Dr Fenton Howell
A leading public health doctor has called for mandatory bicycle helmet-wearing to improve road safety. Speaking after Northern Ireland Assembly members voted last week in favour of a bill to make this law, Dr Fenton Howell said the IMO would welcome a similar bill in the Republic.
“Best evidence supports the use of bicycle helmets for the prevention of acquired brain injuries, similar to motorcyclists. They reduce the risk and severity of head injuries,” Dr Howell told Irish Medical Times.
The former IMO President said the organisation had tabled and passed a motion calling for compulsory or mandatory protective headgear for cyclists at its AGM in 2001.
The motion passed, despite calls by the Galway Cycling Campaign to withdraw the motion in the first instance and, failing this, for delegates to reject it unequivocally.
Helmets provided a limited level of protection, and only if the helmet was properly fitted and worn, while improperly worn or used helmets could kill due to strangulation, the Campaign had argued, adding that such a law could discourage people from cycling.
Meanwhile, the British Medical Association’s (BMA)Council in Northern Ireland, which advocated for the requirement as part of a range of measures to improve cycling safety, said: “The consequences of traumatic brain injury are significant, not only to the individual involved, but to their families and society as a whole.”
Last week, on the day the bill was passed, the IMO won recognition for its unstinting commitment to tackling road traffic accidents over the past 16 years from the European Road Safety Charter — beating 700 other organisations to the award.
Singling out Dr Howell and his colleague Dr Declan Bedford for their dedication to promoting road safety since 1995, IMO President Prof Seán Tierney said the campaign was “founded in the experience of doctors who work to save those with horrific injuries, try to rebuild the bodies and lives of those with disabilities, and to comfort and counsel families with unbearable loss”.
Both Dr Bedford, also a former President of the IMO, and Dr Howell had shown how much of this could be prevented through changing driver behaviour, Prof Tierney added.
The IMO signed the Road Safety Charter last May, undertaking to highlight road safety for three years. The union says it will continue advocating road safety strategies through research, submissions and policy to influence change at national level, Dr Bedford said.
The IMO has passed several motions on road safety at its annual general meetings over the years, published a position paper on the subject, and jointly with the BMA Northern Ireland, presented a submission to MEPs at the European Parliament.
lloyd.mudiwa@imt.ie
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Please could they provide the evidence that compulsory as opposed to voluntary helmet-wearing saves lives?
Surely it could be argued that car drivers and pedestrians should wear helmets?
I say this because I have seen high cervical injuries caused to children because they flipped while pulling a wheelie and hit the back of their head. Because they were wearing a helmet, I believe the excessive levering caused the hyperflexion and resulting paralysis.
A short-sighted decision that does NOT reflect the reality of what has happened in Australia after its introduction of mandatory helmets in 1991.
In the state of Victoria, school kids riding to work dropped by 30%. In the city of Brisbane, Australia, commuter cycling dropped by about 15%. All of that now means MORE CARS on the road causing crashes, obesity and air pollution-related illness. It means LESS safety in numbers for cyclists. It means kids not learning road sense before they are let loose with a car that can kill and statistics show under 25-year-old drivers kill two others for every driver that dies.
The bike hire schemes in London and Paris have thrived without helmet laws. In Melbourne and Brisbane, Australia, the helmet laws are a major part of why the schemes are failing.
Helmets might save a couple of head injuries but at the cost of more crashes for the cyclists that remain, more obesity and all the other problems are that greater than the savings you imagine you’ll get.
And now on the Gold Coast, we have so many cyclists who ignore the law anyway. Those cyclists could have compensation claims rejected even if they didn’t cause the crash. Portland USA has a greater rate of helmet usage through education than the Gold Coast, Australia, has through mandatory helmet laws. Laws do not always achieve what you think they will when you fail to take into account human behaviour.
This law is a short-sighted decision but I hope you at least have enough foresight to measure helmet usage and cycle numbers before it is enforced. Then at least you’ll have a chance to realise the mistake in future years and have the data to repeal it, like Israel did.
PS: are you aware of the recent news in Australia that revealed bicycle helmets worn by children in the home were the cause of several strangulations after their helmets got caught and the kids were hung by the straps?
Sometimes ‘wrapping people in cotton wool’ is more dangerous than the perceived risk, makes them less risk-adverse due to Risk Compensation (or others drive more dangerously, as shown by Ian Walker’s measurements of overtaking distances to cyclists with or without helmets) and is actually more dangerous than letting them have a few falls and learn from their mistakes.
Whilst I am not concerned either way in the helmet discussion, I do however find it disappointing that whilst helmet laws are being pushed, nothing is done to make traffic more secure for cyclists, i.e. better provisioning of cycle ways, better enforcement of traffic violations, etc. etc.
Of course, passing the helmet law doesn’t really cost much to the government – proper cycle paths, however, do.
Hooray for the helmet champions!
Not only should it be law to wear a helmet but also bicycles SHOULD be subjected to an NCT (NBT), just like any other mechanically propelled vehicle. How many catastrophic injuries could have been avoided if the back brakes had been working?
There should also be a law that all bicycles should be fitted with carriers… you might think it is funny but these devices are simple to install and they actually save lives! I personally have seen too many people (older people who should have more sense) carrying the messages hanging from the handlebars, which to my mind is a recipe for total disaster.
Well done to all the safety conscious doctors out there. I sleep better at nights knowing you are thinking of me… and my bicycle, of course!
Marcus
Of course, once again, the opinion (and nothing more) of a doctor is allowed to trump statistics.
