No One Thinks Helmets are a Panacea for Cycling Safety

Last week I published a post about an ABC Radio National piece about bicycle helmets. A colleague of mine contacted ABC’s Media Watch and ran a story about it. In the aftermath, I’ve been told the debate is not about whether bicycle helmets are effective or if helmet legislation has resulted in fewer bicycle related head injuries, the myth that was being debunked on the show Assumptions was whether helmet legislation should be the sole strategy for cycling safety.

The problem is that no one believes bicycle helmets are a panacea for cycling safety, mandatory or not. Helmets are designed to protect the head and therefore are not designed to protect other body parts. Head injuries may be very important, but it is possible for a cyclist to have serious or fatal injuries that do not involve the head. Clearly, other strategies are needed for a comprehensive cycling safety strategy.

On several occasions now, I’ve called for more research into other strategies besides helmet promotion or legislation like increased segregated cycling infrastructure and lower speed limits on roads commonly used by cyclists. Here are a few direct quotes from those papers.

Walter et al [1]

While helmet legislation appears to play an important role in the reduction of cyclist head injuries, further improvements in cyclist safety in general may be gained from a broader focus.  Cyclist safety is a complex issue driven by a range of factors. Cycling in Australia has changed with a considerable increase in recreational road cycling and mountain biking in recent years. Additional research into the diverse and changing risk profiles among these cycling subgroups would facilitate further safety improvements.

Olivier et al [2]

Our study shows that the beneficial effect of MHL in NSW has been maintained since enactment of the law over 20 years ago. This signals a need to focus on other aspects of bicycle safety in order to further reduce cycling-related injuries. Collisions involving motor vehicles clearly have a high risk of head injury indicating that the interaction between cyclists and MVs is a key area for intervention through further changes to transport infrastructure and modification of cyclist and motorist behaviour. 

Walter et al [3]

Safety concerns tend to dominate media coverage of cycling in Australia (Rissel et al., 2010). This public discourse is often framed, or re-framed, around removal or relaxation of mandatory helmet laws (Piper et al., 2011), despite the wearing of helmets by cyclists forming only one part of the safety picture. In contrast, the high levels of cycling participation and the excellent cycling safety environment in northern European countries such as the Netherlands, Denmark and Germany appear to have been predicated on substantial and sustained investment in well-connected networks of thoughtfully designed bike lanes, bike paths and other cycling infrastructure. Other important factors are low speed limits on urban streets, the fostering of consideration and understanding between road users, and adequate legal protection for vulnerable road users, both cyclists and pedestrians alike. These are the essential elements for providing a cycling environment that encourages participation, with all its health, economic and environmental benefits, while maximising safety.

Olivier and Walter [4]

Risk compensation theory for helmet wearing while cycling has generated increased interest in the peer-reviewed literature, although there is little to no evidence to support the theory. Walker’s [2] argument that helmet wearing affects the behaviour of motor vehicle drivers does not support risk compensation theory upon reanalysis. Helmet wearing is associated with a small difference in passing distance and is not associated with close passing. The evidence from this study does not justify recommendations around helmet wearing, but rather highlights the more important factors of kerb distance, road characteristics and traffic type which may inform more effective cycling safety improvements.

Olivier [5]

Helmets, however, should not be viewed as a panacea and instead are an important part of any cycling safety strategy along with segregated cycling facilities and lower speed limits for motorised traffic. The benefits of each intervention are situational – helmets will help a cyclist in an accident and segregated cycling infrastructure will help avoid accidents. I therefore believe the decision to mandate helmet use should be in conjunction with a comprehensive strategy and not in isolation.

The current view of road safety is the safe system approach where many strategies are used in concert to minimize the risk and severity of injury. The notion of framing helmet promotion or legislation as an all-or-nothing strategy is very far from the truth. I stated just that in an article published last year.

