4 December 2013

Politics trumps hard-headed reason on bicycle helmets

| johnboy
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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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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…)

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.

desertdreaming8:06 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,

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.

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

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… 🙂

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.

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?

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.

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.

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.

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.

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.

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.

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.

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.

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’.

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 Cat3:55 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.

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.

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?

KB1971 said :

So, in that case, moot doesn’t really fit as I was not talking about a point but the whole argument.

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.

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?

I think we encourage the banana benders to be guinea pigs and then we can start collating some data about uptake rates, head traumas, reduced obesity etc which can assist with the decision making for the rest of us.

Mouths……

CraigT said :

KB1971 said :

I think we should have the choice. Pretty well everybody I know will still wear it (me included). Even in countries where its not mandatory (pretty much everywhere else in the world) people still wear helmets, especially when riding fast or off road.

Ergo, we don’t need a law teling us to do something we do anyway.

KB1971 said :

In some respects, the argument is mute in the ACT, no one really enforces the rule anyway.

FFS!!!!%$&^@@&%@

MOOT. M. O. O. T.

WTF is wrong with you people? UC?

Whats wrong? Its an internet forum, its not a thesis, the point is the same. I am not TELING you how to spell or construct your grammar…….but here goes:

moot
mo?ot/Submit
adjective
1.
subject to debate, dispute, or uncertainty, and typically not admitting of a final decision.
“whether the temperature rise was mainly due to the greenhouse effect was a moot point”
synonyms: debatable, open to discussion/question, arguable, questionable, at issue, open to doubt, disputable, controversial, contentious, disputed, unresolved, unsettled, up in the air More
having no practical significance, typically because the subject is too uncertain to allow a decision.
“it is moot whether this phrase should be treated as metaphor or not”
verb
verb: moot; 3rd person present: moots; past tense: mooted; past participle: mooted; gerund or present participle: mooting
1.
raise (a question or topic) for discussion; suggest (an idea or possibility).
“Sylvia needed a vacation, and a trip to Ireland had been mooted”
synonyms: raise, bring up, broach, mention, put forward, introduce, advance, propose, suggest More
noun
noun: moot; plural noun: moots
1.
BRIT.
an assembly held for debate, esp. in Anglo-Saxon and medieval times.
a regular gathering of people having a common interest.
2.
LAW
a mock trial set up to examine a hypothetical case as an academic exercise.

Maybe Mute was the wrong word but it is the word I intentionally used to say that the argument we are having about wearing a helmet really has no importance in the legal/police world as its not enforced, we may as well be moving our mounts with no volume.

So, in that case, moot doesn’t really fit as I was not talking about a point but the whole argument.

Anyway, back to the topic.

KB1971 said :

I think we should have the choice. Pretty well everybody I know will still wear it (me included). Even in countries where its not mandatory (pretty much everywhere else in the world) people still wear helmets, especially when riding fast or off road.

Ergo, we don’t need a law teling us to do something we do anyway.

KB1971 said :

In some respects, the argument is mute in the ACT, no one really enforces the rule anyway.

FFS!!!!%$&^@@&%@

MOOT. M. O. O. T.

WTF is wrong with you people? UC?

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.

IF you want to ride on the road, then wear a helmet. If you just want to use the great cycle paths we have then no you should not have to wear one.

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.

My Aunty who died two years ago had emphysema, never smoked a day in her life and had no choice in inhaling other peoples smoke.

At least there is a choice to war a helmet.

I think we should have the choice. Pretty well everybody I know will still wear it (me included). Even in countries where its not mandatory (pretty much everywhere else in the world) people still wear helmets, especially when riding fast or off road.

In some respects, the argument is mute in the ACT, no one really enforces the rule anyway.

howeph said :

snoopydoc said :

I don’t give a rat’s ringhole whether mandatory helmet laws discourage some people from riding, and your houses-crushed-by-trees analogy is cute but is a reductio ad absurdum. 🙂

Yes, the houses-crushed-by-trees analogy was meant to be cute. And yes, it is a form of “reductio ad absurdum”; but I don’t think that means what you think it means.

http://en.wikipedia.org/wiki/Reductio_ad_absurdum

Argument to absurdity is a valid form of logical argument. It is not a logical fallacy.

snoopydoc said :

Why do you think that mandatory helmet laws should be repealed?

http://the-riotact.com/australias-helmet-law-disaster/103266 is a good start.

Thanks for the Wikipedia link but yes, it means what I think it means. Never mind. Move on. 🙂

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. 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.

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.

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.

DrKoresh said :

Dilandach said :

I’ll ask you the question too, If I kick you off your bike and you hit your head on the gutter, would you rather do it with or without a helmet?

An absolute wankerish question, there’s no mass bicycle-kicking endemic in society.

Hah! +1

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. If there was, there’d be calls to put things in place to prevent it.

Ohhh boo hoo, my hair might get messed up or I might get an owie on my bald head. That’s the least of your problems if you end up having to drink through a straw being a burden on all those around you because of your selfish choices.

I’ll ask you the question too, If I kick you off your bike and you hit your head on the gutter, would you rather do it with or without a helmet?

Are there gangs of people roaming Australia kicking people of their bicycles? Is this such an issue that compulsory helmet laws are required? I watched a bloke hit his head on a gutter and pole with a helmet on and blood pissed out of his head, as it doesn’t even protect your face. Should we perhaps move to enforcing full face helmets to save people like him?

IrishPete said :

Watson said :

There is the argument that the helmet makes people perceive riding as more dangerous than it actually is. Which would largely explain women’s increased participation without those laws.

It also makes it seem more like a sport – which requires specialised equipment (other than the bike) – which may put more people off.

People who pay hundreds of dollars for a hairstyle are probably put off by helmet hair. And helmets are actually quite uncomfortable on a bald head (like mine).

