Brief history of helmet law in Australia

Following the precedent of helmets for motorcyclists, opinion unsupported by scientific evidence developed that cyclists, especially children, need more protection and that helmets could provide it. In 1978, the House of Representatives Standing Committee on Road Safety recommended that “cyclists be advised of the safety benefits of protective helmets and the possibility of requiring cyclists to wear helmets be kept under review”. But the evidence submitted to the Committee as published in Hansard includes nothing on the efficacy of helmets as protection. Indeed, in the reports of later parliamentary committees that led to the present policy the earliest study cited, by McDermott and Klug, is dated 1982.

The Government responded with a campaign to promote helmet wearing. In Victoria, the Royal Australasian College of Surgeons (RACS) did likewise, even putting a case for compulsory wearing to the Premier in 1982.

The 1978 inquiry was unfinished, but the House of Representatives Standing Committee on Transport Safety continued it and issued a final report on motorcycle and bicycle helmet safety in 1985. It recommended in 1985 that co-operation of states and territories should be sought to “review the benefits of bicycle helmet wearing … and unless there are persuasive arguments to the contrary introduce compulsory wearing of helmets by cyclists on roads and other public places”.

The 1985 committee assumed from the start, to quote its chairman, “that all cyclists should wear a helmet to increase cycling safety both on and off the roads”. By contrast, the Victorian Government’s submission to that committee said, quote:

“The incidence of bicycle helmet use has not yet reached a sufficiently high level anywhere in the world for a scientific examination of helmet effectiveness in injury reduction to be undertaken.”

Despite flimsy evidence of efficacy, the committee recommended that the states and territories should introduce compulsory wearing of helmets by cyclists on roads and other public places.

The Victorian Parliament’s Social Development Committee (SDC) adopted a RACS recommendation for compulsory wearing, and legislation to take effect in 1990 was announced. In New South Wales, a parliamentary committee in 1988 called for “firm plans in regard to compulsory helmet wearing”, and Prime Minister Hawke announced it in 1989 as a condition of providing funds to the states and territories for eliminating so-called “black spots” in roads. In response, they passed the world’s first laws to compel cyclists to wear helmets.

According to Senator Peter Walsh, reported in the Australian Left Review of April 1992, the black spots component of road investment – of which compulsory helmets is a part – had not been evaluated properly, and the original policy was driven by opinion polls.

A response by the ACT Department of Urban Services to the FOI request of January 1992 by the Cyclists’ Rights Action Group, shows that the only issue which the Department raised in advising the ACT Government on the Prime Minister’s offer was the difficulty of policing the law off-road. The Department’s response to CRAG’s FOI request of 4 October 1994 shows that it held no documents containing any study or advice to the ACT Government on two important matters concerning a helmets law. These are:

(1) intrusion into the private domain of protection of one’s own person, infringing civil liberties; and

(2) unfairly discriminating against cyclists compared to other road users.

On a third important matter, efficacy of helmet wearing in protecting cyclists from injury, the Department held only one document, a 3-page paper entitled “The road safety benefits of the compulsory use of bicycle helmets”, which it obtained from the Federal Office of Road Safety on 9 March 1992. The treatment in this paper is only superficial and the research findings it cites are inconclusive.

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Canberra Times article

WHAT TO TELL THE KING

Helmets protect soldiers and workers, so let’s make cyclists wear them too and save our children from dreaded brain injury. The idea seemed plausible. Surgeons advocated it and as early as 1978 a Federal parliamentary committee on motorcycle and bicycle safety recommended that it be kept under review. The initial response of the federal and Victorian governments was publicity campaigns to increase voluntary wearing.

By 1985, a Federal parliamentary committee inquiring further into helmet wearing declared its belief that all cyclists should wear one. A surgeon-backed group noted that the reason was “obvious to all safety-conscious people but the facts supporting this assumption are not easily obtainable in the research literature” – but then they seized on a study by Dorsch and others in South Australia, which “presents convincing evidence for what has been suspected all along,” and urged helmet wearing for all.

Dorsch provided the best evidence the committee had, but hers was a preliminary study only, she retreated from it in her own evidence and the Victorian Government’s submission indicated it used too small a sample to be scientific. Despite all this, the committee recommended compulsory helmet wearing. In 1989, the Federal Government claimed “overwhelming evidence” it would improve safety, and bribed the states and territories to legislate. There was no evidence of increasing casualties, however; deaths to cyclists had been declining for 20 years and head injuries in the ACT, for example, had fallen sharply.

So the helmet laws are based on popular belief rather than knowledge. For those who remember, it’s like the children’s story of Chicken Little, hit on the head by an acorn. “The sky is falling”, she concluded. “I must hurry to tell the King.” On the way she met Henny Penny … . So her story was relayed from one bird to another, and all believed it. Distracted in their panic, they made easy prey for Foxy Loxy, and no-one was left to tell the King..

The story our politicians swallowed has made Australia an easy captive market for the international helmets industry.

Governments failed to provide the protection due to cyclists by properly evaluating the efficacy of helmets. Though helmets protect soldiers and workers from small, fast-moving objects, their testing and design are unsuitable when it is the person that is moving. No allowance is made for heads being connected to bodies and only the cushioning effect of a direct impact to the top of the head is measured.

Most impacts to the head in accidents occur to the front and sides. Like a knockout blow to the jaw in boxing, they impart a rotational force, which theory and experiments with animals have shown is the main cause of brain injury, not direct impact.

Australian research in 1987 showed that the added mass of a helmet may actually increase rotational force, and to minimise it helmet shells should be very stiff. Instead, to make wearing more acceptable the Australian standard for helmets was degraded on political advice to allow cheaper soft shells. The helmet industry’s market expanded, but research showed soft shells grab the surface upon impact, rotating the head.

In its 1994 inquiry on head and neck injuries to footballers, the National Health and Medical Research Council examined evidence for the efficacy of bicycle helmets. It concluded that helmets may possibly reduce soft tissue injury, but “the use of helmets increases the size and mass of the head. This may result in an increase in brain injury.” As no similar inquiry has ever been made on head injury to cyclists, legislators got no proper advice before passing helmet laws, thereby risking increased danger to cyclists.

Following the helmets law, cycling declined sharply as people gave it up rather than wear a helmet. Though warned this effect was likely, governments failed to monitor it properly, measurements of numbers of cyclists being mainly incidental to surveys of helmet wearing.

An observational survey of law compliance and helmet wearing by bicyclists in New South Wales – 1993, by Smith and Milthorpe, reported on matched surveys made for the Roads and Traffic Authority. These counted 6072 child cyclists (under 16) passing survey sites in April 1991, before the helmets law commenced to apply to them on 1 July, and 3887 and 3478 passing the same sites in similar weather in April 1992 and 1993. The respective declines were 36 and 43 per cent. Consistent across-the-board declines were found at road intersections, at school gates and in recreational areas, as well as in Sydney, inner rural and outer rural areas. This implies that they are realistic estimates of the reduction in cycling. No equivalent surveys were made of numbers of older cyclists pre- and post-law.

Injuries to child cyclists did not decline commensurate with their numbers. Table 1 shows numbers of head and other injuries in NSW and, in brackets, my calculation of what they would have been if they had declined as much as the number of cyclists.

                                TABLE 1 

       HOSPITAL SEPARATIONS, INJURIES TO NSW BICYCLISTS UNDER 16
                   (source NSW Department of Health)

    Year ended    Head        Incr.   Other       Incr.
    30 June       Inj.        risk    inj.        risk

    1991/91       384                 926     
    --------------------------------------------------law for <16 y.o
    1991/92       272 (246)           815 (593)
    1992/93       273 (219)   +24%    893 (528)   +68%

By the second year, rates of head injury to the remaining cyclists were 24 per cent above pre-law and other injury 68 per cent, in contrast to an increase in road safety for pedestrians and road users generally, following better detection of drink-driving and speeding.

A similar decline in cycling followed the commencement of the helmets law in the ACT in July 1992. The Department of Urban Services measured average daily cycle volumes for one week during the spring of 1991 and 1992. Its July 1993 report, Bicycling in the ACT- a survey of bicycle riding and helmet wearing in 1992 stated: “Based on automatic counts of cycles for one week at 23 cycle path locations, mean weekday cycle path daily volumes were recorded in 1992 to be about one third lower than the similar period in 1991, with mean weekend daily volumes declining by about half.”

The report suggested on page 5 that twice as many days with rain recorded during the 1992 survey period than 1991 “could have accounted for the reduction in cycling between the two surveys” – but this is not plausible because page 12 recorded that “all bicycle data collection was undertaken on rainless days” and detailed records show little variation in the weather.

By 1994, in its report ACT Bicycle Volumes, trends, variations, survey results, helmet wearing and cyclists’ characteristics 1991-1993/94, the Department belatedly conceded that “the most apparent reason” for the “remarkably consistent decline in cycling between 1991 and 1992 may be the introduction of helmet legislation in 1992.” The report went on to say that an increase of 34 per cent had been recorded for 1993/94, and to suggest that cycling may have bounced back to previous levels “after the initial settling-in period when riders establish new habits.” The suggestion is not valid. The 1993/94 counts were done mainly in February, when cycling is seasonally higher than in spring and counts available for four sites in the same month, December, show no significant change from 1992 to 1993.

Though cycling declined by more than a third, admissions of bicycle casualties to public hospitals did not. According to the ACT Department of Health and Community Care there were 89 admissions for fiscal 1991/2, immediately before the law, and 87 and 88 in the following two fiscal years. This suggests the risk of serious injury to the remaining cyclists increased by more than half, much like NSW.

One likely cause of an increased rate of injury is that children feel safe with a helmet on and are less careful. In Victoria, a study following much official publicity about helmet wearing found that teenagers believed helmets would save them in a serious accident with a bus or a truck! Over-confidence would increase the risk of accident – in which a helmet is likely to reduce soft tissue injury but increase brain injury.

Governments concerned for the well being of our youth would review the helmet laws. Instead, seeming to be content with creating an impression of effective action, however false, they misuse statistics to reinforce it.