Olivier et al [6]

Quite often arguments against helmet legislation are framed as an all-or-nothing safety intervention strategy that is in direct competition with creating segregated cycling infrastructure. In other words, it is believed a government will support one but not both. To wit, Ian Walker in a recent New York Times article states “Any solution to bicyclist safety should focus on preventing collisions from taking place, not seeking to minimize the damage after a collision has occurred” [35]. This strategy runs counter to the safe system approach supported by government and safety advocacy groups, where personal protection is seen as a critical component of the whole system to reducing vulnerable road user (cyclist and motorcyclist) injuries. There is also little support for focussing on injury avoidance alone in the injury record. In NSW from 1991 to 2010, only 12% and 23% of bicycle related head injury hospitalisations for children and adults respectively involve a motor vehicle. The goal of the safe system approach, on the other hand, would be to minimise the risk of a crash (crash avoidance) and to minimise the risk of injury when a crash occurs (personal protection), i.e., a holistic approach is used to reduce road trauma.

No one believes bicycle helmets are a panacea as a cycling safety strategy, and that includes me and my colleagues. There’s no myth to be busted.

  1. Walter, S.R., Olivier, J., Churches, T., & Grzebeita, R. (2011). The impact of compulsory cycle helmet legislation on cyclist head injuries in New South Wales, Australia. Accident Analysis and Prevention, 43, 2064–2071.
  2. Olivier, J., Walter, S.R., & Grzebieta, R.H. (2013). Long term bicycle related head injury trends for New South Wales, Australia following mandatory helmet legislation. Accident Analysis and Prevention, 50, 1128–1134.
  3. Walter, S.R., Olivier, J., Churches, T. & Grzebieta, R. (2013). The impact of compulsory helmet legislation on cyclist head injuries in New South Wales, Australia: A response. Accident Analysis and Prevention, 52, 204-209.
  4. Olivier, J. & Walter, S.R. (2013). Bicycle helmet wearing is not associated with close motor vehicle passing: A re-analysis of Walker, 2007. PLOS ONE, 8(9): e75424.
  5. Olivier, J. (2014). The apparent ineffectiveness of bicycle helmets: A case of selective citation. Gaceta Sanitaria, 28, 254-255.
  6. Olivier, J., Wang, J.J.J., Walter, S. & Grzebieta, R. (2015). Anti-helmet arguments: lies, damned lies and flawed statistics. Journal of the Australasian College of Road Safety, 25, 10-23.
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Media Watch Segment “Helmet claims under fire”

Alan Todd of Freestyle Cyclists was recently interviewed for an upcoming piece on ABC Radio National. Much of Todd’s responses were the same misleading information he gives in all his interviews (see here and here, for examples). I sent an email to host Susan Carland detailing some of the misinformation given by Todd and received no response.

A colleague forwarded my email to ABC’s Media Watch. They ran a segment on last night’s show. You can read the transcripts or watch the video here. Note the website includes links to responses from Alan Todd, ABC Radio National Manager Deborah Leavitt, Professor Raphael Grzebieta and Dr Andrew McIntosh.

I found Todd’s conclusion quite curious which seems to be a common argument by anti-helmet advocates.

In conclusion, it is now twenty five years since Victoria become the first place in the world to mandate helmets for cyclists. Since then, only three countries have introduced nationally enforced all ages helmet laws for cyclists. If the evidence for the benefits of such laws was indeed overwhelming, why have the other one hundred and ninety three countries not followed suit?

In my own view, this is a self fulfilling prophesy. There are several anti-helmet advocacy groups that are very vocal like FreestyleCyclists, the Bicycle Helmet Research Foundation and Cyclists Rights Action Group. They may seem like legitimate research organizations to the uninformed, but they are not comprised of experts from relevant fields like road safety, injury epidemiology, trauma surgery, biostatistics, etc. The ones who do have research backgrounds are from other disciplines like Dorothy Robinson (beef industry research) Nigel Perry (computer science) and John Adams (geography).

I don’t understand how it happened, but anti-helmet advocates have gained a foothold among some influential organizations including policy makers. This has likely stopped other jurisdictions from moving ahead with either helmet legislation or promotion.

To be clear, I’m not an advocate for helmet legislation in other jurisdictions. That is a decision the people of each country/state/city must make for themselves from an informed position. The problem is the spread of misinformation about helmets and helmet laws means that is unlikely to happen.

Note: The comments are full of the usual names like Colin Clarke and Chris Gillham. Neither are ever shy about promoting their anti-helmet views.

Update: Interesting Tweet from Wendy Carlisle who initially reported on the 2010 Voukelatos and Rissel paper that was later retracted.