Abstract

Despite having one of the worst track record, Australians academics try to lecture the world about cycling safety.
This may seem odd.
Yet it fits with the Australian government agenda of obfuscating the disappointing results of its controversial bicycle helmet law.
This is not about cycling safety.
It is about defending government policy.

An odd display of confidence

Professional conferences are places where people present results they can be proud of. For example when they have achieved superior outcomes.

It was a surprise when academics from Australia went all the way to Finland to lecture about bicycle safety.
Australia is far from being a role model in cycling safety.

Australia’s cycling safety record is 22 TIMES worst than best practice

Why would a country with a poor track record attempt to lecture others?

Australia was the first country to introduce a compulsory bicycle helmet law in 1990.

27 years later, it is still controversial.

The main result has been to reduce cycling:

Following the helmet law, cycling declined sharply in Australia

Fewer people cycling lead to a less healthy population. Obesity rates rose sharply after 1990.

Source: Australian Institute of Health and Welfare
Australia’s obesity rate rose sharply after the helmet law was introduced in 1990

Australia is now one of the most obese nation in the world.

Countries with less active transport (walking, cycling) have higher obesity rates.

The cost of obesity in Australia is estimated to be $58 BILLIONS per year.
If the helmet law was responsible for only 5% of obesity, that would cost $3 BILLIONS per year.

Why would any country want to emulate such results?
Only one country, New Zealand, has followed Australia, in 1994.
The result has been a reduction in cycling and an increase in the risk of injury:

New Zealand helmet law resulted in a reduction in cycling and an increase in the risk of injury

Other countries have shun this policy.

This policy has done more harm than good.
Australian politicians have failed to admit it.
Instead, bureaucrats have commissioned “studies” to defend government policy.

Injuries are up?  Let’s label it a “success”

Australian government agencies have commissioned academics to defend its controversial helmet law for more than 20 years.
For example, a 1993 “study” tried to deny that the helmet law reduces cycling.
A 2009 “study” tried to deny that helmets can aggravate brain injury.

Generous funding rewards studies praising bicycle helmets.
It is a brave academic who risks their career criticising government policy.

Australian academics went to Finland full of confidence. They are rarely challenged at home. They receive generous funding for “studies” defending government policy.

An example is this study, that claims the helmet law as a success.
Yet, the data within the study shows rising injuries after the helmet law:

Despite rising injuries, this “study” claimed the helmet law was a “success”.

How to claim “success” when injuries increase? The creative spin used was to claim that, as head injuries did not rise as much as arm injuries, the helmet law was a success. The injury rate tripled after the helmet law. That’s labelled a “success”.
The government quoted this study to defend its policy:

“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.”

This “study” was conducted by the academics who presented in Finland.

The target audience is in Australia

The presentation in Finland was widely covered in the Australian media.

The presentation in Finland made it to the front page of a major Australian newspaper

“Bike helmet review throws cold water on sceptics: they’ll likely save your life:
The largest review yet of bike helmet use by 64,000 injured cyclists worldwide has found helmets reduce the chances of a serious head injury by nearly 70 per cent…”

The article promotes claims favoring helmets, without mentioning that helmets increase accidents. There were many similar articles in the Australian media. They claimed the “study” proves helmets efficacy, and thus justifies the helmet law. Australia’s high injury rate was not mentioned. ​

If helmets truly reduced serious head injury by 70%, Australia’s serious injury rate wouldn’t be 22 TIMES higher than best practice:

Most of the Australian media stills defend the helmet law based on theoretical benefits, ignoring actual results.

Trying to rewrite history

The academics who presented in Finland also claim that the helmet law did not reduce cycling.
They claim that data showing a decline in cycling participation suffers from

“convenience sampling”

The inconvenient data includes the national census from the Australian Bureau of Statistics.

According to the academics to who presented in Finland, the national census from the Australian Bureau of Statistics suffers from “convenience sampling”. Inconvenient data can be dismissed.

The academics claim that they have

“better quality data”

When pressed for evidence, their “better quality data” turned out to be hospital data. 

Hospitalisation data is “better” data to measure cycling levels than cycling counts? This beggars belief.
Helmet fanatics own study does show a sharp increase in injuries after the helmet law was introduced.
Yet rising injuries does not mean that there are more cyclists. This can be due to more accidents.
The evidence that the risk of injury has increased after the helmet law has been ignored.

Shooting the messenger

The government-funded academics presenting in Finland have been defending the helmet law for years. Their latest attempt is a meta-analysis, making bold claims favoring helmets. It suffers from publication bias: selecting studies favorable to the desired conclusion. This meta-analysis was re-analysed in 2017 by Colin Clarke, who concluded:

“When examined in detail, all (claims) were found to be unreliable claims due to weaknesses of the supporting evidence and methodology”

The Australian government commissioned a similar meta-analysis in 2001. It claimed polystyrene-based bicycle helmets are effective in preventing deaths. In 2011, an independent researcher, Elvik, re-analysed this meta-analysis. He concluded it:

“was influenced by publication bias and time-trend bias that was not controlled for. As a result, the analysis reported inflated estimates of the effects of bicycle helmets”

Brave researchers who have the courage to expose government funded propaganda face the wrath of those who feed on government funding.

