The usual statistical BS - disappointing to hear it from so-called "experts".
"On a per population basis, 2010 enjoyed the lowest head-injury rate since the collection of hospitalisation data going back to 1988-89"
The appropriate measure is per exposure hour. Why this is important will become clear next.
"Our research published last year established that bicycle-related head injuries fell by 29 per cent immediately following mandatory helmet legislation. That reduction was unrelated to any other changes occurring in cycling around that time: helmets plainly worked as intended."
Factually incorrect. Cycling rates dropped by approximately a third immediately after MHLs (mandatory helmet laws) were introduced, and have never really recovered from that setback. At best, the decline in injury rates per population mirrors the decline in cycling exposure hours per population, and on the basis of exposure hours it may have even marginally worsened.
"Ask any trauma surgeon..."
Correct on this one, helmets do improve (reduce) head injury incident rates and severity rates, and I'll continue weareing mine.
My beef with this spin is that it ignores the wider indirect cost to the community of the precipitous reduction in casual utility cycling the imposition of mandatory helmet laws caused: obesity at epidemic proportions, declines in activity and fitness levels, widespread adverse health consequences of sedentary living, and the resultant impost on health budgets and community quality of life.
Put simply, the improvement in injury rates from MHLs came at the expense of a much, much greater cost in long term health consequences that we are now seeing... "penny wise, pound foolish" as the saying goes.
You will never hear this from trauma surgeons, though. And why would you? They're not in a position to see the big picture.
So whenever I hear the words "ask any surgeon" the first thing that enters my head is "sampling bias".
The Australian and NZ history and experience with MHLs continues to be used by most pragmatic governments in Europe as gold-standard evidence as to why MHLS should NOT be introduced.
On the upside, it is good to see some local evidence coming out supporting the expansion of safe cycling facilities.
Now that I've said my bit, I'm off to get some popcorn ... and my helmet. Think I'm gonna need both.
Submitted by cambowambo on Thu, 04/10/2012 - 15:05.
Fewer people riding because they don't want to wear helmets would likely be a major contributor to fewer head injuries when helmets became mandatory - if you don't control for something this obvious then why should we believe the rest of your statistical conclusions?
I'd like to see where they got their numbers from.
I'm old enough to remember the introduction of helmet laws in NSW and saw the direct decrease in the amount of people cycling.
As far as I know WA was the only state to keep accurate figures pre and post helmet laws
They found a decrease then immediate increase e in Cyclist hospitalisation after the laws were introduced in 92
1985 - 623
1986 - 660
1987 - 630
1988 - 698
1989 - 596
1990 - 638
1991 - 730 1992 - 574
1993 - 633
1994 - 644
1995 - 660
1996 - 715
1997 - 754
1998 - 850
1999 - 862
2000 - 913
So even with a decrease in total cyclists there was an increase in accidents but those numbers are little washy as they don't mention severity
So looking at severe accidents
Looking at road fatalities rates they found pre 1990 the average annual cyclist road fatality rate in Australia was 88 and from 1992 to 2002 it was 45. Which is a great decrease of about 49%.
Which sounds convincing but you need to take that in context.
In the same time frame average motorcyclist road fatalities fell from 382 to 195, also down 49%. Pedestrians fatalities fell by 40% (541 to 324). Vehicle passenger fatalities fell by an average 39% (768 to 470) and vehicle driver fatalities fell by an average 28%.
So was this decrease a direct result of helmet laws or was it a result of a general improvement in road safety awareness + better vision/brakes/ safety ratings in cars?
I always wear a helmet on the trail or if I'm doing a serious road ride.
But if I'm just ducking down the road or mucking around in the park I sometimes don't.
I also sometimes strap the full face to the back pack for the ride up to the top of the trail
Now people are going to say that's irresponsible, I'm settle a bad example and what happens if some moron in a car takes me out when I'm not expecting it but what if I'm walking to the shops and some moron in a car takes me out? Injury rates and severity are pretty similar between cyclists and pedestrians.
Is walking around without a helmet being irresponsible and setting a bad example?
The simplistic argument that "helmets prevent head injuries, so wear a helmet" applies equally to all car drivers (not just racing car drivers) and to skateboarders and to pedestrians and you can keep on applying the argument to the point where I should be wearing a helmet here in my office while I type this text - if something were to hit me on the head while I am typing, a helmet could reduce the extent of my injuries. Ludicrous!