IP

Well, Pantani struggled by regardless of this factor. Here’s what I suggest. 1. Stop whinging. 2. Get a buff. 3. Ride.

snoopydoc said :

I don’t give a rat’s ringhole whether mandatory helmet laws discourage some people from riding, and your houses-crushed-by-trees analogy is cute but is a reductio ad absurdum. 🙂

Yes, the houses-crushed-by-trees analogy was meant to be cute. And yes, it is a form of “reductio ad absurdum”; but I don’t think that means what you think it means.

http://en.wikipedia.org/wiki/Reductio_ad_absurdum

Argument to absurdity is a valid form of logical argument. It is not a logical fallacy.

snoopydoc said :

Why do you think that mandatory helmet laws should be repealed?

http://the-riotact.com/australias-helmet-law-disaster/103266 is a good start.

Dilandach said :

I’ll ask you the question too, If I kick you off your bike and you hit your head on the gutter, would you rather do it with or without a helmet?

An absolute wankerish question, there’s no mass bicycle-kicking endemic in society.

Dilandach said :

Watson said :

But where do YOU get the proof from that people riding without helmets are taking massive risks and must therefor be idiots?

Answer the simple question then, if I side swipe you in a car and you hit your head on the gutter or road would you rather have been wearing a helmet or not?

I wouldn’t be riding on the road so you’d have to be going out of your way to hit me. In which case I think having a helmet is the least of my worries.

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

After all the effort to get people to accept wearing helmets it seems like kind of a backward step to let it slide.

Dilandach said :

Watson said :

But where do YOU get the proof from that people riding without helmets are taking massive risks and must therefor be idiots?

Answer the simple question then, if I side swipe you in a car and you hit your head on the gutter or road would you rather have been wearing a helmet or not?

That would make you about as tough as the kid who mugs old ladies.

Dilandach said :

I’ll ask you the question too, If I kick you off your bike and you hit your head on the gutter, would you rather do it with or without a helmet?

I’d rather defenestrate you.

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. If there was, there’d be calls to put things in place to prevent it.

Ohhh boo hoo, my hair might get messed up or I might get an owie on my bald head. That’s the least of your problems if you end up having to drink through a straw being a burden on all those around you because of your selfish choices.

I’ll ask you the question too, If I kick you off your bike and you hit your head on the gutter, would you rather do it with or without a helmet?

Watson said :

But where do YOU get the proof from that people riding without helmets are taking massive risks and must therefor be idiots?

Answer the simple question then, if I side swipe you in a car and you hit your head on the gutter or road would you rather have been wearing a helmet or not?

howeph said :

snoopydoc said :

If you do take the time to sift through all of the relevant literature, though, the bottom line is that while there are studies suggesting that bike use drops off when mandatory helmet laws are introduced, the higher quality studies that look at severity of injury in cyclists who crash either with or without a helmet repeatedly show a significant (both statistically significant and clinically significant) benefit for helmet use.

The problem with using those “higher quality” studies to justify mandatory helmet laws is selection bias.

The selection bias is evident in how you described them:

“… studies that look at severity of injury in cyclists who crash either with or without a helmet…”

In fact the selection bias isn’t just those who crash but those who have a crash significant enough to send them to hospital. All of the other hundreds of thousands, if not millions, of largely uneventful cycling trips that people take don’t get included in the study. This leads to a skewed impression of the risk level.

For example: if I conducted a study of people injured by trees falling onto their homes and it found that those wearing helmets whilst inside suffered less severe injuries – would that justify mandatory helmet laws for people whilst they are in their own house?

Mandatory helmet laws were championed by The Royal Australasian College of Surgeons using this biased data without regard to wider considerations.

Mandatory helmet laws should be repealed. The Queensland proposal looks like a good compromise/step towards that. If the Queensland government isn’t prepared to give it a go, Canberra should.

Cycling is safe.

Yes there is selection bias there. They’re case control studies. It’s inherent, though steps can be taken to minimise it. It’s also almost entirely irrelevant to my point. I am not arguing that we should have mandatory helmet laws. I was merely stating that for those people who do ride a bike, the use of a helmet dramatically reduces the probability of a serious or lethal head injury should they crash. The fact that the studies (mostly) only look at those who crash badly enough to be seen in hospital really doesn’t matter. Unless they died at the scene, the crashed cyclists not captured by such studies all had a good outcome. This does not lead to a “skewed impression of the risk level…”. It provides a good estimate of relative risk, or risk ratio, for those folks involved in a decently hefty crash, dependent on whether or not they were wearing a helmet. The absolute risk obviously cannot be measured but it is, again, rather irrelevant to my specific point.

If you ride a bike, and you crash, you are much better off if you’re wearing a helmet.

I don’t give a rat’s ringhole whether mandatory helmet laws discourage some people from riding, and your houses-crushed-by-trees analogy is cute but is a reductio ad absurdum. 🙂

Why do you think that mandatory helmet laws should be repealed?

MrBigEars said :

I don’t have a dog in this specific stoush, I don’t know (or indeed care) about the broader social complexities. My comment was to imply that a 20% difference between one comparison group and another would (well, could) be statistically significant, especially in the sphere of public health statistics.

https://www.google.com.au/search?q=20%25+reduction+in+mortality&ie=utf-8&oe=utf-8&rls=org.mozilla:en-US:official&client=firefox-a&gws_rd=cr&ei=G16hUuDvMoqIkwWtloGIDA

Whether you care about it or not, when talking about public health policy it is the broader social complexities that really matter.

Let’s say that the helmet laws reduce head injuries by 20%. Say from 100 down to 80 a year in the ACT (Note: I’m just making these numbers up for this hypothetical). But let’s also say that the current mandatory helmet laws mean that 5,000 people (~1.3% of the ACT’s population), who would otherwise regularly ride their bike for transport, don’t and choose to drive everywhere instead.

Now apparently more that 60% of Canberran adults are overweight or obese. That means, given my hypothetical numbers, that potentially 3,000 overweight people could start getting some regular exercise and the other 2,000 are more likely to remain slim and fit.

What could this do to tackle heart disease? Heart disease is the leading cause of death in Australia. Heart disease affects 1 in every 6 Australians and 2 out of 3 families. 1 Australian dies from heart disease every 12 minutes. Risk factors for heart disease include: high blood pressure, high cholesterol, being overweight and physical inactivity (source: http://www.hri.org.au/page.aspx?pid=461).

What about other potential benefits: reduced type 2 diabetes; the improved productivity of fitter, healthier workers; reduced traffic congestion and air pollution?

