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news
White cycle helmetCanadian doctors call for mandatory cycle helmets for all 'to reduce head injury'
Paediatricians in Canada are putting pressure on the government to legislate for mandatory cycle helmets, saying that forcing adults to wear them could protect children who copy their behaviour.
Currently only currently only four of thirteen Canadian provinces and territories have full helmet legislation, but the Canadian Paediatric Society is calling for them to be made mandatory for all ages.
In a paper entitled Bicycle helmet use in Canada: The need for legislation to reduce the risk of head injury, the CPS argues:
Bicycling is a popular activity and a healthy, environmentally friendly form of transportation. However, it is also a leading cause of sport and recreational injury in children and adolescents. Head injuries are among the most severe injuries sustained while bicycling, justifying the implementation of bicycle helmet legislation by many provinces. There is evidence that bicycle helmet legislation increases helmet use and reduces head injury risk. Evidence for unintended consequences of helmet legislation, such as reduced bicycling and greater risk-taking, is weak and conflicting. Both research evidence to date and recognition of the substantial impact of traumatic brain injuries support the recommendation for all-ages bicycle helmet legislation.
"Bicycle helmets reduce the risk of head and brain injuries significantly and studies show that legislation increases the use of helmets," said Dr. Brent Hagel, statement co-author and member of the CPS Injury Prevention Committee.
"Everyone is at risk for head injury, regardless of age group.
"Children see adults and often adopt similar behaviours, so if we can get helmets on adults then children and adolescents will be more likely to wear them too."
Six provinces and territories currently have no legislation at all on bike helmets:
- Saskatchewan
- Quebec
- Newfoundland and Labrador
- Yukon
- Northwest Territories
- Nunavut
-
Three provinces have bike helmet legislation that only applies to children:
- Alberta
- Ontario
- Manitoba
Four provinces meet CPS recommendations for all ages bike helmet legislation:
- British Columbia
- New Brunswick
- Nova Scotia
- Prince Edward Island
The report found that in those places that had legislated, helmet use had gone up.
“Systematic reviews have... demonstrated that legislation increases the use of helmets in children and youth.
“One review showed that bicycle helmet use increased postlegislation, with more than one-half of the included studies demonstrating an increase of at least 30%.
“One Ontario study noted a 20% increase in helmet use among children five to 14 years of age two years after passage of helmet legislation covering riders younger than 18 years of age, demonstrating larger increases in low- and middle-income areas.”
Despite evidence from countries including Australia, showing that helmet legislation reduces the number of people riding bikes, Dr Hagel insists that this is not necessarily proven.
“We definitely don’t want to stop people from cycling, we want to increase cycling,” he said.
“If there’s more education that needs to be done and perhaps more environmental changes to increase cycling, I think that’s where we need to look next rather than target legislation for mixed evidence.”
The report added: “While some individuals may avoid bicycling due to helmet legislation, it would need to be shown that they do not replace it with other physical activities for helmet legislation to be considered to have a negative effect on overall health.”
The report said: “There is... ample research indicating that legislation reduces risk of bicycle-related head injury. Evidence of the potential negative effects of bicycle helmet legislation, such as reduced bicycling, is mixed, and a direct cause-and-effect relationship has not been demonstrated.
“Head injuries rank among the most severe injuries in bicyclists, representing 20% to 40% of all bicycling injuries.
“Overall death rates in Canada are estimated to be 0.27 per 100,000 population.”
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74 comments
The problem with the bicycle helmet debate in a nutshell is that those that propose mandatory helmets don't seem to listen to or understand the arguments of those that are against the mandatory wearing of helmets.
So there we are:
Accident prevention is better than dressing up in preperation for an incident the chance of which happening is less than other risks we find acceptable.
In fact preparing for this risk may actually increase the likelyhood of it happening.
So if this is a "cycling" problem you really want to fix, campaign for reprioritising outside spaces for people over vehicles.
If its a "head injury" problem you feel strongly about perhaps start with car drivers, footballers and drunks who constitute the majority of injuries.
Let's look at some statistics.
A quick Google and on the US Government website for the Centre for Disease Control and Prevention (which I think is a sorta independent scientific group advising the government) it found the following ;
Looking at sports related (i.e. doing sport or doing a recreational activity) and traumatic head injuries for the Under 19 age group in the period 2001 - 2009
It found, of all severe head injuries treated ;
15% of traumatic head injuries were due to bicycle accidents
15% of traumatic head injuries were due to playing American Football
9% of traumatic head injuries were due to playground accidents
6% of traumatic head injuries were due to playing 'Soccer'
etc, etc
The statistics don't give any estimates of time spent doing each activity so you can't rank the activities on risk per hour which would indicate the most dangerous activities.