The government-funded academics presenting in Finland have aggressively attacked Elvik.

Hidden conflicts of interests

The academics who presented in Finland were from the University of New South Wales (UNSW). UNSW has earned generous funding for “studies” defending the helmet law for years.

Between 2006 & 2009, It earned at least $248,000 in funding for bicycle helmets “studies”. Government funding was channeled through the Australian Research Council.

The underlying University department is primarily funded by government agencies.
Such conflicts of interest are not disclosed.
Yet that doesn’t fool independent reporters:

“Aussie government funds scientists: find helmets great after all …

the government of NSW has commissioned research which (surprise!) finds the effect of their helmet law is massive and sustained. 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).”

The cost of letting governments get away with deceit

Government propaganda is not new.
It is rarely exposed on an international stage though.

Should we we let governments get away with deceit?

There is more at stake than it seems. The consequences of failing to act against government deceit can be dire. Consider the deceit behind the invasion of Iraq. This has cost hundreds of thousands of lives. Millions of people are still suffering from the consequences.

Governments can do a lot of damage. When we let governments get away with deceit, the damage can be much worse.
We end up paying the bill.

The Australian federal government senate inquiry on personal choice terms of reference include:

“bicycle helmet laws, including any impact on the health, enjoyment and finances of cyclists and non-cyclists;”

Most submissions to the inquiry requested a review of the bicycle helmet law.

The senate inquiry held hearings on the bicycle helmet law on the 16th of November 2015. This hearing included testimonies from helmet law supporters. The inquiry released its interim report in 2016.

In their opening statements, helmet fanatics claim to be experts on bicycle safety. However they were unable to answer this question:

“CHAIR: Does Australia have a significantly lower rate of serious head injuries and deaths amongst cyclists than other countries in the OECD?

Mr Healy : We would have to take that question on notice.”

The self-appointed “experts” strongly believe in bicycle helmets, to the point of fiercely mandating them on their fellow citizens. Yet they are unable to provide evidence supporting those beliefs. They don’t even know whether the policy reduces serious injuries.

It’s not that difficult to find out though. Australia’s cycling serious injury rate is 22 TIMES higher than in the Netherlands:

Are helmet fanatics unaware? or are they reluctant to acknowledge results that challenge their beliefs?

Helmet fanatics make bold claims like “helmets reduce risk of serious injury or death by about 60 per cent”.
If that was true, Australia’s serious injury rate wouldn’t be so high.

Trying to deny the helmet law reduces cycling

A key point from helmet choice advocates is that a helmet law reduces cycling. Many cycling counts show this. Yet that does not stop helmet fanatics from trying to deny it:

“CHAIR: We do have some evidence. We have evidence relating to participation in cycling. We have evidence in relation to cycling accidents. One of you—I cannot recall which—said that cycling participation has not declined following introduction of mandatory helmet laws, and yet even here in Victoria 679 fewer teenage cyclists were counted in identical pre- and post-law surveys, but the number of teenage cyclists wearing helmets increased by only 30. Doesn’t this suggest that the main effect of the law was to discourage cycling rather than encourage helmet wearing?

Prof. Olivier : No.

CHAIR: Fewer cyclists, only 30 more helmets over pre and post? What does that suggest to you?

Prof. Olivier : If you are trying to estimate the prevalence of people cycling, you do not do it by standing on the street corner and counting. That is not a proper statistical method for estimating prevalence. We would not do that with infectious diseases. We would not do it with other diseases or any other health related thing. We would not just stand on a street corner and ask people: ‘Do you have HIV? Yes or no?’ and then do that over several years and count the number of times someone says yes. That is not how it is done. It is very weak data and, from other stuff that we have done and I have done with colleagues here, we know that, as the data has got stronger—there is not any ideal data around the time of the helmet legislations across the Australian states—and better in terms of quality, we do not find big drops in cycling. We do not find any significant changes in cycling.

CHAIR: But others do, so I am struggling to understand how you can be so positive.

Prof. Olivier : Because, as the data is better—

CHAIR: What data? Which data set are you relying on?

Prof. Olivier : The census data of hospitalisations in New South Wales.”

So, let’s denigrate cycling counts as a method of measuring cycling levels, then claim “we have better data”.
Yet the evasive answer fell flat on its face when pressed for evidence.

Hospitalisation data is “better” data to measure cycling levels than cycling counts? This beggars belief.
Helmet fanatics own study does show a sharp increase in injuries after the helmet law was introduced.
Rising injuries should not be misinterpreted as evidence there are more cyclists. This can be due to more accidents.

