Rapid Responses to:
|
|
Rapid Responses: Rapid Responses published:
-
![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Delighted to hear this
- Anthony Campbell (4 June 1999)
-
Falling Cyclists
- Phillip Brewer (5 June 1999)
-
Broken helmets
- Chris Gould (5 June 1999)
-
A poor argument to stop head injury
- Brian Boettcher (5 June 1999)
-
The New Jersey Experience
- Arthur L Yeager (5 June 1999)
-
Misplaced fears about cycle helmets.
- Adrian Verrinder (5 June 1999)
-
Online Resource on Helmets
- Ernst Poulsen (6 June 1999)
-
Legislate or Encourage?
- Andy Reynolds (6 June 1999)
-
Congratulations
- Giselle Noceti Ammon Xavier (6 June 1999)
-
Wearing of helmets in sport may increase the chance of injury
- Duncan Sim (7 June 1999)
-
Why pick on cyclists?
- Anthony Cartmell (8 June 1999)
-
The Inverse Safety Law
- David Carvel (9 June 1999)
-
Good but more science needed
- Avery Burdett (9 June 1999)
-
Saving even a few lives along the way must be worth making helmets compulsory
- Anna Linden (9 June 1999)
-
Re: Saving even a few lives along the way must be worth making helmets compulsory
- Andy Reynolds (10 June 1999)
-
speed kills
- John Rider (11 June 1999)
-
change in attitude, not helmets, reduce accidents involving cyclists
- Koen De Smet (12 June 1999)
-
Why I Don't Wear a Helmet
- Ken Kifer (15 June 1999)
-
Re: Donning of Lids - Good or Bad Idea?
- Dave Duffield (16 June 1999)
-
Compulsory wearing of cycle helmets
- K Lim (17 June 1999)
-
Cycling and helmets
- Kranti Kumar (17 June 1999)
-
Helmets and serious brain injury
- Bill Curnow (18 June 1999)
-
Mandatory helmet laws in Western Australia
- Chris Gillham (23 June 1999)
-
Compulsory wearing of cycle helmets is needed!
- A Fraser-Moodie (30 June 1999)
-
I fell, it hurt, it hurt my helmet more
- Tim Oates (30 June 1999)
-
Author's response
- Douglas Carnall (9 July 1999)
-
Re: Compulsory wearing of cycle helmets is needed!
- Chris Gillham (10 July 1999)
-
Policy on bicycle-helmet wearing
- Robert Ekman (14 October 1999)
-
Re: Policy on bicycle-helmet wearing
- Chris Gillham (16 October 1999)
-
Tricycles in Winter should be compulsory.
- Colin Guthrie (18 October 1999)
-
Re: Policy on bicycle-helmet wearing
- Brent Beach (20 October 1999)
-
Mandatory=No, By choice=Yes
- Bernard Labelle (30 November 1999)
-
Road Safety
- Malcolm Manby (23 December 1999)
-
Encouragement Might be Worse
- Ian Ker (28 January 2000)
-
Re: Encouragement Might be Worse
- Chris Gillham (15 March 2000)
-
unconstitutional
- Ward Parker (2 July 2000)
-
Re: unconstitutional
- Peter Morrell (3 July 2000)
-
Policy on bicycle-helmet wearing: reply from the Swedish Group
- Glenn Welander (5 September 2000)
-
No. Promote Cycling, not Helmets
- Malcolm Wardlaw (8 September 2000)
-
Reduction in Risk versus reduction in Freedom
- Kieran Brennan (4 October 2000)
-
Statistics and Childish behaviour
- Dominic Bufton (22 April 2004)
|
|
|||
|
Anthony Campbell, Hon. Cons. Physician, Royal London Homoeopathic Hospital
Send response to journal:
|
I was delighted to read that the BMA Board of Education and Science has rejected the view that cycle helmets should be compulsory. The evidence for the effectiveness of these things is at best inconclusive and the reduction in cycling which would ensue from legislation is a good reason for opposing it. The Board's decision is a welcome contribution to sanity in this matter. I am myself a regular cyclist and I endorse the comment that most of the people who campaign for legislation are not themselves experienced cyclists. |
|||
|
|
|||
|
Phillip Brewer, Assistant Professor Yale University School of Medicine
Send response to journal:
|
There is an implication in this article that "a fall in the number of cyclists" has more significance than a number of falling cyclists. The article states that "deaths and head injuries among cyclists fell between 37%and 51%. However, 40% fewer adults and 60% fewer children continued to cycle after the introduction of the laws." It does not, however state whether there was a corresponding reduction in the nymber of kilometers cycled. In other words, was the reduction mostly of casual cyclists or accross the board. If the number of kilometers cycled remained nearly constant, then a reduction of 37% and 51% deaths and head injuries is indeed significant. |
|||
|
|
|||
|
Chris Gould
Send response to journal:
|
As a regular, experienced cyclist, I nearly always wear a helmet except for the short trip to work. I know too many people who have broken their helmets (while they were wearing them) but who escaped head injury more serious than the odd bruise not to. These injuries were mostly off-road, where falls (by adults) are much more common. Alcohol was a contributory factor in some cases. I do not know of any cases of accidents involving bikes and cars where helmets were damaged. |
|||
|
|
|||
|
Brian Boettcher, Consultant Psychiiatrist Shelton Hospital, Shrewsbury
Send response to journal:
|
Dear sir , As an Australian living in NSW up to six months ago, I have found that there was an improvement in mortality amd morbidity in other states besides Victoria following the compulsary wearing of helments. This was also the case in horse riding which changed in this regard after insurance companies announced that riders and instructors would not be covered if there was a head injury. Australians have largely got use to the sight of helmets and it makes my blood run cold to see people not using them in UK were I now work. Once a few role models in the form if champions in the respective sports are seen wearing helmets younger people do not object so much.There is also better acceptence if the design is modernised and made funky. I thing the agrument against compulsary helments in your letter is thin in view of the serious and often permanent after effects that come with head injury. I have not even mentioned the cost to the nation. Your sincerely Dr Brian Boettcher |
|||
|
|
|||
|
Arthur L Yeager, Retired dentist NA
Send response to journal:
|
I have had the privelige to lead legislative efforts to require the use of cycle helmets by children in the State of New Jersey. We were the first state in the United States to adopt this important safety measure. In the year preceding enactment, 14 children died here as the result of cycle injuries. During the first year of implementation, the statewide toll was reduced to only two. Had the decrease been to 10 or to 8, then the effectiveness could legitimately been challenged. However, with such a dramatic reduction, the efficacy of the measure was beyond question. After the first year, at a celebration, children who were spared injury appeared and displayed their broken helmets. Better fractured helmets than fractured skulls! |
|||
|
|
|||
|
Adrian Verrinder, Lecturer La Trobe University, Bendigo, Victoria, Australia.
