Category Archives: Helmet Law

Official misrepresentation of Australia’s bicycle helmet law

Abstract

The helmet law has failed to achieve its stated goal of reducing the cost of cycling injuries.
Several government agencies have 
obfuscated this disappointing result through misrepresentation.

The information below is an extract from CRAG submission to the Prime Minister in 2009.
Following this submission, the federal government abandoned its policy of supporting compulsory bicycle helmets.

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Federal authorities’ commitment to compulsory wearing of bicycle helmets has never wavered since 1984 and excessive assurances of its value have continued. Although federal authorities knew of the deficiencies of helmets that Corner et al. had found, they pressed the states and territories to pass laws for compulsory wearing. The federal minister threatened to seek reimbursement of funds in the event of non-compliance and he dismissed his South Australian counterpart’s reservations, arguing that permanent brain injury would be prevented.[17],[18]Federal authorities also criticised an exemption which the Northern Territory granted for adults on cycle paths[19],[20], but their main effort to uphold compulsory wearing was directed to Western Australia.

Western Australia [162-63]

Opposition to compulsory wearing of helmets was strongest far from Canberra, Western Australia being the last state to legislate, in 1992. Its Parliament’s Select Committee on Road Safety reviewed the application of the helmets law to adults in 1994. As this threatened the integrity of the national policy, the Federal Office of Road Safety made a submission which argued for upholding the law  FORS’s argument on the effects of compulsory wearing on fatalities and injuries, and the fall in rates of usage of bicycles is examined here.

Fatalities

FORS presented two graphs which purport to show the effect of compulsory wearing on bicycle fatalities. The first, Figure 1 (with data for 1994 and pedestrians added here), is misleading in not taking any account of the effect of the fall in usage.

Figure 1.  Road user fatalities, Australia (indexed to 1986)

Separate listing of fatalities to children and adults, as in Table 1, together with data from surveys showing declines in cycling post-law [162], makes it possible to correct for both the effects of reduced usage and the general improvement in road safety.

Table 1. Fatalities to road users, Australia 1989 – 1993

YearTotal road usersAdult          ChildPedestriansAdult         ChildBicyclistsAdult          Child
19892505           296428             7354               44
19902093           238344             7647               33
19911915           198292             5135               23
19921783           191297             5324               17
19931775           178284             4730               15
Change, 1989-93-29%         -40%-34%         -36%-44%          -66%

Source of data: FORS, 1997. Road Fatalities Australia: 1996 statistical summary.

The fall in fatalities to all cyclists from 1989 to 1993 can be explained as being the product of improved road safety and declines in cycling of 40 per cent by children and perhaps 20 per cent by adults; it is not evidence that the helmet laws reduced the risk of death. FORS also claimed that the reductions in head injuries and fatalities are far greater than the decline in cycling, but this made no allowance for the general improvement in road safety; the claim is irrelevant.

Injuries

FORS stated that helmets have little or no effect on injuries other than to the head, but this discounted the possibility, well known at the time, that wearing one could change behaviour and the risk of accident. Decreases in head injury in some states were cited, but with no allowance for improved road safety or the declines in cycling. According to FORS, reduction in head injury is the best measure of compulsory wearing, but this highlighted its failure to understand the real problem, namely, how to protect from brain damage and consequent death or chronic disability, not from minor trauma.

For Victoria, FORS noted that in the first year after helmets became compulsory, cyclists’ claims on the Transport Accident Commission (TAC) for head injuries decreased by 51 per cent compared to a fall of 24 per cent in non-head injuries. In the second year, the respective decreases were 70 per cent and 28 per cent. FORS said that Lane and McDermott (1993) ascribed the difference to increased helmet wearing. As the difference would seem to be unaffected by the general improvement in road safety or declines in cycling, it might appear to be persuasive evidence of the efficacy of helmets – until inquiries to the TAC revealed a similar trend for pedestrians. This is shown in Figure 2, the vertical line showing the start of the helmets law. Again, it would appear that the cause of the decline in the risk of head injury was changes in other conditions, not helmets.

Figure 2.  Per cent head injury, of accepted TAC no-fault claims, Victoria

Source of data: Transport Accident Commission, pers. comm. 1.12.95.