Mucking around down the park isnt exactly a reason to not wear a helmet in my eyes
I was going for a leasurely roll around the block with my girlfriend after she got her new bike. I ended up with bits of my face missing as i decided that 10 seconds of speed would be safe and i wouldnt have an accident.... that 10 seconds was all it took to come a cropper..... i still bear the scars today unfortunately
I also think that the argument that those out for a casual ride shouldnt need one is a bit flawed as normally the casual rider is just that, a casual rider, and they wont be as experienced as a person who rides regularly. They also are a bit more blase (spelling?) so i feel its even more reason to wear a helmet.
They say when riding your motorbike that you should dress for the crash, not the ride..... thinking of how i dress when i ride a motorbike to the shops makes me wonder sometimes just how stupid i am wearing some fox shorts and a t-shirt when i ride my pushbike..... i am after all only legally able to do 60kph around suburban streets which is the same speed i have managed to get up to on a decent downhill slope on my mtb.
I found this comment quite amusing, but has some truth about it
"Helmets are not compulsory for car drivers and passengers because they have seat belts, airbags are crumpling technology. Sure, go without helmets, but wear seatbelts and install airbags instead!
The problem with not wearing helmets is that once you have a head injury, you clearly lose the rational ability to understand the need for them"
Submitted by kymbolino on Sat, 06/10/2012 - 17:45.
Like all living things, humans have evolved reasonable protection (such as the thickness of our skull) from dangers they'd experience in a 'typical' pre-historic day. Speeds experienced on bikes, cars and planes have come about way too sudden, so it's important that some further protection is added in the mean time while our DNA catches up (but don't hold your breath).
I also like to think I don't make a parametic jobs any worse than it needs to be if I have an accident. If the accident was gruesome just because I wasn't wearing a helmet, I wouldn't blame the parametic for thinking I'm a jerk avoiding the incovenience of wearing something on my head.
But Kymbo.... wearing a helmet flies in the face of evolution. Survival of the fittest would mean that only those who were thick headed enough to survive accidents at speed would live to breed.
There will always be pro's and con's but personally i wont ride without one. Seeing concrete that close to my face while skidding along the footpath at approx 30kph was enough of a scare for me to make me wear one from that day on on
As for the helmets in cars, i am sure they would have something to say about it given the lack of vision most helmets create. Roll cages also save lives to some degree but apparently they are dangerous in street cars....
The help all these safety devices offer in one instance will more than likely turn into further injury in the next. Some will wear some items, others wont. You can never please everyone
"Cycling rates dropped by approximately a third immediately after MHLs (mandatory helmet laws) were introduced, and have never really recovered from that setback. At best, the decline in injury rates per population mirrors the decline in cycling exposure hours per population, and on the basis of exposure hours it may have even marginally worsened."
Is there any credible reserch to back up this statement please? I must admit that I don't recall observing such a decrease - but personal observations are subjective.
He does make a couple of leaps where it seems to me he doesn't properly and completely join the dots to support the point, but those flaws are not sufficient to be fatal to his thesis overall.
As you read you will see that I may well have understated the increase in risk to individual cyclists per exposure hour that has resulted from these laws.
An interesting quote:
Danish urban planner Mikael Colville-Andersen, who specialises in cycling, noted:
“Good ideas tend to travel and this idea, that you simply must wear a helmet when you cycle, has not. What does that tell you? You are the fattest country in the world, you should be encouraging cycling, not convincing people it’s dangerous.”
The view overseas seems overwhelmingly to be that the risks associated with utility cycling are no more than for walking.
Talk about making leaps of logic, that quote takes the cake
“Good ideas tend to travel and this idea, that you simply must wear a helmet when you cycle, has not. What does that tell you?"
Just because an idea is not adopted widely means it's a bad idea? For example; tobacco advertising has not been banned in much of the world and will most likely never be stopped in the US, does that mean banning tobacco ads is a flawed idea? Not at all, it's just that the world is more complex than just good or bad ideas.
Thanks for your reference to CRAG (Cyclists Rights Action Group) – there is a lot of information to follow up there. From my brief inspection of their information on reduction in cycling after introduction of mandatory helmets, I can see very few specific studies aimed at this question. There is a lot of conjecture on decreases in cycling following mandatory helmets. Just because B follows A, does not mean that B was caused by A (although it is one factor you would look at).