According to The Canberra Times of June 5 1998, a spokeswoman for Urban Services said assertions that helmets do not reduce the incidence of injury are not backed by the facts. She used national data for casualties, cited in a Federal Office of Road Safety leaflet. From a pre-law base period 1987-90 to post-law 1993-96, it shows a decline of 33 per cent for cyclists compared to 23 per cent for all road users. FORS credited the difference to the helmet laws.

This assessment is biased. Including 1990 in the base period inflates the difference, but is wrong because the first helmets law was introduced in Victoria in mid-1990. As the last was in mid-1992, in the ACT, it is fairer to compare 1989 with 1993. The respective declines, 29 and 24 per cent, are then less different.

More importantly, FORS ignored the decline in numbers of cyclists. Taking this into account, the result of the law has not been the increased safety that FORS claims, but continuing casualties at a higher rate and loss of exercise beneficial for health … the truth the greatest casualty.

What to tell the king? Democracy owns no king but the people. Governments owe them the truth about the helmet laws. Only an open and independent inquiry can tell it.


This article was written by Bill Curnow, and was published in The Canberra Times on 29 August 1998.

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Submission to “CYCLING AUSTRALIA, THE NATIONAL STRATEGY”

In August 1998, Austroads Inc., a body comprising Australian transport authorities, invited comments on a consultation paper for a national cycling strategy. On behalf of CRAG, Bill Curnow submitted the following comments.


COMMENTS ON “CYCLING AUSTRALIA, THE NATIONAL STRATEGY, COMMUNITY CONSULTATION PAPER, AUGUST 1998”

The paper does not give any attention to the effects that compulsory helmet wearing laws have had on cycling.

The existing and proposed national strategy purport to be directed to public action to encourage safe cycling, but the initiative of all Australian governments in introducing helmet laws has had the effect of substantially discouraging it. By contrast, in the three calendar years before helmet laws, 1986 to 1989, total bicycle travel in Australia rose between 10 and 12 per cent each year[1], but without a commensurate increase in deaths and serious injuries to cyclists.[2]

Further, there are good grounds for concluding that the helmet laws have resulted in an increase in the rate of injury to the remaining cyclists, including head injury and brain injury in particular.

Discouragement of cycling

In Victoria, before the helmets law, some students at schools which compelled them to wear helmets chose to give up cycling instead.[3] It would therefore have been sensible for governments to ensure that the effect of compulsory wearing on numbers of cyclists was monitored accurately. This was not done, but some measurements of numbers were made, most being incidental to surveys of helmet wearing.

Official surveys, carried out shortly before and after the helmet laws, consistently showed substantial declines in numbers of cyclists in the following jurisdictions.

  • New South Wales: Matched surveys counted 6072 child cyclists (under 16) passing survey sites in April 1991, before the helmets law commenced to apply to them on 1 July, and 3887 and 3478 passing the same sites in April 1992 and 1993, declines of 36 and 43 per cent respectively.[4] Though the survey sites were not chosen as a representative sample, consistent across-the-board reductions in numbers counted were found at road intersections, at school gates and in recreational areas, as well as in Sydney, inner rural and outer rural areas. This implies that an almost identical result would have been obtained whatever the choice of sample sites and the declines stated here are realistic estimates of the reduction in cycling.
  • Victoria: Total bicycle use by children aged 5-18 decreased by 36 per cent from May/June 1990 to May/June 1991.[5] There were further decreases to May/June 1992, with teenage cycling in Melbourne showing by then a 46 per cent decrease from pre-law levels.[6]
  • South Australia: The Office of Road Safety, in reporting its evaluation of helmet legislation, said “Due to the disparate nature of the results from different sources, it is not possible to be conclusive about the effect of the requirement to wear bicycle helmets on the number of cyclists.”[7] The report noted that Harrison’s (1994) study of school children showed a 38 per cent decline in cycling from September 1988 to March 1994. This is likely to under- estimate the decline due to the helmets law because cycling is more popular in March than September in southern Australia. A review of this report may be found here
  • Western Australia: A 1992 survey commented that the numbers of children cycling to primary schools and numbers of recreational cyclists declined from 1991 to February 1992.[8] A 1993 survey presents limited data which show some decline in numbers of WA children cycling to school.[9] Its limited observations of “commuter” cyclists indicate an increase in numbers after the helmet law, but a decline of over 50 per cent for cyclists classed as recreational. Data from automatic counter surveys conducted by Main Roads showed a decline of 38 per cent from October-December 1991 to October-December 1992 in cyclists crossing the Narrows and Causeway bridges on Sundays. I obtained from Main Roads similar data for weekdays. These also showed sharp declines.
  • ACT: Automatic counters on bicycle paths registered declines from 1991 to a similar period in 1992 of about one third on weekdays and about half at weekends.[10]In Queensland and the Northern Territory, surveys were done by other organisations.
  • The Royal Automobile Club of Queensland conducted surveys, mainly of cycling to schools, which showed a decline of 22 per cent from 1990 to 1991. Owing to changes in the survey conditions, however, the real decline probably exceeded 30 per cent – and it occurred before the law was enforced.[11]
  • The Road Safety Council of the Northern Territory did surveys which showed there was little change just after the law in the numbers of children cycling to primary schools, but a decline of 17 per cent by the following year. Numbers cycling to secondary schools declined by 36 per cent soon after the law and were down 39 per cent within a year.[12] These figures would under-estimate the effect of the law because two of the schools surveyed had themselves introduced compulsory wearing before the surveys. One report on the surveys noted that secondary students had earlier advised that “if it was made compulsory to wear helmets they would decide whether to comply or not to ride. Information which the Council provided per letter to me on 15 October 1993 shows that the number of “commuter” cyclists declined by about half. The numbers are as follows:Surveys pre-law, Aug. 1990, Apr. 1991, Aug. 1991: 252, 222 and 350 respectivelySurveys post-law, Apr. 1992, Aug. 1992, May 1993: 142, 122 and 131 respectively.

Bicycle casualties, pre- and post-law

Contrary to popular belief, there is no good evidence that compulsory helmet laws have improved the safety of cycling, indeed the contrary is indicated.

In New South Wales, numbers of head injuries and other injuries to child cyclists before and after the helmets law are shown in Table 1, with, in brackets, my calculation of the numbers if they had declined in proportion to the number of cyclists counted in the above-mentioned surveys.

                                TABLE 1 

       HOSPITAL SEPARATIONS, INJURIES TO NSW BICYCLISTS UNDER 16
                   (source NSW Department of Health)

    Year ended    Head        Incr.   Other       Incr.
    30 June       Inj.        risk    inj.        risk

    1991/91       384                 926
    --------------------------------------------------law for <16 y.o
    1991/92       272 (246)           815 (593)
    1992/93       273 (219)   +24%    893 (528)   +68%

Contrary to a general trend to improved road safety for other road users, these data suggest that for those still cycling after the law the risk of serious injury, both to the head and otherwise, increased substantially. Robinson’s analysis put it that “if similar numbers of child cyclists had been on the roads in 1993 as before the law, deaths and serious injuries to child cyclists would have increased by 21 per cent, compared with a decrease of 21 per cent for child pedestrians and 20 per cent for child road users in general.”[13] But the NSW Roads and Traffic Authority, conveniently disregarding the decline in the number of cyclists, interpreted the data as “a substantially larger decrease in bicycle head injuries than other types of injuries, and increased helmet wearing has had a positive effect on the head injury rate.”[14]

For Victoria, Robinson’s analysis of statistics suggested that for the same cycle use as before the law there would now be no fewer head injuries and more total injuries to children. In the ACT, admissions of cyclists to public hospitals hardly changed. The numbers advised by the Department of Health per letter of 26 March 1996 were 89 for fiscal 1991/2, immediately before the law, and 87 and 88 in the following two fiscal years. This suggests the risk of serious injury to the remaining cyclists increased by more than half.

Available evidence for other jurisdictions is less detailed, but that which I have seen also suggests that the helmet laws have been counterproductive.

Explanation of a counterproductive measure

Though helmets protect soldiers and workers from small, fast-moving objects, their testing and design are unsuitable for when the person is moving. No allowance is made for heads being connected to bodies and only the cushioning effect of a direct impact to the top of the head is measured.

Most impacts to the head in accidents are to its front and sides. Like a knockout blow to the jaw in boxing, they impart a rotational force, which theory and experiments with animals have shown is the main cause of brain injury, not direct impact.

Australian research in 1987 showed that the added mass of a helmet may actually increase rotational force, and to minimise it helmet shells should be very stiff.[15] Instead, to make wearing more acceptable the Australian standard for helmets was degraded on political advice to allow cheaper soft shells. These grab the surface upon impact, rotating the head.

In its 1994 inquiry on head and neck injuries to footballers, the National Health and Medical Research Council examined evidence for the efficacy of bicycle helmets. It concluded that helmets may possibly reduce soft tissue injury, but “the use of helmets increases the size and mass of the head. This may result in an increase in brain injury.” As no similar inquiry has ever been made on head injury to cyclists, legislators got no proper advice before passing helmet laws, thereby risking increased danger to cyclists.

More detailed explanation and references are contained in an article of mine which was published in Current Affairs Bulletin, April/May 1998, pp. 18-25 and here

Unhappily, some government authorities, seemingly unwilling to accept responsibility for introducing a counterproductive measure and to take action to remedy its detrimental effects, namely discouragement of cycling and reduction in safety to the remaining cyclists, have misrepresented data so as to under-estimate or discount such effects. One example is given above and others are mentioned in my CAB article.

Conclusion

As the compulsory helmet wearing laws have done more to discourage cycling and increase its hazards than any other measure, any realistic national strategy for encouraging safe cycling and reducing the severity of injury to cyclists must consider recommending their repeal. The first requirement, we suggest, is an open inquiry conducted by independent persons of suitable competence, with provision for the public to make input, so ensuring that all available knowledge is brought to bear.

I commend these comments for your earnest consideration, look forward to your response and stand ready to provide, as far as I am able, such further information as you may require.

Yours sincerely, Bill Curnow President

References

[1] Department of Transport and Communications, SPOKES, Information for cycle-conscious communities, Canberra,1993, p.1.