 

Usage

FORS discussed the fall in bicycle usage as shown by survey data from Victoria, NSW and Western Australia. For all three states, the declines in cycling that followed the helmet laws were underestimated and similar declines pre-law to post-law which had been measured in Queensland, the ACT and the Northern Territory were disregarded. FORS argued that reductions shown in surveys are not a proven result of helmet laws, which could only be found from much bigger surveys or over a longer time. “Unfortunately, long term data is not available”, it said, but it is government, not fortune, that was to blame for that. It was known in 1985 that cycling had declined when private schools compelled students to wear helmets[21], but FORS’s advice to its Minister on the compulsory helmets proposal did not mention this or the need for monitoring.[22]

Monograph 19

FORS’s Monograph 19 (1997) makes three arguments. The first is that compulsory helmets resulted in serious casualties to cyclists declining by more (33 cent) than all road users (23 per cent), from the 4 years “prior to compulsory wearing” (1987-1990) to the 4 years after (1993-1996), but if 1989, the last year before any helmet laws, is compared with 1993, the first year when all were in force, the respective declines are 31 per cent and 25 per cent, much less different. FORS says use of a 4 year period allows evening out of random variations from year to year, but the argument is specious because the numbers in each year exceed 1000. (By contrast, FORS’s submission to the review of the law in Western Australia, discussed above, claimed a reduction in fatalities by using numbers of less than 200.) Also, it is wrong to include 1990 in the base period because the helmets law came into effect in Victoria mid-year. As casualties to all road users in 1990 were 13 per cent below 1989, those to cyclists being unchanged, this results in further over-statement of the difference in the declines in the two groups from pre- to post-law. Also, FORS disregards the decline in numbers of cyclists. Taking this into account, it is clear that cyclists became worse off compared to other road users [164].

Second, FORS states that helmet wearing rates, as measured from casualty crashes, are negatively correlated with deaths and casualties to cyclists, but it provides no details of statistics or sources. The meaning of the claim is not clear and it is at odds with data on wearing rates of casualties [166].

Third, FORS finds from pooled data for 1988, 1990, 1992 and 1994 from its Fatality File that known wearers of helmets suffered fewer severe head injuries on average than non-wearers. It concludes that the absence of a helmet significantly increased the number of severe injuries by up to 21 cent. It is not clear that the finding has any clinical importance, it not being shown that the number of head injuries was related to fatality, nor even stated that head injury was the cause of death, and the data are confused by a change in coding practice by which multiple injury to a single region of the body was coded as multiple in 1990 but under that region in 1992.[23]Also, the data span a great increase in the wearing of helmets after compulsion, and a change in the standard. In 1988, hard shells were required, but from 1990 cyclists were able to wear soft helmets. A more apt description of FORS’s pooling of data is jumbling together and obscuring the important trends that are shown in Table 3 [165].

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Why did the injury rate triple after the helmet law?

Abstract

The injury rate has tripled since the helmet law.
By increasing the risk of accidents, helmets have made cycling more dangerous.
Wearing a helmet can make us feel safer. However feeling safe is different than being safe.

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A recent study reveals a steady increase in cycling injuries in New South Wales (NSW), Australia, after the helmet law. Between 1991 and 2000, cycling injuries increased sharply.

cycling_injuries
A 1996 cycling survey in Sydney revealed that cycling counts were 48% below 1991. According to the census, cycling in Sydney further decreased between 1996 and 2001. sydney_cycling_counts After adjusting for the number of injuries per number of cyclist, the injury rate is shown below:

cycling_injury_rate
A decade after the helmet law, the injury rate tripled, indicating a large increase in accidents.

Why did the injury rate triple?

How can the widespread wearing of a device that protects the head result in almost a 3 time increase in the risk of head injury? There are several reasons for this unexpected result.

Safety in numbers

There is a well-known phenomenon called safety in numbers. Research published in the Injury Prevention journal concluded:

“the behavior of motorists controls the likelihood of collisions with people walking and bicycling. It appears that motorists adjust their behavior in the presence of people walking and bicycling … A motorist is less likely to collide with a person walking and bicycling if more people walk or bicycle. Policies that increase the numbers of people walking and bicycling appear to be an effective route to improving the safety of people walking and bicycling.”

safety_in_numbers_6A key factor for cycling safety is the number of cyclists. This is “safety in numbers”. The fewer cyclists, the more dangerous cycling becomes.

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The “safety in numbers” effect has been measured. The 48% decline in cycling observed corresponds to an increase in risk by 48%.

