Bicycle helmets – Do they really save lives?

by Emma Hammett | Dec 9, 2020 | for First Aid for Life

My cmnt: Be sure to read the readers’ comments I have included below this article. There is a growing body of people with very low risk tolerance who believe that virtually any risk is too much. This is germane to the ongoing Covid-risk debate. Essentially democrats want to restrict freedoms in the name of “safety” while Republicans want to maximize freedoms in the name of common sense and joyful living.

My cmnt: The upshot is this: Riding a bicycle for recreation on side streets, sidewalks and designated paths and trails is NO more dangerous and in need of wearing a helmet than walking or jogging. Even when commuting on busy streets with heavy car traffic (which I don’t recommend) most of the injuries are broken bones and bruises NOT head injuries. Nevertheless – just like with masks – wear one if you want but don’t demand that everyone else do so also.

My cmnt: However even the above statement isn’t entirely true. Democrats, especially those in leadership and in the media, simply have an entirely different value system from Republicans and the vast majority of Americans and people everywhere. Democrats take huge risks all the time in the name of their religion, which is sex and their sacrament which is abortion.

My cmnt: The only “safe” sex is between mutually monogamous, married men and women. Even during the Covid-19 epidemic (not a pandemic as it posed very little risk of severe illness or death to the vast majority of healthy people under the age of 65 and virtually none at all to children!) Dr. Fraud Fauci said it was OK to engage in sexual hookups with total strangers if you wanted to. But – going to church was absolutely out of the question.

My cmnt: ALL homosexual anal intercourse is extremely dangerous. Not only is it completely unnatural to insert a penis into a rectum it is inherently unsafe and spreads disease. The entire AIDS crisis, which contrary to Fauci was almost entirely limited to homosexuals and IV drug users, came about because of risky anal intercourse.

My cmnt: On top of that America and the world has a pandemic of STDs, many of which are incurable and deadly. Yet you never hear a democrat politician or media lackey rant about that. Why? Because ALL sex and sexual perversions must be protected and promoted at all times, down to and including pedophilic sexual abuse.

There is a lot of debate surrounding the use of cycle helmets.  Do they really provide vital protection – or do they just give cyclists a false sense of security, that leads to more accidents?  The eternal question is – do they really save lives?

In March last year, cyclists in Australia risked police fines by cycling without helmets in a protest ride against the country’s mandatory helmet laws.  These laws, however, were introduced after a campaign led by the Royal Australasian College of Surgeons, which indicates that many health professionals believe the use of helmets has positive outcomes for cyclists involved in accidents. Here in the UK, a Government review is taking place this year – also considered forcing all cyclists to wear helmets. Transport minister, Jesse Norman, tweeted that the mandatory wearing of helmets was ‘sure to be raised in the consultation’ which was a wide-ranging look at road safety for cyclists.  However, there are strong lobbies both for and against the wearing of helmets.

The arguments against helmets:

Those against making helmets a legal requirement believe it is an ineffective safety measure which discourages people from cycling and creates an image of a high-risk activity. They argue cycling is a healthy, cheap and environmentally friendly form of transport and that many of the risks that cyclists face could be reduced through improvements to infrastructure, signage, education and training.

Another argument against helmets arises from research at the University of Bath that demonstrated cyclists wearing protective helmets did have an effect – but a negative one. The research showed that car drivers passed, on average, 8.5cm closer when overtaking cyclists wearing helmets, than when overtaking those without. This effect is known as ‘risk compensation’ and can increase the likelihood of a collision.

Interestingly, as many cyclists are perceived to be young and male, the same research discovered that motorists gave more space to a cyclist who wore a long flowing wig to look female. Research demonstrates ‘risk compensation’ also affects people participating in a range of sports who tend to take more risks once they are wearing protective clothing, including helmets, as they are lulled into a false sense of security. However, it maybe that it is the nature of the sport being undertaken that increases the risk rather than the act of putting on a helmet.