Golf accounted for 1% of traumatic head injuries, but as Under 19s probably ride their bicycles far more often than they play golf it could be argued that golf has a higher risk of head injury than cycling.
Here is the report ;
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6039a1.htm?s_cid=mm6039a1_w
Doing anything in life has an element of risk. We take steps to minimise the risk until we are comfortable with the balance between doing something and not getting hurt.
So the Canadian doctors have called for mandatory helmets in their favourite hobby-horse activity, cycling. It is just so easy to do.
Yet the statistics show that for children there are other at least as risky, if not more risky, activities that can cause head injuries. Why do they not also call for mandatory helmets for playing in the playground, 'Soccer', and golf.
"Motorcyclists are obliged to wear crash helmets. Drivers are obliged to wear seat belts. No one considers these to be 'an assault on the basic right to move'. Well I guess there may be one or two oddballs out there but the argument has largely been won that quite frankly it would take an absolute dingbat to disagree."
Are you mad? Of course they are exactly the same. The laws that make these compulsory do restrict our right to do as we please. There is no way that you can disassociate cycle helmets from the same argument.
And to make any of them compulsory is wrong. Its my head and no government should have the right to say what I do with it. I'll agree with the additional costs argument but only when every other "self inflicted " injury is treated the same.
I am not trying to! It is the same argument! and ultimately helmets will become compulsory if/when the data is as conclusive as it was in the case of motorcycling helmets and seatbelts.
It is not there yet which is why my preference (as clearly stated in my original post) is for children under 16 to be compelled to wear helmets while over 16s should be allowed to make an informed choice.
We do not have the right to do as we please. We never have and I hope we never will.
In the run up to the vote in Parliament to make seat belts mandatory for drivers, those who were anti belts made enough noise for the government to ask for a report from J.E.Isles about the efficacy of seat belts in the countries where they had already been made mandatory. Unfortunately Isles's conclusion was that no benefit could be shown.
This report was not published and only became known when a copy was leaked to the New Scientist.
http://www.john-adams.co.uk/2007/01/04/seat-belt-legislation-and-the-isl...
There is much more on this website about seat belts, helmets, and risk generally.
If you imagine that politicians examine the evidence before legislating, all I can say is, you have not been paying attention.
And yet here you are doing everything you can to defend the motorist's right do do as he/she pleases and insisting its everyone else's responsibility to try and minimise the consequences of his/her choices!
Agendas, agendas *yawns*
.
Helmets for car drivers would save more lives... There have been studies, I can provide science on request
Summer before last I was sitting on wall by a beck on a warm afternoon mid way through a bike ride when a canadian lass wandered along the road hoping to hitch a lift with a driver going over the hill I was headed for next. We got chatting and she said back home hitch hiking was illegal. I made a joke about what a hardened criminal I was talking to but she then told me I would also be breaking the law for riding my bike without a helmet. Had the two of us had been passing the time of day on a sunny afternoon on the side of a country lane in her home province we both would have been criminals. I aways thought of canadians as rugged independent types, pioneer spirt and all that, but actually you seem to need permission from the government take a piss over there. Let's not go down that route here.
so what the author is suggesting is that those people put off cycling, may take up other sports, fair enough, until you think how they are going to get to the ice rink/football pitch/swimming pool/etc. by CAR....
So the author is suggesting making the roads less safe by forcing everyone wear helmets.
AND WHEN ARE WE GOING TO SEE A CALL FOR MANDATORY HELMETS FOR CAR DRIVERS AND PASSENGERS!!!!!!!
To your last point (YOU KNOW, THAT ONE), airbags achieve the same effect as helmets, by reducing deceleration and spreading the load.
You might like to be a bit more up to date when you shout (assuming there'll be a next time).
Mandatory helmet laws are an assault on the basic human right of freedom of movement.
They are about suppressing cycling and pandering to the petrolheads, that's the whole point of them.
"those discouraged from cycling by helmet laws may move to alternative sports"
Slight flaw in this moronic argument is that cycling isn't a "sport", its a means of travel.
"those women discouraged from walking outside by burka laws may move to alternative sports"
What, like mandatory seatbelts? Like mandatory motorbike helmets? Stop being so precious.
Road.cc is becoming the Daily Mail of cycling news: Non-stop helmet / hi vis / bike-cam / rabble rousing pap. I'm off to order some Rapha deep winter tights in order to make people even angrier.
Unlike seatbelts, in that seatbelts have been clearly demonstrated to reduce deaths, while helmets have not.
