Kidney Punch

Helmetless bike riders – a dying breed John Pickering Oct 24

21 Comments

This post is syndicated from $100 Dialysis – Original Post

A few weeks ago a member of Christchurch City Council and Canterbury District Health Board advocated the non-wearing of bike helmets. I commented on the idiocy of this at the time. A source tells me that said person got a hard time from other CDHB board members-good.

Perhaps this recent research will put the anti-establishmet hair-brained non-conformists back in their box. According to Canadian researchers those not-wearing helmets are three times more likely to die in a road accident than those wearing helmets. Their interpretation of the results is simple:

“Not wearing a helmet while cycling is associated with an increased risk of sustaining a fatal head injury.”

Tagged: bicycle, bike, CDHB, cycle, head injury, helmets, safety

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John Fouhy 211 days ago

Leave your comment here…I thought the argument is that not cycling is bad for your health & helmets put people off. So the increase in deaths from head injuries is offset by the decrease in deaths from health conditions related to being overweight / unfit.
So it’s nice to know that helmets aren’t pointless but it dies t refute the anti – helmet argument.
NZP 211 days ago

Disclaimer – I always wear a helmet.

The research was carried out in areas that often required helmet use. As a result, there is a strong chance that those who disobey the helmet rules are also risk takers and wind up in more dangerous situations.

Not saying the results are invalid, but these studies are notoriously difficult to rely on. Being run over a car or truck tends to end poorly whether you are helmetted or not.
Green Tamarind 211 days ago

John, yes the arguments you mention are valid.
Another argument against helmet-promotion generally is that it tends to replace promotion of any other safety measures, such as riding skilfully in traffic, that could reduce the likelihood of collision. It merely reduces the severity of injury resulting from collisions, while absorbing all the attention, energy and funding of safety-promoters.
The factor that tends not to be addressed in research on this topic is that helmet-wearing is not randomly distributed. Helmet-wearers may be (are likely very) different in their risk acceptance thresholds and thus may have different behaviours beyond helmet wearing that confound the effect of the helmet. This is likely true even after you factor in pre- and post-legislation, as legislation-followers are different from non-followers.
John Pickering 211 days ago

NZP – the comment I read was that only under 18s are required to wear a helmet in that jurisdiction. The researchers also provided age specific data.
John Pickering 210 days ago

John F – I have heard that argument – pretty poor one in my opinion – there are plenty of ways to stay fit without cycling.
Have your run across any evidence that people get/stay unhealthy because they don’t cycle?
Smu 210 days ago

Nobody really claims that helmets cannot save lifes, but the question is does a helmet law safe lives. Factors other than physical injuries play a role. In NZ with introduction of the helmet law the head injury rate remained stable as did the death rate while both pedeastrian and motorist death rates declined. In fact since the helmet law was introduce the head injuries per cyclist increased. This does not mean the helmets are ineffective but indicates that possible beneficial effects overfall might be overridden by other factors like increased risk taking a decrease in safety in numbers.

John P “John F – I have heard that argument – pretty poor one in my opinion – there are plenty of ways to stay fit without cycling.
Have your run across any evidence that people get/stay unhealthy because they don’t cycle?”
I think this is a poor argument since it is that increased casual cycling would benefit the poplation, replacing cycling with anything else does nothing. If poeple would commute more to work, go to the shops on their bike it would be very beneficial. You would not replace any commuting you do with rugby for instance you would do both.

Cheers

stefan
Helen 209 days ago

A couple of studies you might find interesting:

Bassett et al, 2008, Walking, Cycling, and Obesity Rates in
Europe, North America, and Australia. Journal of Physical Activity & Health 5 (6):795-814.
(This paper suggests that active transport use is inversely related to obesity – it’s not a direct indication of cause and effect, and isn’t only about cycling, but it does relate to this discussion non-the-less).

de Hartog et al, 2010, Do the health benefits of cycling outweigh the risks? EHP 118, 8, 1109-1116.
(The conclusion is that “On average, the estimated health benefits of cycling were substantially larger than the risks relative to car driving for individuals shifting their mode of transport”)

I have also heard about a study that demonstrated that car drivers take more risks around cyclists when the cyclists are wearing helmets than when they’re not. I haven’t read this paper myself and don’t have the reference to hand but I can track it down if anyone’s interested.

