Evidence That Bike Helmet Laws Don't Help Rider Safety
citylab.com
citylab.com
1. Helmets are very very useful if you're riding fast. In fact they are mandatory in all cycling sports. However most people don't commute to work going much faster than they would if running, hence they are not very useful for them.
2. In countries where helmets are compulsory, the chilling effect of risking a fine for not wearing a helmet has meant a decrease in the number of cyclists. Now, since bike accidents are relatively rare, but the health effects of cycling to work rather than driving benefit every single cyclist, helmet laws tend to have a negative effect on public health.
This said, whenever I'm going for a sporty ride (longer, or faster than usual) I usually wear a helmet. When riding 5 minutes to meet a friend for a beer I don't.
I can't find a reference with a short Googling, but as I recall helmets only help in a fairly narrow window, something like 18-23 mph or so. If one's going sufficiently fast, they're unable to do much good (because the forces are too much for a flimsy assembly of foam and plastic to reduce enough to prevent injury or death).
> In fact they are mandatory in all cycling sports.
They're the equivalent of a elephant-repelling rock.
I'd really like a citation on that. I'm into motorcycles and while helmet design is different, every motoGP season has plenty of examples of riders tumbling at +100kph and walking away after.
You could likely make the argument that over a certain speed your other body parts will sustain large enough injuries for the bike helmet to not matter, but that's not what you're arguing, you're arguing that the bike helmet itself stops working at an extremely low speed of 23 MpH or above.
I actually Googled this a bit. Cannot find anything on it.
It indicates that helmets in the U.S. are only tested for 14 mph impacts.
It's not that the helmet stops working altogether, it's that the helmet's protection really isn't sufficient. It'd be better to wear a full-face motorcycle helmet, but of course that'd be miserable on a bike.
If your torso hits a solid object at 30mph, there's about ~50% chance you'll rupture your aorta[1]. Hit something like a narrow signpost pole at 30mph and you'll be in a whole world of trouble - I'd post a link to a thread on a motorcycle forum, but it's a bit grisly. Guy survived, but he had to be opened up to treat the internal injuries.
Motorcycle helmets have mostly the same minimal impact requirements of preventing brain injury from the vertical component, but also need plenty of abrasion resistance.
[1] I heard this on London Met police BikeSafe day, a day-long course where London police do a presentation to motorcycle riders and go on an ride with a police observer. But for specific reference, see http://www.nhtsa.gov/people/injury/research/pub/HS809012.htm... - "UK Department of Transport Traffic Advisory Leaflet 7/93 (TAU, 1993), figures quoted are, for 20 mph impact speeds: 5 percent death, 65 percent injured, and 30 percent uninjured; for 30 mph impact speeds: 45 percent death, 50 percent injured, and 5 percent uninjured"
I really don't understand all these "helmets don't help" folks, having ridden motorcycles and bikes all my life you would not catch me dead without a helmet: a helmet is not an invulnerability cloak but in the end if you fall down and hit your head and you don't have one, you are not going to be in a good place, whether you are going at walking speed or 30mph.
I have no idea if its true or not.
I'm not saying helmets don't work, I'm saying it's not very likely to hit your head at high velocity on the ground if you were going 10 km/h. And if that means you're not gonna ride a bike at all because you forgot your helmet you're probably having a higher risk of cardiovascular disease further down the line than you have of breaking your head now.
Head injuries are nothing to take lightly.
Because bikes constrain falls. Millions of years of evolution plus my own personal practice means I'm pretty good at falling safely. But when I am wrapped around a bike, a lot of that goes out of the window.
Also, I'd like to see some stats on your "not very likely". In 20 years of adult riding, I've fallen twice at low speeds hard enough to crack a helmet. And that's not counting the time as a kid I knocked myself unconscious on a low-speed ride.
> because you forgot your helmet
Is this a problem people have? When I'm not riding, I clip my helmet to my bike. This doesn't strike me as a particularly challenging habit to develop. Maybe just keep necessary equipment together? That sounds easier than trying to decide whether the odds are small enough to risk traumatic brain injury.
And in 28 years of both adult and kid riding, with some years totaling over 3000 km, I've fallen several times, even cracked a couple of ribs, but never once hit my head. See that's the problem with anecdotal evidence.
> I clip my helmet to my bike
Do that in Rome, you'll come back to find none.
I'm not the one who said "not very likely". I'm not offering my story as evidence, just as an explanation for why I'd like evidence.
> Do that in Rome, you'll come back to find none.