[2] Federal Office of Road Safety, Road Injury Australia, quarterly bulletin, June quarter 1997

[3] Evidence given to House of Representatives Standing Committee on Transport Safety, 1985, p.1078

[4] Smith, N.C. and Milthorpe, F.W., An observational survey of law compliance and helmet wearing by bicyclists in New South Wales – 1993, for the New South Wales Roads and Traffic Authority, Sydney, 1993.

[5] Cameron, M., Heiman, L. and Neiger, D., Evaluation of the bicycle helmet wearing law in Victoria during its first 12 months, Report No. 32, Monash University Accident Research Centre, Melbourne, July 1992, p.6.

[6] Finch, C.F., Heiman, L. and Neiger, D., Bicycle use and helmet wearing rates in Melbourne, 1987 to 1992: the influence of the helmet wearing law, Monash University Accident Research Centre report no. 45, February 1993, pp. 35, 36.

[7] Marshall, J. and White, M., Office of Road Safety Report Series 8/94, South Australian Department of Transport, Walkerville, South Australia, 1994, pp.i,11.

[8] Healy, M. and Maisey, G., The impact of helmet wearing legislation and promotion on bicyclists in Western Australia, Traffic Board of Western Australia, Perth, 1992.

[9] Heathcote, B., Bicyclist helmet wearing in Western Australia: a 1993 review, Traffic Board of Western Australia, Perth, 1993.

[10] Ratcliffe, P., Bicycling in the ACT – a survey of bicycle riding and helmet wearing in 1992, ACT Department of Urban Services, Canberra, 1993, p.5.

[11] Wikman, J. and Sims, C., Bicycle helmet wearing surveys 1990 and 1991, Royal Automobile Club of Queensland, Brisbane.

[12] Van Zyl, R. Bicycle helmet wearing in the Northern Territory, May 1993, and 1993 bicycle helmet survey report, Road Safety Council of the Northern Territory, GPO Box 1176, Darwin.

[13] Robinson, D.L., Head injuries and bicycle helmet laws, Accident Analysis and Prevention, Vol.28, No. 4, pp463-475, 1996

[14] Roads and Traffic Authority, New South Wales, The current state of bicycle riding, June 1994.

[15] Corner, J.P., Whitney, C.W., O’Rourke, N. and Morgan, D.E., Motorcycle and bicycle protective helmets: requirements resulting from a post crash study and experimental research, Federal Office of Road Safety report no.CR 55, Canberra 1987.


The Australian Minister for Transport and Minister for Health jointly launched Australia cycling, the national strategy on 19 February 1999 and Austroads Inc. has since published the strategy document, see http://www.transport.sa.gov.au/invplan/bikesth/bikesth_fr.htm.Though the material CRAG submitted was supported by 15 references to published sources, the strategy document neither reflects nor refutes any of it. On behalf of CRAG, Bill Curnow therefore wrote to Austroads to convey comments on it, as follows.


AUSTRALIA CYCLING – THE NATIONAL STRATEGY

I write to convey this group’s comments on Australia cycling – the national strategy.

The strategy rightly recognises that people’s health and the environment would gain if they cycled more, but does not examine deterrents to that and action needed to deal with them. We suggest that the two main deterrents are the negative attitude towards cycling in this country, as mentioned in the consultation paper for developing the strategy, and, flowing from that, the laws for compulsory wearing of helmets.

In Australia now, cycling is not accepted as a form of local transport deserving serious consideration. Bikes are seen as children’s toys and respectable for adults to use only for competitive sport or recreation; but for transport the common assumption of other road- users is that cyclists lack road sense and can barely be tolerated, and then only if they wear helmets to minimise the cost of their accidents to the public health system.

A realistic strategy must deal with the fact that governments’ own actions have strengthened this attitude and discouraged cycling. Official promotion of helmets did it by exaggerating the dangers of cycling, and helmet laws have had the opposite effect of the strategy’s Objective 4, “to increase bicycle use while simultaneously reducing the casualty rate.” A legitimate deduction from the evidence we submitted is that repeal of the laws would soon provide most of the increase needed to achieve the strategy’s goal of doubling bicycle use, and reduce the rate of serious casualty per cyclist. By contrast, the effects of the measures proposed in the strategy are conjectural.

The public inquiry we suggested is now needed to bring reality to the strategy, in place of irresponsibly concealing the effects of the helmet laws. We request your comments.

Yours sincerely, W.J. Curnow, President

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COMPULSORY SELF-PROTECTION ON ROADS: GAIN OR HARM TO SOCIETY?

Introduction

A subject of current controversy in Australia is the role of governments in individuals’ choices about protecting themselves against disease and injury. Concerns have been expressed about infringement of civil liberties and possible adverse effects of preventive medical treatments that governments are urging, immunisation for example. People are rightly demanding the full scientific knowledge that shows the efficacy of these, but have never done so for preventive treatments in the form of compulsory self- protection of road users, namely helmet wearing for motorcyclists, beginning from the 1960s, seat belts for motorists from the 1970s and helmets for pedal cyclists from the 1990s. Authorities have accorded to these much of the credit for the halving of fatalities on the roads since 1970. Is this true? Does it compensate for loss of the centuries-old right of individuals to choose how to protect their own persons? These questions are important now because the relevant laws are scheduled to be entrenched as uniform Australian Road Rules.

Self-protection and the individual

In our system of government, the powers of public authority are contained within law consistent with two basic beliefs of Western Christendom: the rational and organic nature of society and the transcendent value of the human person. [1] A balance exists between the right of the state to impose legal sanctions and the rights of the individual, including self-protection. J.S. Mill defined the balance in 1858 as follows:

“The only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant. … Over himself, over his own body and mind, the individual is sovereign.” [2]

Mill went on to describe a proper office of public authority to guard against accidents:

“When there is not a certainty, but only a danger of mischief, no one but the person himself can judge of the sufficiency of the motive which may prompt him to incur the risk: in this case, therefore he ought to be only warned of the danger; not forcibly prevented from exposing himself to it.” [3]

Under Hitler’s doctrine “Law is what benefits the people”, individual rights and freedoms in Germany were subjugated to the common good, as evaluated by the state, and the balance as Mill had defined it was destroyed. [4] The Universal Declaration of Human Rights, 1949 (UDHR) re-affirmed individual rights: freedoms to be limited only as necessary to safeguard rights of others. This established Mill’s definition as an international standard which liberal democracies have generally followed. In effect, they have left self-protection largely to the instinct of self-preservation, the function of public authority being to assist by providing information and advice and setting safety standards for protective devices.

Paradoxically, while legislation was taking away the right of individuals to choose whether to wear a helmet or seat belt, their right under the common law to decide upon other preventive medical treatment to protect their health was being strengthened. A 1990 guide to the law noted that over the previous twenty years it had “increasingly been recognised that patients have the right – indeed the responsibility – to decide for themselves what medical tests or treatment they will have” and doctors have a duty “to give patients sufficient information to enable them to make their own decisions about the treatment that is offered to them.” [5] Superior courts have since continued to strengthen individual patients’ rights. In 1992, England’s highest court upheld the right to refuse medical treatment, as follows: “The patient’s interest consists of his right to live his own life how he wishes, even if it will damage his health or lead to his premature death. Society’s interest is in upholding the concept that all human life is sacred and that it should be preserved if at all possible. … In the ultimate the right of the individual is paramount.” [6] Subsequently, the High Court of Australia acknowledged “the paramount consideration that a person is entitled to make his own decisions about his life.” [7]

The UDHR declares that everyone is entitled to all the rights and freedoms set forth in it, without distinction of any kind, such as race, sex or other status. The International Covenant on Civil and Political Rights, 1976 (ICCPR), to which Australia has acceded, provides that the law of parties to it shall guarantee protection against discrimination on any ground. Parties to the ICCPR may depart from it only in time of “public emergency which threatens the life of the nation and the existence of which is officially proclaimed.” Avoidance of unfair discrimination has thus become a standard for laws in Australia.

Compulsory self-protection of road users in Australia

For compulsory self-protection of road users, the motive of reducing casualties is laudable, but, as an eminent American judge warned:

“Experience should teach us to be more on our guard to protect liberty when the Government’s purposes are beneficent. The greatest dangers to liberty lurk in the insidious encroachments by men of zeal, well meaning but without understanding.” [8]

The late Justice Lionel Murphy similarly warned Australians:

“Every generation has to fight over and over again the battle for our fundamental rights and liberties and this generation has to do that also. In recent times, almost every one of our fundamental rights and liberties has been either trampled on, whittled away, challenged or ignored.” [9]

Nevertheless, the Australian public has hardly questioned the usurpation of the democratic right of individual road users to choose how to protect themselves.

Individuals could reasonably expect members of legislatures to protect their civil liberties from infringement, but few members have attempted this. Strident propaganda has generated a willingness to accept measures which appear to promise to reduce the road toll. Even the Victorian Council of Civil Liberties condoned compulsory bicycle helmets “in the interests of protecting people from further road disaster.” [10] The practice of governments acting in concert, such as state and federal ministers agreeing in conclave on the principles of the legislation for compulsory bicycle helmets, has facilitated the overriding of individual liberties in the supposed national interest. Action under an agreement between heads of government is now due to entrench compulsory wearing of helmets by motorcyclists and pedal cyclists and seat belts by motorists in law as Australian Road Rules. [11] These three forms of enforced self- protection are examined below against suggested criteria for measures to enforce behaviour in a democracy: the existence of a social ill needing a remedy, efficacy, and compliance with international standards.

Motorcycle helmets

The Government of Victoria did not define a social ill needing a remedy when it introduced the world’s first legislation, in 1960, to compel motorcyclists to wear helmets. Though their death rate was much higher than occupants of cars, motorcyclists were mainly young men, [12] the group which also has the highest rate of accident as car drivers. There was no public emergency or even increase in casualties, deaths of motorcyclists having halved over the previous five years. [13] Despite voluntary wearing of helmets having reached 56 per cent, it was simply assumed that motorcyclists could not be responsible to protect themselves.

