Saturday, November 28, 2015

BMJ Article Finds No Benefit to Bicycle Helmet Laws

I have read countless scientific studies since embarking on this bike helmet discovery journey more than ten years ago, so when I find one that is readable, concise, and easy to understand, I just have to share. This one, recently published in the British Medical Journal (BMJ), clearly shows the important finding that bike helmet laws have little if any effect on head injury rates.

To give you an idea of how thorough the study is, here is an excerpt:

“…Helmet legislation was not associated with hospitalization rates for all injury or traffic-related injury causes. We separately examined potential associations for each body region expected to be protected by helmet use (brain, head, scalp, skull or face; brain; head, scalp or skull; face) as well as for the neck which, in some studies, has had elevated odds of injury with helmet use. 7 8 There was variation in helmet use with helmet legislation, and this may have been related to municipal by-laws mandating helmet use within some provinces or territories without helmet laws (table 3). We therefore also examined the relationship between hospitalization rates and helmet use proportions in the strata, and again did not find the expected protective effect. Studies among those injured in a cycling crash consistently show lower odds of head, brain or face injuries among those who wore a helmet,7 8 though the potential for uncontrolled confounding in observational studies of a health behaviour suggests that confidence in the effect estimates should not be unquestioning.47 Before–after studies of the impact of helmet legislation have shown weaker and less consistent effects. Some have found reductions in brain or head injuries of 8–29% related to legislation,10–13 whereas others have found no effect for some or all outcomes.9 11 13 Differences may be attributable to study design features including location, the selection of a control group unexposed to helmet legislation, whether baseline trends in injury rates were modelled, and whether surrogates were used for cycling rates and if so, which ones. Our study compared bicycling hospitalisation rates across jurisdictions rather than within a jurisdiction before and after legislation, and used exposure-based denominators to control for differences in cycling rates.”

To read the whole article, click here. Great stuff.

Sue

Tuesday, November 10, 2015

Are Helmet Programs Scaring Kids Away from Bicycling?

When I was in elementary (primary) school in the 1970s, my friends and I rode our bikes as naturally as we walked. We might walk to the house next door, but a journey of any farther distance was obviously done by bike – duh, no discussion. Also no helmet. And no finger wagging at “improper” riding methods.

The only bike safety course I recall was in fifth grade when the teachers cleared our paved playground to show us braking distances. A car was brought in and set at one end of the playground. At the wave of one flag, the car took off. At the wave of another, the driver slammed on the brakes. Tires squealed and blue smoke billowed. The distance was marked between the flag wave and where the car stopped. Then we each got our chance on our bikes and the braking distances were compared. The whole exercise took about half an hour, but it stuck with us because it was cool and involved us in the discovery of the message. From then on, we gave cars a lot more room.

We never went through bike rodeos or learned hand signals or got lectured about our heads splattering like dropped melons. How did we survive? Quite happily, thanks. And with those happy memories of riding as children we became proud adult cyclists.

As I found myself involved in bicycle advocacy, bicycle safety programs gave me pause. I get twitchy anyway around the term “safety.” To set something out as “safe” is simply a lie. We all know that it is an impossible aim. And yet bike safety programs propagate along with their escalating assertions that if cyclists do this or that they will be safe.

I understand that certain riding behaviors will increase the likelihood of a cyclist reaching their destination unharmed. But these behaviors are easily taught through exercises like the one I enjoyed on that playground. We weren’t frightened about any potential outcomes, only shown a bit of physics so we could change our riding behavior to accommodate them. The same could be done to show riders why riding with traffic is a better choice than riding against it.

Yet today’s bicycle safety programs go far beyond physics and most land squarely on an irrational assertion – that all cyclists must wear a helmet all the time in order to be “safe.” Not only is this a lie, it does nothing to teach cyclists better riding behaviors so they can avoid a crash.

Taking this message to our schools is a dramatic change from my experience as a child. I wonder how my friends and I would have responded if we had spent that half hour watching our teachers drop melons and eggs as if they were our heads as we rode our bikes. I hope we would have been independent thinkers enough to call bullshit and just continue to ride. But we sure wouldn’t have learned about braking distance and the whole thing would have been a negative, miserable, and scary experience.

Do an internet search for kids bike safety videos and you will find countless, proud examples of melon drops. Look for kid’s bike safety brochures and you will find many with scary titles like “The Dangers of Bicycling.” This is the backdrop teachers are now expected to use when discussing bicycling with their students.

Never mind that bicycling is one of the least likely ways to suffer brain injury. Find a few charts that show this clearly on One Street’s Bicycle Helmet page. I’ve never seen a melon drop video made for children who ride in cars, but that would be the more logical reason for searing this horrifying image into children’s memories.

Never mind that frightening children into wearing bike helmets does nothing to show them how to avoid a crash.

And never mind that bike helmets are only designed to withstand crashes up to the speed reached by falling over from a standstill. They do little if anything to prevent brain injury in most crashes. See my previous post “My Bike Helmet Saved My Life!” for more details on this misconception.

More importantly, I am concerned that bicycle safety programs are scaring our kids away from bicycling. If children aren’t riding, we are losing our next generation of adult cyclists. The evidence is frightening in itself:


Kids who buck the trend, perhaps because they are independent enough thinkers to call bullshit on these scare tactics, are losing the Safety in Numbers protection we enjoyed as kids. We rode in packs, which made us very visible. But my pack was just one of many packs of bike-riding kids in my town and others around the world. Drivers expected to see kids out on bikes and drove accordingly. Now to see even one kid riding a bike is a surprise.

This mess bothers me to no end. I can hear all the bike safety schoolmarms justifying their strict doctrine with their belief that if just one life is saved the reduction in bike riding by kids is worth it. Bullshit. No one can claim they saved a life with a frightening safety message. The life, rather the person in charge of that life, needs a whole package of knowledge in order to make the decisions that will keep them from harm. With that full package, including the knowledge of how safe riding a bike actually is and how little protection a bike helmet offers, the decision to wear a bike helmet will be the last on their list for crash avoidance tactics.

Even as I wallowed in the sorrowful heap of fearmongering materials to write this post, I was cheered by one hopeful discovery from, of all places, Detroit. Awhile back some fearmongers had passed a slate of ordinances criminalizing any kid in Detroit who dared pedal a bike in the streets. As I waded through the muck left by similar fearmongers all over the world, I came upon the uplifting news that Detroit has repealed all their restrictions on youth cycling. While it was a sad occurrence to begin with, this repeal may be a sign that people of all ages are finally calling bullshit on scare tactics that do nothing but frighten away our next generation of cyclists. Thanks Detroit!

Are you fed up with fearful tactics that could be scaring kids away from bicycling? Do you have childhood memories that cause you to question their claims? If so, please offer them in the comments section. A solution may take many small steps like the one in Detroit, but the more people who stand up against these scare tactics, the more small steps will be taken until kids can finally ride free again.

Sue

Friday, October 30, 2015

Fear of Cycling

Tomorrow is Halloween, which makes it the perfect time for a re-post of one of the most articulate and well stated articles I've found on why many people fear the very thought of cycling; helmets included:

Fear of Cycling

By: Dave Horton
Originally posted on his blog, Thinking About Cycling

Cycling has formed part of UK society for over a century. For much of that time, the bicycle was the most numerous vehicle on the roads, a major means of everyday mobility (Alderson 1972; McGurn 1999). But the amount of cycling in the UK has fallen dramatically and more or less continuously over the last half century; it accounted for 37 per cent of all journeys in 1949, but accounts for only around one per cent today (Department for Transport 2002). The number of cycles bought has never been higher, yet the number of cycling trips made on UK roads has never been lower.

Across government, cycling is now seen as ‘a good thing’. But despite growing pro-cycling rhetoric and policy in the UK, many people appear remarkably reluctant to ‘get on their bikes’. Why? Discussion about impediments to cycling tends to concentrate on lack of good cycling infrastructure, such as cycling routes and cycle parking. Seemingly insurmountable barriers, such as hilly topography, high levels of rainfall and cold winters, are also considered influential. But what about emotional barriers to cycling?

