Australian researchers claim to have proved that compulsory helmet laws work

Helmet debate rages on Down Under as others claim helmets aren't sole factor at work

by Simon_MacMichael   June 23, 2011  

Australian flag.png

Academics in Australia claim to have settled for once and for all the question of whether compulsory helmet laws in the state of New South Wales have indeed led to a reduction in head injuries among cyclists.

Their assertion, reported by ABC News, is the latest chapter in a long-running argument ignited last August by a paper by Clinical Associate Professor Chris Rissel and Dr Alex Voukelatos of the School of Public Health at the University of Sydney published in the August 2010 issue of the Journal of the Australasian College of Road Safety (JACRS).

The Journal subsequently retracted that paper after fellow academics held that the data it was based upon were flawed, a criticism that Dr Rissel accepted, although he said he continued to believe that factors other than compulsory helmet laws, such as better road safety generally, were behind a fall in the number of head injuries recorded among bike riders after their introduction in 1991.

Now, however, some of Dr Rissel’s critics led by Dr Jake Olivier and a team of researchers at the University of New South Wales (UNSW) and the Sax Institute have published their own research in the Accident Analysis and Prevention Journal which they claim supports their view that helmet laws did result in a reduction of head injuries suffered by cyclists.

Their research suggests that there was a 29 per cent reduction in head injuries from the period immediately before the laws coming onto the statute book and the period immediately after.

"We set out to perform the most comprehensive analysis possible on the subject while addressing any data limitations and possible confounding factors," said Dr Olivier in a press release.

"What we found provides compelling evidence that the legislation has served its purpose in reducing bike-related head injuries and any repeal of the laws would only put lives at risk," he continued.

UNSW's Chair of Road Safety and Professor Raphael Grzebieta, co-author of the study, commented: "It shows what we've suspected for a long time — that you would be unwise to 'hit the road' without a helmet."

Funding for the research was provided by the NSW Department of Health, the NSW Roads and Traffic Authority, the Motor Accidents Authority and the Australian Government Department of Innovation, Industry, Science and Research – all bodies that opponents of mandatory helmet laws might view as having a vested interest in keeping legislation as it is.

Researchers from UNSW’s Injury Risk Management Research Centre and the Sax Institute studied trends in NSW hospital admissions among cyclists and pedestrians, making a comparison between the rate of head injury relative to arm injury, and another for head injury relative to leg injury, for the months either side of the law being enacted.

They discovered that there was a significantly greater fall in head injury rates among cyclists than among pedestrians, and that head injuries declined at a greater rate than leg injuries, which they said was evidence of the benefits of compulsion.

"We endeavoured to identify the effect of the legislation on head injury rates as distinct from other road safety interventions and we've shown that the improvements could only have come from the helmet legislation," added Dr Olivier.

However, he emphasised that compulsory helmet laws were not the only solution to ensuring that cyclists are safer while riding their bikes.

"Cyclist safety is a complex issue driven by a range of factors,” he explained. “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 could facilitate further safety improvements."

Professor Rissel, however, continues to assert that compulsory helmet laws should be scrapped because he believes they "do more harm than good," pointing to a reduction in the number of people cycling since their introduction.

"The health benefits to physical activity through more people cycling really outweigh the injury risk that there is," he told ABC News.

"If someone doesn't take up cycling because the helmet law is a barrier to them, there is nothing to say that they won't take up something else."

Richard Birdsey, Vice-President of Bicycle New South Wales, acknowledged that compulsory helmet laws, which he supported had been a "hugely contentious issue," but added that they had clouded what he saw as the issue that most needs to be addressed, road safety.

"We really feel that it is a bit of a distraction in terms of people debating backwards and forwards as to whether they are a good thing or not," he explained.

"We'd really want to see the Government, community groups and motoring groups working towards making our roads safer for all road users, including cyclists.

"Many people I speak to on the road say that they like riding without a helmet, others say they would never even dream of getting on a bike without one.

"Certainly I never would and a helmet has saved me on a couple of occasions," he concluded.
 

25 user comments

Oldest firstNewest firstBest rated

I shouldn't think anyone'll have anything to say about that though.