Good public health policy must look at the bigger picture; otherwise you’re likely to get unintended consequences.

Dilandach said :

What an idiotic argument, ‘selection bias’ are you that mentally deficient that you honestly think that studies that look at injuries sustained cycling with and without a helmet has a bias because they only focus on those that have crashed? Stand back and honestly look at that, they’re studying the injuries sustained not whether helmets or not wearing helmets induces more crashes.

If you want to be an idiot and not wear a helmet while riding then go nuts just all your medical expenses incurred if you have a crash while not wearing a helmet should 100% be paid by you. If you don’t want to wear the helmet then man up and accept the consequences for it.

But where do YOU get the proof from that people riding without helmets are taking massive risks and must therefor be idiots?

And the “but then you have to pay for your own medical expenses because I’m not paying for it” argument is so tiresome. We do not have a “user pays” type system for health, nor will we or should we so stop using it as if it is some common sense argument. I don’t go to the hospital to scold mangled up motorbike riders or car drivers that were at fault in a crash or people that are fat because they like Maccas and cakes or kids that have fallen out of trees or off trampolines. Give it a rest already. No one decides to take less risk because they worry about the hospital costs, let alone your personal health care contributions.

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.

Robertson 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.

No it isn’t. It’s a small reduction at the cost of increased presentations for reasons of ill-health caused or aggravated by lack of exercise.

We could reduce traffic mortality and morbidity by 20% or more by reducing all on-road speed limits by 20.

Do you think a broader examination of the effects of such a policy would be in order than to just look at the amount of deaths and injuries involved?

I don’t have a dog in this specific stoush, I don’t know (or indeed care) about the broader social complexities. My comment was to imply that a 20% difference between one comparison group and another would (well, could) be statistically significant, especially in the sphere of public health statistics.

https://www.google.com.au/search?q=20%25+reduction+in+mortality&ie=utf-8&oe=utf-8&rls=org.mozilla:en-US:official&client=firefox-a&gws_rd=cr&ei=G16hUuDvMoqIkwWtloGIDA

troll-sniffer said :

Until I see a fair system where all groups that would benefit from the compulsory wearing of helmets are targeted, (and this includes drivers of vehicles, for they too would suffer lower head injury rates if forced to wear helmets), I shall treat the helmet laws with the complete disdain they deserve. They are poorly thought-out, discriminatory, counter-productive, anti-social and based purely on economic considerations, ie the notion that the most important factor to be considered in setting such laws is the direct observable health cost.

We should also fine pedestrians for not walking on the left. Or perhaps, to make it equal, allow cars to drive whereever they want.

Stupid argument, there are lots of things that ‘are not fair’ across all groups.

I still go back to my original comment. Why is helmet use blamed for reducing cycling rates? Are people really going to do something other than ride simply because of the helmet? Do we want people that stupid – that they will forego riding totally because of the insignificance of a helmet – riding anyway?

Dilandach said :

What an idiotic argument, ‘selection bias’ are you that mentally deficient that you honestly think that studies that look at injuries sustained cycling with and without a helmet has a bias because they only focus on those that have crashed? Stand back and honestly look at that, they’re studying the injuries sustained not whether helmets or not wearing helmets induces more crashes.

If you want to be an idiot and not wear a helmet while riding then go nuts just all your medical expenses incurred if you have a crash while not wearing a helmet should 100% be paid by you. If you don’t want to wear the helmet then man up and accept the consequences for it.

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

howeph said :

In fact the selection bias isn’t just those who crash but those who have a crash significant enough to send them to hospital. All of the other hundreds of thousands, if not millions, of largely uneventful cycling trips that people take don’t get included in the study. This leads to a skewed impression of the risk level.

Spot on.

Dilandach said :

What an idiotic argument, ‘selection bias’ are you that mentally deficient …

No, you are. You have an irrational belief and you are rationalising it.

Pay attention to what Howeph’s saying, he explains it very well.

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.

Or, to put it another way, you have saved 20% of a very, very small number who are at risk while cycling, at the cost of a very much larger number (by many orders of magnitude) who have ceased cycling entirely as a result of the policy.

Some people are just not very good at risk management. These kinds of people line up for the flu shot every year, and think bicycle helmets should be required by law.

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.

No it isn’t. It’s a small reduction at the cost of increased presentations for reasons of ill-health caused or aggravated by lack of exercise.

We could reduce traffic mortality and morbidity by 20% or more by reducing all on-road speed limits by 20.

Do you think a broader examination of the effects of such a policy would be in order than to just look at the amount of deaths and injuries involved?

howeph said :

snoopydoc said :

If you do take the time to sift through all of the relevant literature, though, the bottom line is that while there are studies suggesting that bike use drops off when mandatory helmet laws are introduced, the higher quality studies that look at severity of injury in cyclists who crash either with or without a helmet repeatedly show a significant (both statistically significant and clinically significant) benefit for helmet use.

The problem with using those “higher quality” studies to justify mandatory helmet laws is selection bias.

The selection bias is evident in how you described them:

“… studies that look at severity of injury in cyclists who crash either with or without a helmet…”

In fact the selection bias isn’t just those who crash but those who have a crash significant enough to send them to hospital. All of the other hundreds of thousands, if not millions, of largely uneventful cycling trips that people take don’t get included in the study. This leads to a skewed impression of the risk level.

For example: if I conducted a study of people injured by trees falling onto their homes and it found that those wearing helmets whilst inside suffered less severe injuries – would that justify mandatory helmet laws for people whilst they are in their own house?

Mandatory helmet laws were championed by The Royal Australasian College of Surgeons using this biased data without regard to wider considerations.

Mandatory helmet laws should be repealed. The Queensland proposal looks like a good compromise/step towards that. If the Queensland government isn’t prepared to give it a go, Canberra should.

Cycling is safe.

What an idiotic argument, ‘selection bias’ are you that mentally deficient that you honestly think that studies that look at injuries sustained cycling with and without a helmet has a bias because they only focus on those that have crashed? Stand back and honestly look at that, they’re studying the injuries sustained not whether helmets or not wearing helmets induces more crashes.