Numerous studies have shown fear to be a significant barrier to cycling (British Medical Association 1992; Davies et al 1997; Gardner 1998; Gardner and Ryley 1997; Pearce et al 1998; Ryley 2004). One study based on quantitative and qualitative research, Barriers to Cycling (CTC et al1997, 7), concludes ‘the most prominent practical barriers perceived to be deterring potential cyclists were danger and safety’. The UK Department for Transport (2007, 2) reports that 47 per cent of adults ‘strongly agree that “the idea of cycling on busy roads frightens me”‘. Nor is fear of cycling confined to the UK. Gary Gardner (2002, 76) reports how, in ‘surveys in three U.S. cities in the early 1990s, more than half of respondents cited lack of safety as an influential factor in their decisions not to cycle’. This fear of cycling impinges on cycling promotion; for example, one person who tried to encourage colleagues to cycle to work during National Bike Week notes that: ‘Several people have criticised my efforts as irresponsible as cycling is “Dangerous” and by encouraging it we are putting employees at risk’ (email to cycle-planning discussion group, June 2004).

So fear is an important emotional barrier to cycling. Yet this fear of cycling has been insufficiently analysed; many efforts have been made to challenge it, but few to understand it. This article aims to explore and better understand contemporary fear of cycling. I begin by setting fear of cycling in a wider context; we live in fearful societies and it is possible to fear cycling for many reasons beyond the fear of having an accident on which I concentrate, at least to begin with. I move on to critically examine some measures which are apparently designed to improve cycling’s safety; road safety education, cycle helmet promotion, and the separation of cyclists from motorised traffic.

Later in the paper I broaden my interest in fear, and attempt to make connections between the constantly produced fear of cycling and common media representations of ‘the cyclist’ as a figure to be feared. If the first half of the paper tends to prioritise people’s fears of the accident and physical injury via cycling, I here switch to consideration of people’s existential fears, of having to negotiate with (their representations of) cyclists and with the possibility of themselves becoming a cyclist. I contend that fear of the accident and fear of being pushed towards cycling (and thus towards adopting a cycling identity, becoming ‘a cyclist’) are related, and together constitute contemporary fear of cycling. Cycling promotion needs to recognise and develop more effective strategies to overcome both these fears, of cycling as a practice to be feared and of the cyclist as a figure to be feared. I should perhaps make it clear, for what is to follow, that I write not only as a sociologist but also as a cycle campaigner.

The Complexities of Fear of Cycling

Before I concentrate my analysis on people’s stated fears of traffic and accidents whenever they engage with the idea of being or becoming a cyclist, I want briefly to note how these are not the only fears of cycling. We know far too little about people’s fears of cycling, but such fears certainly extend beyond fear of the accident. Fears of cycling may also include fear of being on view, of working one’s (perhaps ‘unsightly’, perhaps ‘sightly’, certainly gendered) body in public, fear of harassment and violence from strangers (on safety fears of using cycle paths, see Harrison 2001, 23; McClintock 1992, 28, 35; Ravenscroft 2004; Ravenscroft et al 2002). The city is full of fear, which is partly why and partly because people move in cars. Increasing car use can be seen as a retreat from the ‘public’ world of the city, a means of cocooning oneself and one’s family from ‘the outside’, from fear of traffic but also from dangerous places and people. Cycling puts the person back into this fearscape in a much less mediated way.

The car is experienced as an extension of the home for people (mainly women) who are fearful of public space (Davidson 2003, 71, 102). In contrast, the bicycle affords no shield from the (masculine) gaze.[1] There is surely an existential vulnerability attached to performing physical activity in public space. Especially for novice and returning cyclists, the potential psychological barriers are massive; people are afraid of appearing inept, and (although this situation is thankfully changing) most people do not currently receive formal training in either how to ride or how to repair a bike. It is easy to trivialise someone’s fear of feeling embarrassed and humiliated by falling off a bike in public, but it is significant (although if you do want light-hearted examples, see Moore 2002). Importantly, maintaining composure is harder for people perceiving themselves as ‘under the watchful eyes of others’ (Davidson 2003, 78). For many people, a fear of cycling in public no doubt forms a major barrier to cycling (and partly explains people’s preference for pedalling static machines in gyms and at home).

Then there is fear of using one’s body, of sensing one’s body, of getting sweaty, of experiencing ‘hard work’, of hills. Other fears are more connected to issues of identity and include the fear of ridicule, of losing status, of riding a gendered, classed, raced and stigmatised vehicle, of undermining one’s existing sense of identity; fear, in other words and as we will see later, of becoming ‘strange’.

All these fears of cycling are socially, geographically and historically variable. Unequally socially distributed, they will tend currently in the UK to be greater among women than men, among those people riding with children than those without, and among ethnic groups with little history and experience of cycling. Unequally spaced, they will tend to be lesser in places with higher levels of cycling and where cycling is correspondingly closer to ‘ordinary practice’, such as Cambridge in the UK, or the Netherlands and Denmark. Fears of cycling also shift over time. High-wheeling cyclists feared ‘coming a cropper’; in the late nineteenth century, many women undoubtedly feared the damage cycling might do to their respectability (Simpson 2001; this volume); and today, we have this omnipresent fear of traffic.

Finally, before returning to specific focus on that fear of traffic, I want to note how fears of cycling in general are culturally embedded, and therefore hard to change. Fear is never a solitary emotion; it is not only constructed by wider social forces but also crucially mediated by key social relations. In such social relations, care and commitment are performed and demonstrated through advising someone against engaging in ‘risky’ behaviours. So that, increasingly rooted in a landscape of fear, exercising the agency required to choose cycling is undermined by other people’s fears. The anxieties of family, friends and colleagues can all work against a desire to cycle, just as they can encourage currently more socially-acceptable demonstrations of care through car-dependent practices, such as the chauffeuring of children (Maxwell 2001).

Existing Accounts of Fear of Cycling

Although below I explore how fear of cycling – and more specifically a fear of traffic – is constructed, I am not suggesting that fear of cycling is somehow wrong, or not real. To the contrary, we must recognise the realities of the situation currently confronting cyclists. The UK is a massively automobilised society (Sheller and Urry 2003; Urry 2004), its roads dominated by cars. Year on year, more vehicles take to the roads, and these vehicles keep getting bigger, and – certainly for those on the outside – more dangerous (on the SUV (Sport Utility Vehicle), see Vanderheiden 2006).

Different studies demonstrate the increasing dangers faced by cyclists and pedestrians on our roads (Adams 1995; Davis 1992/3; Dean 1947; Hillman et al 1990). A key insight of these studies is that advances in road safety tend to be unequally distributed. For instance, John Adams (1995, 125) argues that making the use of seat-belts compulsory ‘had no effect on total fatalities, but was associated with a redistribution of danger from car occupants to pedestrians and cyclists’. Motorists wearing seat-belts are told they are safer and they start to feel safer. This increased sense of safety promotes an overall decline in standards of driving. Those on the outside of cars become objectively less safe, and therefore sensibly more afraid. Thus, ‘cyclists and pedestrians have responded, and are likely to continue to respond, to the increasing threat of motorized traffic by withdrawing from that threat’ (ibid., 125).

Fear has driven huge numbers of cyclists off UK roads (Hillman et al 1990). This downward trend in levels of cycling results in the remaining cyclists feeling less safe because those in a minority generally perceive themselves to be less safe than those in the majority. But these remaining cyclists are also objectively less safe, because other road users become less considerate of cyclists as cyclists become less common (and more strange) and as these road users themselves become less likely to also sometimes cycle. The more people who cycle, the safer cycling becomes; the fewer people who cycle, the more dangerous cycling becomes (Jacobsen 2003).