Proven efficacy is an obvious requirement for any safety measure, but the Government adduced no scientific evaluation of it. The minister merely said the police had been experimenting with helmets and “the Police Department and other organisations are now satisfied that the wearing of protective helmets will prevent deaths.” [14] It was assumed, perhaps by false analogy with helmets that protect workers from small fast-moving objects, that helmets would reduce brain injury, but, as pointed out in a 1987 study, the response of the head and neck system to impacts is an unsolved problem. [15] Testing of helmets is simply by simulation of direct impact, at only 22 kph for motorcycle helmets, 20 kph for bicycle helmets, of the top of the head onto a hard surface, [16] but oblique impacts are more common in actual crashes. These generate high rotational forces which are the main cause of brain injury, and which the 1987 study suggested are actually increased by helmet wearing.

Similarly, the National Health and Medical Research Council, in a report on football injuries in 1994, said helmets may possibly reduce the incidence of scalp lacerations and other soft tissue injury, but

“The use of helmets increases the size and mass of the head. This may result in an increase in brain injury by a number of mechanisms. Blows that would have been glancing become more solid and thus transmit increased rotational force to the brain.” [17]

A study of motorcycle collisions in the early years of compulsory helmet wearing in Victoria observed that “the only visible protective effect was that the helmet stopped soft tissue injury to the scalp.” [18] Thus, there was no sound basis for the assumption that standard helmets would protect against brain injury. That an innovative measure of unproved efficacy could be passed into law without question may perhaps be attributed to motorcyclists being a minority with a high rate of casualty, and a dread of brain injury.

Empirical studies have since claimed to show benefits from helmet wearing. A 1964 study by the Australian Road Research Board concluded, from statistics before and after legislation, that it had reduced the risk of death in Victoria by two-thirds, but the study lacked data for some important variables and had no basis in mechanics of head injury taking account of rotational forces. [19] In 1994, the Australian Government chose instead to cite an empirical study in America, which estimated that helmets are 28 per cent effective in preventing fatalities to motorcyclists involved in accidents. [20] As well as being narrowly based, that study did not allow for an effect suggested by Davis, namely that helmeted motorcyclists may feel safer, ride a little less carefully and therefore have more accidents, in which other road users may also be injured. [21] This suggestion is supported by detailed data for Britain, where compulsory helmet wearing was introduced in June 1973. Motorcyclists and pedestrians they collided with did not enjoy the decline in deaths and serious injuries that other road users experienced from 1972 to 1975, even after making allowance for an increase in distances travelled by motorcyclists. Claims have been made that death rates of motorcyclists increased after the repeal of helmet laws in some states of the USA, but Davis noted that the main evidence for this was a graph of fatality rates across states, whether they repealed the law or not, and the rate of increase was greater in states that did not repeal their laws.

In their inquiries on motorcycle helmets in 1978 and 1984, standing committees of the House of Representatives did not question efficacy. The Federal office of Road Safety (FORS) made the following strong statement to the 1984 committee, [22] but when requested could not provide supporting evidence for it: [23]

“At the outset, it is appropriate for the Office of Road Safety to re-affirm unequivocally that the wearing of safety helmets by motorcycle riders and pillion passengers and by bicyclists is the principal means of reducing casualties in crashes. … any doubts about the safety of helmets need to be quickly resolved. It is most important that there is no erosion of public confidence in the use of safety helmets.”

Compliance with international standards was not considered when the compulsory helmets law was introduced in 1960. [24] Debating it with twelve unrelated provisions in the same Bill, the Victorian Parliament did not even recognise it as a world precedent in enforced self- protection. Infringement of liberties was not mentioned, though self- protection on roads was an innovation and helmet laws discriminate unfairly, head injury being the commonest cause of death for occupants of cars also, and many more of them dying from it. [25] A 1987 report of the Federal Office of Road Safety recommended that occupants of cars should use protective head wear, but governments did nothing. [26] “Later FORS reports noted that the frequency with which injury to the head was still occurring “to front seat occupants wearing a seat belt is very disturbing.” Injury to the head was identified as by far the highest contributor to the total cost of injury but protective head wear was not even mentioned among protective measures canvassed. [27] Clearly, the helmet wearing laws fall short of accepted standards in a democracy.

Seat belts

In compelling the wearing of seat belts in cars in 1970, Victoria was again first in the world [28] and there was no suggestion of any emergency. Though undefined, the social ill presumably was seen as continuation of the two-thirds increase in deaths of occupants of cars in the 1960s. In the first half of the 1960s, when many families were first experiencing motoring, fatalities increased more rapidly than the numbers of licensed drivers and vehicles on register. In the second half, the reverse was true, not only in Victoria but also for deaths and injuries in Australia as a whole. [29] It would seem that experience had taught safer driving, towards a remedy for the social ill.

Again, no thorough evaluation of efficacy was made by competent authority, to support the legislation. There was just a report by a parliamentary committee, citing statistical correlations of casualties with voluntary seat belt wearing in Sweden and Victoria and with compulsory wearing in vehicles operated by the Snowy Mountains Authority. [30] Despite this, the other states quickly followed Victoria’s lead and wearing has been compulsory throughout Australia since 1972. New South Wales did a feasibility study, but it did not discuss efficacy because the political decision on compulsory wearing had already been made. [31] There was no nationally co-ordinated monitoring in Australia to evaluate compulsory wearing in practice. From a review of the studies that were done soon after its introduction, FORS reported that the reduction in occupant fatalities from expected trends was 15-20 per cent, [32] but this was on the assumption that the rising trend of the 1960s would have continued. [33] More recently, FORS has chosen instead to cite American research of the 1980s which estimated that seat belts would reduce the rate of fatality to front-seat occupants of cars involved in fatal accidents by 40 per cent. [34] Again, this is narrowly based and, if drivers wearing seat belts drive a little less carefully, the risk to other road users would be increased. According to Hamer, [35] a report by the British Department of Transport supports this theory. He said “The DoT found that making drivers belt up had no significant effect on injuries among car users. However, it did find a significant increase in injuries among other road users.” This possibility was neglected in Australia; an official report in New South Wales in 1972 stated that only occupants of cars would be affected. [36] Moreover, FORS misrepresented Hamer, citing him as saying that the theory was refuted by statistics produced by the DoT. [37] No conclusive evidence of the efficacy of seat belts in practice in Australia has been adduced. On the contrary, from a wide-ranging study of accidents in New South Wales, Knott concluded in 1994 that no specific improvements in road traffic engineering and vehicle design, including seat belts, have had a measurable effect on the road toll. [38]

Democratic standards for laws were given scant consideration. In Victoria, the parliamentary committee considered objections on grounds of infringement of personal liberty, but declared “there should not be a compromise with death and injury where motor vehicle accidents are concerned.” Civil liberties were lightly dismissed in the parliamentary debate. Some legislators argued that injured people became a burden on the community, and compulsion was justified to reduce costs to hospitals. [39] In New South Wales, objections based on preserving the traditional liberty of persons were disposed of by an argument similar to Hitler’s doctrine, namely that “compulsion is necessary to secure the greatest good for the greatest number, that society is entitled to protect individuals from their own foolishness, and that it is superficial for the individual to assert that his own death or incapacity because of accident affects only himself.” [40] Perhaps the most insidious effect of the seat belt laws was to blunt people’s sensitivity to infringement of their civil liberties.

Pedal cyclists

Confident that compulsory motorcycle helmets and seat belts had been successful, governments were careless about meeting criteria for measures to enforce self-protection upon cyclists. Victoria was the first in the world again, announcing compulsory helmet wearing in September 1989. In the following December, the then Prime Minister, Mr Hawke, announced that a condition of providing federal funds to the states and territories for eliminating “black spots” was that they should pass helmet laws by 1992. [41] No social ill had been shown, deaths of cyclists having been in long-term decline despite bicycle travel in Australia increasing by 10-12 per cent a year from 1986 to 1989. [42]

The Federal action was based on recommendations by Federal, New South Wales and Victorian parliamentary committees, but all lacked good evidence of the efficacy of helmets. [43][44][45] The 1978 Federal committee, which recommended “that cyclists be advised of the safety benefits of helmets and the possibility of compulsory wearing be kept under review,” simply took efficacy for granted. So did its successor, the 1985 committee, saying, early in the course of its inquiry: “It is, of course, this Committee’s belief that all cyclists should wear a helmet to increase cycling safety.” In support of its subsequent recommendation of compulsory wearing it used evidence of efficacy from only one study, by Dorsch and others, which estimated from statistics for self-reported injuries to members of bicycle clubs up to 5 years earlier “that the risk of death from head injury was considerably reduced for helmeted relative to unhelmeted bicyclists, depending on helmet type.” [46] This was a tentative finding only, acknowledging reporting bias and a need for further research. The Victorian Government noted that the study was based on a small sample of users and use of bicycle helmets had not reached a sufficiently high level anywhere for a scientific examination of its efficacy. [47]

In evidence to the 1985 committee, Dr Dorsch emphasised the need for care in using an estimate in the study that people wearing good, hard helmets were 19 times less likely to die, saying: “That was a hypothetical procedure based largely on an adult group of cyclists” and warning against generalising the findings to young bicyclists. Yet the committee’s report cited the 19 times estimate without qualification, adding that the Dorsch study had “received almost universal acceptance by bicycle groups who have been working for many years to have bicycle helmets widely accepted.” FORS, the proper authority to advise the Government on the efficacy of helmet wearing, did no evaluation of it. Though the stated purpose of the compulsory helmet wearing was to reduce the cost of bicycling injuries to the community, FORS did not seek advice from the NHMRC or other health authority. [48] No competent state or territory authority evaluated efficacy. Helmet manufacturers submitted no evidence of it, but said it was essential that helmets be used.

