Poking the Helmet Debate

I’ll be up front – I usually wear a helmet while riding the bike. Both of my kids have bike helmets, and are pretty religious about wearing them, even to the point of telling their friends “Hey, wait – I’ve got to get my helmet” when they go to ride bikes. Helmets are good, m’kay?

But bikes are better.

The couple of times I’ve caught the kids without helmets, I’ve just handed them to them, and a couple of times when we’ve been out as a family in the evening, Missy and I walking and the kids riding, I’d just told them to keep going, ’cause in my mind building kids who love cycling is going to make them healthy years later. I’d rather treat the helmet as a “nice to have” instead of an all-or-nothing, making riding the bike sometimes a negative experience.

I’m not arguing that helmets don’t work – they do, even in high speed situations. But making them completely mandatory with punitive makes people not ride bikes, or so sez some Commonwealth medical researchers via BikeRadar:

For example, a 1989 case-controlled study (i.e. directly comparing helmet wearers with non-helmet wearers) published in the New England Journal of Medicine concluded that bicycle helmets reduce the risk of head injury by 85 per cent.

Writing in the British Medical Journal in 2006, Dorothy Robinson, a statistician at the Department of Primary Industries in Armidale, Australia, claimed that helmet laws caused cycling levels to drop by 20 to 40 percent in several Australian cities and states.

Robinson’s point seems to have been backed up by evidence from 1990 – Victoria, Australia, introduced an all-ages cycle helmet law in that year and helmet use rose from 31 percent to 75 percent, with the number of head injuries dropping by 40 percent.

However, cycle counts in Melbourne showed drops of between 33 percent and 46 percent. Injuries dropped roughly in proportion to the decline in cycling. The proportion of serious head injuries compared to overall injuries fell only slightly.

I’ll be clear again: I think if you’re going to ride and have a helmet, you ought to wear it. However, if you’ve got a bike and a car and decide to go somewhere on the bike instead of in the car, do it. If you want to go cruise the rail-trail in a straw bowler, feel free. And if you really, really want to go climb wearing a USPS cap and pretend you’re Lance back in 1999, knock yourself out, helmet or not.

Bikes rule. Go ride.

2 thoughts on “Poking the Helmet Debate

  1. I too used to be a bit obsessive about wearing a helmet, until some inconvenient facts came out. Robinson’s work is the best academically because she uses the best scientific methods, all available control groups and so on. The full reference, if you need it, is Robinson DL. No clear evidence from countries that have enforced the wearing of helmets. BMJ 2006;332: 722-5. http://www.bmj.com/cgi/content/full/332/7543/722-a. To summarize, helmet laws have stopped a lot of people cycling and have done nothing for head injury rates.

    The main reason may be that helmets break easily, but don’t absorb the impact, see the engineers quoted at http://en.wikipedia.org/wiki/Bicycle_helmet. A broken helmet has simply failed. Helmets have also strangled some young children who were wearing helmets while playing off their bicycles.

    No, I don’t wear a helmet any more. Among other things, they’re always mildly uncomfortable and inconvenient. But I’m still riding. At my moderately advanced age it’s far too dangerous not to cycle – regular cycling, Danish style, not too far, not too fast, nearly halves the death rate, see http://archinte.ama-assn.org/cgi/content/abstract/160/11/1621 All-Cause Mortality Associated With Physical Activity During Leisure Time, Work, Sports, and Cycling to Work. Andersen et al, Arch Intern Med. 2000;160:1621-1628. I’d like to stay mildly healthy as long as I can, and anyway it’s a great way to get about. But I really don’t think that a helmet will help me to stay safe. Checking that my brakes work, and riding defensively as part of the traffic, probably will.

  2. Jank: thanks for the post. You hit the nail on the head: just ride, but wear a helmet if you can.

    And the moral of the studies mentioned by Richard is this: math has its limitations when it comes to human nature.

    The problem with all of these studies is the immense number of variables that are often omitted to try and validate a hypothesis. Sure, there are studies that show that helmets both improve safety and encourage cycling, or have a negligible effect on safety and discourage cycling. Each of these studies has merit, and each one is deeply flawed as certain variables (e.g. fellow cyclists, road conditions, weather, motivations and goals of the cyclists, et al) are thrown out to make the studies publisher-ready.

    Yes, the primary safety features of the bicycle (brakes, drivetrain, headset and wheel axles) are part of the safety equation, as is how one rides (aggressively vs. defensively – and there are good arguments in support of both approaches). But then there is the “what if?” aspect, which involves road conditions, fellow road occupants (both fellow cyclists as well as motorized and non-motorized users of the roads), fatigue level of the cyclist and other road users, etc.

    And given all those variables, a little piece of insurance in the form of a helmet is nothing to discard or ignore. Helmets can – and do – provide a level of safety, both perceived and real, to the rider. Most are built to stringent standards of impact, and most provide good ventilation to help strike down the “they’re too hot” argument. And they don’t cost much: in the United States, all helmets must meet CPSC standards, whether they cost $20 or $200. That’s a cheap insurance policy.

    Brain injuries are nothing to take lightly, and any means to help minimize the potential side-effects of cranial impact is worth the investment and “trouble” to implement. Putting on a helmet is simple. And the protection they can provide is real.

    Sure, there are variables that can’t be controlled. I’ve seen far too many helmet-wearing cyclists ride with poorly-adjusted straps that either leave the helmet too loose on the head or place it too far back to provide proper frontal protection. I’ve seen folks wear the helmet backwards. And I’ve seen people wear helmets that are so old and decrepit that they wouldn’t provide much in the way of safety on impact.

    All it takes is one good crash that totals a helmet, yet leaves the rider mostly unscathed, to work as a convincing argument to the wisdom of helmet use (and yes, I’d make it mandatory for all ages – the costs of treatment for severe brain injuries are high and affect us all). Last year, I went down in the middle of a pack of cyclists while riding along at 20 miles per hour. My helmet took a decent impact from the side, crushing and cracking as it was designed to do. I had no ill effects from the crash, other than some skin abrasions and a bent wheel. I dare say, given the state of my helmet, what the outcome would have been had I not been wearing the lid.

    Just my $0.02 – your mileage may vary.

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