I was speaking of the "I am going riding now" case. In Rome can you leave your bike outside overnight? In SF you can't, so people store bikes and helmets indoors. In which case, I'd submit that storing them together is a pretty good idea.
Helmet theft might be a problem here in the "I am already out riding" case. Where I worry about that here, I clip my bike to my bag, so again it's not a "I forgot my helmet" problem.
Because if you fall over while walking, you're likely to manage to get your hands down before you head hits the ground. You have nothing to lose by getting your hands down quick.
By contrast, when you run into problems while cycling, your instinct is to try and regain control of the bike. You don't immediately drop the handlebars, You keep your hands on the bars and try to steer/brake. Moreover you're likely to go over sideways and only one hand tends to be able to break the fall.
A fall from a bike and a fall from your feet is a massively different thing.
I'm not sure whether helmets really work, and just to be on the safe side I almost always wear one, but I seem to remember one European biking site -- possibly mentioned here in HN... I forget -- where the author argued that helmets are designed to crack so that it seems they work. But, he argued, whether they crack or not bears no relation to protecting from head injuries; the crack simply leaves you satisfied that the helmet "saved" your life.
The article seemed convincing. Sadly I cannot remember where I read it.
This is also why you should replace helmets after a fall and every few years since the material they are made of degrades with age.
http://www.cyclehelmets.org/1209.html
> "It's not a simple matter to draw conclusions about the benefit a broken or deformed helmet might have provided in a crash. However, the fact that serious injury to unhelmeted cyclists is as rare as helmet damage is common, suggests that most of the claims of benefit from damaged helmets are likely to be exaggerated."
> "The next time you see a broken helmet, suspend belief and do the most basic check – disregard the breakages and look to see if what's left of the styrofoam has compressed. If it hasn't, you can be reasonably sure that it hasn't saved anyone's life."
The point seems to be that anecdotes of the type "my helmet worked and saved my life, see? It's cracked" are not conclusive.
Cracking, in this case, is the expected failure model, since the material has to be hard to provide a sliding surface.
Helmets should not be re-used after a crash.
http://www.bhsi.org/ideal.htm point 5 - outer shell
The study persuades me not at all for a few reasons. 1) it's Canada, 2) it's all of Canada, and 3) it's only in-patient hospital stays.
I'm biking in a US urban area. I know that Canada's automotive death rates are lower, and I'm happy to believe that's due both to Canada's famed niceness and to a more European attitude toward infrastructure. I might also not bother with a helmet tootling along some leafy Canadian rural road, but when dealing with California's drivers in an environment that's mostly cement and metal, thanks, I'll take the helmet.
I also get the theory that in-patient hospital stays might be a good index to help decide the public benefit of helmet laws. But I don't think my helmet kept me from two hospital stays. I think it kept me from two concussions. Given the long-term cognitive effects of even nominally mild brain injury, I'm again sticking with the helmet. Those here who think themselves so smart that a) this study proves it for them, or b) they have smarts to burn are welcome to go without.
I subscribe to the above reasoning. A population may be healthier if not compelled to wear helmets when cycling. But for me, I never ride without one. Ever. Short trips, long trips, commutes to work. I have mine with me now.
Also you might not buy it, but the data is out there…
30% fewer cyclists in NZ and Australia
I just ride bikes when it's convenient: there's a pretty good public transport network around my city, you can walk short distances, and car traffic is also reasonable; biking supplements these three options very nicely, esp. now that there's a bike-sharing thing in the city (unlock a bike via an app, ride it wherever, lock it via the app again, minimal fuss). Lugging a helmet around, just in case I should decide to use a bike, is rather inconvenient (I tried). If there were a mandatory helmet law, it would certainly increase the gap between "casual rider" and "dedicated bicyclist," driving out people like me.
(OTOH, if I'm on a bike trip, I do have my helmet, as I usually go beyond paved streets, longer distances and probably higher speeds. Different tools for different purposes.)
TL;DR: assuming "bicycling requires dedication" reduces ridership by definition.
In Copenhagen, where everyone rides bikes (young, old, hipster, business guy, dad, child - not only "dedicated riders"), there are plenty who would bike less by simply dropping some bike rides if they choice was between bike+helmet and eg. walking, bussing or cardriving.
"[Bike lanes] has dual advantages, both reducing injuries and encouraging cycling, an important public health goal of its own given the physical activity and environmental benefits. Comparisons between North America and the Netherlands or Denmark have long suggested that their route design focus is better at welcoming cycling and achieving lower injury rates. Many were concerned that Dutch and Danish infrastructure wouldn't have the same impact here, but there is more and more research in North America showing that it does."