If you want to be an idiot and not wear a helmet while riding then go nuts just all your medical expenses incurred if you have a crash while not wearing a helmet should 100% be paid by you. If you don’t want to wear the helmet then man up and accept the consequences for it.

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.

snoopydoc said :

Yes, which is why I suggested that old Cochrane review is a good _starting_ point, not the definitive answer. 🙂

And yes, the media (and many other people) are very prone to confirmation bias and cherry-picking the literature. I would caution against doing the same: “…it took me a 10 second google to find at least 2 journal articles that claimed that that study’s conclusions were flawed…”

Give anyone with half a brain 5 minutes and access to Google and Pubmed and they can find any number of articles either supporting or refuting any given hypothesis you can imagine.

If you do take the time to sift through all of the relevant literature, though, the bottom line is that while there are studies suggesting that bike use drops off when mandatory helmet laws are introduced, the higher quality studies that look at severity of injury in cyclists who crash either with or without a helmet repeatedly show a significant (both statistically significant and clinically significant) benefit for helmet use.

As I said, I’m not a scientist. I have at times made the effort to analyse journal articles on certain topics. But sometimes it’s like comparing apples to pears and I never was all that good at statistics. Plus it takes me forever and a day to do this and I am aware of my own bias and how this may affect how I search, etc, etc.

Then there is the interpretation of “significant” in a matter like this. In one study ABC Science reports on, they conclude: “His team found states with mandatory helmet laws had significantly lower rates of fatalities/incapacitation injuries after bicycle-motor vehicle collisions than those without (2 per million versus 2.5 per million). ” Really, 0.5 per million is a significant decrease?

snoopydoc said :

If you do take the time to sift through all of the relevant literature, though, the bottom line is that while there are studies suggesting that bike use drops off when mandatory helmet laws are introduced, the higher quality studies that look at severity of injury in cyclists who crash either with or without a helmet repeatedly show a significant (both statistically significant and clinically significant) benefit for helmet use.

The problem with using those “higher quality” studies to justify mandatory helmet laws is selection bias.

The selection bias is evident in how you described them:

“… studies that look at severity of injury in cyclists who crash either with or without a helmet…”

In fact the selection bias isn’t just those who crash but those who have a crash significant enough to send them to hospital. All of the other hundreds of thousands, if not millions, of largely uneventful cycling trips that people take don’t get included in the study. This leads to a skewed impression of the risk level.

For example: if I conducted a study of people injured by trees falling onto their homes and it found that those wearing helmets whilst inside suffered less severe injuries – would that justify mandatory helmet laws for people whilst they are in their own house?

Mandatory helmet laws were championed by The Royal Australasian College of Surgeons using this biased data without regard to wider considerations.

Mandatory helmet laws should be repealed. The Queensland proposal looks like a good compromise/step towards that. If the Queensland government isn’t prepared to give it a go, Canberra should.

Cycling is safe.

Become a sikh, they get away with not having to wear a helmet. Funny, I thought this country had separation of state and religion. Obviously not when it comes to sikhs.

Holden Caulfield10:51 am 06 Dec 13

snoopydoc said :

…If you do take the time to sift through all of the relevant literature, though, the bottom line is that while there are studies suggesting that bike use drops off when mandatory helmet laws are introduced, the higher quality studies that look at severity of injury in cyclists who crash either with or without a helmet repeatedly show a significant (both statistically significant and clinically significant) benefit for helmet use.

Of course, if helmet use does indeed bring a reduction in cycling participation then it could be argued that helmet use has already made a significant contribution to cycling-related safety before anyone even leaves the house, haha.

troll-sniffer10:45 am 06 Dec 13

Riding in Canberra without a helmet isn’t a big deal. Sure, you get stopped occasionally, once in a blue moon you get a helmet tax from a zealous or new kid on the block cop, and occasionally a nearby laneway will allow a quick getaway.

Until I see a fair system where all groups that would benefit from the compulsory wearing of helmets are targeted, (and this includes drivers of vehicles, for they too would suffer lower head injury rates if forced to wear helmets), I shall treat the helmet laws with the complete disdain they deserve. They are poorly thought-out, discriminatory, counter-productive, anti-social and based purely on economic considerations, ie the notion that the most important factor to be considered in setting such laws is the direct observable health cost.

Watson said :

snoopydoc said :

Watson said :

” there is very good quality evidence that helmets significantly reduce both morbidity and mortality from head injury.”

There are credible counter studies that show that the impact of wearing helmets is exaggerated. This is not an exact science because of the many variables involved.

If by “not an exact science” you mean there are confounders, a lack of randomised controlled trials, and the best evidence available is epidemiologic/observational (such as case-control) studies then yes. However this does not mean that such studies, when well-conducted, are worthless or their conclusions unlikely to be true/real.

The counter studies to which you refer are presumably those which suggest that the changes in cyclist head injuries before and after the introduction of mandatory helmet laws can be at least partially attributed to the reduction in absolute numbers of cyclists after the laws were introduced. These data speak to the overall effectiveness of mandatory helmet laws for reducing the overall burden of head injury in the population, but they do not address the question of the efficacy of helmet use in preventing or mitigating the severity of head injuries in those who are cycling. There’s a difference there, and it’s an important one.

With regard to the evidence for helmet use reducing the burden of head injury morbidity and mortality, there are a number of studied which can be found fairly quickly with the standard search engines, but this quite dated Cochrane review is a good starting point:

http://www.ncbi.nlm.nih.gov/pubmed/10796827

Yes, and it took me a 10 second google to find at least 2 journal articles that claimed that that study’s conclusions were flawed. I don’t pretend to be a scientist. Science has become a religion. The media will publish the research results that they like – and they are all on the risk aversion bandwagon because fear sells – and they don’t publish any of the peer review conclusions afterwards.

I do know that the countries with the highest rate of cyclist participation don’t have mandatory helmet laws.

Yes, which is why I suggested that old Cochrane review is a good _starting_ point, not the definitive answer. 🙂

And yes, the media (and many other people) are very prone to confirmation bias and cherry-picking the literature. I would caution against doing the same: “…it took me a 10 second google to find at least 2 journal articles that claimed that that study’s conclusions were flawed…”

Give anyone with half a brain 5 minutes and access to Google and Pubmed and they can find any number of articles either supporting or refuting any given hypothesis you can imagine.

