With the 2446mile Transcontinental Bike Race in aid of Injured Rugby Players and WWF coming up in a matter of days, I wouldn’t dream of not wearing a helmet; practically going to be glued to my head for 2 weeks.
This is a heated discussion among many cyclists but admittedly not an issue that is a focus of many cycling charities. I think it should be.
Many people would agree, or at least this is an observation from the discussions I have been having, that helmets have at least ‘some’ protection for cyclists. The main focus of the counter argument is that the public health benefit of getting people out on the bike (and it is argued that mandatory rules on helmets would put people off this) outweighs the risk associated with not wearing a helmet. I would like to break this argument down into 2 main points – the protection from the use of a helmet and public health.
– Protection from the use of a helmet
There is a very interesting study by Michael Dinh, Co-Director of Trauma Services, Royal Prince Alfred Hospital at University of Sydney – Australia being one of the few countries in the world in which mandatory helmet laws exist – (you can find the article here: http://theconversation.com/bike-helmets-an-emergency-doctors-perspective-13935) in which it was concluded, using data from 7 major trauma centres in Sydney, that the risk of severe head injury was more than 5 times higher if a cyclist doesn’t wear a helmet – compared to 3 times higher in motorcyclists. Severe head injuries were defined as significant brain haemorrhaging, skull fractures or brain swelling, with 70% of these patients ending up on a ventilator in an intensive care ward. Each of these cases was estimated to cost $4.5 million Australian dollars, an important fact when we come on to spending on public health campaigns later. The Cochrane Collaboration (an independent, globally recognized, leading body on providing high quality evidence for health care decision making) concluded that by wearing a helmet it reduced the risk of head or brain injury by approx two-thirds or more, regardless of whether the crash involved a motor vehicle – study can be found here. But let’s move on to the public health topic because of course that is the main element of the debate I feel – The British Medical Journal is an example of one organization that promotes the use of bicycle helmets but doesn’t wish for them to be made compulsory because they feel it would reduce the number of cyclists on the road.
– Public Health
I like to view this part of the debate in much the same way as the use of seatbelts in cars, rather than in the context of a healthy population. I’ll explain. The state/government takes away your personal freedom to choose whether to wear a seat belt because it has been found to protect you in the case of a car accident. Now as I have just described I think it is fair to say a bike helmet protects you in the case of an accident. In terms of public health, as Dr Michael Dinh explains in his blog, there have been conflicting studies on what deters people to cycle. The National Heart Foundation survey showed that overall road safety, road speed and the presence of dedicated bike paths was the main obstacles in limiting bicycle use, with only 17% of respondents identifying helmet use as a problem in Australia. On the other side we have Professor Chris Rissel, from the University of Sydney, who supported moves to make helmets optional to double the number of cyclists.
It is fair to say that a mandatory helmet law would deter some cyclists. However I would argue that the benefits of wearing a bike helmet – i.e. reducing head trauma as already described – outweighs those arguments on needing to encourage this minority to take up cycling. More effort needs to be made to get people active, that goes without argument. But I think that effort needs to be made through some of the ‘tactics’ listed below and not by compromising the safety of cyclists on the road. I think just like seat belts it is the state’s responsibility to enforce laws that are for the public good; need we compare this to the outlaw of harmful drugs because of people’s safety over personal freedom. I think ignoring this point and encouraging people to cycle without a helmet to improve physical activity rates is just putting off the more daring, controversial, but far more beneficial decisions that need to be made; some of which I have listed below:
– Get people out of the car – if we want to talk about the need for physical activity this is the big one. At a faction of the budget of motorways you could build extensive cycle lanes (which are protected from traffic – I appreciate this is very important to prevent accident on blind corners etc which has been the cause of many recent cyclists deaths in London).
– Making it easier to get bikes on trains (3 spaces on a whole train simply isn’t good enough) or perhaps providing discounts on rail tickets for those commuting at each end by bike.
– Here’s a big one – ban smoking. You want a big solution to help the health of the individual while also legislating for the health & safety of the public – there you go. Big debate on that one, but hey why hasn’t this decision been made while we can compromise on major head trauma with cyclists?
And of course the list goes on. But let’s leave this for comment below. I do admit my opinion is bias, I had a very bad bike accident 18 months ago and my helmet got destroyed while my head was left pretty intact (broken jaw and that’s about it). I also do appreciate the argument to get people on the bike as much as possible, however I don’t think this should compromise the safety of those on a bike. If we want to talk about personal freedom let’s talk about the choice for people to make that decision to get active – either by cycling with a helmet or running etc. Having a discussion on making helmets mandatory doesn’t need to distract from the larger environment of safe cycling – as the London Cycling Campaign argues (and in their support they are ultimately trying to bring down cycling deaths through better infrastructure; which as recent cyclist deaths would demonstrate is the major factor in improving safety in London) – and I think it should be on the table. In a fly away comment, at the very least why can’t Boris bikes provide a helmet and give casual cyclists the choice?
If you share my passion for helping sports injuries – and of course I include both sides of the fence in this (wearing helmets or not) – please take the time to visit my post on raising money for rugby injuries during my Transcontinental Bike Race from London-Istanbul, starting on 3rd August. – http://howtomeetamillionpeople.com/2013/07/24/why-i-picked-the-rfu-injured-players-foundation-as-one-of-my-charities-for-the-transcontinental-bike-race-london-istanbul-in-9-days/