One of the most reputable groups that study this area is the Monash Uni Accident Research Centre (MUARC). The CRAG website gives the following info from a MUAC report (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):
From CRAG:
"4) Surveys in Melbourne by Monash University Accident Research Centre (MUARC) showed total bicycle use by children had decreased by 36 per cent. Finch and others provide data showing the following decreases in numbers of bicyclists observed during the first year of the law: adults 29 per cent, teenagers 46 per cent and children 24 per cent."
However, if you go to this MUARC report and look at the Conclusions – especially the second paragraph:
"7. CONCLUSION
The mandatory helmet wearing law has achieved its goal of increasing bicycle helmet wearing rates for all groups of bicyclists throughout metropolitan Melbourne. Two years after its introduction, high levels of helmet wearing have been maintained in adults and children. Both adult and teenage rates, in particular, are continuing to increase.
The first year following the introduction of the helmet wearing law coincided with a reduction in the number of people riding their bicycles, particularly amongst 12-17 year olds. By 1992, two years after the law, the number of bicyclists was approaching pre-law levels in adults and children but were still greatly reduced in teenagers."
I conclude we have to be VERY careful looking at information presented by a group whose sole aim is to fight the compulsory use of helmets.
You could equally conclude that you need to be very careful looking at information presented by a group whose sole aim is to reinforce the compulsory use of helmets... ie, the government, looking to justify its position. Who funds these studies?
Agenda can be a consideration in deciding how credible a conclusion is, but it does not answer the question whether the agenda is driving the evidence, or the evidence the agenda.
I'm happy to go where the evidence leads, and it does point to helmet use providing a limited level of protection. Hence, I continue to wear one especially out on the trails and in traffic, and would do so even if the mandatory laws were repealed. I don't have any argument with those conclusions.
However, I think it is naive to take the view that compulsory helmets do not act as a significant disincentive to casual cycling, for example for errands to the local shops or a quick trip across the CBD. The only places in the world where bike share schemes have failed are where there are compulsory helmet laws.
This disincentive to take up active transport feeds into sedentary lifestyles and all the health consequences that flow therefrom. It is my view that the evidence supports the view that the cost of this unintended consequence of MHLs is much higher than the savings made. Saving a dollar has cost us more elsewhere.
The Australian experience continues to be the most persuasive argument made against the introduction of MHLs in other jurisdictions.
The usual statistical BS - disappointing to hear it from so-called "experts".
"On a per population basis, 2010 enjoyed the lowest head-injury rate since the collection of hospitalisation data going back to 1988-89"
The appropriate measure is per exposure hour. Why this is important will become clear next.
"Our research published last year established that bicycle-related head injuries fell by 29 per cent immediately following mandatory helmet legislation. That reduction was unrelated to any other changes occurring in cycling around that time: helmets plainly worked as intended."
Factually incorrect. Cycling rates dropped by approximately a third immediately after MHLs (mandatory helmet laws) were introduced, and have never really recovered from that setback. At best, the decline in injury rates per population mirrors the decline in cycling exposure hours per population, and on the basis of exposure hours it may have even marginally worsened.
"Ask any trauma surgeon..."
Correct on this one, helmets do improve (reduce) head injury incident rates and severity rates, and I'll continue weareing mine.
My beef with this spin is that it ignores the wider indirect cost to the community of the precipitous reduction in casual utility cycling the imposition of mandatory helmet laws caused: obesity at epidemic proportions, declines in activity and fitness levels, widespread adverse health consequences of sedentary living, and the resultant impost on health budgets and community quality of life.
Put simply, the improvement in injury rates from MHLs came at the expense of a much, much greater cost in long term health consequences that we are now seeing... "penny wise, pound foolish" as the saying goes.
You will never hear this from trauma surgeons, though. And why would you? They're not in a position to see the big picture.
So whenever I hear the words "ask any surgeon" the first thing that enters my head is "sampling bias".
The Australian and NZ history and experience with MHLs continues to be used by most pragmatic governments in Europe as gold-standard evidence as to why MHLS should NOT be introduced.
On the upside, it is good to see some local evidence coming out supporting the expansion of safe cycling facilities.
Now that I've said my bit, I'm off to get some popcorn ... and my helmet. Think I'm gonna need both.
Fewer people riding because they don't want to wear helmets would likely be a major contributor to fewer head injuries when helmets became mandatory - if you don't control for something this obvious then why should we believe the rest of your statistical conclusions?
Also, see this at Pinkbike
I'd like to see where they got their numbers from.
I'm old enough to remember the introduction of helmet laws in NSW and saw the direct decrease in the amount of people cycling.
