1) Cycling is safer in non-helmet law countries  Few people realise that, because helmet laws reduced cycling, they also reduced safety in numbers.  Countries with low helmet wearing rates have more cyclists and many fewer deaths and injuries per kilometre cycled – see below.

2) “Helmets not even in top 10 of things that keep cycling safe” - UK Cycling expert Chris Boardman  UK Cycling policy adviser, Olympic gold medallist and world record holder, Chris Boardman, explains: “Helmets not even in top 10 of things that keep cycling safe" … “It’s time for the cycling community to put the debate about mandatory cycle helmets to bed and get across the message that helmet use is one of the least important cycling safety measures. Even talking about making helmets mandatory ‘massively puts people off’ cycling.”  Boardman likened the culture of helmet use among keen cyclists to people wearing body armour because they have got used to being shot at.

3) Laws reduced cycling, not injuries per cycle-km When Australian helmet laws were introduced, surveys showed fewer people rode bicycles.  At the same observation periods, time of year and the same 64 sites in Melbourne, 1110 fewer cyclists (36%) were counted post law in 1991, but only 297 more cyclists wore helmets.  This implies that more cyclists were discouraged from cycling, than were encouraged to wear helmets.

The graph below (from http://cyclehelmets.org/1194.html) shows numbers of head and non-head injuries before and after Victoria’s helmet law. The only plausible explanation for the large reduction in non-head injuries is that (as also demonstrated by the observational surveys) the helmet law discouraged cycling. Although head injuries may have fallen slightly more than non-head injuries (suggesting there might have been a small benefit from increased helmet wearing), this is clearly not the dominant effect.  In fact, dividing numbers of injuries by the amount of post-law cycling indicates that, compared to what would have been expected without legislation, helmet laws increased injuries per cyclist[1].

4) Misleading information Qantas felt pressured to complain that the carbon tax had a major impact on its financial problems http://www.businessspectator.com.au/news/2014/3/7/carbon-markets/qantas-pressured-carbon-stance-report  Organisations that rely on government funding may face even greater pressures.  The misleading claims about helmet laws from two government-funded organisations are described at http://www.cycle-helmets.com/helmet-law-spin.html together with evidence that, after allowing for the effects of speeding, drink-driving and other road safety initiatives, cyclists were no safer than would have been expected without helmet laws.  The confusion was compounded when Canadian researchers claimed that Ontario’s helmet law had not reduced cycling without telling people that the non-enforced law had only a temporary effect on helmet wearing rates cyclehelmets.org/1244.html In 2013, a com­prehensive evaluation failed to find any benefits of helmet laws in Canada[2, 3].

5) Reduced cycling = substantial health and environmental damage  When helmet laws were introduced, questionnaires and telephone surveys found that many people cycled less, e.g. 51% of school children said they had not cycled because of helmet laws, not safety concerns nor other reasons. In Western Australia, the equivalent of 64% of adult cyclists in Western Australia said they would ride more except for the helmet law - www.ncbi.nlm.nih.gov/pmc/articles/PMC1410838/

Before helmet laws, cycling to work was becoming increasingly popular, especially in regional areas – see census data on cycling to work (above).  Cycling was generally considered healthy and safe away from the capital cities.  These areas suffered big reductions in cycling after helmet laws were introduced, from which they have never recovered, perhaps because the laws made cycling seem less safe as well as less convenient.

Capital cities tend to have busier roads and longer travel times, so proportionately fewer people cycled to work even before helmet laws. In areas where cyclists already wear helmets because of perceived danger, helmet laws are less likely to discourage cycling than regional areas where cycling is generally considered safe and helmet wearing is low.  UK surveys show a much higher helmet wearing rates in London (69.5%) than elsewhere (29.9%).  Although many people say they don’t cycle because of safety, the same concerns are expressed by Australians in areas with many safe, low-traffic roads.  This suggests that helmet laws (which make people think that cycling is unsafe) are perhaps an even greater deterrent than actual road safety conditions.

6) Safety in Numbers and the decline in Australian cycling  In 1985/86, a National travel survey showed that 3.9% of all trips in Australia were by bike[4].  At least 85% of bicycle trips were for transport purposes (suggesting that the survey did not cover recreational cycling).  The same amount of cycling today (2.24 km per person per week, about 85% for transport purposes) would generate estimated health, environmental and other benefits of $2.4 billion per year[5].