Risk Compensation

A false sense of safety can induce people to take more risks, leading to more accidents and more injuries. This is risk compensation, a well-known safety factor:

“the law of unintended consequences is extraordinarily applicable when talking about safety innovations. Sometimes things intended to make us safer may not make any improvement at all to our overall safety”

risk-compensation

Risk compensation is the tendency to take more risks when wearing safety equipment.
Lured by a false sense of safety, helmeted cyclists take more risks and have more accidents.
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Wearing a helmet can induce cyclists to take more risks, as reported in the New York Times:

the rate of head injuries per active cyclist has increased 51 percent just as bicycle helmets have become widespread. …

the increased use of bike helmets may have had an unintended consequence: riders may feel an inflated sense of security and take more risks. …

The helmet he was wearing did not protect his neck; he was paralyzed from the neck down. …

”It didn’t cross my mind that this could happen,” said Philip, now 17.
”I definitely felt safe. I wouldn’t do something like that without a helmet.” ”

Safety experts recognise the role of risk compensation. From the New York Times article:

”People tend to engage in risky behavior when they are protected,” he said. ”It’s a ubiquitous human trait.”

Even cyclists who discount the daredevil effect admit that they may ride faster on more dangerous streets when they are wearing their helmets.

1989 study found that helmet wearers were 7 times more likely to have accidents.

Risk compensation also affects motorists who tend to be less careful around helmeted cyclists. As reported in a study published by the University of Bath in the UK:

“Bicyclists who wear protective helmets are more likely to be struck by passing vehicles”

Both the behaviour of helmeted cyclists and surrounding motorists increase the risk of accidents.

Cycling injuries have kept rising throughout the 1990’s. This coincided with helmet promotion campaigns exaggerating the benefits of helmets. This may have given cyclists a false sense of safety.

Degrading the bicycle helmet standard

Before the helmet law, Australia’s bicycle helmet standard required hard shells. Government research warned of deficiencies in the standard, as helmets can increase brain injury.

The research recommended improvement to the standard. Instead, the government degraded Australia’s helmet standard to accommodate ”soft-shell helmets”. Soft-shell helmets are more comfortable and facilitate compulsory helmet wearing. However they provide little protection and can cause brain injury.

hard-shell-vs-soft-shell-helmet By degrading the helmet standard, the government legitimized a weaker helmet. Calling a polystyrene hat a “helmet” doesn’t give it protective abilities. Still, it can fool people into believing that it provides more protection than it does. This is likely to have contributed to the increase in head injuries after the helmet law.

Discouraging the safer cyclists

Following the helmet law, many cyclists who used a bicycle for transport gave up cycling. Transport cyclists have fewer injuries than sport cyclists. The increase in injuries after the helmet law can in part be explained by a reduction in transport cycling. However, the reduction in transport cycling cannot have quadrupled the injury rate.

Summary

The injury rate has tripled since the helmet law. This is most likely due to:
  1. safety in numbers: the risk of accidents increased as there were fewer cyclists.
  2. risk compensation: helmeted cyclists lured into a false sense of safety, taking more risks.
  3. Degrading the helmet standard to include polystyrene “helmets” that provide little protection.
  4. The safer cyclists stopped cycling.

But wait, the study claims the helmet law was a success!

Despite the large increase in head injuries, the study claims:

“the benefit of MHL to lowering head injuries”

How can the study make such a claim?

  1. It ignored the decrease in cycling measured by cycling surveys.
  2. It ignored the increase in injuries.

This study is like doing a cost benefit analysis while ignoring the costs and exaggerating the benefits.

This “study” was commissioned by a government struggling to justify its policy. Bureaucrats quote this study claiming:

“A recent study from the University of New South Wales showed that the initial benefits of the mandatory helmet laws have been maintained over time.”

What?

Do they think we are complete fools?

This study did not fool a reporter:

As the fallout from Australia’s failed bike sharing schemes continues, it seems we haven’t seen the last of government-funded research showing that helmet laws are great actually, thanks very much. …

The authors, Olivier, Walter and Grzebieta, previously published a paper in 2011 claiming to “end the debate about the effectiveness of cycle helmet legislation”, but which was severely criticised by fellow boffins

the government of NSW has commissioned research which (surprise!) finds the effect of their helmet law is massive and sustained, ignoring the uncomfortable fact that helmet wearing rates have actually fallen back significantly without any accompanying jump in head injuries. The authors …  include all types of minor flesh wounds, bruising etc. which you would certainly hope would be prevented by helmet use, rather than looking at a reduction of critical injury / death which is what public health policy should be worrying about, when the alternative is serious sedentary disease. It’s generated some nice headlines and superficial reinforcement for the helmet law (which is probably what the government were really trying to commission).

