Campaigning

Cycle Helmets

In the two years I have been writing this blog I have largely stayed away from the issue of cycle helmets, I generally despair at the debate, equal despair for how easily cycle campaigners allow themselves to get dragged down into a pointless argument and how ignorant the opposition shows itself to be. However one of those ill informed articles that occasionally crops up in the media has spurred a change to that situation.

The piece in question is in the Telegraph and written by Beverley Turner, former ITV F1 presenter and Mrs James Cracknell, the hook to it is that Michael Schumacher has suffered a serious head injury and is currently in an induced coma in a French hospital following a skiing accident. It’s not surprising she would write this article, after all she has that history in F1 (she’s the one who exposed middle aged-millionaire-Italian-motor racers (Flavio Briatore) as being sexist; insightful, I’m sure you’ll agree) and her husband suffered a brain injury following an RTI. He was cycling in the US when he was hit by the wingmirror of a truck, he was wearing a helmet, the doctors said he would have probably been dead without it. Since then James Cracknell and now his wife are advocates of cycling helmets.

Beverly Turner

I’m going to point out now that questions have been raised regarding financial motivations the Cracknell’s might have to promote compulsory helmet use. That the sponsor of Cracknell’s cycling trip stands to gain from helmet sales and that Cracknell was a brand ambassador for a helmet manufacturer. I don’t know if this is correct but they are raised sufficiently frequently that it would behove them to state once and for all their interest or lack thereof.

[edit 03/01/2014: The Merida site has a piece about James Cracknell being ‘Brand Ambassador’ and appearing on the One Show to promote helmet compulsion and at the same time getting some nice free advertising in for Merida. Does James do this out of the goodness of his heart or is he or anyone associated with him benefitting?]

[edit 03/01/2014: Beverley Tweets…

/]

As I say I’ve stayed out of the cycling debate so far, but this time I’m interested, not least of all because Beverley Turner insulted me on Twitter and I’m a delicate soul who takes exception to that and Twitter is a poor medium for conducting this debate. For many years before being a cycling advocate I was a petrolhead, Senna was my boyhood hero and after a few wilderness years Schumi was my next hero, at a time when it was very unpopular in the UK to admire him. Senna’s death was devastating to me, arguably the greatest driver ever, killed when a suspension arm pierced through his helmet. Now Schumi’s freak accident on a ski slope, he was wearing a helmet but it split in two on impact.

So what’s my take on helmets? Cyclists spend hours debating their effectiveness, many seem to enjoy a good helmet debate as much as they do riding; they love to talk about blunt impacts, 12mph test limits, HGV crush injuries, rotational injuries, risk homeostasis, passing distances and a whole slew of other aspects, my opinion is: NONE OF THIS MATTERS.

Let me clarify this a bit, from a public health perspective: NONE OF THIS MATTERS.

When considering the particular circumstances of an individual incident or whether a helmet may prevent injury in a specific instance, they may matter. But the reason the whole debate gets so heated is because the evidence is so unclear one way or another, so the only possible conclusion can be, if you want to wear a helmet, wear one, if you don’t, don’t. If you don’t like other people’s choices, STFU.

Problems arise when people start conflating helmet use as a public health issue or helmet use as a private safety issue. It is unfortunately the case that the people who make this conflation are sometimes people who have a loved one killed or seriously injured due to a head injury, such as Beverley Turner or the Put Things Right campaign. It gets uncomfortable because you have to tell them that what they think they know, what seems self evident and ‘common sense’ may not actually be the right course of action. That as in any situation where emotion can cloud judgement, perhaps they aren’t the correct people to be deciding what action to take.

As a matter of public health helmets are a bad solution they drive down cycle usage and consequently increase chronic ill health leading to a net loss to public health. If you want to save lives, helmets will not do it, they kill people, just not in quite so obvious a way as cars. Our well meaning campaigners don’t worry about this though, they care more about preventing brain injuries, they are a single issue campaign with no thought to the side effects. Side effects, there’s an interesting analogy, if a drug company produced a drug that saved fifty lives today but left a thousand people with chronic ill health leading to their early death in twenty years time, would it be permitted for use? I doubt it.

In her article Turner appears to be arguing for compulsory helmets for children only, however all the same issues apply, some even moreso. Cycling rates amongst girls in particular are very low, cycling already has a dorky image and helmets are definitely not cool. If you want to accelerate the obesity epidemic amongst children, compulsory helmets are the way to go. To this we can add that legislative creep will ensure that what is compulsory for children today will probably be compulsory for adults tomorrow.