If you do take the time to sift through all of the relevant literature, though, the bottom line is that while there are studies suggesting that bike use drops off when mandatory helmet laws are introduced, the higher quality studies that look at severity of injury in cyclists who crash either with or without a helmet repeatedly show a significant (both statistically significant and clinically significant) benefit for helmet use.

snoopydoc said :

Watson said :

” there is very good quality evidence that helmets significantly reduce both morbidity and mortality from head injury.”

There are credible counter studies that show that the impact of wearing helmets is exaggerated. This is not an exact science because of the many variables involved.

If by “not an exact science” you mean there are confounders, a lack of randomised controlled trials, and the best evidence available is epidemiologic/observational (such as case-control) studies then yes. However this does not mean that such studies, when well-conducted, are worthless or their conclusions unlikely to be true/real.

The counter studies to which you refer are presumably those which suggest that the changes in cyclist head injuries before and after the introduction of mandatory helmet laws can be at least partially attributed to the reduction in absolute numbers of cyclists after the laws were introduced. These data speak to the overall effectiveness of mandatory helmet laws for reducing the overall burden of head injury in the population, but they do not address the question of the efficacy of helmet use in preventing or mitigating the severity of head injuries in those who are cycling. There’s a difference there, and it’s an important one.

With regard to the evidence for helmet use reducing the burden of head injury morbidity and mortality, there are a number of studied which can be found fairly quickly with the standard search engines, but this quite dated Cochrane review is a good starting point:

http://www.ncbi.nlm.nih.gov/pubmed/10796827

Yes, and it took me a 10 second google to find at least 2 journal articles that claimed that that study’s conclusions were flawed. I don’t pretend to be a scientist. Science has become a religion. The media will publish the research results that they like – and they are all on the risk aversion bandwagon because fear sells – and they don’t publish any of the peer review conclusions afterwards.

I do know that the countries with the highest rate of cyclist participation don’t have mandatory helmet laws.

Maybe we need a LAMS (learner motorcycle) equivalent scheme for bicycles without helmets.
I got my shopping bike with handlebar basket in Feb and it does not encourage fast riding, so I’ve rarely ridden it with a helmet – its all about sitting very upright and getting there eventually.

Innovation said :

It’s a little tongue in cheek but mandating helmets for all road users would probably increase cycling participation.

Especially as pedestrians are road users.

Watson said :

” there is very good quality evidence that helmets significantly reduce both morbidity and mortality from head injury.”

There are credible counter studies that show that the impact of wearing helmets is exaggerated. This is not an exact science because of the many variables involved.

If by “not an exact science” you mean there are confounders, a lack of randomised controlled trials, and the best evidence available is epidemiologic/observational (such as case-control) studies then yes. However this does not mean that such studies, when well-conducted, are worthless or their conclusions unlikely to be true/real.

The counter studies to which you refer are presumably those which suggest that the changes in cyclist head injuries before and after the introduction of mandatory helmet laws can be at least partially attributed to the reduction in absolute numbers of cyclists after the laws were introduced. These data speak to the overall effectiveness of mandatory helmet laws for reducing the overall burden of head injury in the population, but they do not address the question of the efficacy of helmet use in preventing or mitigating the severity of head injuries in those who are cycling. There’s a difference there, and it’s an important one.

With regard to the evidence for helmet use reducing the burden of head injury morbidity and mortality, there are a number of studied which can be found fairly quickly with the standard search engines, but this quite dated Cochrane review is a good starting point:

http://www.ncbi.nlm.nih.gov/pubmed/10796827

If the majority agrees that helmets reduce the degree of risk of cyclist injury then the only issue is whether mandating helmets has reduced cyclist participation. It’s a little tongue in cheek but mandating helmets for all road users would probably increase cycling participation, with obvious health benefits, and might even reduce head injuries for some vehicle occupants as well. Sure, we would all feel dorky for the first twenty years or so but eventually it would become second nature……

zorro29 said :

” on roads with a speed limit of 60 km/hr or less”

that’s still pretty fast when a car goes past you on a bicycle.

Was thinking about that as I rode home. 30 something on the path felt fast. The cars doing 90 as I crawled up Caswell Drive, not so much.

When I ride Northbourne, the ground is often faster than the cars, relatively speaking, so again they don’t feel fast.

Pork Hunt said :

poetix said :

By the way, that little leather hanging-man-bag-on-a-bike is very nice, and expertly matched with the fancy handgrips.

Now back to the brainier discussion…

I think they are called “tool bags”…

That’s what cyclists would like you to think. They’re really man-bags.

I do like the semi-retro look of the set up though.

poetix said :

By the way, that little leather hanging-man-bag-on-a-bike is very nice, and expertly matched with the fancy handgrips.

Now back to the brainier discussion…

I think they are called “tool bags”…

Gungahlin Al4:37 pm 05 Dec 13

DrKoresh said :

maxblues said :

You don’t need to wear a helmet if you don’t ride fast is like saying you don’t need to wear a condom if you don’t thrust quickly. Did I just compare cyclists to dicks?…sorry

How often have you face-planted off a pushie at low speed? And I mean actually face-plant, head hit the concrete type biz. Is it never?

Raises hand. Knocked out, head split open.

Snowboarding, treddly, motorbike, rockclimbing. All with a helmet on. Saved my skull several times for each activity.

Adult decisions? If you sign a contract to pay all your medical expenses resulting from head trauma, rather than imposing yourself on the tax-payer funded hospital system, then I’m fine with that.

gazket said :

I haven’t ridden my bike since I got hassled by the pigs for no helmet over 15 years ago. I had to show them money to prove that I was going to the servo for a drink like I told them I was doing.

So you gave up riding because wearing a helmet was too hard?

How is no helmet on a skateboard or scooter any safer than no helmet on a bike.

Helmets are ripp off if you want something decent or there cheap as chips and offer very little protection at all. I can still gravel rash my face off ,smash my Jaw , poke out my eye, break teeth, bite off my tongue, hit my temple, break my nose the list just carries on.