As far as I know WA was the only state to keep accurate figures pre and post helmet laws
They found a decrease then immediate increase e in Cyclist hospitalisation after the laws were introduced in 92
1985 - 623
1986 - 660
1987 - 630
1988 - 698
1989 - 596
1990 - 638
1991 - 730
1992 - 574
1993 - 633
1994 - 644
1995 - 660
1996 - 715
1997 - 754
1998 - 850
1999 - 862
2000 - 913
So even with a decrease in total cyclists there was an increase in accidents but those numbers are little washy as they don't mention severity
So looking at severe accidents
Looking at road fatalities rates they found pre 1990 the average annual cyclist road fatality rate in Australia was 88 and from 1992 to 2002 it was 45. Which is a great decrease of about 49%.
Which sounds convincing but you need to take that in context.
In the same time frame average motorcyclist road fatalities fell from 382 to 195, also down 49%. Pedestrians fatalities fell by 40% (541 to 324). Vehicle passenger fatalities fell by an average 39% (768 to 470) and vehicle driver fatalities fell by an average 28%.
So was this decrease a direct result of helmet laws or was it a result of a general improvement in road safety awareness + better vision/brakes/ safety ratings in cars?
I always wear a helmet on the trail or if I'm doing a serious road ride.
But if I'm just ducking down the road or mucking around in the park I sometimes don't.
I also sometimes strap the full face to the back pack for the ride up to the top of the trail
Now people are going to say that's irresponsible, I'm settle a bad example and what happens if some moron in a car takes me out when I'm not expecting it but what if I'm walking to the shops and some moron in a car takes me out? Injury rates and severity are pretty similar between cyclists and pedestrians.
Is walking around without a helmet being irresponsible and setting a bad example?
From the NY Times.
The simplistic argument that "helmets prevent head injuries, so wear a helmet" applies equally to all car drivers (not just racing car drivers) and to skateboarders and to pedestrians and you can keep on applying the argument to the point where I should be wearing a helmet here in my office while I type this text - if something were to hit me on the head while I am typing, a helmet could reduce the extent of my injuries. Ludicrous!
But not as much as the rocks that OldandSlow throws at me. That's why I wear a helmet all the time.
That, and that the sun visor on the front of my helmet is kinda groovy
Mucking around down the park isnt exactly a reason to not wear a helmet in my eyes
I was going for a leasurely roll around the block with my girlfriend after she got her new bike. I ended up with bits of my face missing as i decided that 10 seconds of speed would be safe and i wouldnt have an accident.... that 10 seconds was all it took to come a cropper..... i still bear the scars today unfortunately
I also think that the argument that those out for a casual ride shouldnt need one is a bit flawed as normally the casual rider is just that, a casual rider, and they wont be as experienced as a person who rides regularly. They also are a bit more blase (spelling?) so i feel its even more reason to wear a helmet.
They say when riding your motorbike that you should dress for the crash, not the ride..... thinking of how i dress when i ride a motorbike to the shops makes me wonder sometimes just how stupid i am wearing some fox shorts and a t-shirt when i ride my pushbike..... i am after all only legally able to do 60kph around suburban streets which is the same speed i have managed to get up to on a decent downhill slope on my mtb.
I found this comment quite amusing, but has some truth about it
"Helmets are not compulsory for car drivers and passengers because they have seat belts, airbags are crumpling technology. Sure, go without helmets, but wear seatbelts and install airbags instead!
The problem with not wearing helmets is that once you have a head injury, you clearly lose the rational ability to understand the need for them"
Like all living things, humans have evolved reasonable protection (such as the thickness of our skull) from dangers they'd experience in a 'typical' pre-historic day. Speeds experienced on bikes, cars and planes have come about way too sudden, so it's important that some further protection is added in the mean time while our DNA catches up (but don't hold your breath).
I also like to think I don't make a parametic jobs any worse than it needs to be if I have an accident. If the accident was gruesome just because I wasn't wearing a helmet, I wouldn't blame the parametic for thinking I'm a jerk avoiding the incovenience of wearing something on my head.
But Kymbo.... wearing a helmet flies in the face of evolution. Survival of the fittest would mean that only those who were thick headed enough to survive accidents at speed would live to breed.
Oh?!?.
Interesting article by a helmet expert and tester on the efficacy (or lack thereof) and limitations of bicycle helmets.:
http://www.cyclehelmets.org/papers/c2023.pdf
There will always be pro's and con's but personally i wont ride without one. Seeing concrete that close to my face while skidding along the footpath at approx 30kph was enough of a scare for me to make me wear one from that day on on
As for the helmets in cars, i am sure they would have something to say about it given the lack of vision most helmets create. Roll cages also save lives to some degree but apparently they are dangerous in street cars....