Mandatory helmet campaigners fall into one of three groups.

1. Well meaning busybodies who have had a personal tragedy but don’t really understand any of the subtleties or big picture issues.
2. Cycle helmet manufacturers who have an obvious financial incentive.
3. Motorists or motoring organisations who have two motives.
a. They don’t like cyclists, they think cyclists slow them down or some other ill informed opinion and they just want to make cycling less attractive to get more cyclists off the road. Helmet use makes cycling more expensive, less convenient and makes it appear dangerous.
b. They want to shift blame/responsibility/liability in the event of an accident from the driver to the cyclist.

So cycle campaigners, people who want to increase safety for all and make the whole country healthier, what can we add to the debate?

Firstly do not engage with the opposition on their terms. Cycling helmets are an irrelevance, a red herring, any minute spent debating them is a minute not spent campaigning for proper infrastructure. Even if cycling helmets are really very good at preventing injuries, IT DOESN’T MATTER. Because if you compel the use of helmets, so few people will be riding that their benefit will be an even smaller statistical blip than it already is. Do not get dragged into a debate about the effectiveness of cycling helmets or even one about personal liberty, it’s an argument that neither side can win, you just shout at each other from ever more entrenched positions.

The argument should always focus on prevention is better than cure. Everyone in the country knows that cycle helmets exist, that in the event of a fall they may offer some protection. The body armour that a person wishes to don to protect themselves in the event of a fall, is up to them. But from a public health perspective we want to focus on what can be done upto the moment before the fall or impact to prevent it happening. Helmets are a post – accident solution along with paramedics, A&E and ICU. The public debate must focus on pre – accident solutions here we must turn to the hierarchy of risk control, remember this,

hierarchy of risk control

Eliminating the hazard is the best solution , then we engineer it away, then we train people, finally when everything else has failed and there is still an unacceptable risk, we make people wear funny looking gear. This isn’t just my pie in the sky idea, the hierarchy has been adopted by ISO and is enforced in this country by the government through the HSE.

Fortunately for all of us one solution does exist, a solution that solves the public health problem and the personal safety problem, a solution that simultaneously protects cyclists from injuries and encourages more cycling making the population fitter, the solution is of course the Dutch solution, infrastructure.

I will also say that for a woman who made such a big deal about sexism in F1 her article is strewn with latent sexism. “Macho twits”, “mothers and girlfriends pick up the pieces”, “if our son ever goes cycling”. Most disturbing of all though, ” take heart in the fact that he wore a helmet. A good man does that for his family as much as for himself”.

The message here, whether she meant it or not, A good man wears a helmet, bad men do not wear helmets, men not wearing helmets do not deserve respect, if you hit them and kill them it is their own fault. Not a message that will encourage safe driving around cyclists, indeed it is part of a paradigm that casts the cyclist as outlaw or at least part of a social outgroup whose value as a human is lower than that of other members of society.

So not a good effort overall by Ms Turner, but perhaps a useful learning exercise for campaigners on focusing our attention and efforts on the things that matter.

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35 thoughts on “Cycle Helmets

  1. Great blog. Well put points, and I think a few folk had interactions with a few of your type 1’s yesterday. I guess it must be very hard if you have experienced a death or serious injury to except that PPE might not be the best way forward. I didn’t get cross, but was exasperated by the refuasal to accept other campaigns like 20mph or ‘Go Dutch’ might be a more effective way of reducing TBI.

    Anyway, Happy New Year to you!

    Jono

  2. Pingback: Remember kids... always wear a helmet. (The almighty bikeradar helmet thread) - Page 114 - London Fixed-gear and Single-speed

  3. Hi, very interesting blog, apologise for this being short response but am typing it on phone

    I’m interested in the 2nd bit if this, I agree with the first bit

    “As a matter of public health helmets are a bad solution they drive down cycle usage”

    But I’ve yet to see any studies relating to this bit

    “and consequently increase chronic ill health leading to a net loss to public health.”

    I was just wondering where you got this info from?

    Again apologise if this seems a bit blunt, but difficult to type on phone.

    Thanks

  4. Good points and I totally agree, focusing on something that is required due to the supposed inevitability of incidents instead of working to reduce the root cause of incidents is totally wrongheaded.

    I’d also recommend you add a ‘c’ to your list of motorists reasons for advocating helmets; they won’t feel so guilty driving more carelessly around you, and presume they won’t have a death on their hands if they do hit you.