Send response to journal:
|
As reported in the current BMJ, the Australian State of Victoria made cycle helmets compulsory in 1990 and the following year the number of cyclists was apparently reduced. Nine years on, however, cycling is more popular in Victoria than it was before 1990. Cycle helmets have been accepted as a sensible safety measure much the same as motorcycle helmets and car seat belts. For those concerned about the price: the price goes down dramatically after introduction. In Victoria a standard helmet now costs less than twenty Australian dollars (around eight pounds) and they come with several different thicknesses of exchangeable internal pads to accommodate growing heads and ensure an accurate fit. They keep the rain off too which, as I recall, would be a useful attribute in the UK. Just like the introduction of seat belts and motorcycle helmets, it started off feeling like just another piece of irrelevant bureaucratic madness. But nowadays as I flush out the coronaries up the hill to work, I feel naked without it. |
|||
|
|
|||
|
Ernst Poulsen, Webmaster
Send response to journal:
|
The European Cyclists Federation has formulated it's official policy on bicycle helmets in "Improving Bicycle Safety - Without Mandatory Helmets". This 16 page brochure is available on the Internet at: http://www.dcf.dk/ecf/html/helmetgb.htm The European Cyclists Federation represents 52 bicycle advocacy groups in 31 countries, with a total of 400.000 members. |
|||
|
|
|||
|
Andy Reynolds, Chartered Mechanical Engineer
Send response to journal:
|
I am delighted by most of this report, which I hope will provide weighty evidence against any future campaigns promoting a mandatory helmet law (MHL) in the UK. Too often the engineering solution to a safety problem has failed to take account of the behavioural responses of people; the evidence from Australia appears to show a clear behavioural response (a reduction in cycling) which could, in time, adversely affect the health of that nation. However, I am concerned that the report nevertheless recommends government subsidy of helmets for children. This seems to suggest that it is only the legislation that drives people off their bikes, and not helmet encouragement. I suspect that giving up cycling is not a response to an unreasonable MHL, but rather a response to the implication that cycling is a dangerous activity (parents - especially non-cycling parents - are particularly vulnerable to such misinformation, hence the greater reduction in child cyclists in Australia). Encouraging better cycling skills and mutual respect between road users would be a far more positive way to reduce injuries than encouraging helmet use. |
|||
|
|
|||
|
Giselle Noceti Ammon Xavier, Sports Medicine Physician Santa Catarina State University - UDESC/Brazil
Send response to journal:
|
We develop a pro-bicycle project and we agree with the article, Congratulations. |
|||
|
|
|||
|
Duncan Sim, SHO Gastroenterology Royal Devon and Exeter Hospital
Send response to journal:
|
The reduction in mortality and morbidity from the compulsory wearing of cycle helmets may be relatively small, not cost effective and at the expense of reducing cycle use(1,2,3). Furthermore, protection may be afforded only in low velocity impacts whereas the wearing of helmets tends to give a sense of invulnerability and from personal experience leads to an increase in velocity(4). In skiing where the majority of deaths occur from head injuries, calls have also been made for the compulsory introduction of helmets(5). In Canada, skiing associated head injuries occur most frequently in young males of whom a large proportion already wear helmets(6). Helmet wearing for recreational skiing encourages an increased velocity through added confidence instilled and by identification with ski racing, thus increasing the chance of personal injury and injury to other skiers and reducing any protective benefit of the helmet. One beneficial effect of legislation for skiing helmets might be smaller lift queues if a similar pattern was seen to that with cycle helmets in Victoria. 1. Br J Sports Med 1996 Jun;30(2):130-3 The pattern of injury in fatal pedal cycle accidents and the possible benefits of cycle helmets. Kennedy 2. Aust J Public Health 1995 Oct;19(5):450-4 The cost-effectiveness of compulsory bicycle helmets in New Zealand. Hansen P, Scuffham PA 3. Accid Anal Prev 1996 Jul;28(4):463-75 Head injuries and bicycle helmet laws. Robinson DL 4. Br J Sports Med 1990 Mar;24(1):55-60 Protective capability of bicycle helmets. Mills NJ 5. US call for mandatory skiing helmets. BMJ. 1998 Jan 17;316(7126):172. 6. Inj Prev 1996 Dec;2(4):286-9 Demographics of alpine skiing and snowboarding injury: lessons for prevention programs. Macnab AJ, Cadman R |
|||
|
|
|||
|
Anthony Cartmell, Software Engineer, Cyclist New Design Paradigm Ltd.
Send response to journal:
|
I have been following the arguments in favour and against compulsory helmet wearing for some years. While I admit to personally preferring not to wear a helmet I have tried to be objective. It does seem to be the case that the pro-helmet advocates rely rather too much on emotional arguments, such as "think of the potential injuries". Since more head injuries occur to car occupants and that helmets would be much easier to wear in a car (easy storage, no overheating problems, much smaller percentage of the transport cost) surely it makes sense to initially trial compulsory helmet wearing in cars? It is a constant regret to me that as a civilised society we seem to have lost the desire to prioritise the rights of weaker members ("steam gives way to sail"). The message is that people driving motor vehicles should be allowed to drive as fast and close as they like, so long as people riding bicysles, horses, or just walking, wrap themselves up or preferably stay at home. At least cyclists are still treated with care and respect in France - a very refreshing change from the UK. |
|||
|
|
|||
|
David Carvel, GP locum Glasgow
Send response to journal:
|
Tudor Hart first used the phrase "Inverse Care Law". The debate still continues about the role helmets play in preventing or reducing head injury in cyling and other sports. There are still those who argue that wearing a helmet leads to increased speeds, risks and injuries. (The Inverse Safety Law?) It would seem eminently sensible to wear a helmet to protect against head injury when there is that risk in sports and other recreations. Making it compulsory is a separate issue. In 1959 motor manufacturers and safety experts laughed at Volvo for introducing seatbelts. It was thought "safer" to be thrown clear of a crashing vehicle. David Carvel |
|||
|
|
|||
|
Avery Burdett, Chairman, Ontario Coalition for Better Cycling Ottawa, Ontario
Send response to journal:
|
While the conclusion that the BMA does not endorse compulsory helmet legislation is to be applauded, there are a number of comments in Douglas Carnell's statement which should give cause for great concern to those interested in finding sound scientific bases for any further action related to bicycle helmet use. A demonstrated need, scientifically collected data showing the efficacy of helmets, and an assessment of the effect on participation are essential prerequisites to encouraging even voluntarily use of bicycle helmets. BMA: "Properly fitted helmets manufactured to accepted standards can reduce the severity of head injury in a crash, though the tests on which these standards are based mimic a fall from a cycle rather than collision with a fast moving vehicle, which is most likely to harm an adult cyclist." Concern: While test standards attempts mimic a fall by in a 1.5m to 2.2m drop test, this of no particular relevance since the test measures acceleration of (linear) forces on the solid headform inside a helmet. Such forces are not exclusively generated by falls but can be generated by secondary and tertiary impacts involving collisions with fast moving vehicles. It can be argued that secondary and tertiary impacts are typical of *falls*, not the primary impact implied by industry tests. This explains