In the 2011 National Cycling Participation Survey[6], there was 60% less transport cycling per person than the 1985/86 survey – an estimated loss of $1.44 billion (60% of $2.4 billion)[5].  The latest survey in 2013[7], reported a substantial reduction in cycling compared to 2011, implying even greater losses compared to the amount of cycling per person in 1985/86.

In 1985/86, cycling accounted for 1.6% of trips in Sydney and 5.0% in the rest of NSW.  If the upward trends in cycling to work (in census data) had continued, NSW would have enjoyed many additional health and environmental benefits.  Instead, with entrenched helmet laws, the NSW Household travel survey (covering Newcastle, Sydney and Wollongong) found that cycling represented 0.6% trips, a far cry from what might have been. 

With evaluations showing little or no benefit from the increase in helmet wearing, the lost health and environmental benefits and reduced Safety in Numbers from discouraging cycling more than outweighed any benefits of helmet laws.

Those continuing to cycle are not deterred by helmet laws, so are likely to wear helmets even if the law is changed.  The main benefit of helmet-law reform will be to attract non-cyclists and occasional cyclists back to bicycling, and so generate substantial health and environmental benefits.  An overseas study reported that, even accounting for other forms of exercise, people who did not cycle to work had 39% higher mortality rates than those who cycled to work[8].  As well as health benefits for new and lapsed cyclists, existing cyclists will benefit from improved safety in numbers – a win-win situation.

7) Public bike scheme drove Paris ‘Cycling Mad’ Elsewhere, public bike schemes are generating renewed interest in cycling.  Velib drove Paris ‘cycling mad’[9]. For 181,982 residents using Barcelona’s public bike scheme, the estimated annual change in mortality compared with car users was 12.46 fewer deaths because of the increased physical activity, compared to 0.03 more deaths from road traffic incidents and 0.13 deaths from air pollution[10].

Ten million miles were cycled on New York’s public bike scheme in its first 5 months.  Membership in November 2013 was 90,000, 1.5 times the expected number for the end of the first year.  NY’s Dept of Transport states that "Since 2000, there has been a 72% decrease in the average risk of serious injury experienced by cyclists in NYC, while the number of trips by bike has nearly tripled"[11] 

Dublin’s public bike scheme began with 400 bikes.  It had 47,000 subscribers in its first 12 months with over 1.1 million journeys made on the bikes – an average of about 10 trips per bike per day.[12]  By August 2011, the scheme had 550 bikes, 58,000 subscribers and over 2.2 million rentals[13]. Expansion started in November 2013, by which time the bikes had been used for over 6 million journeys, as part of a 14-stage plan to bring the scheme out into the suburbs and increase the number of bikes to 5,000.[14]

Not wanting to wear a helmet (25%) and difficulty finding a helmet (36%) were found to be major barriers to Australian BikeShare schemes[15]. Dublin’s success, with about 10 trips per bike per day, or the other cities show in the graph below from Elliot Fishman’s paper[15] is a far cry from Melbourne’s 0.7-0.8 trips per bike per day or Brisbane’s 0.3 trips per bike per day.

8) Sydney Public Bike Scheme hinges on helmets ”The City of Sydney is considering a bicycle hire scheme, but only if it wins an exemption from compulsory helmet laws.”  http://www.smh.com.au/nsw/bike-hire-plans-hinge-on-helmets-20120304-1ub4f.html 

9) Injuries per million hours of cycling doubled or quadrupled following NZ’s helmet laws  A recent investigation considered injury rates of cyclists in NZ from crashes involving motor vehicles and other crashes.  Over the years since helmet laws were introduced, the roads have become safer for pedestrians, but cyclists have not enjoyed the same level of improvement.  In fact there has been a dramatic increase in cyclist injuries from crashes not involving motor vehicles, e.g. quadrupling from 11.6 to 45.9 injuries per million hours for 19-19 year olds.  There has also been a dramatic decrease in children’s cycling (79% for children aged 5-12 and 81% for 13-17 year olds (52 to 10 mins/person/week).  The big increases in injuries not involving motor vehicles suggests that relatively safe activities such as transport cycling declined considerably, offset by some increase in riskier mountain-biking and sports cycling http://cycle-helmets.com/new-zealand-road-users.html

10) Qld Parliamentary Inquiry not convinced that helmet laws are justified

A recent Qld Parliamentary Inquiry into cycling issues stated that “the Committee is not convinced there is sufficient evidence of the safety outcomes of compulsory helmet wearing to justify the mandating of helmet wearing for all cyclists of all ages regardless of the situational risk.  The Committee recommended that the Minister for Transport and Main Roads “introduce a 24 month trial which exempts cyclists aged 16 years and over from the mandatory helmet road rule when riding in parks, on footpaths and shared/cycle paths and on roads with a speed limit of 60 km/hr or less”[16]

11) Suggested Changes to Transport Policy

·      The fact that a Qld Parliamentary Committee is not convinced helmet laws are justified demonstrates that the benefits of helmet laws are questionable.  Israel and Mexico City came to similar conclusions and repealed their helmet laws. 

