Bike helmets

general

Those of you who cycle might be aware of the current debate about the merits of cycle helmets, and about whether they should be made compulsory. A couple of weeks ago, the BMA (British Medical Association) threw more mud in the water by voting — against many of their members' advice — in favour of compulsory helmet wearing by cyclists.

I'm in favour of compulsion in safety matters where there is a clear benefit of the safety measure (seatbelts in cars and motorcycle helmets, for example), but the evidence in favour of cycle helmets saving lives seems very contradictory at best. A few studies have concluded that helmets can provide protection, but only if they are worn correctly (most people wear them too far back on the head), and only in certain kinds of accidents. Other studies report that helmets can increase neck injuries by causing the head to rotate on impact, and some argue that cyclists ride take more risks when wearing a helmet because of a false sense of security.

It's also true that compulsory helmet use will almost certainly reduce the number of people who cycle — either because they think it makes them look stupid, or because it makes cycling look like a hazardous activity. This could negatively impact on health in two ways:

  1. Obesity is going to be one of the biggest killers in coming decades in this country. Fewer cyclists means more deaths through obesity-related causes, particularly among children.
  2. There are statistics floating around that suggest that accidents involving cyclists rise steeply as the average distance cycled per person per day decreases. So the weaker the culture of cycling, the shorter the trips that people make, and the risk for the hardy remainder (whether they are wearing helmets or not) increases.

In both cases, it's arguable that the extra deaths and injuries caused indirectly by helmet use would exceed the deaths and injuries that wearing a helmet might prevent. Personally, I wear a helmet, mostly because it makes me feel safer (despite the lack of evidence that it actually does make me any safer). The one time I had an accident involving a car, I suspect that the helmet did save me from a bit of concussion, but that was whacking the back of my head on the tarmac; I'm not sure that it would have been of any use if I had hit a car at high speed. Even though I wear one, I'm against compulsory use given the mixed evidence. I think it's up to individuals to make the decision.

Some sane and practical countries (Holland, France and Germany, among others) seem to manage to ride safely, comfortably and elegantly every day, wearing their normal clothes and shoes (no lycra), and no helmets, and they manage to survive quite well. All of this talk of helmets masks the fact that what we really need is better provision for cyclists (proper cycle lanes and priority for cyclists, as in the Netherlands), and more vigilance by drivers.

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