why head injuries resulting from falls are rarely worse than minor. Furthermore, the solid headform in tests are crude mimics for a human head of bone and soft tissue, and tests are unable to mimic the compression of the skull and contortion of tissue before the foam liner itself starts to crush at just sub-lethal levels. While it might be reasonable to conclude current helmets will spread initial impacts and reduce minor surface wounds, the threshhold at which they start to reduces g forces is too high to make any difference except to only a very minute portion of lethal blows. These fall between the threshhold and the design limit of helmets (lethal at 300gs). The small number must be offset by the number of injuries *caused or exacerbated* by helmets particularly helmets which are non-spherical in shape. Like certain car seat headrests, such helmets increase the risks of adding torque to simple linear force resulting in more deadly rotational traumas. BMA's statement is of little scientific relevance if types of head injury, of whose severity "properly fitted helmets" can reduce, cannot be isolated and quantified. BMA: "About one in five cyclists in Britain currently wears a helmet. This proportion would have to be increased by promotional campaigns encouraging voluntary action before legislation could hope to be effective." Concern: This is ambiguous, but given BMA's apparent support for voluntary helmet use, it implies support for gradual progression to forced helmet use without providing any assessment of the effect on cycling and health of the apparency that cycling is so dangerous that crash helmets are needed. A study is recommended of the negative experiences of communities in the US (particularly New Jersey) where fearmongering approaches have been used by some "health and safety" groups. BMA: "Some cyclists are opposed to wearing helmets. Research by the European Cycling Federation found that non-cyclists tended to be most in favour of helmets. In fact, a much greater number of lives would be saved if pedestrians and car occupants were encouraged to wear helmets." Concern: For it to be true that a greater number of lives would be saved if others wore helmets, it is necessary to show that bicycle helmet use saves lives. This has yet to be shown. It has not been shown in the most likely places - the jurisdictions which have mandated the use of bicycle helmets. BMA: "The report recommends that the government should consider subsidising this cost, along with other measures to promote helmets manufactured to the highest standard (Snell B95)." Concern: Again the BMA supports the use of bicycle helmets without scientific basis and without consideration to the potential social effect of promoting bicycle helmet use. Avery Burdett Chairman The Ontario Coalition for Better Cycling 170 Laurier Ave West Suite 709 Ottawa, Ontario Canada http://www.globalx.net/ocbc The Bicycle Helmet FAQ: http://www.globalx.net/ocbc/hfaq.html Answers are based on current research |
|||
|
|
|||
|
Anna Linden, 4th year Medical Student Manchester University
Send response to journal:
|
As a cyclist (and, for the record, a helmet-wearer) the thing that stuck out the most for me was the idea that drivers should be tested on their awareness of cyclists and other road users. Too many times have cars opened doors, driven too close or pressed their horns as they pass a cyclist, all of which could cause you to fall off (in which case, a helmet would be useful). Although noone wants to decrease the number of cyclists, surely saving even a few lives along the way must be worth making helmets compulsory for cyclists. |
|||
|
|
|||
|
Andy Reynolds, Chartered Mechanical Engineer
Send response to journal:
|
This argument was, I believe, deployed in the final stages of the compulsory seat belt debate in the early 80s. It is a very weak argument for the following reasons: 1. It implies that the 'cost' of compulsory helmets is so small as to be outweighed by the 'benefit' of just a few lives saved. What are the costs? Well, there's the money needed to buy the helmets, the imposition of yet more restrictions on personal choice, the inconvenience of storing and locking the helmet, the cost of enforcing the law, the cost of prosecuting offenders, the increased lifetime care costs of those who - forced off their bikes as in Australia - become sedentary, and (in the words of the RCN's Sue Jones) the loss of the 'spurious right to have the wind blowing through our hair'. What are the benefits? We simply don't know. Jurisdictions that have mandated helmets have shown an alarming lack of improvement in cyclist injury risk per mile cycled. 2. It assumes that the number of lives saved will always be positive. We know that the risk compensation hypothesis suggests some cyclists will ride more dangerously when forced to wear a helmet, which could lead to more crashes per mile cycled. Now, to turn the argument on its head, 'if only a few extra lives are lost, then compulsory helmets must be a bad idea'. But the problem is that we cannot measure the effect to an accuracy of 'just a few lives'. So the argument rests on the false assumption that lives saved cannot be negative. |
|||
|
|
|||
|
John Rider
Send response to journal:
|
I think for most people cycling at about 12 -15 miles per hour helmets aren't necessary. At that speed you can usually throw your arms in the direction you are falling. I think requiring helmets is part of an effort to make bicycling unavailable to the common people and restrict it to people who wear spandex and ride $1000 bicycles. I wear blue jeans and t-shirts and ride a $10 Schwinn I bought at a thrift shop. I am a cautious rider, in no particular hurry, and the only danger I see on the road is helmetted speed demons cutting corners and endangering all. |
|||
|
|
|||
|
Koen De Smet, project leader
Send response to journal:
|
Sir, The main argument for cycle helmets is that it reduces the severity of head injuries in case of a fall or accident. But cycle helmets do not reduce the number of ACCIDENTS, they may only limit the severity of the resulting injury. The former should be the goal, not the latter in any road safety campaign. What is needed is a change in road-users attidute and raising awareness towards weaker road-users. I moved to Ghent, Belgium last year, after eight years of living and cycling in London. The attitude to cyclists here is completely different. For example, in London I approached every junction expecting a car to pass me at the last minute, without indicators on, and then to cut me off when turning right without 'noticing' me. This has never happened to me in Belgium. Here, a driver intending to turn always looks out for and gives way to a cyclist. (On the other hand, drivers would almost always stop for a pedestrian stepping onto a crossing in London, while this is not the case in Ghent...). So while helmets, better provision for cyclist such as seperate cycle paths, etc, may show that the authorities appear to be doing something, it does not deal with the root of the problem. On the other hand, changing drivers attitudes is not easy. Just to quote somebody entirely out of context: "Given the choice of changing human behaviour ... or designing a better device, the device will always be more succesful" (Weinberg, Emerg.Infect. Dis. 4, 416-419, 1998). But just because changing attitudes will be difficult, is that a valid excuse for not trying? |
|||
|
|
|||
|
Ken Kifer, part-time instructor Gadsden State CC, Gadsden, Alabama
Send response to journal:
|
Many people have argued with me that I should wear a helmet, even if it makes me feel uncomfortable. However, I have traveled over 100,000 miles by bicycle, and during that time, I have not had a single accident in which a helmet would have been helpful (and only minor falls). I have tried wearing helmets; in fact, I have purchased three, and I found them painful to wear. My problem is that my head is much more oval than the helmet. If helmet wearing should become mandatory and enforced, I would either quit riding, ride much less, or ride in defiance of the law. This idea that I should be forced to give up riding a bicycle just so people who ride incompetently will gain additional protection is beyond me. If cyclists find helmets to be too uncomfortable to wear, it seems to me that the manufacturers should do a better job of designing them. For instance, a simple helmet-band to replace the foam blocks would do much to make the helmets more wearable. Ken Kifer http://www.kenkifer.com/bikepages/ |