  5. To answer Will’s query you might start with a look at this link:
    http://cyclehelmets.org/1194.html

    found by searching on “Australia cycle helmets use”. I suspect a search on “cycle helmets reduce use” would unearth similar data. I have not seen many pages, unlike with motorbike helmets, that dictate you need to change to a new helmet every 4-5 years. I suspect those pages are in preparation.

  6. I agree that forced helmet wear would put people off cycling as I have just had a prime example of that over Christmas.

    My partner has recently started cycling this year and has a group of friends she rides with regularly, so we agreed that her Christmas presents this year would be cycling gear. She’s happy to wear a waterproof jacket with hi-vis detailing, use lights when needed and use trouser clips – so she’s not uncomfortable about how she looks wearing cycling gear. She wanted to get a helmet but when trying them on she found them very uncomfortable as she almost always has her hair braided and the helmet pressed her braids into the back of her head.

    We had a discussion and, in her own words, she would not cycle anywhere near as much as she now does if she had to fuss with her hair all the time just to wear a helmet. This from a woman who will now cycle to the shops or to meet friends rather than use a car.

    I’m happy for her to go without a helmet as she mainly rides cycle paths at a moderate pace, whereas I’ll always wear a helmet as I ride roads and lanes at a faster pace. She’s comfortable riding without a helmet, I’m only comfortable with one – but we both like to get out and ride.

  7. Well made argument that I agree with however I would argue we should never let helmet legislation advocates off without dissent. There is a real threat that helmet legislation could happen. It’s an easy win for any government trading off deals with lobby groups and only an increased level of awareness of the real facts will help prevent this.

  8. Great blog, and some good points made, as you say it’s all down to personal preference, When i was a child, and into my teens. I never had a helmet, thinking about it i never seen anyone wearing them back then……. then when i hit my late 20’s i got my first one, and now i never leave the house without one (when ridding) i make my sons where them when we ride together (12 and 20), but is it a age thing… young children wear them (made to wear them or as my children call it the Marlin factor from finding Nemo), teenagers and twenties do not (to cool to be seen with one on) and then later in life you start to think more….. personal preference.

  9. SOMETHING that seems to be missed is that motorists will look at cycle helmets in the same way they look at wearing seat belts. The safety belt was in cars a long time and the view it was someone else’s fault was very prevalent in not wearing them. The law change made people wear them and reduced the injury and death rates.
    Cyclists are looked at by drivers in the same way, and helmets are seen as a sign that the cyclist is responsible and therefore won’t have an accident, whereas without they must be slapdash about many things and thus put themselves in risky situations.
    If free helmets were given out by the police and every bike sales had to include them (including second hand ones with free vouchers redeemable at stores) but not obligated in wearing then they would become universal and then there would be proof if they work or not. I think that fundamentally this would put cycle safety on the agenda and give a defence against careless motorists the real cause. Thus bringing true safety in the end.

    • Great article. Very true. Good to engage in helmet debates on the rare occasion to keep the little grey cells alive though. 😉

      To Markus: “If free helmets were given out by the police and every bike sales had to include them (including second hand ones with free vouchers redeemable at stores) but not obligated in wearing then they would become universal and then there would be proof if they work or not.”
      This happened here in NZ. The wearing rate since the helmet law in 1994 has been around 95%. Proof of the outcomes? Not good: http://rdrf.org.uk/2013/12/17/the-effects-of-new-zealands-cycle-helmet-law/

      • Now I read the article, it is complex and there can be other factors that led to more accidents, for example an increase in numbers of car drivers which is the corollary of a reduction in cyclists as for many time is a significant matter and – if I have to hunt around for a helmet and take it off in a bank I need a bag for it then I won’t bother cycling I’ll drive – type attitude. Whatever the reasons it looks like bad overall policy for health to mandate helmet wearing for cyclists.

    • Markus, there is evidence, the famous Ian Walker/University of Bath study that finds drivers actually take less care around cyclists who wear helmets, it’s something I’ve noticed and is one of the reasons I choose not to wear one.

  10. Totally agree. Wearing a helmet makes you even more of a target to drivers than hi-vis clothing. Anyway, my ponytail comes before my structural integrity every time, so even there’s a 1% chance a helmet could save my sanity, I’ll continue to wear my Team Sky fishnet bib, my kevlar thong, my Dove-refined skin, and nowt else.

