It is at first surprising to many people that the wearing of helmets
by cyclists is a controversial subject. However, cycling safety is a
much more complex issue than many people realise, where best evidence
and real-world experience sometimes conflict with received opinion. Key
considerations about risk when cycling, what influences cycling safety
and the inter-relationships between safety interventions, cycle use,
behaviour and health (both individual and public) are often poorly
understood. In particular, opinions as to whether cycle helmets are an
appropriate, proportionate or effective intervention are often dominated
by emotion and expressed with exaggeration, which can make it difficult
to know what to believe. (...) A little history
Cycle helmets have been around since 1975. They were originally a 'spin-off' product from the development of expanded polystyrene foams in motorcycle helmets, intended to supersede the old 'hair net' style of head gear then used in cycle sport. However, the protection offered by cycle helmets is very much less than that provided by motorcycle helmets due to the compromises in weight and ventilation necessary in order to make them acceptable for an activity such as cycling that involves much physical exertion. Indeed, because of changes to design in order to address concerns about comfort, modern helmets with soft shells are considered to offer less protection than some earlier designs with hard shells.
At first cycle helmets were promoted mainly by their manufacturers, with competing claims about their effectiveness. Then, during the 1980s, reports began to be published suggesting that if cyclists wore helmets they would be less likely to suffer head injury. From that time, the promotion of helmet wearing by cyclists has been a main thrust of road safety and health practitioners in many countries.
Attitudes to cycle helmets
The active promotion of helmet use by cyclists is a fiercely controversial and often emotional subject, with views put forward with great conviction both for helmets and sceptical of their value (very few people argue against the voluntary use of cycle helmets per se). Controversy is particularly acute with regard to mandatory helmet laws.
The arguments in favour of helmet use are invariably based upon the premise that in the event of a fall, a helmet might substantially reduce the incidence and severity of head injuries. A relatively small number of medical research papers are cited in support of this premise, most based on case-control studies. One 1989 paper is cited more often than any other, with its claim that helmets reduce head injuries by 85% and brain injuries by 88%. However, the methodology and findings of this paper have been widely criticised and there is no real-world evidence to support its predictions.
Proponents of helmet use include people from within the medical and road safety professions and also people who believe that a helmet has already saved them, or a relative or acquaintance, from serious injury.
Helmet-sceptic arguments are more varied. Originally based largely on issues associated with personal liberty, the balance of helmet-sceptic arguments changed during the 1990s as the health benefits of cycling became more acknowledged and as independent research started to be undertaken into the outcomes of rising helmet use and, in particular, the effects of cycle helmet laws.
Principal helmet-sceptic arguments are:
- The risk of serious head injury is small and frequently overstated. The promotion or mandation of cycle helmets is a disproportionate response to this risk.
- There is no real-world evidence that helmets have reduced the likelihood or severity of head injuries among whole populations of cyclists.
- Helmet promotion (and especially compulsion) reduces cycling and the health benefits of cycling. Less cycling increases risk for those who continue to cycle, whether they wear helmets or not.
- Much pro-helmet research and promotional material is flawed or one-sided.
- Insofar as there are risks associated with cycling as a form of transport, the greatest risks of serious injury come from inappropriate motor vehicle use and poor cycling behaviour. Institutionalising the idea that wearing a helmet is necessary for safe cycling diverts attention from more important actions to prevent crashes happening in the first place and results in victim-blaming when crashes do occur through no fault of the cyclist.
- Cyclists should not be singled out for helmets when head injuries to pedestrians and motorists are much more numerous.
In recent years many individuals and cycling organisations have swung from pro-helmet to helmet-sceptic as a result of experience with helmet laws and the growing breadth of evidence.
via: cyclehelmets.org
Image via: Metamorphostuff
