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.


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.