Moreover, the standard for helmets was degraded. The 1985 committee thought it should allow for soft-shell helmets, which would be more acceptable to users, but commissioned research on the matter in 1987 took account of the lethal effect of rotational forces and recommended that shells of helmets should be very stiff, with a low impact sliding reaction. [49] FORS said: “This research was made available to Standards Australia and assisted one of its committees to recommend changes to the bicycle helmet standard. The amended standard allowed the introduction of “soft top” helmets, improving the comfort of helmets helping to overcome an obstacle in introducing mandatory helmet wearing.” [50] The implication that there was research backing for soft top helmets is wrong and the amendment to the standard compromised safety. Tests of impacts of helmets on asphalt have since shown that, unlike hard-shell helmets which slide, soft helmets grab the surface, rotating the head. [51]

After the report of the 1985 committee but before the 1989 announcement of compulsory helmet wearing as Federal policy, statistical studies of helmet wearing and injury were done overseas. Those of Thompson, Rivara and Thompson, and Mills purported to show benefits of helmet wearing, but the British Medical Association commented that though these studies and that of Dorsch and others “provide useful preliminary data, further research is required.” [52] Rodgers examined a larger sample of cyclists than the others: 8 million cases of injury and death in the USA over 15 years. He concluded that “There is no evidence that hard shell helmets have reduced the head injury and fatality rates. The bicycle- related fatality rate is positively and significantly correlated with increased helmet use.” [53] Though this study was published in 1988, the year before Mr Hawke’s announcement of compulsory helmet wearing as Federal policy, FORS gave no warning about it to the ministers who decided on the policy and its implementation, [54] and did not act upon the 1985 committee’s recommendation that it should establish the costs and benefits of universal bicycle helmet usage. This was negligence.

Mr Hawke’s announcement acknowledged the advocacy of a prominent member of the Royal Australasian College of Surgeons (RACS), which had long been campaigning for compulsory helmet wearing. The RACS told the 1978 committee that cyclists should wear helmets, but provided no evidence of efficacy. [55] As Dr Trinca said,

“We could perhaps worry a little less about and take a little less time in proving what is precisely right according to all standards … As doctors we are impatient. We cannot wait for 2 or 3 years’ evaluation.”

Consequently, and in advance of research cited later in support of helmet wearing, the RACS pressed Victoria to make it compulsory, which eventually influenced Federal policy. Similarly, the denial of medical exemptions for both cyclists and motorcyclists is based on advice from the RACS, [56] but imposition of preventive medical treatment careless of conclusive evidence of its efficacy and particular medical circumstances is the antithesis of scientific medicine and medical ethics. In the absence of an evaluation of the efficacy of helmet wearing by public authority, the RACS’s views would appear to have been unduly influential. A former minister in the Hawke Government observed that after 1987 “increasingly, the Government, and most importantly Hawke, became hostage to narrow and unrepresentative pressure groups.” [57] He also said that the black spots program was not evaluated properly and was driven by opinion polls, [58] a view supported by official documents.

With efficacy unproved and the standard degraded on political whim, compulsory wearing of helmets is a reckless experiment with cyclists’ safety. It is also an uncontrolled experiment; transport authorities neglected the unique opportunity to make a scientific examination of the costs and benefits of helmet wearing when it reached a high level after compulsion. One cost was that cycling was discouraged. Though such an effect had not occurred with motorcyclists and motorists, it was known to be likely with cycling [59] and could have been measured on a consistent national basis. Instead, measurements of cycling before and after compulsion were mainly incidental to surveys of helmet wearing. Surveys in Victoria and the NT indicated that cycling by children declined by 36 per cent. [60][61] In the ACT, automatic counters on bicycle paths registered an average decline of 37 per cent. [62]

In NSW, matched surveys counted 6072 child cyclists (under 16) passing survey sites in April 1991, before the law commenced on 1 July, and 3887 and 3478 passing the same sites in April 1992 and 1993, declines of 36 and 43 per cent respectively. [63] Numbers of head injuries and other injuries to child cyclists before and after the helmets law are shown in Table 1, with, in brackets, my calculation of the numbers if they had declined in proportion to the number of cyclists counted in the surveys.

                                TABLE 1 

       HOSPITAL SEPARATIONS, INJURIES TO NSW BICYCLISTS UNDER 16
                   (source NSW Department of Health)

    Year ended    Head        Incr.   Other       Incr.
    30 June       Inj.        risk    inj.        risk

    1991/91       384                 926     
    --------------------------------------------------law for <16 y.o
    1991/92       272 (246)           815 (593)
    1992/93       273 (219)   +24%    893 (528)   +68%

Contrary to a general trend to improved road safety for other road users, these data suggest that for those still cycling after the law the risk of serious injury, both to the head and otherwise, increased substantially. Robinson’s analysis put it that “if similar numbers of child cyclists had been on the roads in 1993 as before the law, deaths and serious injuries to child cyclists would have increased by 21 per cent, compared with a decrease of 21 per cent for child pedestrians and 20 per cent for child road users in general.” But the Roads and Traffic Authority, conveniently disregarding the decline in the number of cyclists, interpreted the data as “a substantially larger decrease in bicycle head injuries than other types of injuries, and increased helmet wearing has had a positive effect on the head injury rate.” [64]

For Victoria, Robinson’s analysis of statistics suggested that for the same cycle use as before the law there would now be no fewer head injuries and more total injuries to children. [65] For the ACT, admissions of cyclists to public hospitals hardly changed, suggesting the risk of serious injury increased by more than 50 per cent. Further, former cyclists who travel by another mode may still be injured, and they lose the benefits of the exercise for their health, which the British Medical Association has estimated “are likely to outweigh the loss of life through cycling accidents.” [66] Hence, it is likely that the helmet laws have increased costs of medical care, not saved on them, and distracted attention from measures to prevent accidents.

Official evaluations of the helmet laws commonly employ biased selection of research and statistics, resulting in benefits being unduly attributed to them and adverse effects underestimated. Examples abound. One from NSW is given above. In the ACT, the Department of Urban Services tried to explain away the post-law decline in cycling as being due to changes in the weather, [67] but its report says “all bicycle data collection was undertaken on rainless days”, and detailed records show little variation of weather. In Victoria, a government-funded study pointed to a post-law decline in the proportion of head injuries among injured bicyclists without acknowledging that this was so for pedestrians too. [68] It would seem that better detection of drink-driving and speeding had changed the character of accidents generally. The same study claimed that use of bicycles by adults during the first two post-law years “increased markedly,” but the only increase measured had been from the first to the second year, that claimed for the first year being by comparison with a survey in 1987/88 but subject to the caveat that it was “made at different times of the year and almost 3.5 years apart and therefore considered unreliable.” Though bicycle use by persons under 18 years declined by 43 per cent during the first post- law year and 29 per cent fewer adult cyclists were observed in Melbourne than in a survey the year before, [69] the study did not suggest the likelihood of a similar decrease in use by adults in the first year, and a net decrease over the first two years.

Later authors further distorted the findings of this study. Two members of the RACS said “Teenage cycling decreased … while adult cycling continued to increase. Overall bicycle use has continued to increase.” [70] They did not mention the applicable caveat. Nor did FORS, which cited them to support the following two statements in advice it gave in 1994 to a parliamentary committee inquiring into mandatory helmet wearing in Western Australia: “Adult riding continued to increase. Overall bicycle use has continued to increase since the law.” In the first statement, FORS accepted uncritically what the RACS authors said, though it was unsubstantiated and the evidence indicated the contrary was likely. In the second, the addition of the words “since the law” excluded the true interpretation of the continued increase being from 1987/88. Thus, FORS’s statement was positively misleading.

Democratic standards for laws again were given scant consideration. Governments argued that civil liberties are not infringed because compulsory helmet laws are intended to save the cost to the community of bicycle accidents. [71] The argument is superficial; the helmet laws take away the individual’s long-standing right under the common law to decide what treatment he will undergo to protect his own health. As shown above, wearing a helmet is likely to increase injury to the brain. The Supreme Court of the ACT has interpreted the common law so as to provide people with a remedy against risking such an outcome: a cyclist who believes on reasonable grounds that wearing a helmet will increase the risk or severity of injury is not compelled to do so. [72] This is testimony to the inconsistency of the helmets law with democratic standards. Further, on the governments’ argument, behaviour such as wearing a hat to reduce skin cancer could be made compulsory. Already, in the ACT, so-called mandatory procedures of the Department of Education and Training say “Protective hats are to be worn by all members of the school community including staff and parents assisting at outdoor functions.” [73] The helmet laws discriminate unfairly against cyclists compared to other road users, who suffer far more head injuries. In Australia in 1988, 17 motorists and six pedestrians died from head injury for each cyclist. [74] One author of the FORS report that recommended car occupants wear protective hats suggested bicycle helmets [75] – as illustrated by personnel of the NHMRC’s road accident research unit. [photograph courtesyAdelaide Advertiser].

Gain or harm to society?

Any gains would be in terms of the stated purpose of compulsory self- protection, to reduce death and injury and the consequent costs to society, mainly to the health care system. They would need to be substantial to compensate for the departure from the traditional balance between the rights of the state and the individual. A difficulty in assessing gains is that no social ill needing a remedy was ever clearly defined. Nor did governments establish systems to monitor compulsory use and evaluate it with accuracy, but the available data indicate that gains have been problematic at best. For bicycle helmets, the indications are of a net loss in health and welfare.

Three important harms to society have occurred: the rights of individuals to choose self-protection and medical treatment eroded; unfair discrimination institutionalised in statutory law; and democratic processes and institutions corrupted. Corruption occurred, first, by governments not trusting the people and their instinct for self-preservation, and disregarding their rights. Individuals’ rights under common law to protect their own persons and to refuse medical treatment were lightly set aside. Second, governments failed to use democratic processes to identify the social ill for which compulsory helmets or seat belts were supposed to be the remedy, and to ascertain their efficacy. They did little more than adopt popular notions that were largely a product of the propaganda of narrowly-based groups, and never soundly evaluated. Lacking a basis of experience of enforced wearing of helmets and seat belts in any other country, and conclusive evidence of their efficacy, governments were only experimenting when they made use compulsory. Social ill and efficacy should have been ascertained through open public debate informed by all available knowledge. Would compulsory helmet wearing have been supported if people had known that fatalities to motorcyclists and cyclists were decreasing? In a process of open public debate, proposals having mere popular appeal but no scientific validity, such as the degradation of the standard for bicycle helmets, could hardly have been adopted, and the1988 finding of an increased fatality rate to helmet wearers would have been taken into account. After such a finding, what government would endorse the use of any other medical treatment, say a new therapeutic device?

