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 

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.

Australian Mandatory Helmet Law Challenged

Readers who have followed bicycle helmet initiatives over the years will be familiar with the Australian law. Australia and New Zealand are the only two countries with all-ages, fully enforced mandatory bicycle helmet laws. These laws have been central to arguments opposing proposals for similar laws because of the evidence showing significant reduction in cycling after the law was enacted.

Well, after many years of calling for a repeal of their law, some Australian bicycle advocates are thrilled to announce that it is being seriously challenged. I received the below call to action in my inbox last evening. I’m not sure if non-Australians are welcome to respond, but if you are Australian, please submit your response by August 24^th. Also, please forward this on to any Australians you know.

It’s been a long, dull slog to this point, but suddenly your action could make an enormous difference!

Sue

The Australian Federal Senate has appointed a committee to inquire into “Personal Choice and Community Impacts”.  The Inquiry, instigated by Senator Leyonhjelm, is better known as the Nanny State Inquiry.  The committee is currently seeking submissions from the Australian community.

Senator Leyonhjelm has singled out mandatory bicycle helmet laws as the foremost example of where the State exceeds its proper bounds by interfering in a matter that should be left to the individual.  It would be a pity to miss out on this opportunity to be heard, and to influence government policy.

I understand that many of our supporters may be reluctant to become involved, on account of political differences with the inquiry’s instigator.  It must be pointed out that this is a Federal Government inquiry, and that Senator Leyonhjelm’s role is as a member of the committee, and that it is not a vehicle for any particular party or point of view.

My understanding is that the committee do not want to restrict discussion to submissions from the usual health and safety professionals. Rather, they are seeking a broader input to include members of the public who can bring before them an understanding of the impact of a range of “nanny state” regulations on their day to day lives.

I know that many of our supporters have the knowledge and skills to include detailed analysis of the many failures of our mandatory helmet laws, and I would encourage them to include this in their submissions.  But please, if you are just someone who has been put off riding a bike, fined or harassed by the police and the courts, or are just plain upset by the dead end path that mandatory helmet laws have taken us down, please make your voice heard.

The closing date for submissions is 24^th August.  There will be some opportunities to be heard in person by the committee in all State and Territory capitals in the ensuing months. It would be best to make it clear in your submission if you wish to be invited to appear in person. Details of how to make a submission are at http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Economics/Personal_choice

Thank you for your support.

Alan Todd
President, Freestyle Cyclists

Picturing Bicycle Helmets Makes Cycling Less Attractive

A picture of a cyclist with a bicycle helmet makes cycling less attractive. This conclusion can be drawn from a big survey carried out among 3,500 respondents from major Danish cities.

The survey tested the impact on opinions from pictures representing different "marketing" messages. Seven pictures were used, namely the ones shown as well as a neutral “no picture”, which was used as a reference.

The following graph shows how the respondents' view on cycling attractiveness was influenced by the different pictures. This can be regarded as a measurement of the pictures "marketing value" for cycling. An increase in cycling attractiveness is shown in green, a decrease in red. The impact is the result of viewing the picture in a few minutes.

The graph shows that the picture "Leisure" works well as positive marketing for cycling, while the "Traffic jam" and "Helmet" pictures do the opposite. The other pictures have a smaller, not statistically safe impact.

Surprising results

Often concern is raised that "scary" campaigns on bicycle safety and car advertising have a negative impact on cycling. The graph shows that this, if any, has only a small negative impact.

The picture "Traffic jam", on the other hand, has a strongly negative impact, probably because the repondents don't like the idea of cycling in the middle of all the cars. While this may not be surprising, it is indeed remarkable that the pictures "Helmet" and "No helmet" showing the same person on the same bicycle in the same situation with and without a bicycle helmet have a totally different impact on the attractiveness of cycling.

This is even more surprising, as the respondents - when asked on the last page of the questionnaire - associate more positive values with the "Helmet" than the "No helmet" picture. It seems that public campaigns for bicycle helmets have managed to create a positive public opinion on  the issue, but that Danes still are reluctant to actually using the helmets. A 28% wearing rate has been reported.

Several Danish municipalities are working hard to promote cycling. Quite often City Councils require helmet wearing cyclists to be shown in the promotion materials. The findings of the survey show that this is counterproductive, as it makes cycling appear less attractive for the potential users.

Technicalities

"Cycling attractiveness" is, in short, respondents' opinion on cycling experience minus the average opinion of car, bus and train. Respondents scored their experience of the different modes on a scale from "I do not like travelling by ..." to "I enjoy travelling by ....". 

The survey made use of an indirect questioning technique. Every respondent was presented for one and the same picture as background for several opinion- and behavior questions. The picture itself was only addressed at the last page of the questionnaire.

  

More details on the survey can be found here.

TED x Talk - Why We Should Bike Without a Helmet

Welcome to The Bike Helmet Blog

Well, this is exciting! After two long years of talking about what could possibly work next for bringing balance back to perceptions about bike helmets, we’ve launched this blog. A lot of research and academic studies have been published, but this will be the first open-discussion platform where everyone should feel comfortable jumping in with comments.

There are five of us pitching in as authors for this blog. My particular interest in the topic comes from my personal shame for falling for the fraud of bicycle helmet propaganda. I owned a bike shop here in Prescott, Arizona for 13 years from 1991 through 2004. During that time I terrified countless customers by asking them “How much is your head worth?” in order to sell them a helmet. But it wasn’t just sales I was after. I truly believed I was saving their lives with each helmet sold.

Then, in 2004, the same year I sold the bike shop to my husband, I met advocates who were fighting against the very messages I was spreading. When they showed me the stats and explained that scaring people into wearing helmets only scares them away from bicycling, I felt sick for my part in it. Through my participation in this blog I hope to redeem at least some of the damage I did. 

Since then I have read countless research papers and engaged in many lively discussions with like-minded advocates. We continue to uncover more and more evidence that bicycling is not dangerous and even if it was, bicycle helmets do not provide the protection people believe they do. But how to break this barrier to bicycling out of our close-knit circle so that it receives just as much attention as bicycle helmet promotions? I hope this blog will become part of the solution.

My particular passion within this topic is the disturbing relation between bicycle helmet promotions and the budding culture of fear paralyzing our society. Perhaps this stems from my own guilt for using fear to sell helmets.

Other authors of this blog, like Thomas Krag and Lake Sagaris (joining us soon), will present the best of research papers and academic studies in their posts. Interlaced in these research-based posts you will find posts from Mikael Colville-Andersen, Kaethi Diethelm, and myself presenting the broader view of the damage bicycle helmet promotions and mandatory helmet laws are doing to the overall bicycle movement.

Thanks for joining us on this journey. Let’s get this blog started!

Sue