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Bicycle helmets should not be compulsory, say doctors

Tuesday 2nd August 2011

In a poll carried out by the British Medical Journal (BMJ) doctors say that wearing a bicycle helmet should not be mandatory, reports the Telegraph.

More than two thirds of BMJ readers said they opposed compulsory helmets for adults, fearing that if people are forced to wear helmets they may give up cycling altogether and lose the health benefits of regular exercise.

One respondent in the poll of 1,427 people said: “It gives out the message that cycling is dangerous, which it is not. The evidence that cycling helmets work to reduce injury is not conclusive.

“What has, however, been shown is that laws that make wearing helmets compulsory decrease cycling activity. Cycling is a healthy activity and cyclists live longer on average than non-cyclists.”

Another said: “Since nowhere with a helmet law can show any reduction in risk to cyclists, only a reduction in cyclists, why would anyone want to bring in a law for something which is clearly not effective at reducing the risk to cyclists?”

Wearing a helmet has been a legal requirement in Australia since 1991 but Sydney University researchers have called for the law to be repealed, arguing that the fall in head injuries was down to road safety improvements, rather than the law. They cited figures from Western Australia which suggested that the legislation led to a 30% drop in cycling rates.

Click here to read the full Telegraph report.

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The wearing of cycle helmets should only be mandatory for children as adults should know better.

When teaching cycling to children that are going on the road for the first time it is essential to protect them as much as possible.

A friend of a colleague of mine donated his broken helmet to show what can happen if you fall off your bike on a cycle path, god knows what his head would have looked like if he hadn't worn it.

And this about educating drivers, I find as a driver/cyclist that the cyclist is usually at fault cutting up traffic or dodging drains too late.
Liam, Essex

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Crikey is this thread STILL running? I think Nick should issue mandatory tin hats to all who travel through the RSGB website. :-)
Mike Mounfield, Birmingham

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The figures say it all really.

With all the bike lanes in London, and the fact that (lets face it) most drivers DO look out for cyclists on the road then I am not shocked that cyclists suffer less head injury then a pedestrian.

@ David S
You are right, helmets are hardly ever worn right and a twisting injury is far more dangerous than a bash to the head.

So... Why are helmets a requirement?

http://www.ukcrimeprevention.com/
Tom, London

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Something is not always better than nothing. Helmets may actually increase the chance of some types of brain injury (rotational injuries can be more serious than direct impact). They may just give a false sense of security and no actual protection (few helmets in impacts actually crush to absorb energy as intended? many helmets are not worn correctly). They might make it harder for users to sense hazards (eg interfering with hearing or vision). They may alter perception and lead to more dangerous behaviour (eg by cyclists or drivers taking less care if they think there is less risk or by people not cycling and becoming less healthy because they think cycling is more dangerous than it is or it becomes less convenient).
David S, Midlothian

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From Reported Road Casualties Great Britain 2009 – ‘Extrapolated from table 6c “Proportion of road casualties with injury to selected body regions, by road user type and age group.”

Number of head injury Casualties

Pedestrians 2980.34
Pedal Cyclist 2650.68
Motorcyclists 982.08
Car 4001.92


There are a relatively low number of Motorcyclists head injuries, (the only user group that wears helmets) which would suggest that the wearing of helmets is effective.

However the figures would suggest it is the pedestrians and car drivers that need to wear the helmets the most!

I think it should be a matter of personal choice on a bicycle. I’m fed up with the H&S nanny state legislating against common sense. If the health and safety Nazi’s had their way all user groups would be wearing helmets, hi-vis head to toe, and bubble-wrap body armour.
Adam, Hants

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Sadly Renee that's where you're wrong, skull fractures can occur from direct impacts at about 13 mph upwards (so stay at 12 and you'll be fine...) depending on some physical factors. This is why motorcycle crash helmets are tested at about this speed. They are designed to reduce head injury in low speed collisions - a rider crashing at 70mph would probably die regardless of wearing a helmet or not. And it's less the speed your doing at the time of the crash and more about the force of the impact and what you hit. At the end of the day only we as individuals know what our heads and brains are worth, if it's not much then don't wear a helmet.
Dave, Leeds

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I suggest instead of spending a lot of money to enforce this, they should invest the money in bike helmets and with every new bike bought the customer receives a helmet. A much better investment than forcing people to wear it. The individual would then have the right equipment and the choice whether to wear it.
Joe, Edinburgh

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What I find interesting is the research and the position taken by some that wearing a helmet decreases cycling intention/levels due to the perception of it being "dangerous".

I accept that a helmet doesn't provide protection to certain parts of the head in certain types of collisions, but surely something is better than nothing?

Perhaps what road safety professionals need to do is reposition the helmet debate away from the current arguments and look at how we can encourage people to use suitable protection, without the "dangerous" connotations.

