Monday, 16 March 2009

The Cycle Helmet Issue

Helmets for cyclists have been around since at least the 1960s when they used to consisted of padded metal bars across the cyclist's skull and tended to be worn only by racing cyclists. Even then it was well into the 1990s before they became common in long races like the Tour de France and there was resistance to making them compulsory when the rules were changed in 2003. In fact what led to widespread adoption was that teams found it was easier to fit two-way radios into them and keep in contact with their teams to advise them on tactics.

For the general public helmets became increasingly familiar in bicycle shops in the late 1980s particularly focused at children. Also with the increase of mountain biking they seemed to be part of the fashion that went with that sport. There has been much discussion about their effectiveness. The main thing is that people who have never worn one, do not seem to understand the difference between bicycle helmets and those for motorcyclists. Bicycle helmets are made of plastic and foam design to compact like a 'crumple zone' on a car. They tend to sit on the top of the head and give no protection to the back of the neck. They do not contain the head in the way that motorcycle helmets do. Motorcycle helmets are metal or carbon fibre and are far tougher. In an accident they can actually keep a damaged skull in place which is why you should never remove a helmet from an injured motorcyclist and leave it on until they reach hospital. A cyclist wearing a bicycle helmet that had sustained such an injury would be dead. Of course motorcycle helmets were not made compulsory in the UK until 1973 and there were many who protested against this compulsion, I remember one man who was constantly being imprisoned when I was a boy for refusing to wear his and I always wished he would have expended his energy on a better campaign.

Until this week court cases which have implied cyclists are negligent in not wearing cycle helmets have failed. There was an attempt to introduce legislation to make it compulsory in 1998-9 and 2004. One challenge is policing the issue, I suppose we would see police pursuing cyclists not wearing one or more likely neighbours would inform on people not having one. Unlike with cars and motorcycles, the UK has no bicycle licensing system so you cannot take the number of the bicycle and say that a certain person is responsible as you can with motor vehicles. This court case Smith v. Finch 2009 has suggested that a cyclist injured while not wearing a cycle helmet would not be entitled to full compensation and cyclists not wearing one can be seen by the law as negligent even though there is no legal compulsion to wear one. The cyclist Robert Smith brought a claim against Michael Finch who had hit him with his 600cc motorbike. Finch counter-claimed saying that Smith had been responsible for the head injuries he had sustained because he was not wearing a helmet even though he had one.

Medical evidence showed that the helmet would have done nothing to reduce Smith's injuries as the back of his head was hit and he hit the ground at 12mph which was more severe than the helmet could take. The motorcyclist had come very close to the cyclist while speeding and the court put the bulk of liability on Finch. Cycling journals have noted that whilst the judgement does not compel people to wear cycle helmets they can be seen as negligent if claiming compensation and court cases usually see a 25% reduction in compensation if the cyclist is not wearing a helmet. The government claimed that 1,200 children under 16 received a head injury in a year from cycling and crash helmets would reduce this by 85% but they have now withdrawn this claim. Negligence against children is difficult legally anyway. In the UK you are not criminally responsible until you are 10 years old and for children up to the age of 14, in cars, it is the driver who is responsible for whether they are wearing their seatbelt, which is compulsory in the UK. It is hard to get children to wear helmets, in 2004, 29% of adult males; 30% of adult females; 11% of child males and 26% of child female cyclists wore one. Boys are loathe to wear them. Also people in general are less likely to wear them when travelling on minor roads, which is similar to how people used to behave to wearing seatbelts before it became compulsory.

Current cycle helmets are fine for stopping you injuring your head when you fall off, they do not protect you if hit by a motor vehicle. In these cases the helmets generally shatter anyway. A friend of a friend had hers smashed open by something sticking out from a lorry as it drove past.

New Zealand, Canada, the Czech Republic, Iceland and parts of Australia have made cycle helmets compulsory. I would argue that if this is going to be the case then the helmets need to be far more encompassing and far tougher. I am not suggesting that cyclists wear motorcycle helmets but perhaps something more like what mountaineers wear which protects the back of the head as well as the top. In many accidents cyclists are thrown to the side or backwards, and are unlikely to come down on the very top of their head which is the part that bicycle helmets most protect.