Such a “study” helps bureaucrats deny they made a mistake.

How does that serve the public?

The fundamental role of science is to serve the truth. It is NOT to serve the interests of the state.

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Federal government abandons compulsory helmets policy

The Federal Government instigated in 1989 the nationwide policy of compulsion to wear a helmet, by offering ‘black spot’ funding for roads to the states and territories. All complied by 1992.

In 2009, CRAG made a comprehensive submission to the Prime Minister calling for the Government’s policy on helmets to be based on sound evidence of their efficacy. We (CRAG) said that the prime need was to protect the brain, the main site of fatal and disabling head injury, but that research had shown a potential for helmets to aggravate it.

We also pointed out that cycling declined sharply after helmets became compulsory. Benefits of the exercise for health were lost, but the risk of serious casualty, including fatal head injury, increased compared to other road users. As the policy had failed to serve its purpose, we called for corrective action.

The PM did not directly reply to our submission. Instead, the Federal Government quietly abandoned the policy later in 2009, stating in a letter to CRAG:

“Please note that helmet wearing policies are entirely determined at a state and territory government level and not linked to federally administered black spot funding”.

Despite being the instigator of this policy, the federal government has now disowned it, and refuses to take responsibility to fix it.

The federal government remains responsible for the mandatory standard for helmets. It is supposed to guarantee the efficacy and safety of helmets, but it does not. The standard does not contain a test for rotational acceleration, that would assess whether helmets can aggravate brain injury.

We in CRAG are working to press the Federal Government on the mandatory standard.

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Political parties supporting cycling

In Australia, the Liberal Democratic Party supports cycling through its policy opposing victimless “crimes”. It states about the bicycle helmet law:

Mandatory bicycle helmets – not only are such laws offensive to liberty, but they do not achieve their aim.

You may not be able to vote for the Liberal Democratic Party for the parliament (local Member of Parliament), but you can vote for the Liberal Democratic Party in most states for the senate.

In Western Australia, the Democrats support the decrimilisation of cycling without a polystyrene hat. You can vote for the WA democrats in the senate.

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Canada: helmet laws have made little difference to head injuries

A recent Canadian study found that bicycle helmet laws had little effect on head injuries. The study analysed 14 years of data, comparing provinces with and without helmet laws. Unlike other studies in this field, it attempts to remove the effect of confounding factors by controlling for background trends and modelling head injuries as a proportion of all cycling injuries. It concludes:

the incremental contribution of provincial helmet legislation to reduce the number of hospital admissions for head injuries is uncertain to some extent, but seems to have been minimal.

This study has been reported here:

“(the study) analyzed the rate of cycling-related hospital admissions for head injuries across the country between 1994 and 2008 — an enormous research sample of more than 66,000 people…

What they found initially seemed to suggest that this legislation improved public safety…

But upon closer inspection, according to Dennis and company, this positive effect failed to stand. On the contrary, the researchers concluded that head injuries were decreasing across the country at a rate that wasn’t “appreciably altered” by the new helmet laws. Other rider health initiatives — namely, public safety campaigns and the introduction of better bike infrastructure — rendered the contribution of helmet laws “minimal” …

Mandatory helmet laws, meanwhile, may discourage riding to the point where public safety as a whole suffers from the relative decrease in physical exercise.”

The effect is consistent with an analysis of cycling fatalities in Canada, that concludes:

It is apparent that mass helmet use is not contributing to the reduction in cyclist fatalities, at least not in any measurable way. The results suggest that traffic authorities should refocus to put their efforts into other proven measures.

The study contradicts other studies that had claimed a benefit from helmet legislation in Canada. However, many of these studies have serious methodological flaws rendering their claims invalid. Often, such studies are done by helmet advocates keen to “prove” their beliefs, with a disturbing lack of scientific discipline.