  11. I am a personal injury lawyer. I do cycle accident claims and work accident claims and many of my clients have suffered brain injury. Most of them were not actually cyclists, but nobody asks why we are not wearing helmets as car passengers!
    I agree 100% with the hierarchy of health and safety approach that you take in your blog. If you are a press operator you are at risk of having your hands crushed from the machine. Employers cannot blame the operator if his hand accidentally gets caught by the press, the employer has to ensure that the machine concerned has guards and other safety measures in place, such as sensors, to PREVENT the hand of the operator from getting crushed, in other words the danger is engineered out of the situation. . Personal Protective Equipment is only ever the very last thing to put in place if the risk of injury has not been reduced to an acceptable level or eliminated.

  12. I have studied the issue extensively. I agree with almost your entire take except for the fact that if helmets would prevent the vast majority of serious injuries and deaths related to cycling, I would support them. The fact is that the majority of serious injuries and deaths would NOT be prevented by a helmet. The statistics show this to be true.

    Knowing this, we should be very wary of even letting people think that helmets serve a purpose which they do not serve. They also suck the air out of the room (as you said) and are a tremendous distraction to real safety.

    The only reason we are still having the helmet debate is because so many people, without knowing anything of how useless helmets actually are, have voluntarily worn them. This created a market and a perception that helmets have some merit.

    Now, cyclist, many of whom choose to wear helmets are fighting AGAINST mandatory helmet laws instead of working for safety features that actually work like a better built environment.

    As you admitted, mandatory helmet laws (MHL) are toxic to discussions of cycling. They take a really safe and fun activity and create an extreme sense of danger that we only face while walking and showering (both activities which rack up waaay more serious head injuries than cycling).

    If the edge of debate is “letting people make their own decisions” then we’ll continue to “find the middle” in some kind of helmet law or at least helmet promotion.

    Thus, I challenge the status quo and push the debate all the way to its logical end. HELMETS DO FAR, FAR, FAR MORE HARM THAN GOOD IN CYCLING. Promoting helmets as any kind of safety feature is malpractice kind of like replacing modern surgery with witchcraft. The exception is racing and mountain biking which I know nothing about and am not concerned with. Since I know how useless modern bicycle helmets are, if I have to wear a bicycle helmet to do something, I’d probably opt out just as millions are opting out of cycling.

    Thanks for pushing back at the helmet nonsense. Every time I give facts, figures, and logical analysis the opposition has personal stories, idle speculation, moronic phrases, and of course name calling.

  13. Pingback: The Dutch Solution | Gillies

  14. Humans are basically lazy, & having to wear a helmet will make no difference to most people. Just look at your local shopping centres, if there is no parking close by, the shops die. People don’t ride bicycles because it takes a bit of physical effort.
    Pick your study to support your stance on bicycle helmets, there are enough for & against in this largely circular discussion & in the end it always comes back to the compulsion, not the actual benefit / inconvenience.
    However, the argument for physical infrastructure & the education of motorists & cyclists should be a paramount consideration. Here in Australia we are starting to see cyclists riding with a motorists attitudes.

  15. Pingback: One activity can have different forms | As Easy As Riding A Bike

  16. In my opinion, there is another point to never place using cycle helmets in an order. If you are a teenager, being took up by the police should only happen if you do something REALLY wrong. If that happens to normal children doing normal things, they will begin to see the police and the government as their enemy.

    So, the question is, should the police stop teenager in mid-summer on their bicycles on the way to the next lake, only because the only wear bathers? Should such a superb summer-holiday event converted in a crime?

    Finally, ALL ways of muscle-driven movement have to be without orders for self protecting forever. Otherwise cycle helmets would be only the beginning and insurances with good lobbyists will force helmets for retired persons as next thing “without any alternative”.

    PS: Sorry for my bad english. I’m writing from germany, but unfortunately we have the same debate.

  17. The important point is really: “Problems arise when people start conflating helmet use as a public health issue or helmet use as a private safety issue.”

    You cannot emphasise that enough, and it’s something that always goes wrong in helmet debates. On a personal level, there are many good argument both for and against wearing a helmet in the individual situation, but for a public health policy decision, personal anecdotes and individual cases are simply not sufficient. You have to look at the side effects such legislation would have, and balance that with the positive effects on society.

    We should really all just remember this point and make clear in debates whether we are talking about personal safety or public health policy, and clearly separate the two.

  18. This is one of the best pieces I have seen on the topic of cycle helmet use/legislation – much more informed and far better written than the nonsense spouted by Mr and Mrs Cracknell in their columns.

    I am one of those cyclists who has been “dragged down into a pointless argument”, in my case with an A&E doctor who thinks that his anecdotal “evidence” of crash victims is grounds for helmet legislation. However, after reading your article, and particularly the Hierarchy of Control diagram, I’ll be much better prepared next time this topic comes up.

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