Do we know a sizeable chunk of the population is being excluded from cycling due to a law which achieves very, very little?

Yes, we do. Haven’t you been paying attention?

I’m sorry, I didn’t mean to question you. It’s just that I’ve been paying attention and I know there’s a lot of conflicting studies and reports, and I’m curious as to where your confident conclusions are coming from. You offer no source for your use of the word ‘sizeable’. What does ‘sizeable’ mean in regards to percentages and where are you pulling it from?

You also claim the law achieves very, very little. What is your criteria for ‘achievement”? The intention of helmets is to reduce head injury and the intention of the law is to enforce the use of helmets. The focus of the helmet law is reduction of head injury, not the promotion of cycling. Let’s roll out a couple of links that support the argument for helmet laws:

http://theconversation.com/bike-helmets-an-emergency-doctors-perspective-13935

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2598379/

http://www.infrastructure.gov.au/roads/safety/publications/2000/pdf/Bic_Crash_5.pdf

So I’m wondering what definitive evidence and criteria of achievement do you have that indicates that the law has achieved very, very little? If the aim of the law is to reduce cyclist head injuries, and as a result of the law a sizeable chunk of people stopped cycling, it could be argued that the law has successfully reduced cyclist head injuries.

Finally, who the fark is being ‘excluded’ by the helmet law? Where are the exclusion clauses? I think the word you’re looking for is ‘deterred’.

snoopydoc 5:32 pm 08 Dec 13

CraigT said :

damien haas said :

CraigT said :

Dilandach said :

howeph said :

So you think that you should wear a helmet inside your own home, just in case the ceiling collapses on you?

An absolute wankerish question, there’s no mass ceiling collapses endemic in society.

Just as there are no mass bicycle crashes endemic in society.

The vast majority of cyclists don’t crash
The vast majority of crashes don’t involve hospitalisation.
Thye vast majority of hospitalisations don’t involve head injuries.

But forcing the 99.9995% of cyclists who don’t crash to wear a helmet for the sake of the 0.0005% who do has other effects, it inconveniences people, it costs them money, and it turns them off cycling, with about 40% of cyclists curtailing or ceasing any bicycle activites following the law’s introduction.

You could apply the same logic to smoking in pubs. Secondhand smoke may injure a very tiny percentage of people, over the longer term, yet wowsers have convinced legislators to ban it.

What are the negative effects of,
– allowing it
– banning it

Doesn’t seem anything like the equation we are talking about here, which is a sizeable chunk of the population being excluded from cycling due to a law which achieves very, very little.

No-one is being excluded from cycling. They have a choice. Stipulating that one has to use a helmet is not like someone is asking you amputate a limb and hand it over.

Felix the Cat 3:55 pm 08 Dec 13

CraigT said :

Just as there are no mass bicycle crashes endemic in society.

The vast majority of cyclists don’t crash
The vast majority of crashes don’t involve hospitalisation.
Thye vast majority of hospitalisations don’t involve head injuries.

But forcing the 99.9995% of cyclists who don’t crash to wear a helmet for the sake of the 0.0005% who do has other effects, it inconveniences people, it costs them money, and it turns them off cycling, with about 40% of cyclists curtailing or ceasing any bicycle activites following the law’s introduction.

The reason more people don’t ride bikes is they are fat and lazy and using mandantory helmets as a reason when it’s just an excuse. The cost of a helmet is cheap, under $20 at stores like K-Mart/Big W etc. That’s only 4 beers or 5 takeaway coffees.

The worst crash I’ve had riding a bike was at walking pace on a path where I went over the handlebars and hit my helmeted head on the cement,so you don’t have to be riding at high speed to have one.

MrBigEars 3:44 pm 08 Dec 13

Postalgeek said :

CraigT said :

Doesn’t seem anything like the equation we are talking about here, which is a sizeable chunk of the population being excluded from cycling due to a law which achieves very, very little.

Do we know a sizeable chunk of the population is being excluded from cycling due to a law which achieves very, very little?

Yes, with a but. 20% of a 600 person survey said the law would prevent them (self-excluded) from riding a bicycle in the previous year. I’m not going to go into the robustness of self-reporting phone surveys, but a more cynical person than I would suspect that the 20% may have found a convenient excuse.

It’s hard to pick out whether the reduction in head injuries/fatalties is because of the helmet laws or the reduction in the rate of cycling, and it’s hard to pick out the reduction in the rate of cycling is because of the helmet laws, or because people got lazier. Head injuries were trending down before the helmet laws, but so was participation in cycling. Maybe there was better TV shows?

Either way, not a question that is going to be answered by dick waving.

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