Are laws requiring cyclists to wear helmets bad for our health?
Sue Abbott is a longstanding cycling enthusiast and advocate, a solicitor, a resident of rural NSW, involved in organising medical education, and a blogger.
She is concerned that laws requiring us to wear helmet laws are misplaced. She writes:
“The large increase in bicycle helmet-wearing rates since Mandatory Helmet Laws (MHLs) were enacted (circa early 1990s) has not resulted in reduced head injury rates – in fact head injury rates have increased relative to the amount of cycling.
No randomised controlled trials have been done on the subject of bicycle helmet safety. Current data comes from two main types of observational study; “time trend analyses” and “case control studies”. Most of the literature that mentions bicycle helmets and bicycle helmet promotion refers back to a small number of these studies, rather than actually providing primary evidence.
Yet peer-review of bicycle research to date has led some scientists, traffic engineers and medical practitioners to conclude that helmets are actually dangerous for your health (W Curnow, ‘Bicycle Helmets: a Scientific Evaluation’ in Anton de Smet (ed), Transportation Accident Analysis and Prevention (2008) 139), analogous to findings investigated by “Catalyst” ABC TV that football helmets ‘designed to prevent head injury had allowed another kind of head impact to become part of normal play’.
What really concerns me is that when you explore this matter, it becomes quite apparent that mandating the use of bicycle helmets was a commercial reality, and one grasped at by politicians in a bid to pass the cost of cycling safety onto the consumer in terms of helmets rather than expensive cycling infrastructure and education of motorists. Plainly, bicycle helmets should never have been the first and last words on cycling safety, yet the notion became the grim reality of Australian cycling.
In 2008, Civil Liberties Australia published an assessment of MHLs in Australia, and concluded that MHLs were not justified. Colin Clarke’s detailed “Assessment of Australia’s Bicycle Helmet Laws” outlines the negative impact MHLs had not only on cycling activity but on our health and the environment, in addition to the extra burden of resources for law enforcement.
Given that there are only about 2 ‘cyclist’ deaths per year per million population compared with about 2,000 plus ‘circulatory’ deaths, the question remains to be answered whether the current helmet legislation is the best option for the health and safety of our nation. Prima facie, cycling ought not to be a criminal issue but a health issue.
Further, Malcolm Wardlaw’s journal article in the British Medical Journal, “Three lessons for a better cycling future” reflects that:
- cyclists do better when they act and are treated as drivers of vehicles
- deaths of cyclists have increased since the introduction of helmets
- attendant safety campaigns destroyed cycling participation, compromised public health, increased risks on the roads, and decreased road skills for all concerned.
Wardlaw’s position is reinforced by literature from the European Cyclist Federation, “Ask me why I cycle without a helmet”, which clinically outlines the perils of portraying cycling as far more dangerous than it is, and the notion that bicycle helmets offer far more protection than they actually do, advising that governments ought ‘to refrain from promoting or enforcing helmet wearing without sound evidence that this would be beneficial and cost effective compared to other safety initiatives.’
A proposed new cycling initiative is destined to fail before it gets off the ‘drawing board’. Unquestionably, the survival of the internationally acclaimed bike share program, destined for Brisbane and Melbourne this year, is under threat because of our MHLs, (the National Interest report (Friday 16 April 2010 - http://www.abc.net.au/rn/nationalinterest/stories/2010/2875160.htm). Mandatory helmet laws will literally kill “spur-of-the-moment decisions to use a bike“. Yet relevant state transport ministers continue with blinkered advice that:
* regular users should bring their own helmets
* helmet buying options will be provided
* helmet hiring options will be provided – though cycling authorities remain silent on the issues of nits, contagious scalp disease et al, or previously incurred damage to helmets.
Bike share programs work in other cities for one very simple reason – they do not have to contend with MHLs (http://freedomcyclist.blogspot.com/2010/04/unfortunately-for-australia-success-of.html).
We have been sold a ‘pup’ with our MHLs; we are the fattest nation in the world, and obesity is now causing more illness and premature deaths than smoking. Given that cycling rates have diminished significantly over the past 19 years there even appears to be a correlation to the obesity epidemic if not an actual contribution to the causation.
Clearly, the hoped-for community benefits emanating from MHLs have been considerably outweighed by the actual losses incurred by the community. Notwithstanding our politicians stubbornly cling to anecdotal notions that helmets save lives and protect cyclists. In a stark parallel with our previous reticence to absorb the evidence against smoking and front & side sleeping positions for babies (see Dr Ruth Gilbert – “How wrong was baby sleeping advice“), we just don’t want to face the ‘public health music’ yet!”
• Some more bio about Sue Abbott:
- commenced my cycling existence on the back of my parents’ bikes in Holland, before being moved onto my own bicycle by the time we reached England and Cyprus
- have cycled for well over 40 years throughout Europe, the US, the Mediterranean, and Australia
- have lived in Scone for the past 26 years with my rural proceduralist husband
- coordinate “unsponsored” continuing medical education (CME) for doctors, primarily rural proceduralist and emergency physicians
- we have 4 adult children none of whom own a car
- I completed a law degree at Newcastle Uni at the end of 2009 and was admitted as a solicitor in February 2010
- have never worn a helmet as have always felt they were a commercial reality that did not afford the protection claimed by the hype
- member of the cyclists’ rights action group based in Canberra
- booked by the police in Scone in March 2009 for not wearing a bicycle helmet while riding a bicycle
- took the matter to court at both the local and district court level
- raised the narrow defence of necessity; that it was necessary to cycle without a helmet on therapeutic grounds and grounds of civil liberties
- court of first instance received a criminal conviction, which was subsequently quashed after I appealed the matter in the district court
- actively involved in campaigning to repeal the laws
- dismayed by evident lack of academic process in determining the rationale for mandatory helmet laws – anecdotal evidence has dictated our current cycling reality, not science
- also dismayed at the lack of consistency applied to this matter because if government rationale was to always protect us from the perils of our life-style choices, why has smoking, over-eating and overdrinking not been outlawed? The data on these habits is catastrophic yet government has not reacted to save us.