(Personally, I wouldn’t cycle without a helmet…but I’m not at all convinced that the evidence is in favour of the helmet law).

An interesting discussion…

Helen
Stuartg 208 days ago

Warning – anecdote!

I bought a good helmet (Bell) well before the law required it. I considered it a good investment.

Cycling along SH1, in heavy traffic, passing North Ground, a large, heavy tree branch detached and hit me on the helmet. I stayed conscious and somehow stayed on the bike. Behind me there was a pile-up as drivers tried to avoid the branch.

I consider that, if not for the helmet, I would have been rendered unconscious and the traffic would have been trying to avoid me instead of the branch.

I haven’t cycled for some years but wouldn’t consider cycling again without a helmet.
Eric Crampton 208 days ago

I’m reasonably sure the mounting evidence shows:
1) helmets save lives; conditional on your being in an accident, you do better if you’re wearing a helmet.
2) helmet laws discourage cycling – it’s often a hassle to wear a helmet.
3) bad health effects from failing to cycle outweigh the savings from reduced fatalities among those in cycling accidents.

Sure, people *could* take other forms of exercise. But they mostly don’t.
Glen K 205 days ago

Eric’s surmising of the evidence lines up with my reading. Yes, IF you have a cycle crash and IF you fall on your head then a helmet is likely to be helpful. But the benefits of wearing a helmet are NOT the same as the benefits of a mandatory helmet law.

It’s a bit like saying that wearing sunscreen and a hat is a smart idea to avoid some melanomas and deaths, but I don’t see anyone advocating a law making it mandatory (esp. if people miss out on the Vitamin D and physical activity of being out in the sun).

Unfortunately, the average Jo Bloggs can’t see past the “wearing a helmet is a no-brainer” thinking, making it a tricky proposition to even debate in NZ (and Aaron Keown’s appeal to vanity didn’t help when there are far better reasons to review it).

Helen, I think the research you referred to was by Dr Ian Walker from Bath Uni, who found he got given greater clearance by motorists when riding with a long wig than when wearing a helmet.
Brendan Moyle 205 days ago

Well I can only speak anecdotally to this, but a few points.
First, the cycling I do to and from work is actually the most regular form of exercise I do. It’s easy to fit into the day’s schedule. Sure, I do other things as well (runs or hikes) but not with the same regularity. So in this sense, encouraging cycling as a transport mode seems sensible.

Second, the perception that cycling is dangerous is manifest. There are a lot of people who think I’m nuts for biking. I’ve been cycle-reliant for nearly 2 decades on the North Shore Roads here, and I’m still (as a cyclist) a great rarity. It seems a legitimate question to ask if helmet-laws do deter cycling by promoting the perception its dangerous.

Third, the interplay of behaviour and risks on the road are complicated. When I see the ‘wheels of death’ behind me, I get off the road and jump on to the footpath or verge. It might be utterly illegal but, as a cyclist you’re often evaluating the risks constantly and making judgements based on them. You’re not dealing in an homogenous environment where the only variable is the helmet or not.

What perturbs me, is I sometimes think the helmet makes more visible to other motorists than I really am, in which case I take on more risks than is prudent.
John Pickering 205 days ago

It seems a legitimate question to ask if helmet-laws do deter cycling by promoting the perception its dangerous.

Fair qn. But how can you distinguish it from, say, a news item about a cyclist being killed? Furthermore, even if it did deter, perhaps it saves lives in this way?

btw – I wear a helmet and legally go on footpaths (slowly) and I avoid the roads – I ride a Trikke (see http://www.trikke.com)
alison 205 days ago

Speaking personally – I find the greatest disincentive to cycle around Hamilton is the near-total lack of safe routes to/from work. Until the latest part of the Wairere Drive extension was opened, I had to travel along Hukanui Rd where there is nil separation of cyclists & cars: the ‘cycle lane’ (haha) – where it exists – is narrow & cars often either park or drive in it. Plus the potholes, broken glass etc don’t make for a fun experience. The plethora of roundabouts is also part of this – they are distinctly unsafe for cyclists. (Used to laugh when a previous mayor expounded – as they often did – on what a great city this is for cycling.)