In the context of a car-centred culture with low levels of cycling, then, fear of cycling might be seen as wholly appropriate. But despite its worsening context, cycling’s advocates remain understandably keen to present a more favourable view. Typically, those promoting cycling attempt to counter perceptions of cycling as unsafe with ‘objective’ risk assessments. Thus, the risk of being killed while cycling on UK roads remains ‘very low’, or ‘negligible’. Roads may not always be pleasant places to cycle, but they are still relatively ‘safe’. This kind of claim is often accompanied by statistical analyses, which either demonstrate how unlikely it is for someone to die or be seriously injured whilst cycling, or favourably compare the risks of cycling with the risks of using other modes of mobility, particularly car travel, or even other leisure pursuits. Patrick Field (1994), for example, asserts that cycling is less risky than either cricket or horse riding. That such comparisons are not new demonstrates fear of cycling to be long-standing: a Cyclists’ Touring Club leaflet of 1959, for example, states ‘Your chances of being involved in an accident are 1 in 19 if you drive or ride on a motor-cycle; 1 in 32 if you drive or travel in a car; but only 1 in 155 if you ride on a bicycle’ (Cyclists’ Touring Club 1959). On his cycle advocacy website, Ken Kifer states bluntly: ‘The belief that cycling in traffic is dangerous is widespread but cannot be supported through accident and fatality statistics’ (http://www.phred.org/~alex/kenkifer/www.kenkifer.com/bikepages/index.htm).

Another response to the perception of cycling as dangerous is to point out that not cycling is more dangerous; the health benefits of cycling easily exceed the small risk of death or injury, and non-cyclists forgo an important means of health and fitness (Seifert n.d.). The British Medical Association (1992) estimates the health benefits of cycling to outweigh the hazards by a factor of 20 to 1. In an article titled ‘Is Cycling Dangerous?’, Ken Kifer argues that ‘cycling is much less dangerous … [than] the fearmongers insist and … has compensating benefits which are more important than the risks involved’ (www.kenkifer.com/bikepages/health/risks.htm).[2]

So on the one hand, we have understandable fear of cycling based on people’s perceptions of the risks of accident and injury. On the other hand, we have well meaning attempts to challenge these perceptions and the fear they generate. My concern here is that denial of cycling’s danger tends too quickly to dismiss people’s genuinely held fear of cycling, and effectively blocks consideration of other factors which may be involved in the construction of that fear. Therefore, this chapter does not take sides in the debate over whether cycling ought to be perceived as dangerous and thus as a practice to be feared. It instead follows another path, one which explores some of the mechanisms which might contribute to perceptions of cycling as dangerous, and thus to be feared. Jonathan Potter and Margaret Wetherell note how ‘factuality can be understood as a situated product of a range of social practices’, and we must attend to ‘the procedures through which some part of reality is made to seem stable, neutral and objectively there’ (1994, 50). We might therefore do better to try to understand the procedures which produce a fear of cycling.

Constructing Fear of Cycling

Fear of cycling belongs to a fearful culture (Glassner 2000; Massumi 1993). UK sociologist Frank Furedi (2002) argues that western societies have become dominated by a ‘culture of fear’. We have never been so safe, yet never have we been so fearful. ‘“Be careful” dominates our cultural imagination’ (ibid., viii). We belong to ‘a culture that continually inflates the danger and risks facing people’ (ibid., xii). ‘Activities that were hitherto seen as healthy and fun … are now declared to be major health risks’ (ibid., 4). What is more, ‘to ignore safety advice is to transgress the new moral consensus’ (ibid., 4).[3]

Our fears are produced (Sandercock 2002), which is why they are subject to such variation. Obviously, some fears take more work to produce than others. Most people fear a lunging shadow down a dark alleyway. Fewer people fear waste incinerators, nanotechnologies or the policies of the World Trade Organisation (Goodwin et al 2001, 13) because those fears are more difficult to produce. Fear of cycling is neither inevitable nor ‘natural’ and needs similarly to be produced. It also always exists relative to other fears. For instance, cycling in London became substantially less fearful, relative to travel by bus and underground train, in the wake of the bomb attacks on public transport in July 2005; consequently the level of cycling increased significantly immediately after the bombings, but then dropped back down again (though remaining above its previous level) once people’s fears of travelling by underground and bus had subsided (Milmo 2006). Fear of cycling is most effectively produced through constructions of cycling as a dangerous practice. By saying that cycling is constructed as a dangerous practice, I am not denying that cyclists are really injured and killed on the roads; rather I am noting how people’s fears of these (im)probabilities of injury and death are culturally constructed.

The rest of this section explores three ways in which cycling is constructed as dangerous, and thus a contemporary fear of cycling is produced; road safety education, helmet promotion campaigns, and the increasing separation of cycling from motorised traffic. The irony, of course, is that these interventions are responses to a fear of cycling, clearly aimed at increasing cycling’s safety. But I will demonstrate how, contrary to intentions, each intervention actually tends to exacerbate fear of cycling, and sometimes literally invokes it in order to promote the ‘solution’. Fear is also used for financial  profit in the sale of safety equipment; for example, adverts for high visibility clothing cite the numbers of cyclists killed and injured on UK roads, and claim starkly, ‘you must be seen’ (www.vissiwear.com; last accessed 4/2/07).

Constructing Fear of Cycling, 1: Road Safety Education

With accelerating automobility, the tension between the street as a space for communal sociality and as a space for cars had, by the 1930s, become acute. The unruly social worlds of the street and the car’s increasingly voracious appetite for space could not peaceably co-exist, and one or other needed to be tamed.[4] Motoring organisations such as the Automobile Association and the Royal Automobile Club argued that children should be taught to keep out of the car’s way, and road safety education was born, as an alternative to preserving streets for people (some local attempts were made to institute the latter, an early – but not widely followed – example being the Salford play streets scheme of the 1930s).

The transformation of streets for people into roads for cars, perhaps inevitably, produced death and injury. By 1936 concerns about the alarming rise in cyclist casualties had led to the idea of a cycling proficiency scheme, eventually adopted nationally in 1948 (CTC 2005). To stem the carnage, cyclists must be trained to deal with the new, dangerous conditions. But things could have been otherwise. A 1947 book by J. S. Dean, former Chairman of the Pedestrians’ Association, is instructive here. In his ‘study of the road deaths problem’, Murder Most Foul, Dean’s basic tenet is that, ‘as roads are only “dangerous” by virtue of being filled with heavy fast moving motor vehicles, by far the greatest burden of responsibility for avoiding crashes, deaths and injury on the roads should lie with the motorist’ (Peel n.d., 3). Yet road safety education concentrates not on the drivers of vehicles, but on those who they have the capacity to kill. Dean saw how placing responsibility for road danger on those outside of motorised vehicles might lead, by stealth, to placing of culpability on those groups, and Murder Most Foul is a tirade against the placing of responsibility for road accidents on children.

The dominant assumptions on which UK road safety was originally based have remained in place. Today, rather than producing strategies to tame the sources of danger on the road, road safety education tries instead to instil in ‘the vulnerable’, primarily school children, a fear of motorised traffic, and then to teach them tactics to escape from road dangers as best they can. The title of the UK Government’s highway code for young road users is Arrive Alive (Department for Transport 2000a). The message such a title sends to children is not how much fun and freedom can be derived from sustainable modes of mobility such as cycling and walking; rather, it tells children that the world outside is a dangerous place, full of potential accidents, and they had better make sure they ‘arrive alive’.

The introductory paragraph to Lancashire County Council’s child cyclist training scheme, Passport to Safer Cycling, likewise seems deliberately designed to instil fear. It states how in Lancashire ‘the number of cycle casualties reported to the police in 2001 totalled 421; of these 141 (33%) were children less than 16 years of age. Information from hospital casualty departments suggest that there are many more casualties that do not get reported’ (Lancashire County Council 2004). The stated aims of the scheme have nothing to do with pleasure (in fact, an objective is to help the child ‘understand the difference between riding and playing on cycles’), or with thinking about and attempting to change the current uses of the road. On the contrary, they focus firmly on the practices and psychology of the individual child: ‘to encourage and develop safe cycling’ and ‘to enable trainees to consider their personal safety and develop a positive attitude towards other road users’ (Lancashire County Council 2004).

Roads are full of danger, and it is children who must be afraid and take care. Road safety educators inculcate ‘safety-consciousness’ in various ways: they provide children with a variety of reflective gadgets; children are encouraged to wear high visibility clothing and cycle helmets; and exercises in road safety literature teach children to walk or cycle by convoluted routes because they are ‘safer’ (see Department for Transport 2000b). The road safety industry thus strives to reduce casualties by inculcating fear in children, and giving them not incentives but disincentives to walk and cycle.

