British Medical Journal poll says 'no' to helmet compulsion

But British Medical Association wants mandatory helmet use

by Mark Appleton   July 29, 2011  

White cycle helmet

A British Medical Journal poll asking: “Should it be compulsory for adult cyclists to wear helmets?” has returned a result that conflicts with the British Medical Association’s stated position on helmet compulsion.

Of the 1,439 people who responded to the BMJ poll, over two-thirds, 68%, believed that the use of cycle helmets by adults should not be mandatory in the UK.

Many of those who responded left comments, including Steven Charkin, who said: "Making helmet wearing compulsory gives out the message that cycling is a dangerous activity, which it is not.

"The evidence that cycling helmets work to reduce injury is not conclusive, what has however been shown is that laws that make wearing helmets compulsory decrease cycling activity. Cycling is a healthy activity and cyclists live longer on average than non cyclists."

Another, Richard Burton, said: "Since nowhere with a helmet law can show any reduction in risk to cyclists, only a reduction in cyclists, why would anyone want to bring in a law for something which is clearly not effective at reducing the risk to cyclists?"

The British Medical Journal is editorially independent of the BMA whose position is clear.

Dr Vivienne Nathanson, Director of Professional Activities at the BMA, said: "The BMA, as a part of its policy to improve safe cycling, believes that children and adults should wear helmets when cycling. This has been debated a number of times at the BMA's annual conference and when doctors hear the evidence they vote for the mandatory wearing of helmets.

"Wearing a cycle helmet prevents many low impact crashes causing serious injuries and neurological damage.

"Initially we want to see an increase in the voluntary use of cycle helmets prior to the introduction of cycle helmet legislation and we support initiatives that do this. We fully agree cycling is a healthy exercise and believe that increased helmet wearing will further improve its safety."

Road.cc asked the BMA if the organisation would be likely to revisit the issue in light of the poll.

A spokeswoman for the BMA told us: “We have a policy-making body which meets once a year at our annual conference. If our policy is to change then it would have to be as a result of a motion put forward at the conference by our grass roots members through their divisions.”

So if enough BMA members feel the issue needs to be debated again, there is a chance that the Association may, one day, change its stance on the matter.

However, with the annual conference having just taken place that will not happen in the near future and in the meantime politicians like Annette Brooke MP who are calling for compulsory helmet laws will continue to cite the BMA as a powerful supporter of their position.
 

17 user comments

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If the BMA had its way doctors would still be using leaches and bloodletting to treat patients, the BMA is run by a bunch of old farts who don't like the idea of letting science getting in the way of doing things the way they have always done them! Quacks to a man!!

posted by Kim [140 posts]
29th July 2011 - 12:51

5 Likes

Kim wrote:
If the BMA had its way doctors would still be using leaches and bloodletting to treat patients, the BMA is run by a bunch of old farts who don't like the idea of letting science getting in the way of doing things the way they have always done them! Quacks to a man!!

Just the men or the women too?

OldRidgeback

posted by OldRidgeback [2288 posts]
29th July 2011 - 13:05

5 Likes

The words ascribed to Dr Nathanson are extraordinary; I quote the part in question: "Wearing a cycle helmet prevents many low impact crashes........." I am mystified by this; how can anyone believe, or suggest, that the wearing of a helmet in some way acts to prevent crashes happening? The helmet might or might not prevent or ameliorate damage to your head and brain, if you fall on, or are hit on, those parts of your body, but to suggest that somehow the act of wearing the helmet prevents crashes? I'm sorry, but I just don't understand or follow this. Perhaps the good doctor actually meant to say something else, but has been a little imprecise in her language?

posted by singlespeedfan [5 posts]
29th July 2011 - 13:54

6 Likes

I couldn't help but mentally add a little note after the following quote:

Wearing a cycle helmet prevents many low impact crashes causing serious injuries and neurological damage.*

* citation needed.

It seems like both the responses mentioned for the poll explain exactly this - that the BMA need to approach this decision with the same rigour as we would expect them to treat other scientific issues.

posted by Shwa [30 posts]
29th July 2011 - 13:57

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singlespeedfan - I agree it is a bit poorly phrased. I also misinterpreted it at first, but it does seem to mean it prevents many accidents from causing serious injuries, rather than the accidents themselves.

posted by Shwa [30 posts]
29th July 2011 - 13:59

4 Likes

Well done, BMJ. I have a helmet (stop siggering at the back) but don't use it to pop round the corner for a pint of milk. Pressure from me mam and my girlfriend means I usually wear it on the commute. (The helmet, not the milk, that would be silly.)

