Bicycle helmet legislation ‘not associated’ with head injury rates

12.00 | 9 November 2015 | | 7 comments

Bicycle helmet legislation is ‘not associated’ with a reduced rate of head injuries caused to cyclists, a study published in the British Medical Journal (BMJ) has concluded.

The report, conducted by researchers from the University of British Columbia and the University of Toronto in Canada, compared injury rates between jurisdictions with different helmet laws and the number of journeys made by bike.

The results revealed that helmet legislation was not associated with reduced hospitalisation rates for brain, head, scalp, skull or face injuries, indicating that factors other than helmet laws have more influence on injury rates.

The researchers suggest that in order to reduce bicycling injury rates, transport and health policymakers should focus on encouraging more people to cycle and to teach people how to cycle more safely – following the lead of female cyclists.

It makes this suggestion as the report found that females had lower cycle-related hospitalisation rates than males in analyses of all injury causes. These results are consistent with those found elsewhere and for other travel modes, an effect often attributed to the conservative risk choices that females tend to make.

It also found that hospitalisation rates for traffic-related injuries were lower with higher cycling mode shares, a “safety-in-numbers” association consistent with results elsewhere and for other modes of travel.


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    “policymakers should focus on encouraging more people to cycle and to teach people how to cycle more safely”

    Or they can focus on what actually works, namely providing safe streets with properly protected cycling infrastructure on the main roads.

    All the research you need is available if you just pop across to the Netherlands to see it. Everything else is just a half measure.

    James Avery (@pedalparity), Coventry
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    “in order to reduce bicycling injury rates, transport and health policymakers should focus on encouraging more people to cycle”.

    On the other hand, in order to reduce bicycling injuries, transport and health policymakers should focus on encouraging fewer people to cycle?

    Idris Francis Fight Back With Facts Petersfield
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    Perhaps it is a case that even those wearing helmets suffered the same degree of injury as those that were not. ie. the helmet was insufficient at being protective. Or it may have not fitted properly or may not have been fastened properly enough to be able to mitigate an injury. Some riders that I have seen seem to have a loose strap dangling, thus the helmet is loose on the head and almost ineffective.

    Bob Craven Lancs..Space is Safer Campaigner
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    It is easy to misinterpret and misuse research. There are a few points from this study which do not necessarily point to the conclusion that helmet wearing legislation is not associated with a reduced rate of head injuries amongst cyclists.

    Firstly, they state that “the fact that we did not find an effect of helmet legislation for injuries to any body region is not surprising, since most injuries were not head injuries.”

    They also point out that they were focused on injuries and that “perhaps helmet laws simply influence injury severity, shifting the injury burden from deaths to hospitalisations”. They focused less on injury severity and fatally rates and therefore there could be hidden life-saving benefits to be gained from helmet wearing.

    Lastly, they stated “we did not find a relationship between injury rates and helmet legislation”. However, they did not state that there CAN’T be relationships between injury severity and helmet legislation, or indeed helmet use (regardless of legislation or enforcement of said legislation).

    This is interesting research but should not be taken as definitive proof of the ineffectiveness of helmets. The analysis looked at helmet wearing legislation and did not account for enforcement of said legislation or indeed, actual helmet wearing rates. Research into head injury and helmet wearing rates would provide a better insight.

    George, Road Safety Analysis
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    Mark and David
    In response to your comments, we have modified the headline on the story. However, in essence what this report is saying is that having in place legislation to require cyclists to wear helmets does not reduce the proportion of them who end in hospital with head injuries. I should stress that we are simply reporting the findings of the study, not endorsing them.

    Nick Rawlings, editor, Road Safety News
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    I have been to the scene of many collisions involving cyclists and wearing a cycle helmet does have a difference on the severity of injuries caused to cyclists. I think your headline is misleading.

    Mark, Norfolk
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    Perhaps the researchers would like to comment on the female cyclist situation in London where over recent years they make about 25% of all journeys, yet represent more than 50% of the deaths suffered by cyclists. Riding like a female is not some sort of panacea.

    The research states by the way that helmet legislation has no effect on head injury hospitalisation, yet the headline to your article states that bicycle helmets have no effect on head injury rates – those two things are not one and the same.

    David, Suffolk
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