|||
|
|
|||
|
Dave Duffield, Senior Engineer Yazaki North America
Send response to journal:
|
Mr. Campbell, Although I defend your right not to wear a helmet, I think your mistaken, as well is the article in the British Medical Journal, about their disuse being a good incentive for attracting more people to cycling. Ask anybody in the medical field about closed head injuries and how they can change a person's mental abilities for ever how they feel about wearing helmets. I am an experienced rider and never wore one for the majority of miles I rode in my youth and can tell you that I wear one now and will never be without it. All it takes is one event with a head injury to ruin your life and I'm willing to put on one extra piece of equipment to guard against that event. For your sake, I hope that one event never happens to you as it would be one hell of a way to discover you may have been mistaken. |
|||
|
|
|||
|
K Lim
Send response to journal:
|
Editor I was interested to read the news article in the 5 June issue of the BMJ, and found it difficult to believe that people would choose not to cycle, simply because they have to wear a cycle helmet! Contrary to the quoted research, I am a keen cyclist and am also a keen advocate of helmets. I am currently working as a Paediatric SHO and, as the summer approaches, the ward is increasingly populated by children being observed for head injuries; having fallen off their bikes (usually without having collided with a vehicle) while not wearing a helmet. A number of points spring to mind: -Parents claim that they will do anything in the best interest of their children's health; surely this should stretch to ensuring that they wear cycle helmets? -It is one thing to concentrate on reducing motor traffic speeds, but surely campaigns promoting the use of helmets (at least in children) would also be indicated; there has not been much evidence of promotional campaigns so far in this country. -If cycle helmets were compulsory in children (i.e. under 16 years), by the time these children became adults, they would feel 'unsafe' cycling without a helmet (just as adults who have always had to wear seat-belts while driving do not now feel 'safe' driving without them). The parents of every child discharged from the ward following a cycling accident claim that helmet wearing will now become compulsory in their home; it is a shame that an accident has to happen in order to prevent further potential accidents. K Lim Paediatric SHO Nevill Hall Hospital Abergavenny Gwent NP7 7EG |
|||
|
|
|||
|
Kranti Kumar
Send response to journal:
|
Editor-It is puzzling to read the conclusion of the British Medical Association's Board of Education and Sciences that cycle helmets should not be compulsory(1). There is no shortage in Accident & Emergency departments of cyclists who are accident victims. These days when there is so much emphasis on accident prevention, advice from such a respected body is absurd.Very few towns can plan exclusive roads for cyclists. Milton Keynes has Redways but even they do not give complete immunity from accidental injuries resulting from falls and skids.With ever increasing gears and gadgets , cyclists are now able to propel at high speed and some of the injuries seen by me in the department are quite astonishing such as multi fragmented intra articular fracture of the wrist in fit healthy adults. Wearing a helmet will not prevent accidents completely, but it acts as a constant reminder to the cyclists that the activity is hazardous and there is need to be careful.I think that the cycle manufacturers/importers and the Government should work out a deal where safety features are subsidised.The cost to the nation for unsafe cycling will be pretty high. Cheaper, safer bikes would reduce health hazards. The cost should not be prohitive to the user nor should it be the driving force to recommend its rejection. Kranti Kumar Consultant A&E Medicine MK General NHS Trust Milton Keynes MK6 5LD 1 DouglasCarnall reporting BMJ 1999;318:1505 |
|||
|
|
|||
|
Bill Curnow, Retired scientist
Send response to journal:
|
Helmets and serious brain injury The BMA’s decision not to support the compulsory wearing of bicycle helmets is welcome, but there are stronger reasons than the discouragement of cycling. There are good grounds for believing that helmets as currently tested and designed can do no more than protect against superficial injury to soft tissue and fracture of the skull and may actually increase injury to the brain. Injury to the brain is the head injury most important for public health, and has been the focus of campaigns in Australia to promote the wearing of helmets. It is what makes the wearing of helmets a more important medical treatment than say pads to protect knees or other parts of the body. Holbourn formulated a mechanics of brain injury according to physical properties of the brain and laws of physics.(1) He pointed out the extreme incompressibility of brain substance and its low rigidity. Thus, the brain does not appreciably change in size when subjected to uniform pressure in all directions, and there is no injury from strains of compression and rarefaction produced by linear forces of acceleration/deceleration from a direct blow. But brain substance offers little resistance to changes in shape and is easily injured by shear-strain, the type of deformation which occurs in a pack of cards when it is deformed from a neat rectangular pile into an oblique-angled pile. The predominant cause of shear-strain and brain injury is sudden rotation of the head. After Holbourn, experiments with monkeys showed that linear forces are a minor cause only.(2,3) Development of bicycle helmets began empirically and has had insufficient regard to the mechanics of brain injury. By analogy with helmets worn by soldiers, miners and the like, it might seem that helmets can protect cyclists against brain injury, but the analogy is false. The dominant mechanism that results in rotation of the head when a cyclist weighing say 50 kg is in a collision is a large change in momentum. By contrast, when the head is struck by a 10 gram bullet travelling at 400 metres per second, per Holbourn’s example, the dissipation of its high kinetic energy is dominant but its low mass and momentum produce little rotation - according to Holbourn about the same as that produced when one walks into a wall at 2 miles per hour. Another comparison would be a 100- gram stone that had fallen 80 metres. Various studies in recent years are cited as proving the efficacy of helmet wearing, but none of them tests a hypothesis of brain injury according to scientific laws; they are all empirical correlations of helmet wearing and head injuries which shed no light on the processes involved. The mode of development of helmets is reflected in the standards by which they are tested and designed. The concern here should be with the problem of reducing rotation of the head due to change of momentum, but the standards reflect no cognisance of that. Instead, their concern is with reducing the linear deceleration of the head by absorbing energy upon impact. To measure this, a helmeted head form is dropped onto a hard surface. The impact is direct to the top of the head, though blows to its front and sides are more common in cycling accidents and therefore more likely to cause rotation. This preoccupation with absorbing energy apparently is a result of plastic foams becoming readily available. Rather than a rational response to the main cause of brain injury, the development of helmets has been driven by the technology of mass-producing new styles in which energy-absorbing foam is the constant component, while hard shells have largely been abandoned in favour of thin shells or no shells. Helmet wearing may actually increase the risk of brain injury. In Australia, Corner et al showed experimentally that the added mass of a helmet has the effect of increasing the rotation which a glancing blow may impart to the head.