I haven’t ridden my bike since I got hassled by the pigs for no helmet over 15 years ago. I had to show them money to prove that I was going to the servo for a drink like I told them I was doing.

” on roads with a speed limit of 60 km/hr or less”

that’s still pretty fast when a car goes past you on a bicycle.

I’m a cyclist and don’t see what the big deal is with wearing a helmet. It’s no hassle to buy and wear one – and it’s for your own safety. Why don’t people just wear one? As far as I’m concerned, it’s like a seatbelt. I don’t drive anywhere without one, nor would I cycle anywhere without a helmet.

Watson said :

” there is very good quality evidence that helmets significantly reduce both morbidity and mortality from head injury.”

There are credible counter studies that show that the impact of wearing helmets is exaggerated. This is not an exact science because of the many variables involved.

The two points about helmets I find most interesting are:
1) By wearing a helmet, a rider is more inclined to take risks (known as the Peltzman effect) and
B) Drivers sharing the road with an unhelmeted cyclist take more care (around the cyclist) than those sharing the road with a helmeted one.

DrKoresh said :

Nobody has been suggesting that motorcyclists should stop wearing their helmets so I don’t know why so many commenters are bringing them up. The article is specifically talking about low-speed, low-risk, recreational cycling (on bicycles), like down to the shops and such, not motorcycling or (as also mentioned) skiing or skating. Everyone here on RA is always creaming their pants over the Swedish approach to cycling so let me just check Wikipedia… Oh, what does it say? Bicycle helmet laws in Sweden are: “Only applicable to children under 15 years old. No penalty for children cycling alone who do not obey the law. Also applies to Segway use.” Maybe we should be taking the Swedish approach on the helmet issue like so many of you propose for literally everything else cycling related.

It’s not as if it’s being suggested that helmets be banned, just that wearing one should be at the adult’s discretion; If you feel as though you need a helmet, then just wear a bloody helmet. There’s no need to stand around moralising and trying to lay shame on people who don’t want to wear a helmet when they go for a leisurely ride.

A current trend in Canberra is bicycles with motors that don’t require a license by the rider (they are even being marketed to people who have lost their vehicle licence). Only a few months ago, the partner of one of our staff purchased one of these machines that was delivered supposedly ready to go. On her first ever ride on the new ‘bicycle’ she had the great delight of discovering that the handlebars hadnt been properly secured which resulted in a nasty bingle. Luckily she was wearing a helmet.

” there is very good quality evidence that helmets significantly reduce both morbidity and mortality from head injury.”

There are credible counter studies that show that the impact of wearing helmets is exaggerated. This is not an exact science because of the many variables involved.

Nobody has been suggesting that motorcyclists should stop wearing their helmets so I don’t know why so many commenters are bringing them up. The article is specifically talking about low-speed, low-risk, recreational cycling (on bicycles), like down to the shops and such, not motorcycling or (as also mentioned) skiing or skating. Everyone here on RA is always creaming their pants over the Swedish approach to cycling so let me just check Wikipedia… Oh, what does it say? Bicycle helmet laws in Sweden are: “Only applicable to children under 15 years old. No penalty for children cycling alone who do not obey the law. Also applies to Segway use.” Maybe we should be taking the Swedish approach on the helmet issue like so many of you propose for literally everything else cycling related.

It’s not as if it’s being suggested that helmets be banned, just that wearing one should be at the adult’s discretion; If you feel as though you need a helmet, then just wear a bloody helmet. There’s no need to stand around moralising and trying to lay shame on people who don’t want to wear a helmet when they go for a leisurely ride.

DrKoresh said :

maxblues said :

You don’t need to wear a helmet if you don’t ride fast is like saying you don’t need to wear a condom if you don’t thrust quickly. Did I just compare cyclists to dicks?…sorry

How often have you face-planted off a pushie at low speed? And I mean actually face-plant, head hit the concrete type biz. Is it never?

On a bicycle once (and managed to buckle a wheel beyond economical repair). On motorcycles, twice with the assistance of an old lady driver and a chunk of rubber left on Punt Road, Melbourne.

By the way, that little leather hanging-man-bag-on-a-bike is very nice, and expertly matched with the fancy handgrips.

Now back to the brainier discussion…

maxblues said :

You don’t need to wear a helmet if you don’t ride fast is like saying you don’t need to wear a condom if you don’t thrust quickly. Did I just compare cyclists to dicks?…sorry

How often have you face-planted off a pushie at low speed? And I mean actually face-plant, head hit the concrete type biz. Is it never?

While people are fairly keen to jump on the “See, there’s no evidence that helmets do any good!” bandwagon, it’s worth keeping in mind the specific population we’re talking about:

– At a whole population level, there is evidence that the introduction of mandatory helmet laws reduces cycling participation.

– For the segment of the population who do actually ride a bike, there is very good quality evidence that helmets significantly reduce both morbidity and mortality from head injury.

The harm done by fewer people cycling (obesity, diabetes, metabolic syndrome, more cars on the road, more people having to book two airline seats) is difficult to objectively compare with the harm of death and disability caused by preventable head injuries in cyclists.

One can get very excited and try to calculate quality-adjusted life years (QALYs), or raw financial costs to the community, etc., but such endeavours are fraught with huge uncertainties and variability depending on what one chooses to include (direct costs and harms, and a wide range of externalities).

I’m all for encouraging more people to jump on a bike, but the more tangible and relevant consideration here is the impact of helmet vs no helmet in those who do actually ride a bike already, and the evidence for benefit in that population is pretty clear cut.

pink little birdie11:56 am 05 Dec 13

damien haas said :

I was passing the belconnen skate park and observed that only one child there had a helmet on, out of about 20 that were using it. parents need to ensure their kids are safe, adults can make their own decisions good or bad. Yes, i realise skateboarding and cycling are different, but a head colliding with the earth/cement doesn’t know what the rider was riding.

If you ride regularly then i cant see a logical argument against helmet use. i can see an argument for non-helmet use for hire-a-bike schemes such as the Melbourne scheme where the bike racks are unmanned. Where hire-a-bike outlets, such as the one at LBG are manned, it makes sense to provide a helmet.