Dave Atkinson's picture

posted by Dave Atkinson [7492 posts]
23rd June 2011 - 13:54

0 Likes

Thinking

Simon_MacMichael's picture

posted by Simon_MacMichael [8465 posts]
23rd June 2011 - 14:13

0 Likes

I wonder if reserach into the health-damaging consequences of people not cycling becase they were put off by having to wear a helmet, which made them think that cycling is dangerous, will be funded too?

Mike
-------__0
--- --- \_ \¬
------ (+) / (+)______ better by bike!

Mike McBeth's picture

posted by Mike McBeth [73 posts]
23rd June 2011 - 14:25

0 Likes

It misses the point, although I'm judging only by the press release.

Of course a helmet will protect you from bumps, scrapes and needing some stitches. That's what they are designed for, so it is hardly surprising that they do their job.

But many people seem to be under the impression that helmets protect from serious head injury or death or mitigate the effects of such events. How many times are they referred to as potentially 'life-saving'.

Do they save lives or prevent serious injury that's the question, not do they prevent any injuries at all.

If all they do is protect from minor injury then it is unlikely to be outweighed by the negative effects of reducing cycling numbers.

abudhabiChris's picture

posted by abudhabiChris [566 posts]
23rd June 2011 - 14:28

0 Likes

Helmet Panto Time! Big Grin

posted by richiecoops [40 posts]
23rd June 2011 - 14:48

0 Likes

I may have read it wrongly, but it sounds like (and apparently in common with the other studies that I've heard about) they have not distinguished between head injuries suffered by mountainbikers and other cyclists.

This seems to me to be a critical point. The likelihood of suffering a head injury (and the type/seriousness of that injury) whilst mountainbiking and, say, commuting to work is surely very different?

Without information to show which type of cyclists are suffering what types of injury, I can't see how any study like this could possibly be used to justify compulsory helmet wearing on the road.

posted by don_don [149 posts]
23rd June 2011 - 14:51

0 Likes

don_don wrote:
I may have read it wrongly, but it sounds like (and apparently in common with the other studies that I've heard about) they have not distinguished between head injuries suffered by mountainbikers and other cyclists.

I have to admit, that distinction has never occurred to me, in all the years I've spent reading helmet threads online. What a plum.

Anyway, I've got some beer and popcorn. Put on a decent show chaps! Big Grin

Chuffy's picture

posted by Chuffy [190 posts]
23rd June 2011 - 15:10

0 Likes

Is that a 29 percent reduction in head injuries in total, or a 29 percent reduction in head injuries per miles cycled. If the latter then OK, but it should still be the rider's choice. If the former then I'd like to also see figures for the percentage change in heart disease and obesity levels a few decades after the legislation was introduced.

posted by handlebarcam [531 posts]
23rd June 2011 - 15:16

0 Likes

something that might be helpful is to publish this alongside the change in cycle usage, has it increased despite the law or reduced.

mrmo's picture

posted by mrmo [1345 posts]
23rd June 2011 - 17:12

0 Likes

A personal account here. As a teenager cycling in rural Queensland I was struck by a truck. I ended up with a broken collarbone, a few holes in my body and gravel rash up one side of my body, including the face. The helmet I was wearing ended up with cracked foam and the shell (a lot harder and thicker than by today's standards) was scraped raw. I've no doubt that that helmet prevented me from receiving massive head injuries. The ambulance took 2 hours to reach me so I'd go as far as to suggest that it probably saved my life. And in the subsequent years other helmets have also been useful when car doors have been opened on me.

posted by footsore tramp [6 posts]
24th June 2011 - 0:26

0 Likes

Looks like it's a change in the proportion of people pitching up at hospital with head injuries vs. other kinds of injuries. It seems the researchers aren't interested in if people choose to cycle or not, and why. What bothers me is the perception of cycling- inherently dangerous vs. relatively safe, specialist and niche vs. ordinary and everyday- which comes along with compulsory helmet laws and prevents a meaningful proportion of journeys being made by bike.

Patrick.

posted by Littlehuan [46 posts]
24th June 2011 - 1:51

0 Likes

From an Antipodean perspective, helmets have been compulsary here for many years. I have the (unfortunate) experience of being hit by a car in pre-helmet days and, with helmet, having another cyclist fall off in front of me while at speed. In the latter case, I had a crack in my helmet (& a very surprised look on my face), compared with concussion and considerable pain in the first case.