A minority alternative approach, road danger reduction, concentrates instead on making travelscapes less dangerous per se, by for example, reducing the numbers and speeds of cars, and improving enforcement of speed limits. In other words, current road safety education, perhaps reframed as citizenship studies in mobility, could be very different. We do not have to teach tomorrow’s adults to fear cars, or to adapt to the inevitability of motorised metal objects tearing through their lives by incarcerating themselves in such vehicles (Hillman et al 1990). The Cyclists’ Touring Club fought through the first half of the twentieth century against the compulsory use of rear lights by cyclists. One leaflet from the 1930s (Cyclists’ Touring Club n.d.a) states that the ‘use of any rear warning weakens the sense of responsibility of the driver of an overtaking vehicle to avoid running down a vehicle or pedestrian in front of him’. We could educate children into putting such lost accountability onto the car. The relevant argument, then as now, is that danger comes not from cycling, but from cars. The compulsion on the cyclist to ‘be seen and be safe’ puts the onus to change on the wrong group. The resonance with the highly controversial contemporary issue of helmets is clear.

Constructing Fear of Cycling, 2: Helmet Promotion Campaigns

Like road safety education, campaigns to promote the wearing of cycle helmets effectively construct cycling as a dangerous practice about which to be fearful. Such campaigns, and calls for legislation to make cycle helmets compulsory, have increased over the last decade. In 2004, a Private Members’ Bill was tabled in the UK Parliament, to make it an offence for adults to allow children under the age of 16 to cycle unless wearing a helmet. Also in 2004, the influential British Medical Association, in a policy turnaround, voted to campaign for helmets to be made compulsory for all cyclists (for comprehensive detail on these developments, and debates around cycle helmets in general, seehttp://www.cyclehelmets.org). Helmet promotion, especially to children, has become an established part of the UK road safety industry. In 2005, Lancashire County Council’s road safety team ran a ‘Saint or Sinner?’ tour, with anyone cycling without a helmet deemed sinful; sinners were given the opportunity to repent by pledging to ‘mend their ways’, and always wear a helmet when cycling (Lancaster and Morecambe Citizen 2005).

Helmet promotion is hugely controversial among UK cycling organisations (Hallett 2005). The 2004 Parliamentary Bill was unanimously opposed by the cycling establishment, with every major cycling organisation and magazine rejecting helmet compulsion (Cycle 2004). The groups opposing the Bill included CTC (formerly The Cyclists’ Touring Club, and the UK’s largest cycling organisation), London Cycling Campaign, the Cycle Campaign Network, the Bicycle Association, the Association of Cycle Traders, British Cycling, Sustrans and the National Cycling Strategy Board. These groups are not anti-helmet, but argue for the individual’s right to choose. This section cannot hope to do justice to the various arguments for and against (the imposition of) helmets, which can anyway be found elsewhere, but key issues include:

●      efficacy at the individual level. Does wearing a helmet reduce or increase the risk of sustaining a head injury? Here there are three relevant concerns. First, the technical capacities of helmets, which are designed only to resist low-speed impacts, and only then if correctly fitted (Walker 2005). Second, the concept of risk compensation which suggests that both cyclists wearing helmets and motorists in their vicinity possibly take less care (Walker 2007), which therefore increases the likelihood of collision; in implicit recognition of the existence of risk compensation, the Royal Society for the Prevention of Accidents in its leaflet, Cycle Helmets, feels it necessary to caution ‘Remember: Helmets do not prevent accidents … So be just as careful’ (RoSPA n.d.). Third, the greater size of the head, and so increased probabilities of impact, resulting from wearing a helmet;

●      efficacy at the aggregate level. Do helmet promotion campaigns make cycling more or less safe, overall? There is evidence that cycling levels decline when helmets are promoted and collapse when they become compulsory (Liggett et al 2004, 12). Australia, the first country to make cycle helmets compulsory, witnessed a post-compulsion fall in levels of cycling of between 15 and 40 per cent (Adams 1995, 146). According to ‘the Mole’ (2004, 5), in Melbourne ‘compulsion reduced the number of child cyclists by 42% and adults by 29%’. Because cycling tends to be safest where there are many cyclists (Jacobsen 2003), and most dangerous in places with few cyclists, and because helmet promotion campaigns reduce the overall numbers of cyclists, helmet promotion increases the risk of cycling. The relationship between increased cycling and increased safety appears to be confirmed by the experiences of the Netherlands and Denmark, which have high levels of cycling, very low rates of helmet wearing, and low rates of death and serious injury among cyclists;

●      equity. Mayer Hillman (1993) claims that cyclists are at lower risk of head injury than motorists, pedestrians and children at play, yet none of those groups is encouraged to wear helmets (see also Kennedy 1996). Risk theorist John Adams suggests that equitable application of the logic applied to cycle helmet promotion would result in ‘a world in which everyone is compelled to look like a Michelin man dressed as an American football  player’ (1995, 146)!

This should be sufficient detail to indicate why the issue of cycle helmets creates so much interest and controversy among health promotion and accident prevention experts, as well as cyclists. But in the context of my overall argument, my chief point here is to note how helmet promotion campaigns play on people’s existing fear of cycling, and contribute to the reproduction and magnification of that fear. One recent UK Government campaign demonstrates my claim in a particularly vivid way.

In 2004 the UK Department for Transport launched ‘Cyclesense’, a multi-media ‘teenage cycle safety’ campaign centred on a series of images of skull x-rays and helmets (for an example, see the image on the associated blog post, ‘Fear of cycling: article; 27/11/09). Various captions accompany the different images of the helmet-wearing skulls. The script alongside x-ray 01 reads: ‘It’s no joke: cycling is a fun, convenient and healthy way to get around – but if you don’t follow basic safety guidelines the results could be very unfunny’. It continues that ‘in 2001 nearly 3000 cyclists between 12 – 16 were killed or injured on the roads. If you want to protect yourself you must take your cycle safety seriously’. The text accompanying x-ray 02, a helmeted and apparently laughing skull, reads: ‘It’s no laughing matter’, before insisting ‘Get yourself a helmet. No joking – in a study of admissions to an A&E Department nearly 50% of injuries suffered by cyclists were to the head and face’. Elsewhere on the Cyclesense website, on the ‘Protection’ page, the text reads: ‘If you like your face and head the way it is, then wear a helmet!’.

These captions make clear the central and over-riding message of the campaign; if you want to cycle and keep your skull intact, you must wear a helmet. The campaign portrays cycling as dangerous, and instils fear. CTC responded angrily to the images. A rare letter to all members from CTC Director, Kevin Mayne (2004), set out potential consequences of the imagery; children could be frightened from cycling, and their parents and teachers might feel reluctant to let them cycle. Mayne writes: ‘CTC believes [these images] will do huge damage to the perception of cycling as a safe, enjoyable, healthy activity’; and such campaigns ‘raise unfounded anxiety about the “dangers” of cycling, and are known to drive down cycle use’. Against the context of broad governmental support for cycling, Mayne’s tone becomes incredulous:

Images which link cycling with X-rays of skulls can only mean one thing – if you cycle you will end up hospitalised or dead. What sort of message is that to give to young people? … The last thing the Government should be doing is frightening children into NOT cycling!

(Mayne 2004, original emphasis)

Of most relevance here is that every call for cyclists to wear, or be forced to wear, helmets demands the association of cycling with danger, and thus the production of fear of cycling. Whilst I am happy to align myself with CTC’s position, my wider point is that the promotion of cycle helmets is just one more way in which a fear of cycling is constructed. People with experience in the politics of cycling might realise how controversial are calls for cyclists to don helmets, but the majority of people in societies such as the UK are much more likely to take such campaigns at face value, and to be surprised by those of us who adopt a more sceptical line (although scientific research into how different audiences receive helmet promotion campaigns is clearly required). In other words, even in this, the most contentious of areas, constructions of cycling as a dangerous practice, and thus the production of fear of cycling, proceeds for the most part in a remarkably insidious way.