I’d like to see stats on enforcement of this law. Based on my observations, many people – especially children – do not wear helmets while cycling.

when I ride past it’s usually the majority of people wearing helmets.
Were you wearing a helmet is usually the first question ambos and drs ask when you fall off and need medical attention.
I will always wear my helmet when riding my bicycle.

Robertson said :

bryansworld said :

Seems to me people are always going to have some excuse to avoid getting on their bikes, and this is one of them.

Oh yes, the moral superiority of today’s cyclist.

We don’t need “an excuse” to not ride a bike. We either want to or we don’t want to.

But do you blame your helmet for not wanting to?

You don’t need to wear a helmet if you don’t ride fast is like saying you don’t need to wear a condom if you don’t thrust quickly. Did I just compare cyclists to dicks?…sorry

bryansworld said :

Seems to me people are always going to have some excuse to avoid getting on their bikes, and this is one of them.

Oh yes, the moral superiority of today’s cyclist.

We don’t need “an excuse” to not ride a bike. We either want to or we don’t want to.

It is pretty face-palm inspiring for him to say that the “evidence supports helmets” when the evidence of the study conducted there says the exact opposite lol. I would certainly agree with Watson that “Trying to look more safety conscious even when there’s no substance to your claims is quite popular” and that relates to roads, cars, bikes, speed limits etc. That whole area of issues is fraught with people claiming something is necessary for safety without any evidence to back it up. This is probably one of the best supported out of those, but still, this study clearly indicates that overall it’d be better without helmets in those certain conditions.

Watson said :

That just makes you want to bang your head against a wall. Without a helmet.

Trying to look more safety conscious even when there’s no substance to your claims is quite popular though. And how easy is it to gain the right to label others as idiots just by donning a helmet? We wouldn’t want to take that away from them, would we…

It’s not as if I’ll ever get booked for riding without a helmet in Canberra though.

Agreed on all counts. Although people definitely do get booked for not wearing a helmet here. Even kids get on the spot fines that their parents have to pay.

Iquote comment=”510879″]Let’s try this in Canberra!

Let’s have a trial and collect the data and set the trend for the rest of the nation.

Canberra would be a great testcase for this and we should have triparty support:

* For the Liberals it means smaller government interference and greater personal choice.
* For Labor more riders would justify all the expense made on all the cycling infrastructure.
* For Greens – less people driving cars!

Go for it Canberra!

O

Or even fewer people driving cars. I am daily commuter cyclist and will always wear my helmet. I value my skull and brain too much. Seems to me people are always going to have some excuse to avoid getting on their bikes, and this is one of them.

LSWCHP said :

As for bikes…I’m an ex-motorcyclist, and I wouldn’t dream of getting on a bike without a bash-hat.

I grew up riding without a helmet, and occasionally something breaks my routine and I don’t notice I’m not wearing it. Feel embarrassed when I go to take it off. Downside of modern lightweight helmets?

As to when to wear a helmet, 80 kmh roads is easy to say but makes no sense to me. A helmet will help how if I get hit by a faster car? More need for a helmet if I’m riding the racer on the paths, the fixie anywhere, or the MTB on dirt.

Also, helmets mean having to go MUCH FASTER to get my childhood wind-in-the-hair thrill.

I and my attending doctor have had a first-hand demonstration of the benefit of a helmet, after I regained my memory. In fact, I’ve been thankful for a helmet on a number of different occasions involving bikes, skiing, and bicycles.

Maybe I’m just a spaz, but it means I wear a helmet whenever speed and no seat belts are involved. And my kids will meet the iron fist of remorseless grounding and confiscation if they don’t wear helmets.

But if grown adults don’t want to wear a helmet, it’s their scone, though I think it’s a shame kids may not be presented with ubiquitous examples.

I just hope helmets do not distract from the more important issue of constructing safe, practical, direct trunk cycleways physically separated from motor vehicles, as I have little faith in education solutions. I was up in Brisbane, and saw all the CityCycle bikes in their racks, and didn’t see much in the way of dedicated cycle lanes, and it seemed to me that helmets weren’t the only things deterring people.

A helmet will only do so much. A helmet doesn’t offer much protection against a collision with a motor vehicle. Most of them aren’t even full-face. I’m guessing that most cyclist deaths haven’t been for the want of a helmet. That’s not to say I wouldn’t want a helmet between me and a car bonnet, but I would prefer a concrete divider. Only yesterday I observed a car stray half way into the on-road cycle lane on the Monaro Highway. It happens too frequently, and only luck stands between a cyclist and a distracted/incompetent driver.

IrishPete said :

Watson said :

There is the argument that the helmet makes people perceive riding as more dangerous than it actually is. Which would largely explain women’s increased participation without those laws.

It also makes it seem more like a sport – which requires specialised equipment (other than the bike) – which may put more people off.

People who pay hundreds of dollars for a hairstyle are probably put off by helmet hair. And helmets are actually quite uncomfortable on a bald head (like mine).

And they’re a pain in the arse to drag around. I don’t want clutter in my life, and helmets are just clutter. Nor are they free.

Watson said :

That just makes you want to bang your head against a wall. Without a helmet.

Trying to look more safety conscious even when there’s no substance to your claims is quite popular though. And how easy is it to gain the right to label others as idiots just by donning a helmet? We wouldn’t want to take that away from them, would we…

It’s not as if I’ll ever get booked for riding without a helmet in Canberra though.

When they first compulsorised helmet-wearing, I was at that time a daily user of my bicycle, but the police did indeed on several occasions stop me and threaten me with fines until I eventually decided to drive everywhere instead.

It’s pretty clear that participation fell dramatically as a result of helmet laws.

Watson said :

There is the argument that the helmet makes people perceive riding as more dangerous than it actually is. Which would largely explain women’s increased participation without those laws.

It also makes it seem more like a sport – which requires specialised equipment (other than the bike) – which may put more people off.

People who pay hundreds of dollars for a hairstyle are probably put off by helmet hair. And helmets are actually quite uncomfortable on a bald head (like mine).

IP

damien haas said :

I was passing the belconnen skate park and observed that only one child there had a helmet on, out of about 20 that were using it. parents need to ensure their kids are safe, adults can make their own decisions good or bad. Yes, i realise skateboarding and cycling are different, but a head colliding with the earth/cement doesn’t know what the rider was riding.

