In the UK, the helmet law has been debated for a long time, with the usual set of emotional arguments from helmet believers.  So far, rationality has prevailed, thanks to the efforts of the Cyclists Touring Club and independent researchers.  Here is some of the research that has help sanity prevail.

The Hillman report, one of the most comprehensive early research done in 1992.  It was ahead of its time.  Much of what was described in the conclusion subsequently happened in Australia and New Zealand.

The insightful conclusions for the report include:

“By wearing helmets, cyclists are at best only marginally reducing their chances of being fatally or seriously injured in a collision with a motor vehicle which is the predominant cause of these injuries. Even the most expensive ones provide little protection in these circumstances. Moreover, the argument in favour of helmets would have validity if there were proof that behaviour does not change in response to perceived risk. But there is no such proof. Safety devices encourage higher levels of risk-taking. As a result, cyclists are likely to ride less cautiously when wearing a helmet owing to their feeling of increased security. After all, the message of the advocates of helmet wearing is that such a practice will protect the cyclist’s head adequately in the event of any accident, not just a minor one when cyclists are hit by very slow-moving vehicles or fall off and hit their heads on the ground. Cyclists may be less likely to have an accident if they are not wearing a helmet, and are therefore riding with greater care owing to an enhanced sense of their vulnerability. 

Furthermore, people are discouraged from cycling if their perception is heightened that it is a ‘dangerous’ form of travel and that it is only safe to do so if a helmet is worn. The result of this is that the considerable latent demand for cycling – an ideal mode for the majority of the population for most of their journeys – continues to be suppressed. As cycling is also a convenient and routine way of maintaining fitness, a significant route to public health is prejudiced. 

There remain then three questions to be answered. First, should helmet wearing be made mandatory? The report on which this paper is based has revealed no case for such a law. In addition to the absence of proof that helmet wearing reduces the risk of head injury, such a law would represent an infringement of civil rights. Moreover, where it has been introduced, it has led to a significant reduction in cycling. 

The second question to address is whether, whilst not making it mandatory, cyclists should nevertheless be encouraged to wear helmets -in effect, obliged to do so by ‘moral’ persuasion rather than by law. However, other than concern on the civil rights issue, the approach to helmet wearing by this means rather than by coercion through legislation would appear to be equally invalid. 

This then leads to the third question concerned with alternative and effective ways of reducing the risk of accidents, and therefore of head injury, among cyclists. The primary means of reducing serious head injury among cyclists is to create an environment in which accidents are less likely to occur. Such a strategy based on tackling the source of accidents in which cyclists are involved has far greater scope for reducing head injuries than the questionable benefits of promoting helmet wearing among cyclists.“

The 2005 report form the National Children Bureau focused on cycling safety, not just cycling helmets.  The section on bicycle helmets, written by an experienced cyclist who regularly wears a helmet, concludes:

“The conclusion from the arguments outlined above is that the case for cycle helmets is far from, sound. The strong claims of injury reduction made by helmet proponents have not been borne out for fatalities (which this paper argues is the most methodologically sound test of effectiveness) in real-life settings with large populations. …

the benefits of helmets need further investigation before even a policy supporting promotion can be unequivocally supported. ….

The cycle helmet debate shows the dramatic power of real life events in shaping our understanding of causality. Tragedies happen; child cyclists are killed or left disabled for life; and we cannot let go of the belief that something
could and should have been done to stop that particular event from happening – especially when that something is so simple as wearing a helmet. We find it hard to accept that the helmet may have made no difference. We find it harder to accept that encouraging or forcing children to wear helmets might also encourage them to ride in a more dangerous way and paradoxically to increase the risk that they will suffer an accident. And we find it much harder to accept that compulsory helmet use might put children off cycling altogether, leaving them less physically active, and – many years later – more likely to die of heart disease. Think of all the uncertainty behind that line of argument, compared with the seeming rock-solid conviction that a helmet could have saved that particular child’s life, at that particular time. And of course the fact that we are talking about children, who have a claim on our protection and who are still getting to grips with the world, makes it so much more difficult to accept the limitations on our ability to prevent them coming to harm. We cannot ignore the human suffering, pain and loss that lie behind the research and statistics. But our response to it demands reflection and perspective as well as sympathy and conviction.“

In 2011, the Transport and Health Study group, an independent British society of public health and transport practitioners and researchers, released Health on the Move 2, a book aimed to be “a clear and comprehensive account of what would constitute a healthy transport system.”  The section on bicycle helmets evidence, approaches the topic of the helmet law from a health perspective.  It includes a summary of the research on the helmet law.

The report is written in a neutral tone, yet you can sense the frustration of the researchers here: “The failure of mass helmet use to affect serious head injuries, be it in falls or collisions, has been ignored by the medical world, by civil servants, by the media, and by cyclists themselves. A collective willingness to believe appears to explain why the population-level studies are so little appreciated.”

The report conclusions include:

“The disconnect between received wisdom and the facts is stark.

The facts are:

2. There is however a disturbing discrepancy between engineering or clinical evidence of the effectiveness of helmet wearing (which suggest them to be effective) and population studies (which suggest that they are not).
3. Plausible explanations of this discrepancy include cyclists taking greater risks because they think their helmet makes them safe or drivers taking less care of helmeted cyclists because they see them as less vulnerable. A single study has examined this but its findings supports the latter of these.

5. It is now well established that legislation mandating cycle helmet use causes a reduction in the levels of cycling and thereby does more harm than good.
6 It is unclear whether this is because many people find cycle helmets troublesome, because many people find them unfashionable and odd or because people consider the mandation of helmet use as evidence that cycling is dangerous.”