·      Many cyclists will continue to wear helmets, even if the laws are repealed.  However, repealing the laws will encourage more people to take up cycling for transport and enable public bike share schemes to be as successful in Australia as in other cities.  Encouraging cycling will make it safer – a ‘win-win’ situation. 

·      In European cities, many people cycle to pubic transport stations for their daily commute.  This allows door-to-door travel and extends the ability of public transport to provide more frequent services, due to the larger catchment area, another win-win situation that improves transport, public health and the environment.

·      As part of the current policy review, evidence on bicycle helmet laws should be reviewed.  This could be done initially by a subgroup of the Transport Working Group, or by the entire group TWG.  The above evidence and references to further information has been compiled to assist the process.

Further Information

1.         Robinson, D.L., Head injuries and bicycle helmet laws. Accid Anal Prevent, 1996. 28: p. 463-475.

2.         Dennis, J., et al., Helmet legislation and admissions to hospital for cycling related head injuries in Canadian provinces and territories: interrupted time series analysis. BMJ, 2013. 346.

3.         Goldacre, B. and D. Spiegelhalter, Bicycle helmets and the law. BMJ, 2013. 346.

4.         INSTAT, Day-to-day travel in Australia 1985-96, 1988, Federal Office of Road Safety: Report CR 69.

5.         "Spinning" helmet law statistics http://cyclehelmets.org/1194.html (accessed March 2014).

6.         Gillham, C. and C. Rissel, Australian per capita cycling participation in 1985/86 and 2011. World Transport Policy & Practice, 2012. 18(3).

7.         Munro, C., Australian cycling participation 2013. Results of the 2013 National Cycling Participation Survey., 2013, CDM Research.  Commisioned by the Australian Bicycle Council.  Available at: http://www.austroads.com.au/abc/australian-cycling-participation-2013.

8.         Andersen, L.B., et al., All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work. Arch Intern Med, 2000. 160(11): p. 1621-8.

9.         Chrisafis, A., The city's gone cycling mad, in The Guardian2007.

10.       Rojas-Rueda, D., et al., The health risks and benefits of cycling in urban environments compared with car use: health impact assessment study. Bmj, 2011. 343.

11.       NY, Making Safer Streets, 2013, New York City Department of Transportation.  Available at: http://www.nyc.gov/html/dot/downloads/pdf/dot-making-safer-streets.pdf.

12.       BHRF. A Tale of Two Cities.

13.       Daly, M., What's the secret of the Dublin bike hire scheme's success?, T.G.B.B. http://www.theguardian.com/environment/bike-blog/2011/aug/04/dublin-bike-hire-scheme, Editor 2011.

14.       Kelly, O., Major expansion of the Dublin bike scheme begins today in Irish Times, 28 Nov.  Available at: http://www.irishtimes.com/news/environment/major-expansion-of-the-dublin-bike-scheme-begins-today-1.16094622013.

15.       Fishman, E., S. Washington, and N. Haworth, Bike Share: A Synthesis of the Literature. Transport Reviews, 2013. 33(2): p. 148-165.

16.       Queensland parliament, Inquiry into Cycling Issues, 2013, Available at:  http://www.parliament.qld.gov.au/documents/committees/THLGC/2013/INQ-CYC/err-14Feb14-cyc.pdf.

17.       Finch, C., L. Heiman, and D. Neiger, Bicycle use and helmet wearing rates in Melbourne, 1987 to 1992: the influence of the helmet wearing law., 1993, Rpt 45, Monash Univ Acc Res Centre: Melbourne.

18.       Walker, M., Law compliance among cyclists in New South Wales, April 1992.  A third survey., July 1992, Road and Traffic Authority Network Efficiency Strategy Branch.

19.       Smith, N. and F. Milthorpe, An observational survey of law compliance and helmet wearing by bicyclists in New South Wales - 1993., 1993, Roads and Traffic Authority.