(4) Corner et al also recommended against soft-shell helmets being allowed, saying that shells should be very stiff with a low impact sliding reaction, but standards now allow soft-shell helmets. Tests of impacts of helmets on asphalt at 34 km/h have shown that, unlike hard- shell helmets which slide, soft helmets grab the surface, rotating the head.(5) Australia’s National Health and Medical Research Council independently assessed the role of helmets in head protection in a 1994 study of football injuries.(6) In answering the question "Do helmets reduce injury?", the NHMRC assessed four studies examining the effectiveness of cycling helmets. The NHMRC concluded that helmets may possibly reduce scalp lacerations and other soft tissue injury, but may increase cerebral and non-cerebral injuries including diffuse brain injury. On this assessment, any protection from superficial injury would be at the cost of increased risk of brain injury. Experience with compulsory helmet wearing in Australia shows that rates of injury to cyclists increased after compulsion, including total injuries to the head, but official assessments continue to misrepresent this reality. Some details are given at http://www.pcug.org.au/~psvansch/crag/cabart.htm and in Robinson, D.L., Head injuries and bicycle helmet laws, Accid. Anal. and Prev. Vol. 28, No. 4, 1996, pp. 463-475. 1. Holbourn, A.H.S., Mechanics of head injuries, The Lancet, 2, 338- 441, 1943. 2. Ommaya, A.K. and Gennarelli, T.A., Cerebral concussion and traumatic unconsciousness: correlations of experimental and clinical observations on blunt head injuries, Brain, 97, 633-654, 1974. 3. Gennarelli, T.A., Thibault, L.E., Adams, J.H., Graham, D.A., Thompson, C.J. and Marcincin, R.P., Diffuse axonal injury and traumatic coma in the primate, Ann. Neurol., 12: 564-574, 1982. 4. Corner, J.P., Whitney, C.W., O'Rourke, N., Morgan, D.E., Motorcycle and bicycle protective helmets requirements resulting from a post crash study and experimental research, Federal Office of Road Safety report CR 55, May 1987. 5. 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. 6. National Health and Medical Research Council, Football injuries of the head and neck, AGPS, Canberra, 1994. |
|||
|
|
|||
|
Chris Gillham, Journalist Self-employed
Send response to journal:
|
Congratulations on your news item Cycle Helmets Should Not Be Compulsory. Western Australia has the most detailed cyclist number / injury number / injury type / extended timeframe data in the world re this draconian law. Most of the data collected over the past eight years can be found at this site: www.iinet.net.au/~property/bicycle_helmets.html The site provides previously unsighted information regarding the impact of helmet laws which would be of interest to the British medical fraternity. |
|||
|
|
|||
|
A Fraser-Moodie
Send response to journal:
|
Dear Editor I read with interest the BMA's Board of Education & Science conclusion that legislation to make helmets for cyclists would reduce the number of cyclists and not be in the interests of health (D Carnall 'Cycle helmets should not be compulsory' BMJ Volume 518, page 1505). As an Accident and Emergency Consultant for over 20 years, I have seen far too many head injuries in cyclists - some fatal. The main factor in causing most accidents is human error. I agree that cycling proficiency should be taught in all schools and the driving test modified for awareness of cyclists and other road users. The Government should subsidise cycle helmets and promote them through the media by advertising. We also desperately need better cycle routes nationwide. My wife and I as well as our five children all cycle helmeted. My son James races on a mountain bike and helmets are then compulsory. The inconvenience of wearing a helmet is minimal. The benefit of injury protection is enormous. Our Government is committed to reduce injuries from accidents. (Our Healthier Nation). The main cause of death in children is trauma. But I have personally discussed at length the benefits of wearing a helmet with children when each one unhelmeted has suffered a fractured skull in a cycle accident. Many children still remain unconvinced! Parental control is weak. So voluntary action to increase the wearing of cycle helmets in this age group is unlikely to succeed. As a nation we are relatively unfit and car-bound. More people need to cycle to get fitter and also reduce pollution. Un-helmeted in our traffic the cyclist takes his/her own life in their hands. Something needs to be done urgently. My answer is that the compulsory wearing of cycle helmets is needed now. This should be introduced as part of a cyclist's programme - teaching, better routes, helmet subsidies and increased awareness through publicity. The number of cyclists may well reduce initially but more importantly head injuries will become less too! However, in the future, the population of cyclists naturally will then increase as cycling at last becomes safer and so even more enjoyable. Yours faithfully Mr A Fraser-Moodie FRCS Consultant in Accident and Emergency Derbyshire Royal Infirmary |
|||
|
|
|||
|
Tim Oates, researcher QCA 29 bolton st london uk
Send response to journal:
|
Personal perspective: you should have seen my helmet after I wiped out last year - 20 mph off road, straight down onto rocks and stones on a fast, flat section. Amnesia for 7 hours. 3mm rip on the saddle of my bike - that's all. I fell, the total deceleration was through my left temple and left shoulder. All the energy went through those parts of my body. The medical consensus was that I had moderate concussion rather than a fractured skull, since I fell onto sharp flints; the helmet (Specialised Mountainman) was crushed on the left hand side (from about 10mm to 2mm) and was nearly perforated by the sharp stones. The forces were sufficient to detach my left shoulder (type 4 separation as the medics say)...I feel that the same forces which almost cost me the use of my arm would have totalled my skull but for the helmet. That's the personal emprical bit. The helmet companies which operate exchange programmes (Specialised, Giro) also have personal anecdotal stuff - letters which accompany returned helmets....which are an important source of qualitative data. But as a social researcher I must endorse the view that contextual stuff must not be ignored...helmet wearing is no substitute for better cycle lanes, driver education, enforcement of cycle lanes etc etc etc and we must continue to lobby. As in all social (and many medical) contexts, it's not just one thing which counts, it's the interaction of many; and they intereact in different ways in different countries. But now...a bit of reductionism..I love cycling in Amsterdam (structure of cycle ways is great), Berlin (driver attitudes are exemplary) and so on. I am very interesting in the entry on the physio-physics of brain damage...the issue of rotational damage and the design of helmets. More on this, and links to helmet manufacturers re design would surely take us forward. A good contribution to a controversial debate. yes, note...injuries per km travelled is a much better measure and should be used in the stats, hypotheses and conclusions, as well as detailed work on different categories of riders - eg ages, those whose 'leisure' cycling consists of training for events etc. ...as for friday evening on the hills....I'll be wearing my helmet as always.... |
|||
|
|
|||
|
Douglas Carnall, Associate editor BMJ
Send response to journal:
|