Constructing Fear of Cycling, 3: New Cycling Spaces

We might suppose that fear of cycling has become locked into a downward spiral from which it seems almost impossible to break, unless the practice of cycling can be spatially relocated, and performed under ‘new’, ‘safe’ conditions. This section examines recent attempts to create such new, safe cycling spaces (for a recent overview, see Franklin 2006).

For most of the twentieth century, the great majority of cycling in the UK took place on roads. The dominant, widely shared assumption was that (declining numbers of) cyclists shared space with (increasing numbers of) cars, trucks, buses and taxis. Riding in an environment dominated by potentially lethal motorised modes of mobility was a taken-for-granted, normal part of cyclists’ ordinary experience. But over the last decade or so, a fundamental shift in cycling policy and infrastructure has occurred. Cycle lanes have been introduced across the length and breadth of Britain. Many cycle lanes are ‘on-road’; the use of white lines and coloured paint is intended to mark a boundary between space for motorised traffic and space for cyclists. Although often criticised and sometimes ridiculed (for example, see the ‘cycle facility of the month’ pages athttp://www.warringtoncyclecampaign.co.uk; last accessed 4/2/07), at its best this infrastructure aims to make cycling journeys more attractive; quicker, easier, safer, more pleasant.

In the UK, recent years have also seen major development of off-road cycling routes, shared not with motorised traffic but with people walking, dogs and horses (for details, see Cotton 2004). Many such routes have been developed and promoted by Sustrans, a charitable organisation committed to encouraging sustainable transport (see Sustrans 2000;http://www.sustrans.org.uk). These routes are emerging most explicitly around the figure of the cyclist, and they have certainly boosted interest and participation in cycling (Peace 2004; Sustrans 2006). However, an unintended consequence of their popularity may be that the dominant public perception of cycling is becoming of an activity which best occurs in ‘safe’ and pleasant places (on disagreements around this issue within cycling policy circles, see Rosen 2003; Jones 2004). ‘Normal’ roads are no place to cycle; they are to be feared.

It is worth noting here the long-standing contentiousness, among British cyclists’ organisations, of off-road cycling routes. The decades spanning the middle of the twentieth century saw British roads struggling to accommodate the car and the bicycle harmoniously. A pamphlet produced by the Cyclists’ Touring Club and titled Road Safety: a fair and sound policy(n.d.b[c.1935]) states: ‘It is often said that there is not room on our present roads for everybody and so the cyclist should be removed. The only traffic that cannot safely use our present roads is high-speed motor traffic, for which special highways should be provided’. In the ensuing battles over which group of users should be ‘pushed off’ the roads, cyclists eventually ‘won’, with the development of the motorway network for which they had long campaigned. However, the rapid growth in levels of motorised traffic meant that there was no going back to ‘the golden age’ of cycling which they presumably had hoped the provision of motorways, by taking cars off existing roads, would enable. The organisational views expressed in the 1930s, during cyclists’ resistance to the idea that cycling should be relocated to cycle paths, ought perhaps to provoke reflection on the situation today. For instance, in Making the Roads Safe: The Cyclists’ Point of View, we find the following:

It is impossible to escape the conclusion that most people and organisations who advocate cycle paths are not actuated by motives of benevolence or sympathy, although they may declare that their sole concern is the welfare of the cyclist … A great deal of the cycle-path propaganda is based on a desire to remove cyclists from the roads. That is why the request for cycle paths is so often accompanied by a suggestion that their use should be enforced by law. Therein lies a serious threat to cycling.

(Cyclists’ Touring Club 1937, 11-12)

Of course the situation today is different. Perhaps most obviously, many people who fear cycling on the roads apparently desire to cycle elsewhere. Unsurprisingly, forms of off-road cycling – not only leisure cycling on ‘traffic free’ routes, but also BMX, mountain biking, cyclo-cross, trials riding and track – all seem to be gaining in popularity. And with the expansion of places to cycle off-road, the expectation grows that such places are the places to cycle. The road stops feeling like a place to cycle; it begins to feel as though cycling does not belong there. The institutionalisation of this sensibility, anticipated by cyclists 70 years ago, is potentially not far behind. In 2006, the draft of the revised Highway Code instructed cyclists to use off-road routes wherever they exist. These planned revisions were opposed by cyclists, led by CTC, but they nonetheless make clear how the provision of ‘attractive’ alternatives produces the cyclist-on-the-road as ever more out-of-place. New ideas of ‘normal’ are being produced, and it is becoming less normal to see roads as appropriate places to cycle.

Meanwhile, riding on the road becomes an ever more fearful prospect for ever more people. Without any necessary objective change in the conditions prevailing on the roads, the provision of off-road routes increases people’s fear of on-road cycling. Further, the promotion of such routes tends to feed (on) this fear. Sustrans’ publicity material, for example, makes regular use of an adjective which has assumed enormous power in UK cycling promotion; ‘safe’.[5] One recruitment leaflet calls on people to ‘help us build safe attractive cycle routes in your area’ (Sustrans n.d., my emphases).

Arguably therefore, today’s youngsters are growing up with the expectation that, if they cycle at all, it will be away from cars. It would of course be wrong to see these shifting sensibilities as unopposed. Cycling advocates are increasingly insistent that today’s youngsters must be trained to ride on the roads, and government funding towards that aim has recently been forthcoming. But tensions around the proper place of cycling constitute a major new battleground of mobility and sustainability conflicts in the twenty first century. It is also worth noting, for what is to follow, that spatial re-allocation of cycling away from the road is shifting the object of fear, from cycling to the cyclist. On off-road routes, the cyclist is no longer so viscerally threatened and endangered, and instead becomes perceived as the source of threat and danger to slower-moving, more leisurely others. The source of fear shifts from the practice to the practitioner.

Before continuing on the theme of fear of the cyclist, I want briefly to summarise this section. The road safety industry, helmet promotion campaigns and anyone responsible for marketing off-road cycling facilities all have a vested interest in constructing cycling – particularly cycling on the road – as a dangerous practice. Cycling, in other words, is made ‘dangerous’ by these attempts to render it ‘safe’. Each of the cases I have discussed is (perhaps unwittingly) therefore implicated in the production of a fear of cycling. This fear of cycling stops people cycling, and stopping people from cycling is an effective way of continuing the reproduction of a fear of cycling. But now I want to tackle more directly something at which up until now I have only been hinting, the potential relevance of a fear of the cyclist to a fear of cycling.

Making Cycling Strange

I am now switching from thinking about a fear of cycling which is produced from constructions of cycling as inherently dangerous, and thinking instead about how the identity of ‘the cyclist’ tends to invoke fear. There is undoubtedly scope for using psychoanalytic theories here, and in particular ideas to do with projection and transference. But I do not venture far into that territory in the remaining part of this chapter, and draw instead on Georg Simmel’s classic sociological account of the stranger (1971[1908]), as well as more recent sociological work on stigma (Goffman 1968), stereotyping (Pickering 2001) and scapegoating (Cohen 2002[1972]).

In the UK during the twentieth century, cycling gradually moved from being a major mode of mobility to being a minor one. As the volume, speed and dominance of motorised vehicles grew, cycling was designated ever more marginal road space. We have seen that the impulse to altogether eliminate cycling from the road only succeeded on motorways, for which cycling organisations campaigned. Nevertheless, cycling was everywhere else reduced to a practice taking place on the edges of a transport infrastructure which increasingly centred on the car. Automobility’s massive power is well expressed by its current monopolization of space.

The seemingly taken-for-granted dominance of automobility saw UK cycling in a perilous state across the latter third of the twentieth century.[6] By the century’s end, cycling was spatially in the gutter. The spatialities of a practice always have implications for people’s identities (Lefebvre 1991; Shields 1991; Sibley 1995). If cycling was spatially in the gutter, then so were cyclists’ identities. Cycling, and most especially urban utility cycling, had become a polluted and polluting practice and ‘the cyclist’ a polluted and polluting identity.