Studies also suggest those wearing helmets are more susceptible to injury, both due to an increase in head size due to the size of the helmet, and the fact they are less aware of their surroundings due to muffled hearing.

The arguments for helmets:

There is much evidence to support the wearing of helmets and the crucial safety role they play for the wearer. The National Highway Traffic Safety Administration (NHTSA) view helmets as: “the single most effective way to reduce head injuries and fatalities from bicycle crashes.” Both Transport for London and the Highway Code both currently recommend wearing a helmet when cycling too. And although The Royal Society for the Prevention of Accidents (RoSPA) doesn’t call for compulsory cycle helmet laws, it strongly recommends cyclists wear a cycle helmet. Helmets might not prevent crashes or guarantee survival, but they are an important secondary safety feature and can reduce the risk of a serious brain or head injury in an accident.

Figures compiled by RoSPA show head injuries are very common injuries to cyclists: data from hospitals show 40% of cyclists and 45% of child cyclists suffer head injuries and three quarters of cyclist fatalities have major head injuries. Meanwhile, a Cochrane review suggested helmets reduced the risk of injury to the head and the brain by a substantial 65%-88%; and the upper and mid-face by 65%.

Safety benefits:

The safety benefits seem to be more pronounced for children: tests on children’s bicycle helmets show helmets offer up to 87% reduction in the acceleration experienced by the skull during an impact and can help the skull resist forces up to 470 pounds in a crush accident. According to a US study helmets cut the risks of severe traumatic brain injury by half, when riders suffer a brain injury. The report, in the American Journal of Surgery, also concluded that riders with helmets were 44% less likely to die from their injury, and 31% less likely to break facial bones.

There is no doubt helmets cannot resist substantial impact and cannot save everyone. Nevertheless common sense suggests surrounding your head with some degree of protection must offer some cushioning from head impact – a view which neurological studies definitely support. At First Aid for Life we understand the importance of knowing exactly what to do, should you be involved in a bicycle accident – or be the first to arrive at the scene of one.  As such, we offer hands on, practical first aid courses, as well as a tailored, online course specifically for cyclists, a course is designed as an introduction to basic first aid in a cycling environment.

For a more comprehensive course please see  First Aid for Cyclists which includes CPR, spinal injuries, when to move them, asthma and breathing problems, heat exhaustion and much more. First Aid for Life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made, or actions taken based on this information. It is strongly advised that you attend a First Aid course to understand what to do in a medical emergency.

Readers’ comments:

Ian on June 20, 2018 at 9:34 am

The debate over wearing a helmet for cycling is much the same as for horse riding, skiing and I’m sure many other sports too. What is seen all too often on the ski slopes, are people skiing well beyond their abilities, way too fast and possibly because they are wearing a helmet, think they will be safe if they fall / have an accident / etc. Rock climbing most certainly will protect a climber from a rock falling from above, onto their head, but this is different to other activities.
They are likely to be wrapped up in a bubble of a false security. Whether horse riding, cycling, skiing etc, if the person falls, it is very unusual they land head first. If they do land head first, it is more likely they land face first and a helmet will offer little protection in those incidents.
What is necessary is a responsibility of the person partaking in the activity to be competent to the level at which they wish to go / ride / ski / etc and in control and safely AND wear a helmet if they wish. Wearing a helmet does not automatically put a participant at a higher skill level, these must be learnt first. It should be understood that the helmet is a device for slowing down the moving of the brain by a rapid deceleration and therefore shock damage. Being aware of your surroundings is the best protection a participant will have to protect themselves in all situations.

Josie Clowes on August 4, 2021 at 9:37 am

I judge the environment.
Most of my cycling is on the canal, the park and quiet residential roads, so I don’t wear the helmet, I also find it restrictive.
There is a short main road, but if its too busy, I go on the pavement.
I cycle for pleasure exercise, so I choose safe places, but have been fortunate to cycle to work via canal.