Helmet wars: author's response. It is not BMJ style to declare conflicts of interest in News, but for the record, I cycle daily to work, and do not wear a helmet. I gave it up for two reasons: my girlfriend won't wear one, and it's a pain to carry about. Cycling should be convenient. If I die on the road, it will not be because I didn't wear a helmet, but because a motorist failed to exercise sufficient care. To respond to the debate: I hope that Brewer is not advancing the argument that it does not matter if casual cyclists are dissuaded from cycling, just so long as the all-important head injury rate/kilometre decreases. This is the kind of narrow view that gives epidemiology a bad name, ignoring as it does the substantial reduction in cardiovascular disease that regular exercise can bring; and don't forget how much fun it is to ride a bike. Boettcher claims that cycling levels have now been restored to pre-helmet law levels in Victoria. Even so, the British government's 1996 National Cycling Strategy calls for a modal shift from private motoring to cycling, not a decade-long slump in cycle use. Yeager supplies inadequate information on which to assess the success of his campaign: we need a denominator, before we are impressed by the reduction in deaths. If, as seems likely, deaths fell because the helmet laws dramatically cut the number of children who cycle, perhaps he will organise a party in ten years time to celebrate New Jersey children's car dependence and lack of habit of exercise. Verrinder reassures us that once helmets are compulsory their price falls; not to zero, it seems. Kumar's reminder that wearing a helmet does not stop you breaking your arm seems fair enough, but his assertion that wearing a helmet would remind you not to do dangerous things is already elegantly refuted by Sim. Linden suggests that "surely saving even a few lives along the way must be a good reason for making helmets compulsory," What is it about medical students that makes them think like this? I know I was the same. Anyway, I've lurched towards respect for autonomy in my old age, certainly in a case as controversial as compulsory cycle helmet law. I'd like to know why Oates fell off his bike. Naturally I am impressed that he can cycle at 20 mph, but any vehicle should be ridden/driven at a speed within a capacity of the user to control it. It seems that it was this psychological error that caused the crash. His choice of headwear would be about as relevant as the colour of the underpants he was wearing at the time, but for the possibility that it may have caused him to have a hallucination that he was invulnerable to injury. But the problem with the helmet controversy is the time and effort that it diverts from the real problem: that there is no effective sanction for the motorists who speed and kill 10 people a day in the UK. 75% of British drivers admit to speeding regularly. Speed is a factor in the majority of crashes. Note: the word accident implies, at very least, that no one was negligent or breaking the law at the time. Modern cars are designed to blot out external reality for their drivers and unfortunately, this means that otherwise perfectly nice people become motorised killers, while suggesting their potential victims don "safety" equipment. <A HREF="http://www.car |
|||
|
|
|||
|
Chris Gillham, Journalist Freelance
Send response to journal:
|
"As a nation we are relatively unfit and car-bound. More people need to cycle to get fitter and also reduce pollution. Un-helmeted in our traffic the cyclist takes his/her own life in their hands. Something needs to be done urgently. My answer is that the compulsory wearing of cycle helmets is needed now. This should be introduced as part of a cyclist's programme - teaching, better routes, helmet subsidies and increased awareness through publicity. The number of cyclists may well reduce initially but more importantly head injuries will become less too! However, in the future, the population of cyclists naturally will then increase as cycling at last becomes safer and so even more enjoyable." This excerpt from the posting by A Fraser-Moodie seems to be a standard line among pro-helmet advocates. Nine years after mandatory introduction in Australia, cyclist numbers have still not returned to the level pre-legislation - DESPITE a national population increase of well over a million people. The health cost from this decade of cycling avoidance will be astronomical. These people aren't riding their bikes to the local shop like they did in the 1980s. They're driving their cars instead - increasing traffic density and further endangering both cyclists and motorists. The greenhouse input is yet another issue. To say that a reduction in cyclists will lessen head injuries is an absurdity. About a hundred Australian cyclists die each year, but about 300 people drown. Hey, let's ban swimming and reduce the death toll! The pedestrian fatality and injury rate is about four times higher than for cyclists... should the government regulate walking? Regardless, the head injury toll has now hit record levels in Western Australia, despite cyclists numbers still being between 20-30% less than pre-legislation. To say the cyclist population will eventually get bigger because people will find it enjoyable to don a helmet is a prediction barely worthy of response... |
|||
|
|
|||
|
Robert Ekman Falköping Safe Community & WHO Secretariat, Götene, Sweden
Send response to journal:
|
There is strong international evidence that the wearing of a bicycle helmet reduces the risk of being seriously injured in an accident by 60- 80%. There is no empirical justification for saying that a compulsory helmet-wearing law reduces bicycling as a means of transportation. Experiences from Australia and New Zealand show that most people continue to cycle, using a helmet as protection, after legislation comes into force. During a short period following legislation in Australia a slight decrease in bicycling among groups of teenagers and adults was detected, but there is no scientific evidence that this is a lasting effect. A recently published study, "Cycle helmet effectiveness in New Zealand" by L.J. Povey et.al. (1999), shows that the helmet-wearing rate for 1989 was 20% for adults and teenagers, and 40% for younger children. A helmet law was introduced in 1994. In 1998 the wearing rate for all age groups in New Zealand was more than 90%. In Sweden there is the same discussion over the pros and cons of mandatory bicycle-helmet wearing. But, there is also a demand for a compulsory law to provide support for the many individuals with the courage to use a helmet when cycling. Swedish experiences demonstrate high effectiveness of comprehensive bicycle-helmet programs, which result in significant decreases in head injuries. But voluntary movements of this kind develop too slowly, and -- in the meantime - many people are killed or severely injured. Since 1978 more than 1,600 bicyclists have been killed on Swedish roads - comparable with two "Estonia ship disasters". (The Estonia sunk on the Baltic Sea a few years ago.) The Swedish Bicycle Helmet Initiative Group cannot see any point in waiting for lives to be saved. Head injures among bicyclists are a serious problem. In our view, bicycle helmets are an effective "vaccine" against head injuries. A compulsory helmet-wearing law would allow the vaccine to reach all bicyclists - in Sweden 6 million out of 9 million inhabitants. The Swedish Bicycle Helmet Initiative Group: Leif Svanström M.D., Ph.D., Professor Lothar Schelp M.Sc, Ph.D, Associate Professor Robert Ekman, M.P.H., Ph.D., Glenn Welander BJ, Licentiate The Swedish Bicycle Helmet Initiative Group was formed in 1991, and has representatives from: Karolinska Institutet, Dept. of Public Health Sciences; Sweden's National Institute of Public Health, National Injury Programme; the Swedish National Road Administration, the National Swedish Board for Consumer Policies; Sweden's National Board of Occupational Safety and Health; the Swedish National Road and Transport Research Institute (VTI); Sweden's National Police Board; theUniversity of Linköping; Stockholm County Council; Västerbotten County Council; SP Swedish National Testing and Research Institute ; Sweden's National Road Safety Association (NTF); the Swedish Cycle Society; the Swedish Cycling Promotion Organisation; and, the Municipality of Götene. Swedish Bicycle Helmet Initiative Group, WHO-Sekretariat, Centrumhuset, SE-533 80 Götene, Sweden Phone: +46 511 460 67; Fax: +46 511 597 92; Mobile phone: +46 709 42 15 85 E-mail: robert.ekman@phs.ki.se, or glenn.welander@phs.ki.se Website: www.safetyandhelmets.nu |