The only time I’ve ever been to a skate park, we showed up just in time to see a helmetless young bloke, with ambition greater than skill, do a massive face plant. It was a long time ago, but IIRC He was knocked out, and one of his front teeth ended up on the deck, with much blood. We looked after him until the ambos arrived.

I’m pretty sure he would’ve been better off with a helmet on his melon.

As for bikes…I’m an ex-motorcyclist, and I wouldn’t dream of getting on a bike without a bash-hat.

I was passing the belconnen skate park and observed that only one child there had a helmet on, out of about 20 that were using it. parents need to ensure their kids are safe, adults can make their own decisions good or bad. Yes, i realise skateboarding and cycling are different, but a head colliding with the earth/cement doesn’t know what the rider was riding.

If you ride regularly then i cant see a logical argument against helmet use. i can see an argument for non-helmet use for hire-a-bike schemes such as the Melbourne scheme where the bike racks are unmanned. Where hire-a-bike outlets, such as the one at LBG are manned, it makes sense to provide a helmet.

I’d like to see stats on enforcement of this law. Based on my observations, many people – especially children – do not wear helmets while cycling.

I know its compulsory , but you wouldn’t think so out in the burbs.
Most, damm near all, cycle kids bolting at 3 don’t have a helmet on.

pink little birdie6:22 pm 04 Dec 13

I match my cycling outfit to my helmet which incidentally matches to my bike. A whole outfit to coordinate and shop for. (If I’m lazy though I don’t care and wear suitable cycling clothes that don’t match)

I need to go shopping for a matchy matchy summer cycling outfit.

dtc said :

How solid is the evidence that helmet wear reduces cycling participation?

I just dont understand why it does – the odd person may have a political objection but its such a minor cost and inconvenience to wear a helmet.

Are people truthfully saying ‘oh, I would ride down to the shops except I have to put a helmet on. Its too hard. I will get in my car and try and find some parking instead’? Or ‘I would ride to work but because of the helmet I will pay $12 in parking or wait 30minutes for a bus’? I just dont believe this is really the reason they arent riding.

Yes you can get ‘helmet hair’ but cycling without a helmet hardly qualifies as hairstyle friendly anyway.

And if you think you look ‘dorky’ or something wearing a cycle helmet, I’ll tell you this: no one is looking at you. Sad, but true, we dont care what you look like. We arent paying attention to your helmet. Also, grow up and get out of the 1980s

What are the other arguments? That there is no evidence helmets prevent injuries – on a population wide basis (not an individual basis) – so you are not going to ride at all? How is that logical?

I reckon people blame helmets for their own lack of activity.

There are sensible reasons not to ride at times – traffic, kids, cold, injuries. But helmets is surely not one of them.

So if the only real argument against compulsory helmet use is (as the post suggests) reduced participation in cycling, I want to see some real analysis, not survey answers.

And, which state/territory has the highest participation rate for cycling….the ACT. Compulsory helmets and all.

The NT is next, but perhaps the fact that it (like Canberra) is flat and has relatively traffic low roads may contribute. Rather than, you know, helmets use requirements. Regional WA is next highest which…flat and low traffic roads.

Finally, this may be a chicken and egg situation but the state with the highest percentage of households owning a bicycle is… the NT. Its probably hard to participate in cycling if you dont own a bike.

(all stats from AustRoad ‘Cycling Participation Survey 2013’)

There is the argument that the helmet makes people perceive riding as more dangerous than it actually is. Which would largely explain women’s increased participation without those laws.

It also makes it seem more like a sport – which requires specialised equipment (other than the bike) – which may put more people off.

How solid is the evidence that helmet wear reduces cycling participation?

I just dont understand why it does – the odd person may have a political objection but its such a minor cost and inconvenience to wear a helmet.

Are people truthfully saying ‘oh, I would ride down to the shops except I have to put a helmet on. Its too hard. I will get in my car and try and find some parking instead’? Or ‘I would ride to work but because of the helmet I will pay $12 in parking or wait 30minutes for a bus’? I just dont believe this is really the reason they arent riding.

Yes you can get ‘helmet hair’ but cycling without a helmet hardly qualifies as hairstyle friendly anyway.

And if you think you look ‘dorky’ or something wearing a cycle helmet, I’ll tell you this: no one is looking at you. Sad, but true, we dont care what you look like. We arent paying attention to your helmet. Also, grow up and get out of the 1980s

What are the other arguments? That there is no evidence helmets prevent injuries – on a population wide basis (not an individual basis) – so you are not going to ride at all? How is that logical?

I reckon people blame helmets for their own lack of activity.

There are sensible reasons not to ride at times – traffic, kids, cold, injuries. But helmets is surely not one of them.

So if the only real argument against compulsory helmet use is (as the post suggests) reduced participation in cycling, I want to see some real analysis, not survey answers.

And, which state/territory has the highest participation rate for cycling….the ACT. Compulsory helmets and all.

The NT is next, but perhaps the fact that it (like Canberra) is flat and has relatively traffic low roads may contribute. Rather than, you know, helmets use requirements. Regional WA is next highest which…flat and low traffic roads.

Finally, this may be a chicken and egg situation but the state with the highest percentage of households owning a bicycle is… the NT. Its probably hard to participate in cycling if you dont own a bike.

(all stats from AustRoad ‘Cycling Participation Survey 2013’)

That just makes you want to bang your head against a wall. Without a helmet.

Trying to look more safety conscious even when there’s no substance to your claims is quite popular though. And how easy is it to gain the right to label others as idiots just by donning a helmet? We wouldn’t want to take that away from them, would we…

It’s not as if I’ll ever get booked for riding without a helmet in Canberra though.

+1 to howeph

Let’s try this in Canberra!

Let’s have a trial and collect the data and set the trend for the rest of the nation.

Canberra would be a great testcase for this and we should have triparty support:

* For the Liberals it means smaller government interference and greater personal choice.
* For Labor more riders would justify all the expense made on all the cycling infrastructure.
* For Greens – less people driving cars!

Go for it Canberra!

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