I find it really odd that many car drivers show no consideration for cyclists yet say that helmet wearing should be compulsory. If they're concerned about cyclists' welfare perhaps they could just give them more room.

posted by Coleman [329 posts]
29th July 2011 - 14:01

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If we had off road, safe, cycle lanes most ordinary cyclists (not racing cyclists etc.) wouldn't need helmets, they are rarely worn in Holland and Denmark where safe cycle lanes are the norm. I have never fell from my bike onto my head in over 40yrs of cycling, from a bike I usually would fall onto my side (I did break my foot once because I didn't have a foot helmet Wink )It's motor vehicles hitting a bike that knocks a person off their bike and onto their head.

SusieC's picture

posted by SusieC [4 posts]
29th July 2011 - 16:54

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I agree with SusieC. The vast majority of cyclists are those who tootle along the roads and if they fall off their bike it is one of their limbs that will be damaged. Meanwhile the bulk of 'road cyclists' will be going a lot faster and will in general will opt for a helmet.

The real danger is the lack of perception drivers have of cyclists and pedestrians and their psycotic desire to gain a tenth of a second to get past another road user. It will make little difference in road safety if helmets are legislated or not, drivers will continue to drive like thugs and until lessons and the test incorporate 'vunerable road user' awareness the better.

When I did my cycling proficiency all those years ago cars were smaller and slower and there was no issue in cycling on the road and cycle lanes not even thought of! Now cars are bigger and faster and the drivers rely more on the computer to do the driving for them.

Well done BMJ for seeing sense

giff77's picture

posted by giff77 [1063 posts]
29th July 2011 - 19:00

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A nice result, but this poll wasn't limited to BMJ readers though, was it? Anyone could have voted.

two wheels good; four wheels bad

posted by cat1commuter [1372 posts]
30th July 2011 - 6:54

5 Likes

Why do people assume that if a cyclist wears a safety helmet the riding of a bike is dangerous? Why do we not all think the same of the car driver wearing his 'safety belt' does that mean that is also a unsafe activity. I give all road users a lot of room whether driving or riding. It's about time they stopped squeezing past the innocent cyclist 'give us some room'

Live to Ride, 'cycling a real sport'

posted by shaun finnis [24 posts]
30th July 2011 - 7:12

6 Likes

Quote:
Why do people assume that if a cyclist wears a safety helmet the riding of a bike is dangerous? Why do we not all think the same of the car driver wearing his 'safety belt' does that mean that is also a unsafe activity

I'd say the difference is threefold:

1) with a seatbelt you're protecting yourself from the inherent risks of driving. the main risk of serious head injury when cycling is getting hit by a car: helmets aren't designed to protect against that risk, so they're not the best solution for mitigating that risk. The best solution is for cars not to hit cyclists any more. There's any number of ways to start addressing that issue. Madatory helmets isn't one of them.

2) the scientific evidence for the efficacy of seatbelts is clear and unequivocal, thanks to countless tests in controlled situations by motor manufacturers. there's no such body of scientific finding for the efficacy of cycle helmets. Indeed, the most reliable indicator of whether they prevent head injuries – large scale population data – suggests there's very little effect in head injury rates even with a large increase in helmet wearing.

3) we're so inured as a nation to the concept of driving everywhere that we don't assign any risk at all to it, even though there are quantifiable, demonstrable risks to drivers, passengers and other road users. Because we don't see it as risky, we don't pay the attention that we should to our behaviour behind the wheel.

Dave Atkinson's picture

posted by Dave Atkinson [7472 posts]
30th July 2011 - 7:41

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Well said Dave; most people I meet that don't cycle say they don't because it's "dangerous" this back to front thinking doesnt help at all, cycling isn't dangerous. Driving (I do both) is extremely dangerous, just listen to the road reports everyday - flippant words like "collision" "pile up" "crash on the so and so motorway" this is peoples lives every day at risk and often ruined because driving is not taken seriously as a dangerous activity. If only people were more courteous to one another - if only courtesy could be taught and sink in to many motorists thick skulls. But I can't imagine any changes happening in the UK in my lifetime now Sad

SusieC's picture

posted by SusieC [4 posts]
30th July 2011 - 9:32

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dave_atkinson wrote:
Quote:
Why do people assume that if a cyclist wears a safety helmet the riding of a bike is dangerous? Why do we not all think the same of the car driver wearing his 'safety belt' does that mean that is also a unsafe activity

I'd say the difference is threefold:

1) with a seatbelt you're protecting yourself from the inherent risks of driving. the main risk of serious head injury when cycling is getting hit by a car: helmets aren't designed to protect against that risk, so they're not the best solution for mitigating that risk. The best solution is for cars not to hit cyclists any more. There's any number of ways to start addressing that issue. Madatory helmets isn't one of them.

2) the scientific evidence for the efficacy of seatbelts is clear and unequivocal, thanks to countless tests in controlled situations by motor manufacturers. there's no such body of scientific finding for the efficacy of cycle helmets. Indeed, the most reliable indicator of whether they prevent head injuries – large scale population data – suggests there's very little effect in head injury rates even with a large increase in helmet wearing.