The cultural acceptability of cycling’s spatial marginality, particularly when combined with the cyclist’s stigmatised identity, is highly consequential. It means that those cyclists who do not stick to the margins, but either consciously or unconsciously attempt to ‘centre’ themselves, are experienced as threatening and unsettling, and are demonised – most visibly and powerfully within the mass media. So cyclists’ collective protests, such as Critical Mass, are particularly vilified (Carlsson 2002). But even the least ‘political’ of cyclists will sometimes break from the invisibility of the margins and therefore inadvertently challenge automobility’s spatial monopoly. This cyclist can execute a whole range of manoeuvres designed to take short-cuts, avoid hold-ups and escape danger. It should be stressed that many such movements, whether actually ‘illicit’ or simply unavailable to people in cars, are risk reduction strategies, tactics developed by cyclists to reduce conflicts and risks of collision with others. But unlike road safety education, helmets and new cycling infrastructure, many are not officially sanctioned and are therefore not regarded as wholly legitimate. Those very same tactics which have enabled cycling to survive as an urban practice can also therefore reinforce the cyclist’s already stigmatised identity.

The mass media is very alert to the potential of the cyclist’s stigmatised identity to make ‘a good story’, especially in a social context which increasingly encourages people to reflect on transport choices and question their own automobilised lives (see below). Newspaper editors are attuned to knowing what their readers and advertisers want (and we should note how a high proportion of those advertisers belong to the system of automobility, on whose revenues newspapers depend). Media accounts are therefore likely to reproduce dominant representations of the cyclist as a ‘yob’, law-breaker and outsider (for example, Hoey 2003; see also Fincham, this volume). Such stereotyping works by isolating certain behaviours, stripping them from their meaningful context, and attributing them to ‘everyone associated with a particular group or category’ (Pickering 2001, 4). And these stereotypical representations contribute to the maintenance of the cyclist as a strange ‘other’ (Basford et al 2003; Dickinson 2004; Field 1996; Reid 2004).

Against the context of socially and ecologically destructive automobility, the reproduction of concerns about cyclists’ behaviour is a classic example of scapegoating (Cohen 2002). Scapegoating deflects attention away from greater crimes, by in this case sacrificing the cyclist in the ideological pursuit of ‘motoring-as-usual’. Through representing the marginal practice of cycling as ‘deviant’, the dominant practice of car driving is reproduced and reaffirmed as ‘normal’. Representations of cycling as deviant and cyclists as outsiders both contribute to, and are facilitated by, low levels of cycling which mean that few people are able to take, and defend, the cyclist’s point of view.

But the times, they are a changing … Cycling has become strange, and the cyclist has become a stranger. Yet there is an intense ambivalence about the stranger (Simmel 1971). The stranger’s presence suggests the possibility of another way. Against a backdrop of increasingly vocal concerns about climate change and growing unease about ‘the car’, the cycling stranger embodies the possibility of a different social order.

So here is another challenge to cycling as a marginalised practice and the cyclist as a stigmatised identity. But this time it is not Critical Mass or aberrant cyclists who, by moving from the margins to a more central position, are issuing the challenge. It is governments. More accurately, it is transport discourse and policy, which especially in light of a range of social and environmental ‘problems’, is now pushing cycling back towards ‘the centre’. UK Government transport policy (most notably Transport for London) is recognising cycling as ‘a good thing’, and making it clear that people should give cycling a go. The mass media, albeit at its more progressive end, is also now representing cycling in more positive terms. On 7 June 2006, the front page of one UK newspaper, The Independent, featured an image of the front wheel of a bicycle alongside the headline ‘Revolution! Britain embraces the bicycle’ (Milmo 2006).

For the last third of the twentieth century, the cyclist was relegated in favour of the motorist. But the cyclist is coming back. And again, it is experienced by many people as as a threat. The radical separation of the cyclist from the motorist within UK society returns as an unsettling haunting. The push to bring cycling in from the margins suggests that car-centred lives will not continue forever. Forcing an encounter with the idea of oneself as a cyclist, it provokes fear of cycling. So my argument is not only that a fear of cycling is produced by varied attempts to make cycling safer, but also that a fear of the cyclist is related to people’s anxieties that they, too, might end up taking to cycling, and becoming a ‘cyclist’.

Conclusions

Fear of cycling constitutes a significant emotional barrier to cycling. Ironically, this fear is partly produced through attempts to make cycling safer. For as long as cycling remains something to fear, it remains a marginal and marginalised practice. The constant cultural construction of cycling as dangerous justifies the continued spatial marginalisation of cycling practice, which then enables the continued construction of the cyclist as other, a stranger pedalling on the margins. The ideological, spatial and cultural marginality of cycling are continuously reproduced, together.

But cycling is pedalling in from these margins. There are – admittedly tentative – signs of a cycling renaissance. A range of actors is today seeking to elevate cycling’s position in transport policy, to move it into the mainstream. If this push continues into the future, we may well see people’s anxieties, about change away from currently dominant automobility, increasingly projected onto the cycling stranger (Sandercock 2002, 205; Sigona 2003, 70). As people feel increasing pressure to get on bikes themselves, and thus really start to engage with the realities of currently dominant cycling conditions, we may also hear more cries that cycling is too dangerous. People’s fears of cycling will become more real and powerful as the prospects of their cycling grow greater. And people will feel and fear the loss of a way of life as it has come to be lived, as automobilised. When these anxieties become intense and the calls that cycling is too dangerous become really vociferous, we should I think take them as a sign that – as a culture – we are getting really serious about once more getting on our bikes.

In the meantime, what can be done to allay people’s fears of cycling? Although it is constantly produced and reproduced, fear of neither cycling nor the cyclist is inevitable. Both the conditions for cycling practice and representations of the cyclist can change and be changed, and thereby produce different effects. Many people who cycle today – racing cyclists, touring cyclists, cycle campaigners, bike messengers – belong to cycling cultures which produce and reproduce positive experiences and representations of cycling. These people may be aware of constructions of cycling as something to be feared, and of the cyclist as deviant and strange, but such negative representations are easily exceeded by the celebratory and confirmatory evaluations of cycling and the cyclist continually flowing through their specific cultural worlds.

Correspondingly, we can in varied ways promote a pro-cycling culture. At the level of representation, our task is to generate and continuously reaffirm positive representations of cycling as an ordinary and enjoyable practice, something I am pleased to see happening in, for example, the recent marketing campaigns of both Transport for London and Cycling England. Certainly, we must stop communicating, however inadvertently, the dangers of cycling, and instead provide people with very many, very diverse, positive and affirming representations of both cycling practice and cycling identities. Current fear of cycling can be otherwise, but we must help make it so.

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[1]There is an important tension here between apparent visibility and apparent invisibility.  The ‘I didn’t see the cyclist’ argument following a collision shows that even though people cycling feel very visible, in fact many car drivers simply fail to notice them. This inability of people in cars to see people on bikes is I think connected to cycling being ‘out of place’ on today’s roads, something I discuss later in this chapter.
[2] The tragic irony of these statements is that Ken Kifer was killed by a speeding, drunk driver whilst out cycling in September 2003.
[3] I have the increasingly common advice to ‘always wear a cycle helmet’ in mind here, and that is an issue which I will consider in some detail later in this chapter.
[4] We will see later how also at this time a similar tension between the bicycle and the car was becoming pronounced.
[5] Another Sustrans’ project is ‘Safe Routes to Schools’, which aims ‘to create a Safe Route to School for every child in the UK’ (seehttp://www.sustrans.org.uk; last accessed 5/2/07).  This project might have been called ‘Nicer Routes to Schools’, ‘Better Routes to Schools’, or ‘Fun Routes to Schools’. That it was not again testifies, I would claim, to the salience of ‘safe’ as an adjective in a contemporary transport climate characterised by fear.
[6] The negative consequences of automobility’s monopoly on space were/are not of course confined to cycling. Automobility has led to much public space that was once common space being allocated to traffic flow. So community severance (and by implication the marginalisation of community-based use of space) is an important problem here, not just the marginalisation of cycling.

Friday, August 28, 2015

My Bike Helmet Saved My Life!