Ask a statistician whether mandatory helmet laws work.
(Hint: they don’t.)
See in particular Dorothy Robinson’s work published in the BMJ.
I read with interest the debate about a law for cycle helmets in the Assembly.
The Bill’s proposer Pat Ramsey said, “”People have genuine concerns that the legislation may discourage cycling. However, the evidence that I have seen suggests that many of those claims and concerns are exaggerated, and there is no clear evidence for them”. This is not really correct, Sustrans and the CTC have said there is evidence.
In Victoria, Australia, Melbourne survey data, 64 sites at 10 hours per site, following their helmet law:
297 extra wearing helmets and 1,110 fewer cyclists, 1st year;
3,121 cyclists reduced to 2,011, 1,006 helmeted increased to 1,303;
In Victoria they issued more than 19,000 fines in the first 12 months;
About 50% of teenagers did not wear them following the law;
New South Wales, child survey data following their helmet law, 2nd year;
569 extra wearing helmets and 2,658 fewer cyclists;
6,072 cyclists reduced to 3414, 1,910 helmeted increased to 2479.
Mr Ramsey has been misled by claims made by Headway and by unsound reports.
My report on the USA, ‘Health and safety assessment of state bicycle helmets laws in the USA’ refers to a minority group incurring most fines and provides an assessment based on 300+ million population level.
http://www.ctcyorkshirehumber.org.uk/USA_helmet_laws.pdf
Erke and Elvik (Norwegian researchers) 2007 stated: “There is evidence of increased accident risk per cycling-km for cyclists wearing a helmet. In Australia and New Zealand, the increase is estimated to be around 14 per cent.”
Bicycle helmet laws have many problems and are not the best way to improve safety or to promote cycling.
For goodness sake. Please, someone get Dr Howell to read this – http://www.cyclehelmets.org/1139.html
Could Dr Howell please produce the “best evidence” that he quotes?
My knowledge of physiology is limited. I have read Grays as a lad, as well as some basic microbiology, but in the main see myself as a logical thinker. And logic, to me, would be that people simply don’t just fall off of bikes. There is always a reason, and the call for helmet compulsion is denying the existence of that reason.
When you actually look at what causes the incidents it is this: human behaviour.
To tackle the human behaviour is to prevent the collision or fall from happening in the first place. Take the figures from 2009′s DFT transport study and how it found 93% of collisions involving cyclists were not the cyclists fault. Head injuries therefore could have a hell of a lot to do with driver error.
The impact range (in Joules) for helmets is not designed to withstand the force of a moving motor vehicle (many thousands of Joules), but many people assume, even medical practitioners, that cycle helmets are designed for this. They are not. They have been designed to stop scuffs and cuts caused by low branches in off-road cycling.
I also think the BMA need to come clean as to the stats of helmeted specific cyclists. How were they hit? What speed? Brain or head injury (still common from my basic understanding)?
Last point is that in The Netherlands there is a contradiction to what we’re told in the UK and the islands: they have very few helmets, and very few head or brain injuries. They have dealt with the culture of bad driving and realised that you’re statistically very unlikely to sustain a head injury whilst cycling.
In my opinion, these public health freaks are in reality fascists and have caused so much damage. Making cycle helmets compulsory is plain stupid.
Great reaction.
Let’s make roads safer first, let’s have more respect for cyclists before we worry about legislation on helmets. We can stop cars speeding, stop people using phones when they drive, stop them driving too close to each other and to cyclists.
Oh, we have laws? How come they are not enforced to make roads safer?
For those interested in more detail
Robinson 1996 report, Table 2 shows data for children in NSW. The equivalent number of injuries for pre-law level of number of cyclists increased from 1,310 (384 head + 926 other injuries) in 1991 to 2083 (488 head + 1,595 other injuries) in 1993. For NSW the helmet laws discouraged cycling and reduced children’s safety. The increased injury rate was 59%, from 1,310 to 2,083.
In 2008 Curnow concluded: “Compulsion to wear a bicycle helmet is detrimental to public health in Australia but, to maintain the status quo, authorities have obfuscated evidence that shows this.”
Erke and Elvik (Norwegian researchers) 2007 stated: “There is evidence of increased accident risk per cycling-km for cyclists wearing a helmet. In Australia and New Zealand, the increase is estimated to be around 14 per cent.”
European Cycling Federation reported, “The evidence from Australia and New Zealand suggests that the wearing of helmets might even make cycling more dangerous.”
The UK’s National Children’s Bureau (NCB) provided a detailed review of cycling and helmets in 2005, stating that the case for helmets is far from sound and the benefits of helmets need further investigation before even a policy supporting promotion can be unequivocally supported.
Robinson DL: Head Injuries and Bicycle Helmet Laws; Accid Anal Prev, 28, 4: p 463-475, 1996 http://www.cycle-helmets.com/robinson-head-injuries.pdf
Curnow WJ, Bicycle Helmets and Public Health in Australia, Health Promotion Journal of Australia, 2008 Apr. 19 (1):10-15.
Erke A, Elvik R, Making Vision Zero real: Preventing Pedestrian Accidents And Making Them Less Severe, Oslo June 2007. page 28
http://www.toi.no/getfile.php/Publikasj … 7-nett.pdf
European Cycling Federation 1998 ‘ IMPROVING BICYCLE SAFETY
without making helmet-use compulsory’, 060131_ECF_Helmet_brochure.pdf
Gill T, Cycling and Children and Young People, A review, National Children’s Bureau, 2005. http://www.cycle-helmets.com/cyclingreport_timgill.pdf