BORIS BIKES – AN OLYMPIC CATASTROPHE?

Neil S.P. Smith, Dominic N.P. Thompson
St George’s Hospital, London; Department of Neurosurgery, Great Ormond Street Hospital

With the astounding success of our track cyclists, London is likely to see an even greater growth in the number of cyclists sporting Wiggo burns, cruising through the capital on Boris bikes. In fact, when he isn’t dangling from a zip-line, our self-professed ‘cycle mad’ mayor has targeted a 400% increase in use by 2026 on 2001 levels (1).

Cycling brings enormous benefits to the environment and health, with estimates suggesting that 12.46 deaths were avoided annually in the equivalent scheme in Barcelona, as a result of extra physical activity, which dwarfs the average 0.03 increase in road accidents (2). How wonderful would it be if part of the legacy of these Olympics meant that more people take to their bikes, creating a clean, healthy city, where the sound of the car horn is replaced by the tinkle of cyclists bell.

So here’s the catch. Next time you find yourself on a busy road in London, take a minute to watch as Londoners Boris bike through the city. As they gently amble by with London’s busy traffic thundering around them, you will soon notice that they do not look the same as other cyclists. On the whole, they have absolutely no protection on their heads - Boris bike cyclists do not wear helmets.

We conducted a short study of 1331 cyclists in some of the main areas of Boris bike uptake – South Kensington, Oxford Street and Trafalgar Square. Up to a massive 32% fewer Boris bike users wear helmets. In a city the size of London, that’s a lot of people. More importantly, that’s a lot of lives at risk.

Aha you say, but do helmets really work? Doesn’t wearing a helmet actually mean that drivers are more likely to hit you? Come to think of it, surely an expensive piece of shaped Styrofoam strapped to your head will be of little use when a three ton truck upends you from behind? Codswallop.

Meta-analysis data shows that helmets prevent head, brain and fatal injuries (3), and a Cochrane review found a 63 to 88% reduction in risk from cyclists of all ages wearing a helmet (4). Helmet use can be particularly effective, as head injuries comprise one third of emergency department visits, two thirds of hospital admissions and three-quarters of deaths (4). Over 70% of the cyclist fatalities in London have moderate or serious head injuries, and over 45% of child cyclists in accidents suffer head injuries. (5) Convinced?

So what now? How do we prevent this tragedy, turning something so wonderful for the city, a symbol of our nation peddling into the future, from turning into a disaster? King Wiggo himself would avert this catastrophe in one fowl sweep by enshrining helmet use in law. At the very least we need to make this a requirement for Boris bike users. One needless death on a Boris bike is a death too many.

References
1. TFL, Cycling Revolution London, 2010.
2. Rojas-Rueda D, de Nazelle A, Tainio M, Nieuwenhuijsen MJ. The health risks and benefits of cycling in urban environments compared with car use: health impact assessment study. BMJ 2011;343:d4521.
3. R.G. Attewell. Bicycle helmet efficacy: a meta-analysis. Accident Analysis & Prevention 2001; 33(1): 345–352.
4. Thompson DC, Rivara F, Thompson R. Helmets for preventing head and facial injuries in bicyclists. Cochrane Database of Systematic Reviews 1999, Issue 4. Art. No.: CD001855. DOI: 10.1002/14651858.CD001855.
5. Cycling Accidents - Facts and Figures - October 2011. http://www.rospa.com/roadsafety/adviceandinformation/cycling/facts-figur... (accessed 23/12/11).

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Competing interests: None declared