The extension is great. But I’ll still be wearing the helmet.
Glen K 204 days ago

I think the question of whether helmets subtly reinforce a perception of danger is very valid (this is not helped by the sometimes less subtle helmet safety campaigns that show the supposed consequences if you have a serious crash without a helmet). “Heck, parachutists, rock climbers, speed skiers all wear helmets; this must be one dangerous activity!”

It is instructive to compare with driving: motor rally or F1 drivers wear a helmet, but the ordinary motorist doesn’t (although you’d save a huge number of fatalities if they did). A Tour de France competitor or downhill mountainbiker wears a helmet – fair enough, there’s a lot of speed and obstacles involved. But should Jo Bloggs just biking down to the dairy?

The public perception about the “danger” of cycling certainly overstates the true risk (in NZ a person would have to cycle for over 2 million hours on average before being killed, well over 10,000 hrs before being seriously injured). That perception can develop in a number of ways, but I certainly think that some of the more insidious ones are:
(1) the need to wear special “safety” equipment (i.e. a helmet, dayglo/fluoro clothing)
(2) “cycle safety” campaigns that try to scare the bejesus out of people (esp. kids) before telling them what they *should* do
(3) media reporting that highlights cycling fatalities or serious conflicts to a far higher level than your typical car crash (often just page 4 column fodder) – The Press is notoriously bad at this; perhaps because cycling fatalities are relatively RARE and hence “newsworthy”?
Helen 204 days ago

I’m currently engaged in doing an analysis of media representations of different modes of transport…and some of the things I’m finding about representations of cycling support what Glen is suggesting about perceptions of danger (especially from The Press). I haven’t finished yet, so this is all a little tentative, but I’m interested to see it mentioned here too. (Glen, I can get in touch offline if you’d be interested to see what I’ve done when I’ve finished). (And thanks for the tip about Dr Walker’s paper).
Glen K 203 days ago

That sounds very useful Helen; I would be interested. I’ve done a couple of papers before on the representation of cycling and “cyclists”; e.g. you might want to have a look at http://can.org.nz/resources/are-you-a-cyclist-or-do-you-cycle-the-language-of-promoting-cycling. And you can get in touch with me through the weblink on my name.
Ashton Dempsey 203 days ago

I participate in a high risk sport – longboarding. By social contract with the riders I associate with (as a semi-anarchic collective), we must use a range of safety gear including helmets and gloves as a minimum, knee and elbow protection as additional preferred equipment. No safety gear, you don’t get to ride with the group. End of story. This is pretty much universal practise in NZ now, and puts the lie to any claim that safety gear is somehow uncomfortable, unfashionable etc etc and hence reduces uptake.

I note the same in snow sports where the use of helmets has grown exponentially. They are now regarded as must have safety and (critically) fashion accessories in snow sport.

It makes the use of a bike helmet seem like the inconsequential and undemanding thing that it is. While I am sure there are claims made by individuals that they don’t ride a bike because the helmet is uncomfortable for expensive, I take this as more likely an excuse not to ride. This is based on my knowledge of the price of a helmet (typically $30 upward and so not expensive in the overall cost of cycle ownership and use), and that without owning a helmet (and therefore having already met the cost…) its absurd to claim that it is uncomfortable.

The idea that helmets “subtly reinforce the danger” is interesting. Does the same hold true for airbags and seatbelts? For flammability ratings in children’s pajamas? Roll cages on forklifts? The presence of a defibrillator at the bowling green?

I suspect a broad generalisation is being made from a set of very VERY subtle effects.

In any case, while my ACC payments are paying for the costs of injury, I’m happy for the cost to be reasonably controlled. If there is a consequential health hazard (and that is a very big if) then that should be addressed as a consequence, not used as an excuse not to require safe cycling practise.
Helen 202 days ago

Hey Ashton,

I think you’re right that there are some very subtle effects at play here…which is one of the things that makes this topic interesting.

While your example of longboarding is fascinating, I would ask whether you think that participants (in what you describe as a high risk sport) can be likened to the wider population in terms of their attitudes to risk. I think that cycling advocates would argue that they are trying to encourage wide uptake of cycling amongst those who are not comfortable with risk taking (as well as amongst those who are). Glen points out that perceptions of the risk of cycling outweigh the actual risk. It may be difficult to convey the actual risk when things like the helmet law, and media reporting of road incidents, support perceptions that cycling is more dangerous than it actually is.