Another way to denigrate inconvenient evidence is to claim the data is inconclusive. Yet that does not stop helmet fanatics from making bold statements. Senator CANAVAN frustration with evasive answers can be felt here:

“Senator CANAVAN: That is what I continue to hear—that there is not enough data. In your opening statements and submissions you have made some fairly strong conclusions and assertions, but if there is not the data there to judge these matters how do you make those strong assertions and judgments? …”

Trying to denigrate evidence from the Northern Territory

One of the arguments from helmet choice advocates is the Northern Territory. The helmet law has been relaxed. It is rarely enforced. The helmet wearing rate is the lowest in Australia. Cycling to work is 3 times the national average. Cycling injuries are below the national average.

Such evidence shatters helmet fanatics claims of high traumatic injuries should the helmet law be relaxed.

How to denigrate the evidence from the Northern Territory?
How about this …

“Senator CANAVAN: Okay. I suppose that we do have some degree of competitive federalism in Australia, where the Northern Territory have relaxed their laws. I am not sure if you are familiar with this but the evidence to us is that apparently they have allowed bicycle use without a helmet on footpaths, and I think on low-speed roads as well. Do you have evidence that that has led to an increase? They did that in 1994 or some such—in the mid-1990s, so it was some time ago. Has that led to a marked difference in the quantum or severity of brain injuries in the Northern Territory as a result of cycling, relative to the rest of the country? Is there any evidence there?

Prof. Ivers : I am not aware of the specific details about head injury, but I think it is worth noting that the fatality rate for the Northern Territory is three times that of the rest of the country. The fatal—

CHAIR: On bicycles?

Prof. Ivers : No, overall.

CHAIR: Overall?

Prof. Ivers : Yes, that is right.

CHAIR: Not specific to bicycles?

Prof. Ivers : No, that is right. It is not specific to bicycles. As I said—

CHAIR: There might be a few other reasons for that.”

So, it is worth noting an irrelevant statistic that misleads about cycling safety in the Northern Territory.

What is the purpose here? To inform or to mislead?

Trying to deny that bicycle helmets are not designed to protect against brain injury

Bicycle helmets are not designed to protect against brain injury.

This is inconvenient for helmet fanatics. Their rhetoric exploits fears of brain injury. Without it, the emotional appeal for a helmet law dwindles.

This limitation of bicycle helmets is well known. An article in Bicycling Magazine acknowledges it:

“new research is finding that concussions could be as dangerous as splitting open your skull. And that brain bucket you own? It was never designed to prevent concussions.”

Yet helmet fanatics still try to deny it:

“CHAIR: Well, the evidence we heard was that that is not likely to be the most typical injury incurred when you fall off your bike—that you are more likely to have a twisting injury. That was the suggestion.

Prof. Grzebieta : Yes, that is the Curnow hypothesis. Curnow put together evidence on the basis of other people’s work that was not substantiated through appropriate testing. McIntosh and a number of others at the University of New South Wales did some tests ….  That is not in dispute”

What is the denial based on? A study that is an offshoot of this misleading study. This “study” was commissioned to defend the helmet law. It sets up unrealistic conditions. It makes unwarranted claims by generalising the results beyond the laboratory artificial set up.

Helmet manufacturers have been sued for selling helmets that fail to protect against brain injury. They have made prototypes of different designs that might reduce rotational acceleration. Helmet manufacturers don’t deny that bicycle helmets are not designed to protect against brain injury.

Quoting misleading studies

Helmet fanatics eagerly quote claims from “studies”. Such studies are often conducted by helmet advocates. They are funded by governments desperate to defend their controversial policy. The studies bold claims are often contradicted by the data within the study. The inquiry highlighted an example:

“Senator CANAVAN: The submission of the Australian Injury Prevention Network says, ‘A multicentre study found the cost of medical treatment was triple for cyclists not wearing a helmet when they crashed’ and it has the data. However, Dr Robinson’s submission says that the source you have quoted actually compares costs for cyclists and motorcyclists together with the data you have used, that when you use just the cyclist data there is a different result.”

​Such misleading and deceptive conduct is not new. it was attempted in this study that tried to deny that bicycle helmets can aggravate brain injury. The “study” used hard shell helmets, then misleadingly attributed the results to soft shell helmets.

Conclusion

Helmet fanatics have much in common with religious fanatics:

• They are passionate about their belief
• They speak like priests, talking as if they held the unquestionable truth
• They denigrate heretics
• They use emotive arguments: “Why don’t you come and visit us in the hospitals? “
• They exploit fears
• They promise safety

For 25 years. Helmet fanatics have got away with these tricks:

1. Appoint themselves as “safety experts”
2. Conduct or quote misleading “studies”
3. Make emotive statements, exploiting fears

For how long will these tricks keep working?

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

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].