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Galway
Cycling Campaign -Feachtas Rothaiochta na Gaillimhe
c/o Galway One World Centre, William St. West, Galway.
Open letter to the
delegates to the Annual General Meeting of the Irish
Medical Organisation 19/4/01- 22/4/01
Re: Proposal that the Irish Medical
organisation calls on the Government to introduce
legislation to make it mandatory for all cyclists to
wear protective headgear
Summary The motion for
mandatory protective headgear for cyclists is clearly
without merit on either scientific or public health
grounds. We call on the sponsors of this motion to
withdraw it in the first instance and failing this, we
call on the delegates to the annual general meeting to
reject it unequivocally.
On behalf of the committee
of the Galway Cycling Campaign the above motion has
recently come to our attention and we wish to bring the
following matters to the attention of the delegates.
Head injuries as a road
safety problem Head injuries are a factor in a large
proportion of injury and fatality accidents to all road
users. In Ireland in 1996 relative ratios for deaths
among predominantly unhelmeted road users were as
follows: Car User 48%, Pedestrians 23%, Pedal Cyclist
5%. For recorded injury accidents the ratios are: Car
users 64%, Pedestrians 13%, Pedal cyclists 6% . It is
clear that head injuries to cyclists are at best a tiny
fraction of head injuries among recorded traffic
accident victims. A study conducted in Sheffield
compared injuries among different road user groups and
came to the conclusion that helmets for motorists and
pedestrians had the potential to save 12.5 times as many
lives as cycling helmets . Similar comparisons in
Australia have suggested that targeting motorists for
compulsory helmets could save 17 times as many lives .
The Australian Federal Office of Road Safety has claimed
that cycle helmet type devices would if worn by
motorists "be as effective as air bags and better
than seatbelts". It is suggested that targeting
helmets at this road user group has the potential to
reduce injury severity by 50% and prevent the deaths of
20% of head injury sufferers .
In this context the
exclusive targeting of cyclists for helmet use is
clearly illogical. There must therefore be doubts as to
whether the actual intent of this motion is in fact to
address the issue of head injuries. The suspicion must
be that bicycle users have been singled out merely
because they are perceived as an easy target without a
strong lobby to defend their interests.
This would be an erroneous
assumption.
The protective effect of
cycle helmets Cycle helmets are intended to prevent soft
tissue injury in the event of simple vertical falls at
low speeds. As is explicitly expressed in the relevant
British Standard, they are neither designed, intended
nor expected to provide protection from impacts with
moving motor vehicles, the cause of 95% of cyclist
fatalities and of the majority of serious injuries. This
limited level of protection is only provided if the
helmet is properly fitted and worn. Improperly worn or
used helmets can and do kill, with reports of deaths of
children due to strangulation in Sweden, Finland the US
and Canada
The claimed protective
effect of cycle helmets In defiance of the logic of
materials science and kinetics, incredible claims of
injury protection have been propagated, particularly in
medical literature from the US. Much of these have been
based on research that is demonstrably of poor quality,
based on inapplicable assumptions. One notorious case
made a claim for a potential reduction of 85% in brain
injury . It transpired that this was based on comparing
the injury severity of mainly white, helmeted, middle
class children cycling under parental supervision in
parks with the injury severity of mainly black,
unhelmeted, children cycling unsupervised on busy city
streets. Comparisons based on adults' fall into other
traps. In the days before "helmet-hype",
voluntary adult helmet users tended to be experienced
types with a more cautious disposition. Such cyclists
have been shown to be 2.6 times more likely than
unhelmeted cyclists to respect stop signs and seven
times more likely to use hand signals . If this
behaviour results in a lower accident involvement and
injury severity then this is an argument for increased
training in, and enforcement of, the existing traffic
regulations and not for compulsory helmet wearing.
Helmet laws as a public
health problem Cycle helmets were made compulsory in
Australia and New Zealand in the early 1990's, the
overwhelming effect was to discourage people from
cycling. In Australia hospital admissions with head
injury dropped by 15-20%, but the level of cycling fell
by 35% . In New South Wales there were found to be 43%
fewer child cyclists two years after the law . Similar
effects are reported in the US where some states have
imposed helmet laws for children. Even today, ten years
after the law was imposed, cycling levels in western
Australia are 5-20% below the original pre-law level .
This is notwithstanding a large growth in population
during this time. In Australia a recent estimate
attributes an 11% reduction in head injuries to helmets
. This reduction is lower than the overall decline in
cyclist numbers, it has become more dangerous to cycle
in Australia.
In New Zealand
helmet-wearing rates increased by up to 84% for primary
schoolchildren and 62% and 39% for secondary
schoolchildren and adults respectively. However
sophisticated statistical analysis could show no
reduction in serious head injury with increased helmet
use . In the US "the largest survey of cycling
casualties ever undertaken found that helmets did not
prevent injury; indeed, increased use correlated with
increased risk of death" . In the UK it has been
suggested that the lethality of cycling accidents has
actually increased as cycle helmet use has grown .
Cycling and public health
Cycling is demonstrably the safest form of transport.
The British Medical Association has found that all
things considered, the health benefits of regular cycle
use significantly outweigh any increased risk of injury
. In Denmark it has been found that regular adult cycle
commuters show a 40% lower mortality than their
non-cycling peers . Ireland has among the highest levels
of heart disease and obesity in the EU and is facing a
public health crisis as existing government "road
safety" policy forces more and more cyclists and
pedestrians off the roads. About 13,000 Irish citizens
die of heart disease and related conditions annually. In
this context any measure that would act to further
reduce overall cyclist numbers would be a public health
disaster. With this in mind the BMA has rejected
compulsory helmet laws on precisely these grounds.
After motorist behaviour,
the most important factor governing serious accident
expectancy for cyclists is simply the base number of
cyclists. The more cyclists there are the lower each
individual's risk. If it is required to make cycling
safer then it is necessary to encourage more people to
cycle. Helmet compulsion has the exact opposite effect
both on cyclist numbers and on relative safety.
Conclusion The motion for
mandatory protective headgear for cyclists is clearly
without merit on either scientific or public health
grounds. We call on the sponsors of this motion to
withdraw it in the first instance and failing this, we
call on the delegates to the annual general meeting to
reject it unequivocally.
Shane Foran, Safety Officer Galway
Cycling Campaign -Feachtas Rothaiochta na Gaillimhe c/o
Galway One World Centre, William St. West, Galway.
Road Accidents Facts,
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the possible benefits of cycle helmets, Kennedy A.,
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Head injuries and bicycle helmet laws, Robinson DL,
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Motorists get head start in drive for road safety,
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Cycle helmets: 25 years along the road, John Franklin,
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