Should wearing a cycle helmet be compulsory?
Ever since their introduction in the 1970s, cycle helmets have stimulated debate among safety advocates, doctors, politicians and cyclists. The question has always been the same: Do cycle helmets actually protect cyclists from serious and fatal head injuries and should there be legislation in place to make the wearing of cycle helmets compulsory? Even now, the argument still rages on.
The most commonly cited research into the value of wearing a cycle helmet was conducted in Seattle by Thompson, Rivara and Thompson. In their paper published in the New England Journal of Medicine in 19891, they claimed that wearing a helmet reduced the risk of serious head injury by 85% and brain injury by 88%.
Unfortunately, the research was seriously flawed. The sample group was too small and not representative of the general population. The control group was too dissimilar and too many variables were not controlled. Despite this, other researchers and proponents of cycle helmet legislation still quote this research (and the authors continue to repeat their claims based on the study - British Medical Journal, 20002).
More recent research is far less conclusive. Studies conducted in places as far apart as the United Kingdom, Australia and the United States indicate that the wearing of cycle helmets does not lead to a significant reduction in the number of fatalities and serious head injuries among cyclists. According to research in Australia, for example, around 80% of cyclists killed or seriously injured in accidents were wearing a helmet.
In jurisdictions where the wearing of a helmet has been made compulsory, statistics do show a reduction in the overall rate of injuries to cyclists. But, the statistics do not take into account the fact that, after the introduction of legislation, the number of cyclists fell. This has been attributed to a perception that the requirement to wear a helmet indicates that cycling is dangerous, helmets are uncomfortable and some people regard helmets as unsightly. Some health professionals claim that this reduction in cyclist numbers equates to a reduction in the physical wellbeing of the population as a whole and will have consequences for health care systems in the future as people are getting less exercise now. The costs of caring for these people in the future will far outweigh the costs of caring for the comparatively few cyclists needing treatment because they did not wear a helmet.
According to some commentators, the design of the cycle helmet itself can lead to injuries. They point to research that shows that the foam lining in many helmets is too hard to absorb an impact. Instead, it merely transfers the force to the skull. They also refer to claims that the shape of the helmet can lead to severe facial and twist injuries to the neck as the helmet strikes the ground at speed. They also point out that, while a helmet will offer some protection if a cyclist merely falls (especially in the case of children), there is no substantial protection if a cyclist is struck by a motor vehicle and this is where most deaths occur.
Others claim that the wearing of a helmet actually leads to increased risk for the cyclist. They say that the apparent protection offered by a helmet causes some cyclists to take more risks than if they were not wearing a helmet. They also believe that there is evidence to suggest that motorists are less careful if a cyclist is wearing a helmet and will give him much less room.
Interestingly, in countries like The Netherlands that have a long history of cycling, there is no legislation to compel cyclists to wear a helmet despite the comparatively large number of cyclists. And yet, there are very few serious accidents involving cyclists. This is perhaps because there is a popular cycling culture and motorists treat riders with greater respect.
The debate continues to rage on. Though the argument for the introduction of legislation is backed up by research that shows some decrease in serious injuries to cyclists who wear helmets, opponents point out that the numbers are insignificant and that forcing people to wear a helmet will drive them off the road. Most seem to agree, however, that helmets should be mandatory for children, particularly as they do protect from injuries caused by falls.
Perhaps the best answer lies with all road users themselves. If everyone follows the rules and treats all other road users with consideration and respect, then the roads will be a safer place for everyone.
- Thompson, Rivara and Thomson. New England Journal Of Medicine 1989, Vol 320. No.21 p 1361-7
- British Medical Journal 2000, Vol 321, p1035-6