How scientific is this? Not very, but my medical specialist wife has seen a lot of head injuries and certainly believed my helmet saved me from a hematoma in my skull.

Can cycling be dangerous? Yes; both self-inflicted & by those with cars. Should that stop people from cycling? Well, do you stop driving because of the requirement to wear a seat belt?

Use the protection available and be sensible as you ride, is the best approach.

Arguing philosophically requires beer, and virtual beer just doesn't satisfy.

Gerard the Kiwi

GerardR's picture

posted by GerardR [86 posts]
24th June 2011 - 3:56

0 Likes

I will stick with the dutch model, no helmets, no lights, beers, never saw the roads paved with graves.

No doubt helmets help, but yet again it really misses the point. The majority of serious head injuries excluding mtb jumpers are caused by vehicles, as are other road accidents (a few million a year globally, but hey that is acceptable in the name of convenience). Road vehicles are the actual problem not riding without a helmet, solve the actual problem not curtail peoples freedom.

Check out Casey in New York:
http://www.youtube.com/watch?v=bzE-IMaegzQ

no helmet yet manages to crash okay, thing about the body it is pretty good at protecting itself, though it has its limits when ploughed into by a car.

And is it just me but NSW has become and is a nanny state, where did Australia go so wrong, it used be a nation based on common sense and self reliance.

posted by surreyxc [48 posts]
24th June 2011 - 9:52

0 Likes

GerardR wrote:
Can cycling be dangerous? Yes; both self-inflicted & by those with cars. Should that stop people from cycling? Well, do you stop driving because of the requirement to wear a seat belt?

No, many people just ignore the seat belt law. I did the AA streetwatch thing a few weeks ago and a surprising number of drivers weren't wearing seatbelts. Special prize to the lady who had the belt done up behind her, presumably to stop that annoying alarm chime on her posh car.

However, unlike cyclists who are easy to spot without a helmet, you'll only spot these idiots not wearing seatbelts, using phones or fishing satnavs out of their footwells if you look right into the car - or if they crash and it's bleeding obvious.

I'm unconvinced on the safety benefit of helmets, but I usually wear one for cosmetic reasons - I avoid sunburn on my balding head and it stays in place better and feels nicer than a cloth cap! I do object to the principle that we should be obliged to wear them by nanny state red tape before all cars have to be wrapped in thick foam and I will probably stop wearing one if a helmet law is brought in. Let's punish the things that do the damage before punishing what they damage, eh?

posted by a.jumper [721 posts]
24th June 2011 - 10:01

0 Likes

Interesting point about seatbelts, perhaps we should make a law where all occupants except the driver must where a seat belt, then they might drive with a bit more sense.

What really grinds my gear is the 4x4 mum, with 'Baby on Board' sticker driving like an A*hole, so your babies life is worthy but anyone else's is not.

posted by surreyxc [48 posts]
24th June 2011 - 10:44

0 Likes

You only have to look at the press photo, carried in the Evening Standard and - I think - on this site of the recent serious injury incident in Hackney (tipper truck again) to see how useful a helmet is in urban traffic.

The helmet is lying a few feet from the bike, on its own. The bike is fairly comprehensively bent, and anything that can bend a steel frame would have med light work of a polystyrene helmet.

So, when the Oz researchers say that helmet compulsion "works", what do they mean by "work"? They might just as well say that "wearing a helmet will reduce your risk of serious head injury from meteorite strikes by 75%" but would you classify meteorite strikes as the greatest risk you face?

posted by Paul M [325 posts]
24th June 2011 - 11:09

0 Likes

My uncle always liked to quote the idea that the best way to improve driving would be to ban seatbelts and put a six inch spike in the middle of all steering wheels.

abudhabiChris's picture

posted by abudhabiChris [566 posts]
24th June 2011 - 11:32

0 Likes

As an aside on the Aussie helmet issue, an old (London) schoolfriend who lives in Melbourne was over recently and his observation, nothing to do with safety (and he's an ex A&E nurse), was it was just plain weird to see cyclists whizzing around without lids on Surprise