Most people who have engaged in discussions about bicycle helmets have encountered someone claiming that a bike helmet saved either their life or the life of someone they know. Such claims can be tough to counter because they are made with evangelical conviction. I’m still at a loss with these. I can’t say, “No it didn’t.” Or, “Prove it.” Their proof is that their bicycle helmet cracked and because it cracked it saved their life.


What other safety devices do people hold to such a low standard? If I life jacket tore apart and floated away as soon as you hit the water, would you claim that it saved your life? If a seat belt released upon impact, would this bring it accolades? In fact, bike helmet manufacturers brazenly admit how fragile their helmets are – if you drop your bike helmet, the warranty is void and you must replace it. They are, after all, just a bit of Styrofoam.

Yet bike helmets are presented as safety shields of mythical proportion because they break apart on impact. Their manufactures must love this. They only need to test their helmets to a total impact velocity of 20 feet per second, which translates to 13.64 miles per hour (21.95 kilometers per hour). That’s about the same speed a head reaches when a person of average height falls over from a standstill. There’s no room for any additional velocity in the equation, say a motor vehicle impacting the cyclist who is standing still. And perish the thought of the cyclist actually moving! Read the Consumer Product Safety Commission’s (CPSC) own testing regulations if you don’t believe me.

Think about this. If you are in a crash of any speed whatsoever and your helmet breaks apart at the initial impact, your head is not only unprotected at impact, it remains so through the rest of the crash.

The low impact speed for which bike helmets are designed is troubling enough. Then consider that the tests are also limited to the top parts of the helmets, never blows to the side or back. Take a close look at the diagrams in that CPSC link to see this. I suppose if crash victims could reorient themselves during a crash to ensure they only hit the top of their head, this could be useful, at very low speeds anyway.

But then consider that bike helmets must be fitted perfectly to each wearer in order to be useful at all. They come in at least eight sizes, depending on the manufacturer. Then, assuming you choose the correct size, you must spend time micro-adjusting the strap so the helmet sits just so on your head, otherwise there is no expectation for it to protect you at all. Here’s the result of a lawsuit won by a bike helmet manufacturer because the victim, an experienced cyclist, could not prove that he had adjusted the helmet straps correctly.

Some bike helmet manufacturers are trying to do the right thing by developing helmets that can withstand greater impact. The results are extremely expensive helmets that usually look a lot like motorcycle helmets. Are we really going to encourage more people to ride bikes if they have to wear a motorcycle helmet?

All of this still doesn’t get at the larger issue – that no helmet, not even a motorcycle helmet, can prevent brain injury. This is because there is space between our brain and our skull. Upon an impact to our head, whether our skull is wrapped or not, our brain slams against the inside of our skull. Here in the U.S., our NationalFootball League is finally having to face up to this fact. And just as the NFL has reached its limit on helmet design, bike helmet manufacturers will have to face the same facts, too. Nothing can prevent a brain from slamming into the inside of its skull.

Then there is the danger of wearing a bicycle helmet – rotational brain injuries. Because bike helmets are made of soft Styrofoam or similar foam products, they compress and cause friction upon impact. If the crash victim happens to land at any angle rather than straight on, there is a high risk of severe brain damage caused by the sudden rotation at the base of the brain. Read more about rotational brain injuries caused by bike helmets in this paper.


After more than a decade of researching and discussing the bicycle helmet problem I’m more than frustrated with its significant harm to bicycle advocacy efforts. I tend to get a twitchy when I’m forced to listen to an impassioned proclamation that a bit of Styrofoam saved someone’s life. I’m ready for bike helmets to be seen as what they actually are – just a bit of Styrofoam, nothing more, nothing less. If someone feels better riding their bike with a bit of Styrofoam on their head, cool, go for it. But please, let’s stop the irrational claims that these things save lives because they break apart at impact.

Also frustrated by such claims? Please offer your stories in the comment section.

Sue 

Tuesday, August 4, 2015

What the helmet debates are hiding

Cars, not helmets, should be the focus of safety concerns
Santiago, Chile: Mapping the blindspots around
a normal city bus: 16 bikes vanished before
participants' eyes at specific points beside, behind and
even in front of the bus, during a recent
workshop to improve on-road relations between
cyclists and buses. Source: Laboratorio de Cambio Social
As mentioned by other contributors to this blog, the scientific evidence for the effectiveness of helmets is highly questionable, and indeed, hotly debated by researchers themselves (for ongoing coverage of these issues, see The Helmet Foundation website, www.cyclehelmets.org). Rune and Vaa, authors of the bible-like Handbook of Road Safety Measures, for example, conclude that studies on the effectiveness of cycling helmets revealed bias and methodological weaknesses that make their results highly uncertain and overly supportive of helmet use. 
Other researchers point to a 36% increase in damage to the neck, resulting from helmet use, or an increase in risky behaviour. While requiring helmet use might reduce the total number of injured cyclists, Erke and Elvik (2007) considered it probable that accident and injury rates would rise.
Indeed, required helmet use seems to be the chosen strategy mainly for societies that are unwilling to address the main issues behind road deaths and injuries for all road users, particularly pedestrians, but also drivers and passengers themselves. More of the latter die or end up disabled due to unsafe driving. But for some reason the focus is seldom on them. 
In contrast, countries posting the world’s best road safety records, such as Sweden and the Netherlands, emphasize a whole raft of measures that separate drivers from those most vulnerable and make high speeds impossible and socially shunned, particularly in densely populated urban areas. To slow down drivers on rural roads, the Dutch provide a single lane for cars, with wide shoulders for cyclists and walkers on both sides. This design forces slower, more cautious driving, which improves safety for all.
Jacobsen’s now classic work (2003) clearly illustrates the importance of “safety in numbers”, based on studies of 68 Californian cities, Denmark, and even Pakistan, where Bhatia and Wier obtained similar results. The more pedestrians and cyclists on the road, the safer walking and cycling. A measure, such as compulsory helmet use, which reduced cycling by almost 50% in some Australian regions (Robinson 1996), clearly raises profound questions about helmet use as a “safety” measure. Other researchers have also raised the issue of “dangerization” of cycling through fear-mongering tactics (http://thinkingaboutcycling.com/article-fear-of-cycling/).
Avoiding the elephant in the room — drivers’ behaviour, speeds and road designs that favour speed at the cost of the lives and limbs of all — often leads to a “Blame-the-victim” attitude, similar to that experienced by rape victims, who are told their victimization is their own fault, because of the way they behave or dress, a terrible distortion of basic human values and rights. When someone is shot, the shooter, not the victim, is charged and sentenced. Like people with guns, drivers preside over their own and others’ lives. Blaming the victim only excuses, and ultimately perpetuates, often mortal violence.
Like the smelly red herring  
Focusing on cyclists’ rather than drivers’ behaviour pushes some really important issues, which could make a difference to us all, low on the policy agenda. Study after study confirms that in our obesity plagued world, over a life time, the health benefits of cycling are far greater than the risks of death or disability (see bibliography below). In other words, you’re more likely to die of diabetes II or a heart attack, than at the wrong end of a speeding car.
Equally important, many new cyclists put on their helmet and set out to conquer the city’s rough roads, convinced that this is enough to keep them safe. This attitude is reinforced by the perennial question, when a cyclist is run down or killed, “But was s/he wearing a helmet”? This is not scientific thinking. It is not based on experience or evidence. It is magical thinking, and it is a poor substitute for the known strategies for protecting people on roads, including cyclists.
As transitioning cities promote cycling for transport, a high proportion of people cycling are new to the experience. Dutch experts calculate it takes two years for a novice to become an expert cyclist. This is a minimum that could take longer elsewhere, since many cities do not provide the kind of well thought out, carefully designed protection afforded by the Netherlands’ “cycling-inclusive” transport planning. 
If no education is available, there is a high risk that people fall into dangerous habits and repeat them endlessly, without learning proper behaviour on the road. This risk is particularly high in developing cities, where many people do not have drivers’ licenses, so have not even cracked open the highway code or relevant traffic rules and laws. 
Two years or more. What are the implications in a city like Santiago, where cycling’s modal share doubled from 2006-2012, a remarkably short time, and the number of cyclists on major routes is soaring by 20-25% annually? Most cyclists do not have the skills to ride safely, but they nonetheless don their trendy helmets and off they go, ringing their bells at anyone who gets in their way, sliding past others into intersections, or whipping from sidewalk into intersections in the flash of an eye. 
This risky behaviour is further compounded by the fact that many safe manoeuvres are counter-intuitive, especially to people who have never driven a car. Cuddling up to the side of a bus or a lorry ignores the fact that 16 bicycles can fit in the blindspot of this size of vehicle. Squeezing into the curb leaves no margin to manoeuvre when something goes wrong on the road. At night, wearing a helmet is no substitute for using a plain white light on the front and a red light on the back — no flashing please. Riding to the right of a right-turning vehicle seems safer to novices and even some long-time but untrained cyclists. People blithely enter roads or switch lanes without so much as a glance over their shoulder, at anyone who might be coming at them. 
Under all these circumstances, a helmet is no substitute for mastering the requisite skills. 