The third and perhaps most serious corruption is that transport authorities have made unsubstantiated claims for the success of compulsory self-protection and have insisted that it is up to opponents to disprove them, a reverse onus contrary to democratic practice. From such research as has been done, much of it of dubious rigour, authorities have selected findings that appear to show benefits. They have disregarded or misrepresented findings that suggest that compulsion to wear seat belts and motorcycle helmets has done little or nothing to reduce casualties, and that compelling cyclists to wear helmets has been harmful. Moreover, general acceptance of authorities’ claims might well increase support for other forms of enforced preventive medicine. To reduce costs of public health care, why not compulsory wearing of hats in the summer sun, a ban on smoking? … the list goes on.

To undo the harm of compulsory self-protection of road users, and check a trend to enforced preventive medicine, independent and open inquiries into the three measures should first be conducted, beginning with the most recent, helmets for cyclists. This might well result in the making of better policies in the future, that respect democratic values and are more broadly based, with, for example, health authorities making input where reduced costs of health care are sought. Technical matters such as evaluation of efficacy should be removed from the political process to an independent statutory authority with the requisite capability.

Acknowledgments

I thank Jim Arnold, Ralph Curnow and James Grieve for their helpful comments.

References

1. Strakosch, H.E., State absolutism and the rule of law, Sydney University Press, 1967, p. 221.
2. Mill, J.S., On liberty and other essays, World’s Classics, OUP, Oxford, New York, 1991, p. 14.
3. Mill, ibid., p.107.
4. Strakosch, ibid., p. 243.
5. Skene, L., You, your doctor and the law, Oxford University Press, Australia, Melbourne, 1990.
6. Re T (Adult: Refusal of medical treatment), (1992) 4 ER 649 at 668.
7. Rogers v Whitaker (1992) 175 CLR 479, at 487.
8. Justice Brandeis, Olmstead v United States 277 US 438, 1928.
9. Lionel Murphy, Address to Australian Labor National Conference, 1967.
10. The Age, Melbourne,1 July 1990.
11. The Light Vehicles Agreement, 1992.
12. Foldvary, L.A. and Lane, J.C., The effect of compulsory safety helmets on motor-cycle accident fatalities, Australian Road Research, September 1964.
13. Federal Office of Road Safety, Road traffic accident data and rates: Australia, States and Territories 1925 to 1981, Canberra, 1984.
14. Minister for Local Government, Hansard p. 2356, Melbourne, 1960.
15. Corner, J.P., Whitney, C.W., O’Rourke, N. and Morgan, D.E., Motorcycle and bicycle protective helmets: requirements resulting from a post crash study and experimental research, Federal Office of Road Safety report no. CR 55, Canberra 1987, p. 5.
16. Australian Standards AS 1698 and AS 2512.3.1.
17. National Health and Medical Research Council, Football injuries of the head and neck, AGPS, Canberra, 1994.
18. Tony Ryan, NHMRC Accident Research Unit, Crash injury biomechanics, Proceedings of a conference held in Adelaide, July 1992.
19. Foldvary and Lane, ibid.
20. Evans, L.E. and Frick, M.C., Helmet effectiveness in preventing motorcycle driver and passenger fatalities, Accident Analysis and Prevention, Vol. 20, No. 6, 1988.
21. Davis, R., Death on the streets, Cars and the mythology of road safety, Leading Edge Press, Hawes, North Yorkshire, 1993, p. 171.
22. Federal Office of Road Safety, Submission to House of Representatives Standing Committee on Transport Safety, Canberra, 23 May 1984.
23. Federal Office of Road Safety, letter of 25.9.97.
24. Motor Car (Amendment) Bill 1960.
25. Attewell, R.G. and Dowse, M.J., Fatal crash types. Analysis of 1988 fatality file, Federal Office of Road Safety report No. CR 105, Canberra 1992.
26. McLean, A.J., Simpson, D.A., Cain, C.M.S., McCaul, K.A., Freund, J.R. and Ryan, G.A., Head and neck injuries in passenger cars: a review of the literature, Federal Office of Road Safety report No.CR 59, 1987.
27. Fildes, B.N., Lane, J.C., Lenard, J. and Vulcan, A.P., Passenger cars and occupant protection, Federal Office of Road Safety report No. CR 95, Canberra, 1991.
28. Except for Malawi
29. Federal Office of Road Safety, Road traffic accident data and rates: Australia, States and Territories 1925 to 1981, Canberra, 1984.
30. Victoria, Joint Select Committee on Road Safety, 3rd progress report, Votes and proceeding s and papers, session 1969-70, 9 September 1969.
31. Skinner, N., Henderson, M. and Herbert, D., Compulsory wearing of seat belts a feasibility study, Traffic Accident Research Unit, Department of Motor Transport, New south Wales, Sydney, 1970.
32. Milne, P.W., Fitting and wearing of seat belts in Australia, the history of a successful countermeasure, Federal Office of Road Safety report No. OR 2, AGPS, Canberra, 1985.
33. Adams, J., The efficacy of seat belt legislation, Society of Automotive Engineers, SAE Transactions, 1982.
34. Evans, L., The effectiveness of safety belts in preventing fatalities, Accident Analysis and Prevention, Vol. 18, No.3 June 1986.
35. Hamer, M., Report questions whether seat belts save lives, New Scientist, 7 February 1985.
36. Traffic Accident Research Unit, Department of Motor Transport, Compulsory wearing of seat belts, a preliminary evaluation of effects, Sydney, 1972.
37. Federal Office of Road Safety, Vehicle occupant protection in Australia, report OR 10, 1988.
38. Knott, J.W., Road Accidents in New South Wales, Australian Economic History Review, XXXIV, Sept., 1994, pp. 80-116.
39. Hansard report of debate on Motor Car (Safety) Bill 1970, p. 2793.
40. Skinner et al, ibid
41. Prime Minister, media statement, 5 December 1989.
42. Department of Transport and Communications, SPOKES, Information for cycle-conscious communities, Canberra, 1993.
43. House of Representatives Standing Committee on Transport Safety, Final report on motorcycle and bicycle helmet safety inquiry, AGPS, Canberra, 1985.
44. Parliament of New South Wales, Joint Standing Committee on Road Safety, Staysafe 12, Bicycle safety, 1988.
45. Parliament of Victoria, Social Development Committee, Safe Roads for Children, inquiry into child pedestrian and bicycle safety, first report, 1986.
46. Dorsch, M.M., Woodward, A.J. and Somers, R.L., Do bicycle helmets reduce severity of head injury in real crashes?, Acc. Anal. & Prev. 19, 3, pp. 183-190, 1987.
47. Submission to the House of Representatives Standing Committee on Transport Safety inquiry on motorcycle and bicycle helmet safety, 1985.
48. Federal Department of Transport, response to FOI request, 21 September 1995.
49. Corner et al, ibid, p. 36
50. Federal Office of Road Safety, letter of 24 June 1992.
51. Andersson, T., Larsson, P. and Sandberg, U., Chin strap forces in bicycle helmets, Swedish National Testing and Research Institute, Materials & Mechanics, SP report 1993:42.
52. British Medical Association, Cycling towards health & safety, Oxford University Press, Oxford, 1992, p. 84.
53. Rodgers, G.B., Reducing bicycle accidents: a reevaluation of the impacts of the CPSC bicycle standard and helmet use, Journal of Products Liability, Vol. 11, pp. 307-317, 1988.
54. Federal Department of Transport, response to FOI request, 26 September 1995.
55. Evidence to the House of Representatives Standing Committee on Road Safety, 1978, p. 832.
56. National Road Trauma Advisory Council, letter to ACT Minister for Urban Services, 1992.
57. Walsh, Peter, Confessions of a failed finance minister, Random House Australia, Sydney, 1995, pp. 170, 227
58. Senator Peter Walsh, reported in the Australian Left Review of April 1992.
59. Evidence to the House of Representatives Standing Committee on Transport Safety, 1985, p. 1078
60. Cameron, M., Heiman, L. and Neiger, D., Evaluation of the bicycle helmet wearing law in Victoria during its first 12 months, Report No. 32, Monash University Accident Research Centre, Melbourne, July 1992.
61. Road Safety Council of the Northern Territory, Bicycle helmet wearing in the Northern Territory, Darwin, 1993.
62. Ratcliffe, P., Bicycling in the ACT – a survey of bicycle riding and helmet wearing in 1992, ACT Department of Urban Services, Canberra, 1993.
63. Smith, N.C. and Milthorpe, F.W., An observational survey of law compliance and helmet wearing by bicyclists in New South Wales – 1993, for the New South Wales Roads and Traffic Authority, Sydney, 1993.
64. Roads and Traffic Authority, New South Wales, The current state of bicycle riding, June 1994.
65. Robinson, D.L., Head injuries and bicycle helmet laws, Accid. Anal. and Prev. Vol. 28, No. 4, 1996, pp. 463-475.
66. British Medical Association, Cycling towards health & safety, Oxford University Press, Oxford, 1992, page 121.
67. Ratcliffe, ibid.
68. Finch, C.F., Newstead, S.V., Cameron, M.H. and Vulcan, A.P., Head injury reductions in Victoria two years after introduction of mandatory bicycle helmet use, Monash University Accident Research Centre report No. 51, July 1993, p.16.
69. Finch, C.F., Heiman, L. and Neiger, D., Bicycle use and helmet wearing rates in Melbourne, 1987 to 1992: the influence of the helmet wearing law, Monash University Accident Research Centre report no. 45, February 1993, pp. 35, 36.
70. Lane, J. and McDermott, F., Do helmet wearing laws prevent bicycle injuries? Medical Journal of Australia, Vol. 159, pp. 719-721, 1993.
71. Brown, Bob, Federal Minister for Land Transport, letter of 21 February 1992.
72. Van Schaik v Neuhaus, 1 May 1996.
73. Sunsmart policy and mandatory procedures, circular minute No. 49/93, 29 April 1993.
74. Attewell and Dowse, ibid.
75. Ryan, G.A., Improving head protection for cyclists, motorcyclists and car occupants, World J. Surg. 16, 398, 1992.


Special Notes

This article, written and researched by Bill Curnow, has been published (with only minor differences to the original version appearing here) in Current Affairs Bulletin, Vol 74 No 6, April/May 1998.

Current Affairs Bulletin is refereed, with manuscripts reviewed by specialists in relevant fields. Final decision on publication rest with the editors.

