A previous Croakey post put a strong case that mandatory bicycle helmet laws are having a detrimental effect on public health.

Now a leading public health and cycling advocate, Clinical Associate Professor Chris Rissel from the University of Sydney, has weighed in to the debate – suggesting that the laws are “failed public policy”.

He writes:

“I agree with Sue Abbott that the legislation for mandatory bike helmets is failed public policy.

There is little evidence to support the view that there was a drop in head injuries as a result of the helmet legislation. Any observation of the head injury rate since 1950 shows that this declining in New South Wales BEFORE the introduction of mandatory helmet legislation, and certainly before the self-reported level of helmet use increased. This is consistent with the general decline in motor vehicle related fatalities and morbidity in NSW from 1950 to the present, but in particular between 1980 and 1990.

It is most likely that a series of changes in road safety and conditions before 1991 contributed to a generally safer road environment, which benefited people cycling as well as other road users. For example, on December 17, 1982, New South Wales, introduced random breath testing, with an immediate 90-percent decline in road deaths, which soon stabilized at a rate approximately 22 percent lower than the average for the previous 6 years. The introduction of intensive road safety advertising in 1989, and the introduction of speed camera programs in 1990, plus the implementation of national road safety strategies (eg STAYSAFE Committee) all contributed to marked reductions in traffic related mortality and morbidity through the 1980s and early 1990s.

Two previous papers looking at the impact of helmet legislation reported on pedestrian deaths and head injuries as a comparison with cyclists before and after 1991. Robinson found a decline in deaths and serious head injuries among pedestrians paralleled the decline in these injuries among cyclists between 1988 and 1992.[1] Between 1988 and 1994 the decline in deaths from head injuries among pedestrians was 8% greater than the decline in deaths from head injuries among cyclists.[2] Clearly pedestrians are not affected by helmet legislation, yet the reduction in head injuries among pedestrians supports the idea that factors other helmets may be responsible for generally safer road conditions.

From a practical and policy perspective, the introduction of mandatory helmet legislation is not temporally associated with a substantial drop in head injuries among cyclists. The problem with a focus on helmets is that it seeks to attribute injury responsibility with the vulnerable road user rather than the cause of the injury, which is essentially road and traffic conditions such as, for example, poor road surface, allocation of road space for cyclists, speed of vehicles, and attitudes of drivers.

The discussion should not be about whether helmets protect the head or not, but whether the helmet legislation caused less head injuries. There is no evidence that it did, and lots of argument that helmets are a barrier to cycling and the health benefits that come from cycling.”

1. Robinson D.L., Safety in numbers in Australia: more walkers and bicyclists, safer walking and bicycling, Health Promotion Journal of Australia, Vol.16, No.1, 2005, pp47-51.

2. Curnow W.J., Helmets not helpful- and example of poor public policy, Health Promotion Journal of Australia, Vol.16, No.2, 2005, p160.

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