|||
|
|
|||
|
Chris Gillham, Freelance journalist Western Australia
Send response to journal:
|
To justify a perceived need for mandatory bicycle helmet legislation in Sweden, Robert Ekman has based his argument on fallacies. The assertions made in his letter should be corrected to ensure the public is not deceived: "There is strong international evidence that the wearing of a bicycle helmet reduces the risk of being seriously injured in an accident by 60- 80%." Where is the international evidence? The purported 60-80% risk reduction is based on laboratory drop testing of helmets, the validity of which is under question. In any event, the statistic bares no correlation to the "real world" experience in those statutes unfortunate enough to have suffered mandatory helmet laws. To quote official research in Western Australia, where helmet laws were enforced in 1992: "Injury severity for the years 1988 to 1996 was coded using the Abbreviated Injury Scale (AIS)... The percentage distribution of injuries by severity level remained more or less constant over the ten year period... The total number of recorded injuries to cyclists increased from 590 in 1987 to 1,223 in 1996. This averages one injury per cyclist in 1987 (excluding cyclists admitted for observation who had no recorded injury) and 1.7 per cyclist in 1996..." * There has been no 60-80% reduction in injuries, serious or otherwise, in any of the world locations which have enacted this law. In all such locations, any recorded injury reduction has been minimal and does not match the corresponding fall in cyclist numbers. In various instances, an increase in total injury numbers has been recorded despite the decline in public recreation. * Bicycle Crashes and Injuries in Western Australia RR60; March 1998; Delia Hendrie, Carol Kirov, Susie Gibbs; University of Western Australia; RoadWatch; Main Roads WA. "There is no empirical justification for saying that a compulsory helmet-wearing law reduces bicycling as a means of transportation. Experiences from Australia and New Zealand show that most people continue to cycle, using a helmet as protection, after legislation comes into force. During a short period following legislation in Australia a slight decrease in bicycling among groups of teenagers and adults was detected, but there is no scientific evidence that this is a lasting effect." It has been without argument throughout the 1990s that official surveys in all Australian States recorded a substantial decline in cyclist numbers, ranging up to 57% for weekend cycling in the city of Perth and averaging more than 30% across Australia. The law was enforced in the State of New South Wales in 1991, when 6,270 cyclists aged under 16 were counted by the Road Traffic Authority at one survey location. By 1993, the under 16 total at this location was 3,478 - a fall of 41%. The surveys are conducted and collated by government departments, not by independent or vested interests. The same decline has been experienced in New Zealand and, in the Canadian province of British Columbia, the estimated reduction is 25%. To quote a West Australian government official in a 1996 press release: "In the past five years the number of schoolchildren cycling to school has more than halved". West Australian government surveys in 1998 showed cyclist numbers 15% lower than in 1991, despite a 10% population increase during that time. It is beyond question that the helmet law reduces cycling participation and, eight years later, cyclist numbers in Australia remain well down. To suggest otherwise is simply wrong. "A recently published study, "Cycle helmet effectiveness in New Zealand" by L.J. Povey et.al. (1999), shows that the helmet-wearing rate for 1989 was 20% for adults and teenagers, and 40% for younger children. A helmet law was introduced in 1994. In 1998 the wearing rate for all age groups in New Zealand was more than 90%." And? Similarly large improvements in helmet wearing rates have been recorded in all jurisdictions where the State prosecutes its citizens for exercising. Death and injury rates have either declined only marginally (ignoring the considerably greater falls in cycling participation), remained static or reached historic record levels, as in Western Australia. Robert Ekman's citing of helmet wearing rates, in light of the concurrently lower cycling participation and high hospitalisation rates, illustrates the point... HELMETS DON'T WORK. "In Sweden there is the same discussion over the pros and cons of mandatory bicycle-helmet wearing. But, there is also a demand for a compulsory law to provide support for the many individuals with the courage to use a helmet when cycling." A demand by whom? Vested lobby and governmental interests, or the wider community? The source of this claimed demand requires validation. And might one ask... why do individuals need "courage" to use a helmet when cycling? "Swedish experiences demonstrate high effectiveness of comprehensive bicycle-helmet programs, which result in significant decreases in head injuries. But voluntary movements of this kind develop too slowly, and -- in the meantime - many people are killed or severely injured. Since 1978 more than 1,600 bicyclists have been killed on Swedish roads - comparable with two "Estonia ship disasters". (The Estonia sunk on the Baltic Sea a few years ago.)" If you look at Sweden's pedestrian fatalities since 1978, several Titanics have also gone down. And if you wish to consider Sweden's death toll since 1978 from motor vehicle accidents, alcohol, smoking, swimming, horse riding and sky-diving, the Estonia comparison can be seen for what it is... emotional claptrap. I trust Robert Ekman never accuses helmet opponents of using "lies, damned lies and statistics" "The Swedish Bicycle Helmet Initiative Group cannot see any point in waiting for lives to be saved. Head injures among bicyclists are a serious problem. In our view, bicycle helmets are an effective "vaccine" against head injuries. A compulsory helmet-wearing law would allow the vaccine to reach all bicyclists - in Sweden 6 million out of 9 million inhabitants." That "vaccine" can already reach all of Sweden's cyclists if they so choose. Robert Ekman is effectively proposing a mandatory vaccine with a track record as encouraging as thalidomide. Based on the Australian experience, there would soon be about 4.5 million of Sweden's 9 million residents who remain cyclists. Regular cycling is estimated by world medical authorities to add an average ten years to the life of an individual. That 1.5 million reduction in Swedish cycling participation would equate to 15,000,000 years of premature death. Socal engineering of this nature should be condemned. In view of the overwhelming evidence from Australia and elsewhere, the Swedish government would stand liable for damaging public health should a compulsory helmet law be introduced. For detailed analysis of the helmet experience in Western Australia, see: |
|||
|
|
|||
|
Colin Guthrie, applying safety plasters to the heavily haemorraging with one hand behind back 1448 Dumbarton Road Glasgow G14 9DW
Send response to journal:
|