I would also ask whether, for some longboarders (and some snowboarders and skiers), some of the appeal of the sport is related to the risk. I am not suggesting that people want to get hurt, but as a skier myself, I have enjoyed pushing the limits of my ability, and I do find cycling downhill fast to be exhilarating…but I also accept that that is not everyone’s idea of fun. If it is the case that the risk of doing something can be part of the appeal, then it makes sense that the fashion of that activity could acknowledge the risk without deterring participants.

Which leads me to your comments about the ‘lie’ of safety gear being unfashionable. I would argue that fashion is not one universal code. Different people in different situations follow different variants of fashion to different extents. What is fashionable among 13 year old girls may be different to what is fashionable amongst 25 year old men, which may be different again to what is fashionable amongst 50 year old women. The fact that one group (or a number of groups) see helmets as compatible with fashion doesn’t mean that all groups will – so some people may, quite legitimately, say that helmets are unfashionable.

As for it being absurd to claim that something is uncomfortable when you’ve never tried it…you’re right. But people’s perceptions of things they’ve never done play a role in their decisions as to whether to do them. When I say ‘I’ve always wanted to have a go at jet-skiing’ it’s because my perception is that it would be fun – even though I’ve never tried it. Just because you and I know that helmets can be comfortable doesn’t mean that other people don’t avoid them because they think they’ll be uncomfortable. Sometimes this may be an excuse for not riding (as you suggest)…but the point then is that that is an indication that people don’t WANT to ride, and the question we should be asking then is ‘why not?’. People don’t make excuses to not do things they actually really want to do.

Finally, on the ACC matter…yes, it is very reasonable for people engaging in activities to take some responsibility for minimising the risks, and therefore the costs (and you will note that several people in the comments above have said they wouldn’t ride a bike without a helmet). I think the point here though is that if people not being active is more costly in terms of negative health impacts, than being active, then we should encourage people to be active – even if the activities that they may do have some (smaller) health risks of their own.

Again, as you say, this is a subtle, and I would add ‘nuanced’, topic…and we could undoubtedly discuss it for a very long time. Thanks for the opportunity for good debate.

Helen
Helen 198 days ago

A timely comment from the BBC in Berlin…
http://www.bbc.co.uk/news/magazine-20068083
Ashton Dempsey 197 days ago

Thanks for the fulsome and considered response Helen – many valid and well made points and I wouldn’t argue against any of them.

Are longboarders risk takers? Well, pretty much by definition I’d say they are at least risk tolerant – anyone doing 60+kph downhill on a 75cm long piece of plywood and without brakes is likely to be tolerant of risk…

Point for me is, the head injury has no practical mitigation other than helmets. Inactivity as a choice does have mitigations.

Were the costs of these two matters being totally borne by the individual, it would be a non-issue. Fact is, they are not – the costs fall to society in general for accidents, and a mix of personal and social cost for inactivity.

The many and varied (and sometimes conflicting) motivations for cycling (green, cheap, exercise, companionship, solitude, status, statement, etc etc) mean there are going to be many different reasons for and against anything to do with cycling eg some of us wouldn’t wear lycra on threat of death, others have wardrobes of the stuff.

I’m a little wary of the claims that helmets led to reduced cycle use. Very broadly compulsory helmet use coincided with reduced cost of cars, dropping of school zoning and so less kids riding to school (and hence riding later in life), increased commuting and shift from provincial NZ to urban centres where cycling was not practical. In other words, there was a nexus of factors that all may have contributed.

I do look at the annual Taupo cycle event and consider the huge increase in recreational cycling it indicates. Helmets and lycra for Africa!!! Over 10,000 riders with the equipment and motivation to attend and compete in this event says that as a recreational activity, cycling is pretty strong. I don’t think helmets are holding back this area…
Ashton Dempsey 197 days ago

“…any of them”? Many of them. Obviously!

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Kidney Punch

Helmetless bike riders – a dying breed John Pickering Oct 24

“Not wearing a helmet while cycling is associated with an increased risk of sustaining a fatal head injury.”

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Kidney Punch

Helmetless bike riders – a dying breed John Pickering Oct 24

“Not wearing a helmet while cycling is associated with an increased risk of sustaining a fatal head injury.”

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