James on October 22, 2021 at 5:46 pm

I wonder if there are measures we can take to reduce the number of cyclists presenting at hospitals? Surely this would save on all injuries not just the 65% of 40% prevented by helmets.
If only these measures would see the same amount of campaigning vigor. But easier to push the onus on to cyclists than do anything to inconvenience motor vehicle drivers

Peter Clinch on December 28, 2020 at 10:03 pm

It’s good that the Goldacre/Spiegelhalter editorial is picked out, and also that it is acknowledged that there is quite some controversy. Having said that…

Quoting hospital admissions is a loaded way to look at it, because you’re looking at people who’ve already had accidents and that’s not representative of the population as a whole. It’s also the case that if you look at hospital admissions then the things you see the most of for head injuries are car crashes followed by trips and falls, and yet nobody is recommending helmets against those. Why not? As the BMJ editorial points out, it’s about culture, not actual risk. My daughter ended up in hospital with concussion and blurred vision after a fall on foot in a playground: nobody criticised her or her parents for not wearing a helmet, had she had exactly the same injury falling off her bike with the same lack of protective headwear we’d have never heard the last of it! The actual bone-breaking, brain-shaking energy in a fall comes from the vertical acceleration from gravity because that’s the direction one stops suddenly in, and it’s just the same for a fall from feet as from a bike. We know from countless school playground falls that an entirely appropriate response is TLC and a sticker, it really needn’t have a different emphasis just because a bike is involved.

I don’t want to dissuade anyone from wearing helmets if that’s what they want to do, but the common claims of life saving just don’t stack up. if they did then places where they don’t bother with helmets would have significantly higher serious brain injury rates (but they don’t) and we’d see a relative decrease in serious head/brain injury relative to pedestrians as increasing numbers of cyclists took up helmet wearing (but we don’t).

The Cochrane Review is generally good thing, but for cycle helmets it is not reliable. It has a small selection of very dated papers dominated by the work of the editor, and it concentrates on just the sort of hospital study that Goldacre and Spiegelhalter point out large methodological problems for. It is not a credible resource for cycle helmet research.

I would strongly suggest a perusal of Tim Gill’s “Cycling and Children and Young Children”, which has a lucidly argued annex from a children’s risk specialist who admits he wears a helmet to cycle… and concludes that the case has not been properly made to require *or even to recommend them*. Free download at https://timrgill.files.wordpress.com/2010/10/cycling-rpt-gill-05.pdf

The main problem with helmets isn’t the helmets themselves, it’s the loaded discussion about them (as suggested by the BMJ editorial). In the UK they’re felt important because everyone goes on about them, and everyone goes on about them because they assume they’re important. But the lack of clear improvement in numbers since their uptake increased, or in comparison to places where they’re little used, show that they’re not. So we end up with huge amounts of energy spent on something of little real safety effect across a population, at the expense of stuff that makes a genuine difference.

What they were designed for is a “better hairnet” for sports riding, not to save lives. So if you fall in a race it might mean the difference between abandoning with a sore bump and seeing stars or getting back on and finishing your race. That’s a worthwhile thing for people doing that sort of riding, but it’s been extended in to a culture of belittling and shaming people who, entirely reasonably, choose to ride without one. (I’ve had abuse shouted at me in the street by strangers and anytime Cycling UP show a picture of an unhelmeted rider there’s a pile-on saying how irresponsible they are, even though they have an excellently researched briefing on the subject, see https://www.cyclinguk.org/campaigning/views-and-briefings/cycle-helmets). This puts people off of cycling which works against the goal for public health. Maybe a little less work for first aiders, but a lot more work for their colleagues in the cardiac and diabetes wards!

Helmets for cycling for utilitarian transport should be a strictly personal choice with no pressure at any level (including Rule 59 of the Highway Code). The evidence really isn’t up to any more.

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