E.g. around here there are some advance cycle stop zones and advance green lights for cyclists. Both are easy to implement but make a big difference to a cyclist's safety and visibility at a junction.
Also: when you're older your bones will take much less abuse before they break than when you're younger so be more careful when you get older.
Helmets on bikes: if it makes you feel better: wear one. Don't make them compulsory because the statistics are not clear-cut that wearing a helmet is a good thing in more than 50% of the cases. For kids, probably better, if you're in-experienced or insecure, probably better. If you're an adult, know your bike and you're not going for some kind of record you should have the option to cycle without.
edit: tl;dr for you obviously, but ~200 people died over 8 years in NYC. Where helmet use was noted in the police report (~ half), 97% of fatal accidents involved people not wearing helmets. Someone else can do the Bayes' numbers but it's pretty obvious. Anyway, I support bike lanes and oppose helmet laws. But I wear a helmet.
In absence of bike-lanes a helmet probably makes sense. What also really helps is to educate drivers and to shift responsibility to the drivers of cars in car-bike collisions. If there was one factor that made bike riding safer here in NL then I'd point at that one rather than bike lanes or helmets.
People are simply much more careful around bikes.
one pleasant side effect is you'll be walking down the hall at the office and be thinking "i can totally do a series of judo rolls and move along quicker"
So from personal experience: breaking your fall really helps, also in bicycle falls. Can you describe the way you've fallen?
This really helped me out once. I hit a patch of black ice on a badly maintained bike path while going pretty fast. I took off flying while the bike slid along the ground. My training took over, time expanded, and I had what felt like a full minute to rehearse how I would hit the ground. When I landed, I landed on ice and slid about 10 more feet. I got up with mild bruises. The bike was not so lucky --- when I picked it up I saw ball-bearings rolling around on the ground. Then I realized that one of my pedals had been ripped off the crank. Falling is far and away the most useful thing I got from martial arts training.
For what it's worth, I was wearing a helmet. It didn't strike the ground. I still wear a helmet.
You are higher up, have less stability, and as good as you are you don't control many types of collisions (negligent/distracted drivers). It only takes a very minor fall and some bad luck to end up with brain swelling, cracked skull, or a corpse.
Here is a helment advocacy group's take with links to relevant statistics, opposing views: http://www.bhsi.org/shouldi.htm
IIRC, the majority of injuries from cycling accidents are to the hands, arms and shoulders.
> I personally have cracked a helmet and walked away.
Which of course means nothing regarding whether you would have injured your brain. Our hair, scalps and skulls are remarkably good at protecting our brains.
> as good as you are you don't control many types of collisions (negligent/distracted drivers)
True enough, and of course a strike from a two-ton vehicle travelling 20 mph faster than one will impart far more force on one's body than a strike of a 180-pound body travelling at 18 mph will impart on the road.
Helmets are nothing more than magical safety hats; they're placebos; they're a triumph of marketing and emotion over reason and sense. If you wear a bicycle helmet, then logically you should wear a driving helmet, a walking helmet and a sleeping helmet.
Even so, I would rather have a cracked helmet than a cracked skull.
For everyone else, I think it's worth contemplating the statistics I linked to from NYC:
* Almost three-quarters of fatal crashes (74%) involved a head injury.
* Nearly all bicyclists who died (97%) were not wearing a helmet.Not when that is made illegal.
> Almost three-quarters of fatal crashes (74%) involved a head injury.
That's unsurprising, particularly if 'head injury' includes a broken neck; people rarely die from broken wrists these days.
> Nearly all bicyclists who died (97%) were not wearing a helmet.
What percentage of bicyclists don't wear helmets? What percentage of bicyclists in accidents don't wear helmets? That's important.
And of course, what percentage of cyclists who died without helmets would have lived with them? That's the only number that counts, and every bit of research indicates that helmets only make a small improvement in survivability of certain crashes, while also increasing the rate of neck injuries and the rate of accidents in general.
Its clearly not enough. But what is? Its kind of like, you cycle, you sign up for the risk.
Life is risk and it is impossible to enjoy much of it if you're not prepared to take any risks.
What weirds me out is that it is always other people who wish to put limits on what kinds of risks one can take, after all, nobody stops them from wearing a helmet if they so desire and that should be all there is to it, but no, you too have to wear a helmet.