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Submission to the National Road Transport Commission

Entrenchment of Helmet Laws in Australian Road Rules

by Bill Curnow
18 August 1997

Under an agreement by all governments in Australia, the National Road Transport Commission is developing Australian Road Rules that all road users in Australia will need to follow. Draft rules were released for public comment in 1994. In the light of comments received, a proposed rule to compel horse-riders to wear helmets was deleted, but, despite 62 per cent of replies opposing compulsory helmets for adult cyclists, it was retained, in rule 14.14. If approved by ministers, this rule will have the effect of entrenching compulsory helmet laws throughout Australia.

The reason given for retaining rule 14.14 was “safety considerations and the experience of States and Territories where helmet wearing is presently required.” CRAG requested the supporting evidence. In response, the NRTC cited two studies:

  1. Marshall, J. and White, M. (1994) Evaluation of the compulsory helmet wearing legislation for bicycles in South Australia, Office of Road Safety, SA Department of Transport; and
  2. King, M. and Fraine, G., Bicycle helmet legislation and enforcement in Queensland 1991-1993: Effects on helmet wearing and crashes, Road User Behaviour Section, Road Transport and Safety Division, Queensland Transport.

The NRTC cited Marshall and White as claiming: “a 12.1 per cent decrease in hospital admissions for cycling injuries that are potentially preventable by the use of a bicycle helmet” and King and Fraine as claiming that helmet laws have had some effect in reducing injuries beyond that associated with any decline in cycling.

CRAG then made the following submission to the NRTC, including analysis showing that these claims are not supported by the evidence. The submission read as follows:


CRAG’s Submission to the NRTC

In response to your letter of 27 September 1996 about bicycle helmet laws, I am writing to provide you with some more information on studies which show that injuries to cyclists have not declined in proportion to the decline in cycling, and to comment on the two studies which you cited. First, however, I want to say that there has never been a sound basis for the helmet laws.

No sound basis

There are, I suggest, three basic requirements for any legislation in a democratic society: first, the existence of a social ill requiring a legislative remedy; second, proven efficacy of the proposed remedy; and third, compliance with international standards for laws. Governments seem to have implicitly assumed head injury to cyclists to be a social ill, but adduced no evidence of any increase in it. In fact, deaths of cyclists in Australia had been declining by about 1 per cent a year in the 20 years before the first helmet laws; hospitalisations according to police data changed little from 1988 to 1990 before helmet laws; and, in the ACT, admissions of cyclists to public hospitals for head injury in the two years before the helmets law were much lower than a decade before.

The efficacy of helmet wearing in preventing head injury had not been established by proper scientific studies, and no consideration was given to the likely adverse effect of discouragement of cycling. The complex matter of efficacy is discussed in the paper attached as A.

International standards for laws in democracies proscribe laws to compel self-protection, there being no question of harm to another person, and laws which discriminate arbitrarily – see the Universal Declaration of Human Rights 1949 and the International Covenant on Civil and Political Rights, to which Australia has acceded. The helmet laws contravene these standards by compelling people to adopt particular means to protect their own persons. Also, the stated rationale for the helmet laws is to save on the social cost of caring for injured cyclists. Apart from the point of principle – where do you draw the line on restricting individual behaviour to save on costs of health care? – 17 times as many motorists as cyclists died from head injury in 1988, and FORS report CR59 recommends that motorists should wear protective headgear. To compel only cyclists to do so is arbitrary discrimination.

States and territories did not give due weight to these requirements. Enactment of helmet laws was of course to their financial advantage following Prime Minister Hawke’s 1989 offer of Federal funds for roads as a quid pro quo, but belief in the efficacy of helmet wearing as a safety measure would seem to have been decisive. Such efficacy may seem obvious, and government propaganda from the early 1980s reinforced that impression, but, as shown in the attachments hereto, it has no sound basis.

Helmet laws counter-productive

Dorothy Robinson, a biometrician at the University of New England, has adduced evidence in “Head injuries and bicycle helmet laws”, Accident Analysis and Prevention vol. 28, No. 4 pp. 463-475, July 1996, which shows that the greatest effect of the helmet laws has been to discourage cycling. For NSW, she found that neither the number of injuries to the head, nor to other parts of the body, declined as much as the estimated amount of cycling. For Victoria, her Table 5 suggests that, “for the same child cycle use as before the law, there would now be no fewer head injuries and more total injuries”.

Papers which Dorothy Robinson and Bruce Robinson, no relation, will present at the Velo Australis international bicycle conference in Fremantle on 30 October [1996] will contain further evidence on these lines.

I attach as B my own analysis of data for NSW which supports the following appraisal: “Contrary to the general trend to improved road safety, for those still cycling after the law the apparent risk of head injury increased by up to 25 per cent and other injury by up to 69 per cent.”.

This is consistent with a statistical study of 8 million casualties over 15 years in the USA by Rodgers, Journal of Product Liability, Vol. 11, pp. 307-317, 1988. He concluded that “there is no evidence that hard shell helmets have reduced the head injury and fatality rates” and “the bicycle-related fatality rate is positively and significantly correlated with increased helmet use.” My appraisal is also consistent with current theory of head injury as referred to in, for example, the National Health and Medical Research Council report cited in my letter of 3 September. Quoting from it:

“The mechanism of the production of an injury to the head is complex. It involves not only the effects of a direct impact to the skull and its coverings but, more importantly, the effects of the relative motion of the brain within the skull in response to that impact. This relative motion of the brain creates the shearing and rotational forces on the individual neurones which results in axonal stretching and diffuse brain injury. Concussion differs from the more severe diffuse axonal injury in that it represents the mild end of the spectrum of head injury, where the symptoms are transient and the injury does not necessarily result in structural brain damage.

“The addition of a helmet to the head will increase both the size and mass of the head. This means that blows that would have been glancing become more solid and thus transmit increased rotational forces to the brain. Because helmets distribute the force from focal impacts across a larger area, this may result in reduced fracture/laceration injuries but may increase diffuse brain injury.”

Not only has the risk of head injury to cyclists increased, but it is likely that the incidence of brain injury has increased disproportionately.

Studies to evaluate compulsory helmet laws- general

To ascertain the efficacy of compulsory helmet wearing as a public health measure would require a rigorous scientific study based on the testing of a coherent theory including mechanisms of brain injury, vide the NHMRC’s report, this being the injury that protagonists of compulsory helmet wearing profess to be mainly concerned about. Detailed and accurate data are also required. Such data were not available when the helmet laws were decided upon. As the Victorian Government’s submission to the House of Representatives Standing Committee on Transport Safety in 1985 stated: “the incidence of bicycle helmet use has not yet reached a sufficiently high level anywhere in the world for a scientific examination of helmet effectiveness in injury reduction to be undertaken”. Nevertheless, that inquiry recommended compulsory helmet wearing.

The decision-making process that led to the helmet laws did not include any evaluations based on theory of brain injury. The testing of helmets in accordance with the Australian Standard is of direct impacts, not impacts that generate rotational forces. Also, as our FOI requests have shown, the Federal Department of Transport made no evaluation of the efficacy of helmets and gave no advice on it to the ministers of the then Australian Transport Advisory Council who decided on compulsory helmets. Nor did the Department seek advice from the NHMRC or any other health authority. The helmet laws are a response to undue public fears and unfounded belief in the value of helmets.

Despite their unsound basis, the compulsory helmet laws in Australia, the world’s first, provided the best opportunity to that time to evaluate the efficacy of helmets in practice. Changes in cyclists’ behaviour in response to the laws, in particular by cycling less could have been measured. Monitoring systems could have been established to measure this, helmet wearing and casualties, including fine detail of head injuries. All data could have been matched and comparable throughout Australia. Then an accurate scientific evaluation might have been possible. It did not happen. Instead, state transport authorities, parties to introducing the laws, have made evaluations which are simply belated attempts to justify them. Their data, often fragmentary, were collected for other purposes. Such an evaluation is contained in a leaflet issued by the Roads and Traffic Authority of NSW in 1994, copy attached as C. Such also are the empirical studies by Marshall and White in South Australia and King and Fraine in Queensland.

NSW leaflet

The leaflet is full of inaccuracies and misleading statements, for example:

  1. The 1988 report of the Staysafe Inquiry referred to in the first sentence of paragraph 2 noted “Head injuries sustained by 85% of bicyclist fatalities”. In Australia in that year the figure was similar, 80%. What reason can there be then for attributing the statement in the second sentence to 1989 research in America, other than to make it appear that that research, indicating risk reductions of 85% and 88%, supported the Staysafe Inquiry? Also, the American research was empirical only and has been criticised – see for example Robinson’s paper cited above.
  2. In the section headed “Effectiveness of wearing bicycle helmets”, the numbers in brackets in the second sentence are not reductions in the percentages of head injuries as stated; they are percentage reductions in numbers of head injuries.
  3. All statements in the section are distortions because no account is taken of the post-law decline in cycling. It is not even mentioned. When account is taken of reduced cycling, the apparent risk of head injury per cyclist increased, contrary to the conclusion of the last sentence – unless “positive effect” is interpreted as an increase in the head injury rate!

Studies in South Australia and Queensland

Detailed comments on the study in South Australia by Marshall and White are attached as D. A few points are:

  1. The decision by Cabinet in 1984 was premature. Note the reference to Dorsch’s estimate of the chance of death decreasing by a factor of 19. In evidence to a House of Representatives committee in 1985, Mr Hallion, an officer of the S.A. Department of Transport, said studies using Dorsch’s results “show that universal helmet usage would reduce bicycle fatalities by up to 75 per cent and serious injuries up to 40 per cent”, but Dorsch herself refuted this in later evidence – see Attachment A hereto.
  2. South Australian authorities did no systematic monitoring of numbers of cyclists – as they say, “Due to the disparate nature of the results from different sources, it is not possible to be conclusive about the effect of the requirement to wear bicycle helmets on the number of cyclists”. They guessed, on page 32, that the decrease in the number of cyclists was the same as the decrease in the “non preventable injuries”, though it was substantially greater in NSW – see Attachment B As their guess is a factor in their calculations of “helmet effect”, those too are only guesses, and the finding cited in your letter is unsupported.
  3. There is insufficient detail about head injuries to be of use for an evaluation in the terms of the NHMRC report. No tests of statistical significance were done.