Haven't driven for five years, used bike and trike (winter) in general practice for 15 years. Only GP in Britain who is completely car- less?( Sorry , apart from my wife and partner....or should I say my partner and partner or is it partner and wife..oh what the hell.... Thinking of cycling safely in town ? May I give a little advice? Safety when cycling in a town like Glasgow is simplicity itself, it is of course a state of mind. You just have to be an aggressive bastard of the first order. Assume all car-drivers are doped up maniacs hell-bent on destroying as many cyclists per day as possible( not far off the mark in these parts ) Assume...and this is vital for your survival...that all stationary car doors will open. If a car door takes you out then it may legally be their fault but , chum, you know it's really your fault. Take what some people call 'liberties' at those lights that have regretfully failed to provide a safety advance start/ time advantage for us cyclists. This should not of course be to the danger of any pedestrians but the cogging cognoscenti amongst youse will know what I mean...that sweet knowledge of light sequences that sends us on a fast right advance just a second or so before the lights change...those deft swings onto a peddle to push through carefully on the green man...not illegal (and memorably copied by Mr Bean once as he pushed his mini through a red light). That aggression / knowledge is our helmet, but is it something we are born with or is it developed ? I fancy it is the former.Some may disagree. May I conclude with an ad for one of cycling's best kept secrets...the tricycle.(Am currently using a Brompton...T5 of course...well I am a Doctor....and this is the bizz for docs who want to whizz and fizz around town...a celebration of all thats nippy and practical...a bundle of joy that you can pack down in 20 secs to a package that fits on bus, train, taxi...or even back of another bike...slower than conventional machine but a dream of miniature prcticality with s wonderful click-on bag that looks a bit like your'e working for the royal mail but is just right as a GP's bag) Ah yes...the Tricycle....well in Winter one wou;ld be rather a mug to be to risk one's cerebrals on ice...try a trike, more expensive and slower but so much safer in dangerous weather...ie high winds / ice..... Helmets? Not unless your daft enough to go out on two wheels on ice...My view is that we need a big change in Britain with an adopption of Transport 2000's marvellous booklet called 'Living Streets' where drivers will be reduced to 10mph and roads will be centres for play and the community rather than the linear car parks they are now. Roll on Home Zones.(Children's play council) When you're being bombed you don't hide in shelters you stop the bombing. Give the streets back to the people. |
|||
|
|
|||
|
Brent Beach, Retired
Send response to journal:
|
Robert Eckman, a member of the Swedish Bicycle Helmet Initiative Group, is either woefully ignorant of current research on bicycle helmet use and safety, or is attempting to mislead readers of this page. His statements as to ridership rates are unsupported by reference to published articles. They are contradicted by a very large body of published evidence (see a previous item by Gillham for references). If Mr. Eckman is unaware of the published evidence, he should educate himself before offering himself as an expert on bicycle helmets and safety. He should also refrain from using his medical degrees as moral authority when he knows nothing about an issue. It casts a poor light on the entire medical profession. It is well known that WHO has a pro-helmet bias. Is Mr Eckman employed by WHO, or does he receive any benefits for being part of the Initiative Group? Perhaps a statement of his interests in this issue would be appropriate. |
|||
|
|
|||
|
Bernard Labelle, Teacher, adults only !! Govt.
Send response to journal:
|
Should you or your child wear a helmet because : 1. It is your responsability and choice to protect yourself.( Hockey players wore jock straps years before helmets without legislation :*) 2. The legislator refuses to implement safer cycling infrastructures.(They're legislators, not cyclolators!) 3. The police will use their sirens and lights and guns and patrol cars to stop, fine and arrest little 10 year old criminals.(Why use education when you have a Police force ?) 4. You agree with the principle of " I have a car, get out of my way you environmentalcyclomoron " ( I pay my taxes, I'm allowed to pollute !) 5. Highway authorities love good traffic control. If you want to play in the traffic, wear your helmet. ( Rules are rules: if you're not turning right stay in the middle lane, 80 miles/hour.) 6. If you work hard at asking the Govt. to fine you $60. for not wearing a helmet, then for the 4th time you will be proud to pay the #$%@#$%$#@?&@ fine when your 10 year old forgets again to wear it.(If you don't pay, they keep the child!) 7. You think all good things should be legislated IN and bad things OUT, easy. Cigarettes, alcool, cars, mafia OUT. Helmets, masseuses and apple pie IN. (Taxes/sex IN or OUT ?) 8. Promoting a sensible thing is superior to coercing a good thing. Get it ? Education and promotion are the tools of civilization. (To legislate repressive or compulsory measures towards children's safety is worse then convincing us and them to wear our helmets through promotion and education.) |
|||
|
|
|||
|
Malcolm Manby, Road safety consultant Harrogate N Yorkshire
Send response to journal:
|
Dear sir, We are a company that has some ideas, to overcome many of the accidents on the highways, www.hi-lites2000.com This has been put to the head of Network Management and driver information, at the Ministry of Transport, who have said they will authorise any department, willing to try hi-lites. Yours safely Malcolm Manby. |
|||
|
|
|||
|
Ian Ker, Councillor, Town of Vincent
Send response to journal:
|
As the principal author of the Perth Bikeplan of 1985 and the WA Bike Ahead Strategy of 1996, I was interested to have my attention drawn to correspondence on the topic of compulsory helmet wearing, where much has been made of the experience in Australia and Western Australia. Unfortunately, the data for Western Australia cycle usage are inadequate to support or disprove any hypothesis on the impact of compulsory helmet wearing at this stage. Despite anecdotal and location- specific information, the most recent comprehensive data (for 1994) still showed a small increase on the previous survey (1989) in the number of people and the proportion of the population that cycled at least once a week - compulsory helmet wearing was introduced in January 1992 in WA. Nevertheless, it is true that this data, because it is episodic rather than continuous, is consistent with a number of interpretations, including: a) cycling activity continued to increase, but the rate of growth had
slowed dramatically;
It is also possible that some other influence brought about change to the level of cycling activity. In the absence of continuous data showing a significant reduction in cycling soon after the introduction of compulsory helmet laws, it is not possible to do more than infer a causal relationship. However, the data for cycling to school is reasonably robust over a period of years and shows a sustained decline, from 1988 to 1993, in the use of bicycle for travel to school (from 33% to 15% in high schools; and from 15% to 9% in primary schools (TRAFFIC BOARD OF WESTERN AUSTRALIA (1993). Bicyclist Helmet Wearing in Western Australia: A 1993 Review. Perth, WA.)). Given the preponderance of schoolchildren among cyclists, a 50 per cent drop in activity (especially if also reflected in cycling at other times, not just to and from school) has the potential to 'explain' almost any 'measured' reduction in cycling activity over that period. To the best of my knowledge, there was barely a blip on the trend line when compulsory helmet legislation came in. At the same time, the Traffic Board reported:
These data suggest that an alternative, more complex, explanation is
required. This might include:
The hypothesis might be that any initiative that draws attention to the dangers/risks of an activity will, in the absence of additional contemporaneous measures to reduce the danger/risk bring about a reduction in the level of participation in the activity and that the impact will depend upon the level of other benefit the participant gets from the activity. This is consistent with known human behaviour and is independent of the actual level of the risk, as the impact is purely on the perception of risk by the parents. This itself is no more than a plausible hypothesis, but it can, in principle be validated by reference to places where there had been continuing promotion of helmets (such as WA) and other places where compulsion was not preceded by | |||