This has led Ben Goldacre, an epidemiologist, to provide an insightful overview of the challenges of evaluating the effectiveness of helmet legislation:

Standing over all this methodological complexity is a layer of politics, culture, and psychology. Supporters of helmets often tell vivid stories about someone they knew, or heard of, who was apparently saved from severe head injury by a helmet. Risks and benefits may be exaggerated or discounted depending on the emotional response to the idea of a helmet. For others, this is an explicitly political matter, where an emphasis on helmets reflects a seductively individualistic approach to risk management (or even “victim blaming”) while the real gains lie elsewhere. It is certainly true that in many countries, such as Denmark and the Netherlands, cyclists have low injury rates, even though rates of cycling are high and almost no cyclists wear helmets. This seems to be achieved through interventions such as good infrastructure; stronger legislation to protect cyclists; and a culture of cycling as a popular, routine, non-sporty, non-risky behaviour.

Helmet laws are ineffective compared to other safety measures. As the safest cycling countries demonstrate, other measures are far more effective to reduce injuries. Helmet laws seem to contribute little to safety, while reducing cycling and taking the focus away from more effective measures.

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History of helmet law in the US

Opinion

Here are the reflections and impressions of a US resident who has observed the emergence of bicycle helmets in the United States over the last 40 years. While many of these observations cannot be confirmed without dedicated investigative journalism, they are informed by decades of attention to news articles, bicycling publications, bike organization policies, plus conversations and other interaction with helmet lobbyists.

Frank Krygowski is a retired professor of Engineering Technology, and a lifetime commuting, utility, recreational and touring cyclist.  He is active in cycling advocacy on the local, state and national levels.

 

Personally, I think U.S. helmet laws arise from a combination of factors. Here’s my completely undocumented impression of the history of bike helmets in the U.S.:

  1. First, we had a culture in which there is no history or tradition of bicycling. Until the 1970s people thought bikes were only for kids. Very few adults rode at all, and only an infinitesmal number rode for utility or for sport.
  2. Second, we had a big bike boom in the 1970s. Suddenly there was a huge upsurge in novice riders, most of whom knew very little about cycling, and (worse) did not realize there was anything to learn.
  3. Third, some very opportunistic companies – primarily Bell Sports – realized that there was a market among all these new, easily-misled bike riders for a high-profit special hat. (And seriously, people do have an immense psychological urge to wear special hats! Gardeners, sailors, cowboys, baseball fans, military personnel, fishermen and countless others revel in their own stylish and “useful” headgear.)

Bell began a campaign of misinformation, claiming that any bike rider could easily fall at any time, then suffer a truly debilitating brain injury; and that therefore, smart cyclists always wore helmets. There was never any consideration of whether this possibility was at all common, or worse than for other common activities. Bell backed this effort up with very slick and generous ads in low-profit-margin bike magazines, plus (I’m guessing) some back room politicking.

Soon bike magazines showed fewer and fewer photos of bareheaded riders, giving the impression that any “serious” (e.g. club or racing) cyclist always wore a helmet. About this time, “Always wear a helmet” became the first rule of bicycle safety.

This gave Bell some decent profits. But eventually (due to a change in management, I believe) things suddenly pushed further. Bell produced a helmet not for enthusiasts, but for kids, and increased the “danger! danger!” hype. And critically, Bell began donating heavily to Safe Kids Inc., with (doubtlessly) more back room politicking. This was the real genesis of mandatory helmet laws for kids. The national Safe Kids organization began working to convince local chapters, parents and lawmakers that riding bikes (and any other wheeled toy) was as dangerous as juggling chainsaws. “If only one child can be saved…” became a battle cry.

I think this is what caused the surge in statewide MHLs through the 1990s. Since then, things have cooled off quite a bit in the U.S. Most helmet laws are not really enforced, from what I observe. Safe Kids has – for whatever reason – made car seats their prime issue instead of bike helmets (although of course, they still call for bike helmet use). Now we seem to deal with only two factors:

  1. One factor is a cadre of do-gooders left over from the 1990s who have made helmet promotion one of their life’s guiding principles. Randy Swart is probably the prime example, but I suspect most American bike clubs have one or more local examples. These people will probably never admit that they wasted their time on a counterproductive effort. Data will mean nothing to them.
  2. Another factor is that the efforts of Bell, Safe Kids and the do-gooders have worked, in that a very large number of Americans really do believe that a simple bike ride imposes a huge risk of serious brain injury. Oddly, this impression seems greater in higher-income areas, where the little suburban princes and princesses must be guaranteed to rise to their highest creative and earning potential. I suspect, though, that this population can be swayed by data, logic and fashion. This is a group that might eventually be convinced that ordinary bicycling is not dangerous, and has benefits that greatly outweigh it’s tiny risks. Even without a special hat.
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