No need to get angry just because you don't know what you're talking about.. reminds me of the stereotype of readers of a certain paper.
Yours etc,
Outraged, Woking (Clnl. Ret., Mrs.)
That cuts deep, I'm upset now. If this was a paper I'd ruffle it and harumph loudly. Anyway, I know enough that in the event that I get t-boned by a car at 25mph on my bike I stand a better chance of survival or escaping lifelong debilitating injury when my noggin hits the concrete wearing a helmet than not. That's proof enough for me and in the event you wish to argue otherwise, go try it and come back to me with the results. It can count as a serious scientific test if you like, I'll even fund it.
Cheers.
Or you could actually do something to stop yourself from being 't-boned', Use a very bright front light, have lots of reflectives, wear bright clothes, stick an air-zound on your bike, join cycling organisations, write to your MP and express ideas on how to make the roads safer.
Especially the air-zound:
http://www.youtube.com/watch?v=cIOyzyBmRlg
http://www.youtube.com/watch?v=WgTde_J9fCw
http://www.youtube.com/watch?v=gZ2t-9M3VN8
http://www.youtube.com/watch?v=NwvFdHeZOuU
http://www.youtube.com/watch?v=MvNfGwT6gA8
http://www.youtube.com/watch?v=9B6aSrLqtGI
http://www.youtube.com/watch?v=_jx_wFrbmPo
Or you could spend £60 on a piece of polystyrene, stick it on your head and pretend that there's some evidence that it makes a difference.
Or better yet, ride out in the middle of the lane as you approach side roads so you can see drivers pulling out earlier (and they may see you), cover the brake levers so you are ready to stop if the driver doesn't, and keep a look out as you ride along.
All of this could reduce the likelihood of being t-boned.
My concern is that a substantial number of cyclists tend to put too much faith in personal protective equipment such as helmets, and indeed hi-viz, rather than using their own skills as a cyclist. I used to be a cycle instructor and I recall a comment a more experienced instructor made on the subject. Minimise all other risks first of all by your actions and then if you still feel that some risks remain then resort to PPE.
Absolutely, in the last week alone, I've felt that riding further out caused a driver (on a side road) to see me and wait when they otherwise wouldn't of, because of parked vehicles obscuring the view.
A good cycle lane here:
http://goo.gl/maps/IFux9
And still many cyclists ride left of the cycle lane in the door zone... A lot of cyclists need educating.
There's no comparison with seatbelts - why do people keep bringing that up? Its quite a "Daily Mail" point to make, in fact.
There are no health benefits to driving a car, or riding a motorcycle (indeed, quite the reverse - there are considerable risks) to offset against any reduction in car or motorcycle use.
To compare seatbelt or helmet laws for motor vehicles with helmet laws for cycling is to compare apples with oranges, and to miss the big picture:
1. Cycling is, population wide, an overwhelmingly beneficial activity for public health, with or without helmets.
2. Helmet laws demonstrably *discourage* people from cycling.
3. The benefits of helmet laws on injury are somewhere between low and negligible.
Thus helmet laws *damage* public health. Thousands of hearts damaged, to save one or two heads.
Really? Is there evidence for this? We are not compelled to wear helmets yet the majority of cyclists I see during my rides around the Cheshire lanes wear them.
My theory is that it's because people like to emulate their heroes and as long as Cav, Wiggo etc wear helmets so will us lesser road cyclists.
I used to play cricket and retired about 30 years ago before batting helmets came in. When I watch my old club now every batter wears a helmet (and arm guards and chest protectors). Why? In village cricket there's very little chance of being hit on the head as the bowlers are not fast or strong enough to produce the quick steep bounce that professionals achieve, so it must be emulation of the star players they see on TV.
Don't be ridiculous. No one is trying to ban you from running or walking, which let us not forget, are the only natural method of transportation that have zero impact on the environment.
Motorcyclists are obliged to wear crash helmets. Drivers are obliged to wear seat belts. No one considers these to be 'an assault on the basic right to move'. Well I guess there may be one or two oddballs out there but the argument has largely been won that quite frankly it would take an absolute dingbat to disagree.
For what it is worth, I think it should be mandatory for children under 16. They are too young to make an informed choice on this issue and as the data is at present inconclusive, it is better to err on the side of caution.
For adults, I believe that a substantial impact to the NHS of accidents involving cyclists not wearing helmets needs to be conclusively demonstrated before compulsion can be contemplated.
No one is arguing about the effectiveness of helmets in general (although their usefulness in most of accidents involving cars is debatable). On an individual level it's better to wear one than to not to.