The study in Queensland by King and Fraine began by assuming that the road safety benefits of helmet wearing are well established. Not so; the studies they cited all have serious deficiencies – see Attachments A and B.

King and Fraine also lacked accurate data on the post-law decline in cycling. They too assumed, implicitly, that it was equal to the decline in injuries other than to the head. Their data on injuries are fragmentary, many of the numbers are small and no tests were done for statistical significance. Also, they chose to use restricted data from the QISPP, not comprehensive data from the Queensland Road Crash Database from which the following table has been compiled.

Table: Cyclists Killed or Hospitalised with Head Injury (QLD)

    YEAR                   1990   1991   1992   1993   1994   1995p
    1) Concussion            19     21     23     24     29     30
    2) other intracranial    39     28     42     20     20     17
        Subtotal - 1+2       58     49     65     44     49     47
    3) Skull fracture        16     20     23     15     14     15
    4) Open wound to head    47     27     33     20     14     18
    Other injury            202    205    209    162    163    163

Simply because the legislation discouraged cycling, a commensurate decrease in casualties could be expected. Queensland authorities did not measure the decline in cycling, but it is likely to have been about 40 per cent, similar to NSW and Victoria. It would explain the decrease in skull fractures and open wounds to the head without assuming any benefit from helmet wearing.

The numbers for brain injury, concussion plus other intracranial, were higher in 1992 than in 1990, and from 1993-95 little different than in 1991. With fewer people cycling, the apparent risk of brain injury to the remaining cyclists therefore increased substantially. This is consistent with scientific understanding of the mechanism of brain injury as cited by the NHMRC, and with experience in NSW – Attachment B.

Lack of evidence of reductions in head injury has been noted elsewhere. In New Zealand, researchers found “increased helmet wearing has had little association with serious head injuries to cyclists as a percentage of all serious injuries to cyclists.” In Victoria, the proportion of head injured cases in the third year of the helmet law was found to be no different from the trend predicted by the model using pre-law wearing rate trends.

Consequently, the conclusion of King and Fraine that the helmet legislation has been effective in reducing the incidence of head injuries is not supported. I can provide further comment on their study if you wish.

Requests for inquiries

We have made several requests for the compulsory helmets policy/laws to be reviewed, but governments have adopted a defensive attitude.

In the ACT, we were able to present to the Chief Minister personally evidence that the helmets law is counter-productive. In response, she told us she “would be very happy for a legislative assembly committee to be established to examine this matter” and that it would be necessary to gain the support of MLAs for this. Some have stated their support, but Mr De Domenico, who is the Minister for Urban Services and responsible for the helmets law, responded as follows:

“The proposed Australian Road Rules … are being developed … and will automatically become ACT law under an existing Heads of Government agreement. Any amendment which may be made to the bicycle helmet laws in the Traffic Act 1937 will be superseded at the time of introduction of the ARRs. In light of the above, I am unable to support your request for the establishment of a review committee to examine this law.”

Mr De Domenico’s support for the helmets law goes back to its introduction in April 1992, when he was in opposition. The then minister in his second reading speech stated “There is overwhelming evidence that shows the lifesaving benefits of bicycle helmets.” Our FOI inquiries have since revealed that his department had done no evaluation of the efficacy of helmet wearing. Its only evidence was a short paper it received from the Federal Office of Road Safety a month before which claimed such “overwhelming evidence”. In the debate on the bill no MLA questioned this. We have pointed out the lack of evidence to Mr De Domenico, but to no effect.

Mr Whitecross, now leader of the Labor Party that introduced the helmet law when in government in 1992, said “Labor will not support an enquiry until strong evidence is produced that cycle helmets increase the risk of injury”. This is a reverse onus; governments have never produced evidence that helmets reduce the risk.

Conclusion

There has never been a sound basis for compulsory helmet wearing for cyclists. Governments acted prematurely without proper advice, in particular on the critical matter of the efficacy of helmet wearing and its adverse effects.

The helmet laws do not meet international standards for laws, as they infringe civil liberties and discriminate unfairly compared to other road users.

Compulsory helmet wearing has proved to be a counter-productive measure. Its main effect has been to discourage cycling, but, in states where sufficient data on the post-law decline of cycling are available, injuries have declined less than commensurately. This means that the apparent risk of injury to the remaining cyclists has increased. The apparent risk of head injury has not declined, and probably increased, and it is likely that the risk of serious brain injury has increased disproportionately.

There is evidence that transport authorities, for example the Roads and Traffic Authority of NSW, are suppressing and misrepresenting the truth about the effects of compulsory helmet wearing. This is a serious matter as the body of cyclists is largely composed of children and the disadvantaged. Such persons are not capable of making a critical evaluation of the merits of helmet wearing and necessarily have to trust in the advice of government authorities. This is as it should be, but authorities have betrayed this trust. It is clear then that radical reforms of their mode of operation are needed. A particular need is for a strengthening of capacity in science.

Another matter of concern, resulting perhaps from the lack of knowledge of scientific method, is the refusal of transport authorities to reconsider the helmet laws in the light of new evidence. Consequently, the original errors are being compounded, and the nation is the loser.

Finally, transport authorities seem to have the attitude that the onus is on opponents of the helmet laws to show that they are harmful. This attitude is the opposite of democratic practice. The onus should be on governments to show beyond all reasonable doubt that compulsory helmet wearing has substantial net benefits. Even if the studies in South Australia and Queensland were sound, they would not be enough when other studies show there is net harm.

Attachments

Attachment A – Efficacy of Helmet Wearing For Cyclists.
Attachment B – Cycling and Injuries in New South Wales.
Attachment C – NSW Leaflet.
Attachment D – Review of South Australian ORS Report 8/94.


The NRTC’s Response

The NRTC’s response noted that the Australian Road Rules are based on existing law. Only where there were differences in laws between jurisdictions, or a strong desire by the parties involved have the ARRs diverged from existing practice. Representatives of state and territory road authorities have indicated a desire to maintain compulsory helmet wearing laws.

CRAG then pointed out that our submission discredited states’ claims that their experience is that helmet laws increase the safety of cyclists. It seemed, however, that the NRTC had a co-ordinating role only and could not act directly pursuant to our submission. In the interests of facilitating evaluation of available knowledge on the efficacy of helmets, CRAG therefore requested the NRTC to circulate our submission to transport authorities and invite their comments. The NRTC did this. CRAG suggested that if the serious doubts raised about the efficacy of the helmet laws are not refuted, then no responsible authority concerned about the safety and welfare of cyclists could support their being entrenched as Australian Road Rules.

Subsequently, CRAG made requests direct to state and territory road authorities that their comments should include the evaluation, upon which their compulsory helmet wearing law is based, of the evidence of efficacy of helmets in protecting cyclists from injury. CRAG reported the responses received to the NTC on 14 August 1997, as follows.


State and Territory Responses

The responses received are as follows, in summary:

Victoria, by letter of 11 July 1997: “… your letter of 20 June requesting the information on which the decision to introduce compulsory helmet wearing was made. Please find enclosed a copy of the Regulatory Impact Statement that was prepared when the compulsory helmet law was introduced in Victoria in 1990.” I replied pointing out that that statement did not include any evaluation of the evidence of efficacy; it simply assumed, on page 24, that helmet wearing is efficacious. Victoria’s response, by letter of 31 July, was simply to say “The evaluations of efficacy used in justifying the introduction in Victoria of compulsory helmet wearing law were those published papers and reports which were available at the time.”

Comment: This, of course, is a non-answer. I might add that published papers at the time included many which cast substantial doubt on the efficacy of helmets, or on published evaluations of their efficacy – see papers cited in my submission to you of 29 October 1996, by Rodgers, Dorsch, Corner et al and the Victorian Government itself. In other words, the literature shows there was much disagreement at the time about the efficacy of helmets in protecting cyclists from injury. There still is.

Queensland, by letters of 20 June and 11 July 1997: “There appeared to have been a reduction in cycling following the introduction of helmet laws, but it was noted that there was a much greater reduction in injuries to the head than injuries to other parts of the body. We consider this evidence to be sufficiently compelling to justify retention of bicycle helmet laws.”

Comment: Another non-answer; their (unsound) evaluation is post-law.

Western Australia, by letter of 8 August 1997, also could provide only a post-law evaluation: the Report on compulsory helmet wearing for bicyclists, and other bicycling issues by the Select Committee on Road Safety of the Parliament of Western Australia, dated 12 May 1994. The report’s conclusion that helmet wearing reduces the severity of head injuries and saves lives is not supported by the data in it.

Northern Territory responded by email on 23 July, simply to say it had introduced compulsory helmet wearing as part of the Federal Government’s Blackspots Program, and went on to describe the legislation. There was no evaluation.

New South Wales, South Australia, Tasmania, and the ACT have provided no response, despite reminders. Also, in NSW, official claims have been promulgated to the effect that helmets protect from brain damage, but I have received no substantive reply, despite reminders, to my letter of 26 May 1997, copy attached, requesting the supporting knowledge.

In sum, no government in Australia has provided the evaluation, upon which the compulsory helmet wearing law is based, of the evidence of efficacy of helmets in protecting cyclists from injury. Against this, theory of brain injury and experimental evidence cited by Corner et al and the National Health and Medical Research Council, see references 31 and 24 in Attachment A to our submission of 29.10.96, suggest there is no good reason to expect helmets to protect from serious injury, and that they may aggravate brain injury. The obvious deduction is that governments do not have sound evidence of the efficacy of helmets. How, then, can helmet wearing laws be justified?


Conclusions – as at 18 August 1997

Governments in Australia have not shown that the wearing of helmets is beneficial in reducing injury to cyclists.

Indeed, theory and experimental evidence suggest that helmet wearing is likely to increase brain injury.

Surveys, where they have been carried out, have shown that numbers of cyclists declined by around 40 per cent following the introduction of compulsory helmet wearing laws, but injury and head injury to cyclists declined less than commensurately, indicating increased risk of injury.

The helmet wearing laws are therefore inimical to health and safety. The proposed entrenchment of them would be counter-productive.

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