Of course the key problem is that drivers in the UK drive so hazardously around cyclists. British drivers drive very dangerously anyway and it seems to be deteriorating. No-one uses indicators any more and a trend I have noticed in recent weeks (I drive over 300 miles per week) is people from side roads forcing their way into the main road without waiting, causing sudden braking on the main road. Fortunately I always leave generous space between me and the next car, but tailgating is so prevalent in the UK that I am sure 'shunts' must be increasing due to this behaviour. In 2006 research found that motorists drove 8.5 cm closer to a cyclist wearing a helmet than a bare-headed one:

For women, wearing a wig is more effective than wearing a helmet because this research showed that it meant drivers gave them an additional 14cm compared to a bare-headed cyclist, which shows how sexist many drivers are that they want to ogle a beautiful blonde whereas they will mow down other cyclists. However, women cyclists are actually more likely to be injured by lorries than male ones, partly, ironically because women cyclists obey traffic signals and signs more than men. Evidence about this was suppressed by the government:

There has been evidence in the past that cyclists with a helmet on also get complacent as they feel protected, though in fact given the kind of injuries they are likely to sustain, they are little better off than if wearing nothing. Cyclist are generally hit first on their limbs, then their body and finally their head as it smashes into the ground. If motorists are going to drive so dangerously, we need to start introducing armour for cyclists.

A lot of this furore has stemmed from motorists and motorcyclists trying to shift blame on to cyclists. This is a very British attitude. In the UK we have this sense that 'an Englishman's car is his (mobile) castle' which leads to very hostile driving towards all other road users as if any delay in a journey is a personal affront to the driver. If you cycle in continental Europe you find drivers give you so much more space, to the extent that you can tell if you are being overtaken by a British car compared to a French/Belgian/Dutch one. In my experience the difference in the space you are left can be up to 45cm more from a non-British driver, depending on the road. I was often hooted by lorries in France and initially assumed they were being as hostile as British lorry drivers who seem to think that cyclists should be banned from the roads. Many car and lorry drivers think this too and shout it out at you; there was a case I heard of while driving through Dorset of a middle-aged man pushed off last year by people driving by in a car. The rage of British motorists at cyclists who are obeying the law, is incredible. Some cyclists do drive dangerously and jump lights, but it is rarely these ones who are abused verbally and physically by drivers. Simply cycling opens you up to a lot of abuse. This helmet controversy will just add more fuel to their anger at cyclists. Ironically in local newspapers you see numerous complaints about cyclists cycling on pavements but given how hazardous the roads are, is this any surprise?

I wear my cycle helmet religiously these days, though perhaps I should put a long wig on instead. The key issue remains, as on a poster that I saw in the 1980s, that cyclists remain a 'soft vehicle'. In 2007, 136 cyclists were killed and 2,428 seriously injured. Even if we armour cyclists and bicycles, this will always be the case. Even with their far tougher crash helmets and leather clothing, 2,493 motorcyclists were killed in the UK last year and there were a total of 6,737 who suffered an accident, making up a quarter of all road casualties. Given these statistics even stronger helmets and protection for cyclists may not reduce the casualties. Cycle helmets will protect you if fall off your bicycle but not if you are hit by a car or lorry. I suggest we begin moving towards the whole head covering design worn by BMX cyclists which protect the neck and face as well as the top of the head. Yet, even this will not keep you alive if rammed by a car.

What needs to change is the attitude to driving in the UK. Drivers of motor vehicles must learn that the road is not just for them and that there are all sorts of other vehicles out there. People must stop taking it as a personal insult that there is a slower or two-wheeled vehicle in front of them (let alone a horse, I could do a whole posting on how badly drivers behave towards equestrians and their mounts). British drivers need to learn from their continental counterparts that roads are not their for their personal use, but that driving a car or lorry means you become part of a complex system which needs everyone to obey the laws that are clear and well established. Speed limits are there for a reason, however much you whine that they are simply to constrain you asserting your machismo/a. Speed cameras are necessary because so many people think they are somehow exempt from the law and need to be reminded that they are not. If you are not speeding then speed cameras are no worry. Cyclists and motorcyclists have as much right to the road as you do. They should not be persecuted just because they select (or can only afford) a different form of transport to you; certainly you should not try to kill them or cause an accident, that is criminal behaviour even if the law is poor at catching up with you. Stop being so juvenile as to always try to shift the blame on to others, blaming pedestrians for trying to cross a road, especially in a residential area or a cyclist just because they have not got their helmet on. You will encourage responsible use of roads if you behave responsibly yourself. Too many drivers break rules so that they make it seem like some arbitrary thing and that I take a great risk in complying with the laws of the road.