The help all these safety devices offer in one instance will more than likely turn into further injury in the next. Some will wear some items, others wont. You can never please everyone
Great article Hawkeye. I know what helmet spec I'll be looking for next time.
Hi John, about your original post:
"Cycling rates dropped by approximately a third immediately after MHLs (mandatory helmet laws) were introduced, and have never really recovered from that setback. At best, the decline in injury rates per population mirrors the decline in cycling exposure hours per population, and on the basis of exposure hours it may have even marginally worsened."
Is there any credible reserch to back up this statement please? I must admit that I don't recall observing such a decrease - but personal observations are subjective.
Read through this summary of the history of helmet law introduction , and follow the supporting links:
http://crag.asn.au/?p=2046
He does make a couple of leaps where it seems to me he doesn't properly and completely join the dots to support the point, but those flaws are not sufficient to be fatal to his thesis overall.
As you read you will see that I may well have understated the increase in risk to individual cyclists per exposure hour that has resulted from these laws.
An interesting quote:
The view overseas seems overwhelmingly to be that the risks associated with utility cycling are no more than for walking.
Talk about making leaps of logic, that quote takes the cake
“Good ideas tend to travel and this idea, that you simply must wear a helmet when you cycle, has not. What does that tell you?"
Just because an idea is not adopted widely means it's a bad idea? For example; tobacco advertising has not been banned in much of the world and will most likely never be stopped in the US, does that mean banning tobacco ads is a flawed idea? Not at all, it's just that the world is more complex than just good or bad ideas.
Hello John,
Thanks for your reference to CRAG (Cyclists Rights Action Group) – there is a lot of information to follow up there. From my brief inspection of their information on reduction in cycling after introduction of mandatory helmets, I can see very few specific studies aimed at this question. There is a lot of conjecture on decreases in cycling following mandatory helmets. Just because B follows A, does not mean that B was caused by A (although it is one factor you would look at).
One of the most reputable groups that study this area is the Monash Uni Accident Research Centre (MUARC). The CRAG website gives the following info from a MUAC report (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):
From CRAG:
"4) Surveys in Melbourne by Monash University Accident Research Centre (MUARC) showed total bicycle use by children had decreased by 36 per cent. Finch and others provide data showing the following decreases in numbers of bicyclists observed during the first year of the law: adults 29 per cent, teenagers 46 per cent and children 24 per cent."
However, if you go to this MUARC report and look at the Conclusions – especially the second paragraph:
"7. CONCLUSION
The mandatory helmet wearing law has achieved its goal of increasing bicycle helmet wearing rates for all groups of bicyclists throughout metropolitan Melbourne. Two years after its introduction, high levels of helmet wearing have been maintained in adults and children. Both adult and teenage rates, in particular, are continuing to increase.
The first year following the introduction of the helmet wearing law coincided with a reduction in the number of people riding their bicycles, particularly amongst 12-17 year olds. By 1992, two years after the law, the number of bicyclists was approaching pre-law levels in adults and children but were still greatly reduced in teenagers."
I conclude we have to be VERY careful looking at information presented by a group whose sole aim is to fight the compulsory use of helmets.
You could equally conclude that you need to be very careful looking at information presented by a group whose sole aim is to reinforce the compulsory use of helmets... ie, the government, looking to justify its position. Who funds these studies?
Agenda can be a consideration in deciding how credible a conclusion is, but it does not answer the question whether the agenda is driving the evidence, or the evidence the agenda.
I'm happy to go where the evidence leads, and it does point to helmet use providing a limited level of protection. Hence, I continue to wear one especially out on the trails and in traffic, and would do so even if the mandatory laws were repealed. I don't have any argument with those conclusions.
However, I think it is naive to take the view that compulsory helmets do not act as a significant disincentive to casual cycling, for example for errands to the local shops or a quick trip across the CBD. The only places in the world where bike share schemes have failed are where there are compulsory helmet laws.
This disincentive to take up active transport feeds into sedentary lifestyles and all the health consequences that flow therefrom. It is my view that the evidence supports the view that the cost of this unintended consequence of MHLs is much higher than the savings made. Saving a dollar has cost us more elsewhere.
The Australian experience continues to be the most persuasive argument made against the introduction of MHLs in other jurisdictions.