Redefining costs and life-centred investments 
Santiago, Chile: A cyclist experiences bike-bus interactions
from the perspective of a bus driver, during a recent
workshop to improve on-road relations between
cyclists and buses. Source: Laboratorio de Cambio Social.
Speed kills millions of people on the world’s roads every year. Behind these deaths and disabilities, are mostly drivers of cars and other motorized vehicles who believe their rush to reach their destination is more important than anyone’s life or family or potential contributions. By and large, our societies have told them this, for generations, in publicity and public debates. They too become the victims of their own “accidents”: few are so heartless that they can easily write off their destruction of another’s life. For every person killed or disabled, many more suffer the loss, day after day for years and years. These costs are not counted or considered. 
Forcing individuals to invest in expensive helmets, many of which do not meet any standard and most of which are designed for falls in sporting activities, rather than collisions between cars and people, is a waste of their money and a misdirection of their attention.  
Similarly, investing often scarce public resources in police time to control the headwear of a small group of road users seems ridiculous alongside the need to control excessive speeds and other dangerous behaviour. Valuable police resources should focus on controlling potential killers. Road design should protect all vulnerable users. And more carefully considered education for all road users should be a major focus, if we really want to improve health and save lives.

SOME SOURCES ON THE HELMET DEBATE
Clarke, C. (2006). "The Case Against Bicycle Helmets and Legislation." World Transport Policy and Practice 12(3).
de Jong, P. (2012). "The health impact of compulsory helmet laws." Risk Analysis 32(5): 782-790.
Elvik, R. & Vaa, T. 2005. The handbook of road safety measures, Amsterdam ; San Diego, CA, Elsevier.

Elvik, R. (2011). "Publication bias and time-trend bias in meta-analysis of bicycle helmet efficacy: a re-analysis of Attewell, Glase and McFadden, 2001." Accid Anal Prev 43(3): 1245-1251.
Elvik, R. (2013). "Corrigendum to: “Publication bias and time-trend bias in meta-analysis of bicycle helmet efficacy: A re-analysis of Attewell, Glase and McFadden, 2001” [Accid. Anal. Prev. 43 (2011) 1245–1251]." Accident Analysis & Prevention 60: 245-253.
Gillham, C. and C. Rissel (2015). "Children’s cycling participation, inju- ries, fatalities and helmet legislation in the United States." World Transport Policy & Practice 21(1): 30-39.
McIntosh, A., B. Dowdell and N. Svensson (1998). "Pedal Cycle Helmet Effectiveness: A Field Study of Pedal Cycle Accidents." Accident Analysis and Prevention 30(2): 161-168.
Olivier, J., S. Walter and R. Grzebieta (2013). "Long term bicycle related head injury trends for New South Wales, Australia following mandatory helmet legislation." Accident Analysis and Prevention 2013(50).
Rissel, C. (2012). "The impact of compulsory cycle helmet legislation on cyclist head injuries in New South Wales, Australia: A rejoinder." Accident Analysis and Prevention 45: 107-109.
Rissel, C. and L. M. Wen (2011). " The possible effect on frequency of cycling if mandatory bicycle helmet legislation was repealed in Sydney, Australia: a cross sectional survey." Health Promotion Journal, Australia 22(3): 178-183.
Robinson, D. L. (1996). "Head injuries and bicycle helmets." Accident Analysis and Prevention 28(4): 463-475.
Robinson, D. L. (1996). Cycle Helmet Laws - Facts, Figures and Consequences. Velo Australis. Freemantle.
Robinson, D. L. (1996). "Head Injuries and Bicycle Helmet Laws." Accident Analysis and Prevention 28(4): 463-475.
Robinson, D. L. (2001). "Changes in head injury with the New Zealand bicycle helmet law." Accident Analysis and Prevention 33: 687-691.
Robinson, D. L. (2007). "Bicycle helmet legislation: Can we reach a consensus." Accident Analysis and Prevention 39: 86-93.
Rosenthal, E. (2012). To Encourage Biking, Cities Lose the Helmets. The New York Times. New York.
Reynolds, C. C., M. A. Harris, K. Teschke, P. Cripton and M. Winters (2009). "Review The impact of transportation infrastructure on bicycling injuries and crashes: a review of the literature." Environmental Health 8(47).
Scuffham, P. A. and J. Langley (1997). "Trends in Cycle Injury in New Zealand Under Voluntary Helmet Use." Accident Analysis and Prevention 29(1): 1-9.
Teschke, K., M. A. Harris, C. C. Reynolds, M. Winters and S. Babul (2012). "Route Infrastructure and the Risk of Injuries to Bicyclists: A Case-Crossover Study." American Journal of Public Health 102.12: 2336-2343.
Turner, L. (2012). "Australia's helmet law disaster." Institute of Public Affairs 64.1: 28-29.
Walker, I. (2007). "Drivers overtaking bicyclists: Objective data on the effects of riding position, helmet use, vehicle type and apparent gender." Accident Analysis and Prevention 39: 417-425.
Whitelegg, J. (2006). "The Case Against Bicycle Helmets and Legislation." World Transport Policy and Practice 12(3).
Winters, M. and K. Teschke (2010). "Route Preferences Among Adults in the Near Market for Bicycling: Findings of the Cycling in Cities Study." American Journal of Health Promotion 25(1): 40-47.

ADDITIONAL INFORMATION ON CYCLING AND HEALTH
Aldred, R. (2012). "Governing transport from welfare state to hollow state: The case of cycling in the UK." Transport Policy 23: 95-102.
Fee, E. and T. M. Brown (2003). "Bicycling for Pleasure and Power." American Journal of Public Health 93(9): 1409-1409.
Grabow, M. L., S. N. Spak, T. Holloway, B. Stone, A. C. Mednick and J. A. Patz (2012). "Air quality and exercise-related health benefits from reduced car travel in the midwestern United States." Environ Health Perspect 120(1): 68-76.
Pucher, J., C. Komanoff and P. Schimek (1999). "Bicycling renaissance in North America?: Recent trends and alternative policies to promote bicycling." Transportation Research Part A: Policy and Practice 33(7-8): 625-654.
Rojas-Rueda, D., A. de Nazelle, O. Teixidó and M. J. Nieuwenhuijsen "Health impact assessment of increasing public transport and cycling use in Barcelona: A morbidity and burden of disease approach." Preventive Medicine 57(5): 573-579.
Saelensminde, K. (2004). "Cost-benefit analyses of walking and cycling track networks taking into account insecurity, health effects and external costs of motorized traffic." Transportation Research Part A: Policy and Practice 38(8): 593-606.
Teschke, K., C. C. Reynolds, F. Ries, B. Gouge and M. Winters (2012). "Bicycling: Health Risk or Benefit?" UBC Medical Journal 3(2): 6-11.
Winters, M., M. Brauer, E. Setton and K. Teschke (2010). "Built Environment Influences on Healthy Transportation Choices: Bicycling versus Driving." Journal of Urban Health 87(6): 969-993.

Winters, M., G. Davidson, D. Kao and K. Teschke (2011). "Motivators and deterrents of bicycling: comparing influences on decisions to ride." Transportation 38: 153-168.