Excuses, such as people not wearing helmets which are always going to be no protection against dangerous drivers, will always be found. In fact arrogance is what kills and it is the key issue that needs to be tackled if we are going to reduce road casualties.


Richard Keatinge said...

Much wisdom in the above, but it's worth remembering that laws have stopped a lot of people cycling and have done nothing for head injury rates, see Robinson DL. No clear evidence from countries that have enforced the wearing of helmets. BMJ 2006;332: 722-5. It appears that helmets break easily, but don't absorb the impact, see the engineers quoted at A broken helmet has simply failed. Helmets have also strangled some young children who were wearing helmets while playing off their bicycles. At my moderately advanced age it's far too dangerous not to cycle - regular cycling, Danish style, not too far, not too fast, nearly halves the death rate, see All-Cause Mortality Associated With Physical Activity During Leisure Time, Work, Sports, and Cycling to Work. Andersen et al, Arch Intern Med. 2000;160:1621-1628.

Rooksmoor said...

Richard, I agree and thank you for providing those links. I think my posting shows my ambivalence about cycle helmets. I think that the real problem is that drivers are getting increasingly aggressive and reckless rather than cycling itself becoming any more dangerous. People have been cycling for decades without any real need for helmets, but now lawyers and motorists are seeking excuses for why they should not pay out compensation when people hit cyclists. Car drivers find it difficult to accept they are in the wrong and so seek some excuse for the harm they do.

Yes, as I note in my posting, I think the current design of cycle helmets are little more than cosmetic. If there was a genuine wish to create something that really protected the cyclist's head then we would have already adopted something more robust. There are designs out there, I reference the BMX style, but there are the skateboard ones and mountaineering ones too, which offer more genuine protection. I suppose the issue is the cost, cycling should be a cheap form of transport and if you start compelling people to wear expensive equipment to do it then it makes it into a luxury hobby.

In addition, it is not the head that usually takes the first strike of the impact but the limbs and then the body, the head is usually the last bit to be injured, so even with motorcycle-style helmets for all cyclists it would not reduce injury or fatalities.

I agree, cycling is an excellent activity and I wish we were more like continental countries, in our attitude to it. I hope that British success in cycling at last year's Olympics and the Tour de France would encourage more of it, but Britain is always burdened with apeing the USA where the car is king, though ironically they also have a strong cycling community. Of course their speed limits are lower than in the UK and in general their roads are a lot wider.

In Britain things are jammed into narrow roads and speeding seems to be the norm. I have referenced websites that complain about the 30mph speed limit in towns supposedly increasing accidents. Until we get away from such twisted mentality, no cyclist (and many pedestrians) will truly be safe.

yammerhant said...

The facts are thet 30mph is a lethal speed; studies (and areas where it has been implemented) have showed that if the 30mph limit in built-up areas was reduced to 20mph, deaths and serious injuries would decrease dramatically. Roadpeace say that two-thirds of all road casualties occur on built-up roads, and a quick Google reveals that "the chance of a pedestrian being seriously injured or killed if struck by a car is 45% if the car is travelling at 30 mph but only 5% at 20 mph".

Sorry if I've gone off-topic!

Rooksmoor said...

Yammerhant, yes, I agree, I often drive around Portsmouth in Hampshire which has 20mph speed limits right throughout the city. I was pointing out that some websites that I have come across when researching postings in the past on hazardous driving complain that 30mph is far too slow and it compels them to keep checking their speedometers so they feel they are more of a hazard. They also feel that most pedestrians who are hit by cars have stepped or run out in front of a car deliberately. I am not going to privilege such people with a link, but they are all too easy to find out there. Basically anyone on a bicycle or on foot hit by a car let alone a lorry is going to suffer bad injuries and the every 5mph more makes those injuries worse. I am heartened that there are some people like you out there willing to counter those who blame such accidents on the victims rather.

yammerhant said...

I see today that 20 mph limits on all residential roads is being raised; cue the usual protests from irresponsible drivers.