For anyone that has an interest in an informed opinion from someone that knows a small bit more about risk, please take a look at this Spiegelhalter paper: http://www.bmj.com/content/346/bmj.f3817.full?ijkey=I5vHBog6...
"It only takes a very minor fall and some bad luck to end up with brain swelling, cracked skull, or a corpse." I really don't believe that, you are just spreading fud, I have seen people fall but you must be pretty slow to react or go really pretty fast if you can't just put your arms in front of your head or step of a falling bike.
It's easy, never force people to wear a helmet, allow them to arrive at work with hair intact and without hassle, if you value a healthy population that enjoys bicycling (yes yes our views on that are probably the same).
[0] https://www.google.nl/search?q=typical+dutch+bike&source=lnm...
Edit: This video says you're 30 times more likely to be involved in an accident in the US than in the Netherlands: https://www.youtube.com/watch?v=m2THe_10dYs
As far as minor falls leading to death... hopefully an EMT/medical professional can jump in or someone else can offer statistics. I wish I had time to find links/data to show you how sadly and tragically incorrect that is (cycling or not).
I will repeat: I favor bike lanes and do not strongly favor helmet laws (even though I strongly favor their use).
edit: also, if anyone can find a way to quantify how many injuries helmets have prevented, it would be awesome. Everything I found involved autopsies/hospital reports/police reports... nothing where someone crashed and the helmet prevented further injury. Also hard to tell non-fatal effects from reported data (where a fall would have been a concussion otherwise, but was not because of a helment)
Happy to ride my anecdotal evidence all the way to the bank.
That strongly depends on your location.
One fell off a low bridge and the other was riding causally along and somehow ended up going over the bars and hitting her head on the curb.
Seeing just one of these was all the reason I needed to never ride without a helmet.
I wear a couple types depending on what sort of riding I'm doing (mountain, road, racing) they are MIPS equipped when ever available.
I do wear a helmet, even though it's a pain. Reading around I see a lot of sites claiming they are not effective, but it always seems to be secondary effects - like, cars will pass you more closely, or you will ride more riskily due to a false sense of security. Are there any studies on the actual safety record? Intuitively it seems like of course it will be better for you if you fall wearing a helmet - is this true?
Totally anecdotal story, but when I had my last major bike crash (20mph crash during a race), I went to the ER to get checked out. I probably didn't need to go; I knew I had a concussion and lots of abrasions (and know how to treat both). This proves nothing about the efficacy of wearing a helmet.
Keep at it though. It takes a few generations for culture and road architecture to change.
It's a safety measure. It doesn't preclude better infrastructure. Yes, there should be better cycling lanes. Many countries do exactly that whenever cycling is envisioned, they build better infrastructure. But you don't wear a seat belt because the roads have potholes, you wear them because they save your life and prevent injuries regardless of road conditions.
Is it really terrible that people have to wear a helmet? Of course the focus should be on better protecting bikes (they're vastly different types of vehicles), but I'm not shedding any tears over people who claim they will stop biking because helmets ruin their hair. It's simply a basic preservation of health.
Millions of others, bicycling day in day out, think the same way. They're not all dumb.
Because cycle helmets cost money which could be better spent on just about anything. Because they reduce the number of cyclists (which is the worst possible thing to do if one wants to make cycling safer). Because they look stupid. Because forcing people to wear them is flat-out illiberal and hence wrong.
> It's like advocating against the seat belt.
I wear my seat belt, but I advocate against seat belt laws.
> Is it really terrible that people have to wear a helmet?
Yes.
> I'm not shedding any tears over people who claim they will stop biking because helmets ruin their hair. It's simply a basic preservation of health.
Do you wear a walking helmet and a driving helmet too? Have you installed non-skid in your bathtub? Statistically, those measures are more effective than a cycling helmet.
Obviously as well, bike lanes are really important. It's not an either or situation. We can do both.
One statement: Bike helmet laws do not help rider safety. Another statement: If you, the individual, crash, then wearing a helmet can save your life.
These are not contradictory.
Did the author read the study? I can't find anyplace where it has any data about usage. In fact, the words "comply(iance)" or "usage" don't appear in the document once, in any context.
Also, it doesn't distinguish between those who always wear helmets and those who claim they use helmets at least half the time.
> Figure 2 presents the helmet use data in table 3 graphically and illustrates that helmet use was higher with helmet laws than without
"We therefore also examined the relationship between hospitalisation rates and helmet use proportions in the strata, and again did not find the expected protective effect"