As it's been said many times before, the problem is evaluating wider implications of a compulsory helmet wear, especially the perception of cycling as an everyday mean of safe transport by "normal" members of the population.
Obesity, lack of physical activity and pollution will be still killing more people than cycling without a helmet.
It appears that doctors, coroners or cyclists whose lives were "saved" by a helmet display a very narrow minded way of looking at things and are TOO CLOSE to the problem to maintain any degree of objectivity. I would kindly ask those people to stop talking nonsense.
I disagree entirely with you (except maybe the bit about children - children are a separate case entirely) but have had this argument so many times already I can't be arsed with it. Cycle helmets have nothing whatsoever in common with seat belts, so why bring that up?
Also, just because someone doesn't share your ideology, doesn't make their argument "ridiculous". Though if we are going there, I find your comparison with seat belts to be daft.
Your point is ridiculous, not at all because I disagree with it, but because it is self-evidently a hysterical over-reaction to this article.
How could being compelled to wear a hat on your head while cycling possibly "assault your human right" to move?
In such a circumstance, you could either choose to:
a) comply with the law
b) if wearing a hat is too onerous for you, you could use an alternative method of movement, (walking, running, crawling, hopping, jumping, skipping, public transport or dare I say it .... the car
)
c) break the law and accept the consequences (hopefully without complaint)
So, yes, I stand by ridiculous.
As for the comparison between the laws compelling drivers and passengers to wear seatbelts and a potential law compelling cyclists to wear helmets .... if you cannot work out the connection for yourself, I really don't know what to say.
OK, as you are into throwing around rude comments...
If you don't understand the moral difference between laws compelling people to take precautions against risks they impose on themselves, and laws compelling people to take precautions against risks imposed on them by others you are a bit hard-of-thinking and I feel a bit irritated at having to do your thinking for you.
The former are contentious and always open to argument, but only a hard-line libertarian would regard them as always being necessarily unacceptable (such libertarians exist of course, and fair play to them, but that's not my position). Most people would say each case depends on its merits and on what degree of consent there is and on how inconvenient the precautions are.
Seat belt laws are the former case, cycle helmet laws are the latter - as the vast majority of the risk faced by cyclists is not intrinsic to cycling its a result of the presence of fast-moving motor vehicles on the road (plus bad road design and almost non-existent road policing).
Hence the two cases are morally very different. Compulsory helmets are more like compulsory stab-proof vests for anyone living in the inner city. Its the knives and those wielding them you need to be dealing with, not imposing restrictions on the potential victims.
Additionally, having personally witnessed a high-speed car crash, it made me rather skeptical that a plastic hat would help much anyway if it had been me being hit rather than a crumple-zone-and-airbag protected driver. If you put that much trust in yours you may have a false sense of security.
I wear one myself (most of the time) as a desperate attempt to minimise victim-blaming if I ever get hit (a hopeless endevour I suspect) and because I think it just _might_ help if I get doored and hence hit the tarmac at cycling speeds (as opposed to being crushed by a HGV or hit by a car at 50mph, when it will likely be completely useless). But making it compulsory would be YET ANOTHER marker that the car is king and everyone else has to accommodate it. Your ideology is car-centric, I don't share it.
A further, more minor difference, that compounds the fundamental one, is that seat belts offer very little inconvenience to motorists or disincentive to drive and we already do everything possible to encourage driving. Cycling is far more vulnerable to further disincentives, and a helmet is yet another thing to forget when setting off, and would kill bike hire schemes dead. Not to mention that seat belt laws, like no-mobile-phone laws, are rarely enforced as you can't see what a driver is doing inside the vehicle, while a helmet law would probably be much more rigorously enforced.
For children the issue different, both because children are probably far more likely to come off the bike themselves, at the sort of speeds cycle helmets are actually supposed to help at, and because the moral rules about what you can compel people to do work differently when talking about children.
As it happens I don't really care about compulsory seat-belt laws either way, except for child passengers who should indeed be obliged to wear them. Adults can make up their own minds for all I care.
edit - in fact I might even be against compulsory seat-belts for drivers, because there is both a logical argument, and apparently evidence for, the notion that they _increase_ the risk for everyone outside the vehicle.
Incidentally, another reason why the seat-belt comparison is silly is that in the UK the seat-belt argument had already pretty-much been won by the time the law came in. Less so in the US, which is why the airbag was invented I believe, because American drivers refused to wear seat-belts.
I challenge you to find a single person who decided to give up driving because of compulsory seat-belts. But many people are put off cycling because of all the palavar about helmets and high-viz. Make it compulsory and we'll never get above this dismal modal share.
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