 

 

 

 

 

 

 

 

 

Suggested Changes to the Transport Policy

• The fact that a Qld Parliamentary Committee is not convinced helmet laws are justified demonstrates that the benefits of helmet laws are questionable.  Israel and Mexico City came to similar conclusions and repealed their helmet laws. 
•  Many cyclists will continue to wear helmets, even if the laws are repealed.  However, repealing the laws will encourage more people to take up cycling for transport and enable public bike share schemes to be as successful in Australia as in other cities.  Encouraging cycling will make it safer – a ‘win-win’ situation. 
•  In European cities, many people cycle to pubic transport stations for their daily commute.  This allows door-to-door travel and extends the ability of public transport to provide more frequent services, due to the larger catchment area, another win-win situation that improves transport, public health and the environment.
•  As part of the current policy review, evidence on bicycle helmet laws should be reviewed.  This could be done initially by a subgroup of the Transport Working Group, or by the entire group TWG.  The above evidence and references to further information has been compiled to assist the process.

Key information on the amount of cycling before and after helmet laws in Australia
Australian and NZ helmet laws are enforced.  In  Victoria, about 20,000 cyclists are fined every year  for not wearing a helmet.  Some cyclists have even  gone to jail for non-payment of helmet-law fines.   Does the threat of a fine encourage cyclists to wear  helmets, or just discourage cyclists who don’t like  helmets from riding?

Table 1 shows the results of a large, comprehensive survey in Melbourne, using the same  observation periods at 64 sites, in similar weather and the same time of year (May).   Before the law, 442 children wore  helmets voluntarily.  A year later, 43  more wore helmets. The big change was  that 649 fewer children were counted.   This strongly suggests that the main  effect of the law, was to discourage  cycling rather than encourage helmet  wearing.  Compared with before the law,  42% few child and 29% fewer adult  cyclists were counted.

Large declines were also noted in a  comprehensive survey of child cyclists at 122 sites covering Sydney, regional and rural areas of NSW. Before  the law, 1910 children were observed wearing helmets. In the first and second years of the law 1019 and 569  more children were observed wearing helmets, but 2215 (36%)  and 2658 (44%) fewer child cyclists were counted (Table 2).

Proponents of helmet laws have argued that the above data  are outdated and distorted by a reduction in the legal driving  age.  This is untrue.  In Victoria, teenagers who pass the driving  test may drive unsupervised from age 18.  This has not  changed, though the minimum age for a learner permit was  lowered from 17 to 16 in Victoria.  Learners must be supervised  at all times by a licensed driver, so it seems unlikely this caused  any significant part of the 42% fall in children’s cycling, or the  29% fall in adult cycling in Melbourne.  Moreover, there was no  change in NSW, yet, by the 2nd year of the helmet law, child  cycle use had fallen by 44%.

There is no evidence that the decline in cycling was transient or that cycling “recovered”.  Fig 9 shows a series of counts over 6  years at 25 sites in Sydney.  Both adult and child cyclists were  counted (Walker, 1996).  There were four surveys in April and two in  October.  More cyclists were observed in April than October,  perhaps because autumn weather may be more conducive to  cycling.  However, by 1996, there were 48% fewer cyclists than  1991.  This is in complete People often cite helmet laws as a reason for not cycling.  The equivalent of 64% of adult cyclists in Western Australia said they'd ride more except for the helmet law (Heathcote and Maisey, 1994)  In New South Wales, 51% of  schoolchildren owning bikes, who hadn't cycled in the past week, cited helmet restrictions, substantially more  than other reasons, including safety (18%) and parents (20%) (Blacktown).

Effect on Head Injuries

The effect of the laws can be determined  by comparing injury rates before and after  the laws were introduced. Victoria was the first Australian State to introduce bicycle helmet laws, on 1 July 1990.  Over the next few  years, all other States passed similar legislation, because of threats by the Federal Government to reduce  road funding if States failed to comply with a 10-point road safety program including bicycle helmet laws.   New Zealand (NZ) also introduced a bicycle helmet law in January 1994. (Carr, Dyte and Cameron, 1995, Robinson, 2001, Hendrie, Legge, Rosman and Kirov, 1999, Marshall and White, 1994, Robinson, 1996)

Victoria Fig1 shows numbers of  cyclists admitted to hospital with and without  head injuries before and after the helmet  law.  Both head and non-head injuries fell  substantially.  As shown later (section 3),  surveys revealed lots of people were put off  cycling.  Fewer cyclists should mean fewer  injuries.  But if helmets were effective, head  injuries should have fallen by more  than non-head injuries.  Did they?   Which line represents head injuries  and which non-head injuries?

