Guy Chapman - Jul 18 2003

from the Reading Chronicle, 18 July 2003 ANGELA Lee nails her colours to the mast: so will I. I am a year-round cycle commuter, riding about 5,000 miles on the roads per year. I am conscientious about safety and have studied the literature on bicycle helmets with great care. I disagree profoundly with Ms Lee's analysis of the need for compulsion in the use of cycle helmets. The argument for compulsion is built on very shaky ground. In particular the claim that injuries could be reduced by up to 80% is simply not supported by any credible evidence. When mandatory helmet wearing was introduced in Victoria, Australia, some years ago the principal result was a large drop in the numbers of people cycling - the injury rate (the proportion of cyclists suffering head injuries) remained unchanged. So Ms Lee's assertion that "There is no long-term disadvantage in making it compulsory to wear cycle helmets ... [t]his is borne out by countries that have compulsory helmet laws", is a misrepresentation: there is a long-term disadvantage, in that numbers cycling remained depressed even a decade after the law was introduced, and, more importantly, there is no provable benefit. This is hardly a surprise. Cycle helmets are primarily designed to protect in loss-of-control accidents at speeds up to 12 mph. Many adult cyclists on the road will be going faster than this, and the involvement of a motor vehicle in any crash immediately places it outside the design parameters of the helmet. There is also a mechanism known as risk compensation which describes the way in which use of protective equipment can lead to an increase in risk-taking behaviour. The best-known example in the UK is the introduction of compulsory seat-belts for car drivers: the rates of pedestrian, cyclist and rear-seat passenger fatalities rose sharply, and the benefit to drivers declined below measurable levels within two years. Helmets do appear to provide some protection for children and I fully endorse encouragement of children to wear helmets. But compulsion? BHITs own figures show that 90% of child cycle accidents occur in off-road play. They do not suggest how legislation could be extended to cover these accidents, most of which will be on private property. And of course they fail to establish any parallel between children playing and experienced adult cyclists on the road. Ms Lee mentions that helmets are now compulsory in UCI sanctioned cycle races. Are car drivers prepared to use helmets, fireproof suits, five-point harnesses and rollover cages, as required by the motorsport governing bodies? Or are we perhaps prepared to accept that there is a difference in character between competitive sport and everyday life? Promotion of cycle helmets carries with it a serious danger. The extent of risk compensation is dependent on the perceived value of the protective equipment - and in this respect cycle helmets are at best unproven. One unhelmeted rider in a cycle race was killed: helmets are now mandatory. Less is made of the two helmeted riders who have died recently. The countries with the lowest injury rates have the lowest helmet wearing rates, and the countries where helmet use is most prevalent have the highest injury rates. Nowhere in the world is there any evidence of injury reductions anywhere close to the oftrepeated 80% level - the studies which suggest this figure appear to produce it out of a hat. The original study which started the ball rolling, by Thompson, Rivara and Thompson, also demonstrates that helmet wearing reduces leg and torso injuries. Perhaps they were using full-body helmets? Further problems come from the way that helmet promotion portrays cycling as a risky activity. It is not. The BMA suggests that regular cyclists live around a decade longer than average - the danger posed by motorised traffic is more than offset by the inherent health benefits of cycling. So aggressive helmet promotion campaigns risk discouraging a worthwhile activity. Finally, the monomania about helmets draws attention away from far more important issues. The most survivable crash is the one which never happens in the first place - surely we should be focusing our attention on building excellence in cycle training to equip young people with the means to use bikes safely. Fear of a SMIDSY (sorry, mate, I didn't see you) drives many cyclists onto pavement cycle paths, where conflicts with motor vehicles and pedestrians multiply to the extent that they are at least three times more dangerous than riding on the road. Clearly there is more benefit in preventing crashes than in mitigating their effects, particularly if the means of mitigation may increase the chances of the crash happening in the first place. Cycling on the road skilfully and as part of the traffic is a safe, healthy way to travel. The more people do it, the safer it becomes. Polystyrene hats are largely irrelevant to this.