Could it be a change of attitude, rather than legislation? And, if so, what do we need to do to create that?
Neil Hopkins, Sussex

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I think you have to be very careful with figures. For instance, would the figures include deaths of cyclists who would have died whether or not they were wearing a helmet. In other words the non-wearing of a helmet was not a contributing factor to the death?
Peter, St Albans

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@Dave You forget that motorcyclists are travelling at up to 70mph on motorways. If you fall off even if you don't collide with a vehicle, you will be severely injured at such speeds (motorway barriers are a specific worry for motorcyclists). I cycle at about 12mph and if I fall over I may have a bruise or a scratch but that's about it.
Renee, Wolverhampton

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So why are crash helmets mandatory for motorcyclists? They don't stop riders from crashing or from being crushed by a lorry either. Would it be ok not to wear a seatbelt if you're a careful driver? It's about injury prevention in the event of a crash not prevention of a crash in the first place. Given that you can fracture your skull falling over it stands to reason that a cycle helmet will offer some protection in the event of a crash. Responsibility has to lie with the vulnerable in the first instance 'I had right of way' is a rubbish epitaph. As a motorcyclist I accept that my safety on the road starts with me and that includes wearing protective kit.
Dave, Leeds

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Helmets should NOT be compulsory. As pointed out above, compulsory helmets means less cyclists, and the safety in cycling is in numbers. Rather than spending a fortune in setting this up, and enforcing this, I would spend it on increasing safety by enforcing the rules already in existence (ie the highway code!) and educating road users across the board (including cyclists and pedestrians).

Helmets do not protect cyclists from accidents. There is no independent research that shows that a helmet protects us on impact. And it sure cannot protect us from being crushed by a lorry.

Asking, 'did you wear a helmet' after an accident, is like asking a woman who was raped 'did you wear a short skirt'. It's putting responsibility with the vulnerable rather than with the party that caused the accident in the first place.
Renee, Wolverhampton

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Good for them. There is far too much petty regulation in our society. If people want to wear cycle helmets that's fine, but it should not be compulsory. Some fool will be demanding pedestrians be forced to wear hi-viz jackets next.
Chris, Birmingham

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I don't think the BMJ poll was put forward as any sort of research, simply an opinion poll from amongst its readers to a very specific question - should helmets be made compulsory for adult cyclists?

My humble and personal opinion is that they should not. I do think children should be required to wear helmets as they are learning and will make mistakes and are more likely to come off (not as a result if a collision with a vehicle) so a level of protection to the young skull and brain seems sensible and proportionate, say up to the age of 14 years as with horse riding. If I am instructing children and require them to wear a helmet, then I should set an example by wearing one myself - children copy what we do more than what we say.
Higher risk sports can set their own rules, and they do so e.g. trail riding etc.

For the average adult cyclist outside these few specific categories, it's up to you. What research there has been generally supports the assertion that compulsory helmet wearing discourages adults from cycling and the health and environmental benefits from more people cycling that will be lost probably do outweigh the number and severity of head injuries that will be prevented.
Honor Byford, North Yorkshire

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There can be no doubt that wearing of a helmet will give some protection to the head if a cyclist falls off their bicycle or collides with a vehicle. We cannot Cycling for charity unless we wear a helmet.

It seems a contradiction, once again, that we must wear helmets and protective clothing for many sports, on building sites, train line work industrial business ect, with no mention from the British Medical Journal that helmets and protective clothing should not be mandatory.

Unlike parachuting, the danger is not in cycling, it is when the cyclist does not observe the highway code and more often it is when motorist commit criminal motoring offences and thereby endanger cyclists and other road users.

My worry is that the British Medical Journal doctors, like the NHS, have another agenda – that of requiring more organs for transplants. The NHS has stated that there are more people waiting for organ transplants due to decrease in road deaths.
Judith - Norfolk

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Take a look at:
http://www2.cochrane.org/reviews/en/ab005401.html
http://www2.cochrane.org/reviews/en/ab001855.html
Steve Whitehead

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Cycling not dangerous? Tell that to the 2771 people who were killed or seriously injured doing it last year. We need to be honest with people about the dangers and how they can reduce the risks they face, not just assure them that cycling will make them healthier.
Dave, Leeds

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It is of course quite correct to say that cycling is not dangerous, or is it? I have cycled for most of my life and have yet to be killed, but it remains a potentially dangerous activity for me. It is one of those activities, like parachuting, that is perfectly safe for 99.9999% of the time, but perchance fatal for the remainder of the time. By any reckoning, that does not make it safe. Cyclists, and road users of all types, need to be educated that they alone are responsible for managing, and minimising, their own risk.

At present, I am against the wearing of helmets being made mandatory, but before we can make educated choices about whether we wish to wear one, there needs to be genuine, unbiased research on the subject. Most of the research done up until now seems to have been initiated with a view to it supporting an already entrenched point of view. Only when we have good research, can be make up our own minds on this issue, or begin to contemplate compulsory helmet use.

This poll by the BMJ looks to me to be nothing like decent research, and as such deserves no place in road safety circles.
David, Suffolk

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