New Zealand Fig 2 compares  head injury (%HI) rates of primary  school children and adults admitted  to hospital.  Most primary school children were already wearing helmets,  so the law should have had little  effect on their %HI. However, adult  helmet wearing (%HW) increased  from 43% to 92%. If compulsory  wearing is beneficial, there should  have been a large reduction in %HI  of adults compared to primary school  children.  Fig 2 shows there wasn't;  both followed similar declining trends.   What other explanation is there, except that  helmets are less effective at preventing head  injury than most people think?

Western Australia Fig 3 shows percentages of hospital admissions involving head injury for all road users.  Helmet wearing at the start of the data series was virtually nil, increasing to about 39% of cyclists just before the law was enacted on 1 Jan 1992, when helmet wearing increased to over 80%.  The most dominant feature in Fig 3 is the declining trend in %HI common to all road users.  Researchers in Victoria found a similar trend, but mistakenly concluded helmets were remarkably effective.  They didn’t bother to check that the same trend was evident for pedestrians, so had nothing to do with helmets!  If helmet laws are effective, it should be obvious from the WA data when %HW increased from 39% to more than 80%.   Can you tell which year it was?  (a later section has more details.)

South Australia (SA, Fig 4) shows declining trends in hospital  admissions for concussion, but not other head/face injuries, and  again no obvious effect of a law that increased helmet wearing from  40-90%.  The decrease in concussions was noted and explained:    "it is understood that, since helmet wearing became compulsory, the  procedure for patients with a short episode of concussion has  changed in that such patients are not now admitted routinely." (Marshall and White, 1994)

New South Wales (NSW, Fig 5) introduced a helmet law for children  6 months after the law for adults.  Numbers of cyclists admitted to hospital  for head and other injuries were provided by NSW Health (Robinson, 1996).   As in other states, the dominant feature is a declining trend in  %HI for both adults and children, with very little additional effect from the  substantial increases in helmet wearing due to the law.

Summary of head injury data

The data in Figs 1-5 show large increases in helmet wearing, but no  major change in %HI, over and above the general trends. These trends  may relate to new diagnostic techniques (e.g. CAT scans), changes in  admission policies (as in SA), and safer roads (leading to lower impact  speeds in collisions, reducing the risk of head injury - Janssen and Wismans, 1985).   Thus it seems impossible to conclude from %HI data  that helmet laws have any large or significant benefit.

Successful road safety measures

Not all road safety measures show almost undetectable  responses.  Road fatalities fell immediately, and remained at  a lower level, when random breath testing was introduced in  NSW (Fig 6).  Some measures – e.g. those encouraging  responsible driving – seem remarkably effective.

In Victoria, campaigns against speeding and drink-driving were  introduced about the same time as the bicycle helmet law.  A  medical journal reported that accident costs were reduced by an  estimated GBP 100M for an outlay of GBP 2.5M (Powles and Gifford, 1993).  Fig 7 shows the fall in  pedestrian fatalities.  Other states also introduced road safety  campaigns about the same time as their helmet laws.  Fig 8 shows  all road casualties in SA in relation to the timing of the helmet law. Figs 7 and 8 demonstrate why we must take care when claiming  benefits of helmet laws.  Cyclists are likely to benefit just as much as  pedestrians from campaigns to reduce speeding and drink-driving.   Some proponents of helmet laws have shown the equivalent of  Fig 7 and 8 for cyclists, without explaining that similar benefits  were enjoyed by other road users.  The Cochrane Review of  Thompson et al. fails to mention the fall in non-head injuries in  Victoria (Fig 1), and dismisses the much safer road conditions  (Fig 7), leading to the impression that the entire 40% fall in  head cyclists’ head injuries was due to increased helmet  wearing (Thompson, Rivara and Thompson, 2002-9).

Summary of injury data

Despite the lack of obvious change in %HI in response to  increased helmet wearing from legislation (Figs 1-5), proponents of helmet laws have claimed the laws were  effective.  They usually fail to mention important aspects of the data, such as the similar trends in %HI for all  road users (Fig 3), that non-head injuries fell by almost as much as head injuries (Fig 1), or the large  reductions in the amount of cycling (see next section).

Click here to read the full article a discussion of cost-benefit analyses, the causes of brain injury and other information on how helmet laws have been evaluated.