3) we're so inured as a nation to the concept of driving everywhere that we don't assign any risk at all to it, even though there are quantifiable, demonstrable risks to drivers, passengers and other road users. Because we don't see it as risky, we don't pay the attention that we should to our behaviour behind the wheel.

This is spot on. Bit more objectivity when it comes to driving and cycling is what's needed, not legislation based on perceived risk.

posted by Chuck [427 posts]
30th July 2011 - 10:06

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cat1commuter wrote:
A nice result, but this poll wasn't limited to BMJ readers though, was it? Anyone could have voted.

Good to see you're keeping us honest! But in this case, unlike the Telegraph and Evening Standard, we were careful not to suggest that it was "Doctors" responding to the poll. The BMJ press release on the issue refers to "BMJ readers" so that's what we stuck with. I suppose to be really accurate you could say: "readers who have registered with the BMJ website" just as you are not simply a "reader" of road.cc.

posted by Mark Appleton [554 posts]
30th July 2011 - 10:10

4 Likes

I struggle to see how anyone can argue against wearing a helmet?

There is a scale of injuries ranging in severity, and on this scale there is proportion if injuries that will be prevented (note: Injuries prevented, not accidents) by the use of a cycle helmet. This is indisputable. We can argue about the accidents that a helmet will not help all day, in the same way that we could argue that a car seatbelt wont help you if you drive off a cliff.
In short on an infinite timescale, a cyclist will at some point, due to personal error or external influence, fall off their bike and bang their head, and at this point a helmet will help.
The use of a helmet and raising cycle awareness amongst other road users are mutually exclusive. We should be doing all we can encourage both.

Answer me this, with the exception of not wanting mess up your hair, why not wear a helmet? If this is your sole concern then you have far greater issues in life. If you can ride a bike without a helmet without messing up your hair then you are not going fast enough!

Wear a helmet.

TheGriffalo
Fast like a salmon...

TheGriffalo's picture

posted by TheGriffalo [2 posts]
4th August 2011 - 15:29

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Quote:
I struggle to see how anyone can argue against wearing a helmet?

the argument here isn't specifically about wearing a helmet, more about helmet compulsion. But here's some food for thought:

Your argument that in an infinite timescale all cyclists will hit their heads is moot: in an infinite timescale all people doing anything will hit their heads. So following your logic, we should all wear helmets for everything, all the time, because sooner or later we'll need them.

I'm more likely to die from a head injury, statistically speaking, up a ladder doing DIY. I'd never even entertain the idea of wearing a helmet for that. We choose to protect ourselves based on perceived risk, not actual risk. If I'm mountain biking or doing a long road ride, I'll wear a helmet, every time. That makes sense to me. It doesn't make sense to me to wear one to pop to the shops or down the pub.

It doesn't matter that those two (especially the latter one) are probably just as risky, because our urge to protect ourselves is about the perceived risk and the nature of that risk, not the actual amount of risk. That's why people who are terrified of flying, the safest form of transport, are perfectly happy to drive to the airport.

The people that would have us compelled to wear helmets are, for the most part, not cyclists. Cycling probably seems risky to them from the point of view of their cars. And it does carry a risk. But the risk is from being hit, not from falling off, and helmets don't stop cars hitting cyclists.

Whether I'd die or not based on my wearing, or not wearing, a helmet, is impossible to discern; look at the large scale data from countries where compulsion laws exist and you'll see that a) a large increase in helmet wearing didn't correspond with a large decrease in the rate of head injuries; and b) the rate of head injuries is way, way above the low countries, where next to no-one wears a helmet. What does that tell us? Basically it tells us that in the big picture of cycling safety, helmets are at best an irrelevance and at worst a device to move the responsibility for safety to the more vulnerable road user.

Dave Atkinson's picture

posted by Dave Atkinson [7472 posts]
4th August 2011 - 15:57

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TheGriffalo wrote:
Answer me this, with the exception of not wanting mess up your hair, why not wear a helmet?

I do not object to wearing a helmet. I do sometimes not wear one, when the summer heat is extreme, or I haven't got one with me, or the one I have is broken or needs cleaning or drying out. But what I do object to, most strongly, is being compelled to wear a helmet to pursue a mode of transport and a hobby that is a lot safer than a lot of other modes of transport and hobbies. But nobody is clamouring to require the practitioners of those more dangerous modes of transport and hobbies to wear helmets, because they are not, consciously or unconsciously, considered in certain circles to be nuisances to the goal of maximal motorised traffic speeds, and therefore preferable to have their growing popularity be constrained. Nor do those other modes of transport or hobbies have any history of helmet use, so there is no significant helmet-producing industry to lobby for greater, or compulsory, use of helmets, to boost the profits of the manufacturers and their advertising agencies.

posted by handlebarcam [530 posts]
4th August 2011 - 17:37

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