Simon_MacMichael's picture

posted by Simon_MacMichael [8465 posts]
24th June 2011 - 11:52

0 Likes

This kind of research is typicaly narrow in its scope and yet again its the same old same old.
All in England should try to understand the damage that helmet law brought about here in Australia while purportedly saving lives. In some schools the drop-off of students riding to school was of the order of 93% and adolescents are the accident prone ones that comprise most of the statistics, then as now. Of course you are going to get a result if this happens.
None of the studies ever differentiate between the risk-proneness of the different age groups.
Helmet law made all of us who continued to ride have to wear helmets simply because of the few and most people simply gave up.
The roads then became more dangerous for those that were left.

posted by Pjrob [22 posts]
24th June 2011 - 22:37

0 Likes

Pjrob wrote:
This kind of research is typicaly narrow in its scope. In some schools the drop-off of students riding to school was of the order of 93% and adolescents are the accident prone ones that comprise most of the statistics, then as now. Of course you are going to get a result if this happens.

Unless the adolescents are statistically more likely to have a head injury, as opposed to an injury, I think this study does actually make an effort to take the drop off into account. It didn't focus on the drop in head injuries, rather the proportion of the drop in head injuries to the drop in arm / leg injuries.

Unless there is any other specific factor which would account for a greater reduction in only 1 type of injury, it's hard to argue their stated conclusion that "helmet laws did result in a reduction of head injuries suffered by cyclists" is incorrect.

Other arguments about a reduction in general population health due to the law are still valid, but not really touched by this study.

Like the cyclist says in the article though, this all just muddys the waters of what should be a bigger debate about road safety.

posted by El Badgerino [12 posts]
25th June 2011 - 8:40

0 Likes

It will be sadness that when I move back to Australia I have to put a helmet on to ride around the block to pick up a loaf of bread. Since living in London I have liked that I can choose when to wear a helmet.

Evski

posted by Evski [23 posts]
25th June 2011 - 12:56

0 Likes

Evski wrote:
It will be sadness that when I move back to Australia I have to put a helmet on to ride around the block to pick up a loaf of bread. Since living in London I have liked that I can choose when to wear a helmet.

Evski

Great point Evski! I'll also be heading back to Sydney at some point (been here 5 years!) although I do wear a helmet on my regular commute into London ... it is liberating to ride without a helmet for those short trips Cool ... my helmet hasn't been tested on my regular commute yet (touch wood) but it does give me a sense of security I guess .... I wonder if it also gives the car/taxi/truck drivers security they can drive around like idiots sometimes? Thinking (especially in Oz where it's compulsory) ... maybe it gives them false security us cyclists are "safe" with our helmets!

Argy's picture

posted by Argy [147 posts]
26th June 2011 - 9:10

0 Likes

Having just had quite a serious accident, I have no doubt my helmet saved me from even worse. I don't really understand the anti-helmet argument. I would certainly advocate compulsory helmet wearing for young people.

posted by paulfg42 [379 posts]
26th June 2011 - 17:08

0 Likes

paulfg42 wrote:
Having just had quite a serious accident, I have no doubt my helmet saved me from even worse. I don't really understand the anti-helmet argument.

Yeah, that's the main problem. Bloody irrational born-again "I'd-be-dead/crippled-without-my-hat" crashers. Try not crashing instead: it hurts less. And if you were in a crash with another vehicle, like 90% of accidents, you have my sympathy, but remember "this helmet is not designed to protect against violent or sharp impacts" (or similar wording on most of them) - they're only tested at stopping 12mph one-metre drop impacts: falling off your bike, basically. Even bike-on-bike crashes exceed the design parameters fairly easily. You'd do much better to campaign for general road safety improvements so those vehicles become less dangerous to riders, rather than campaign for the mostly-irrelevant victim-punishing hat law.

posted by a.jumper [721 posts]
27th June 2011 - 10:40

0 Likes

I don't think this study shows what the headline here claims. If anything, I think it shows the reverse. When I look at the data in the report, other than a short-term reduction around the time of the passing of the law (which may itself be influenced by things like media exposure of the law change), in the longer run the trend in injury rates *increases*. By the end of the study period, the benefits are nearly gone. We can extrapolate that, longer term, past the study period, the head injury rates likely became *greater* than before the law.

I've a longer response on my blog at http://bit.ly/mLX6FX

posted by Paul J [675 posts]
28th June 2011 - 15:57

0 Likes