Cyclists in Australia who don't wear helmets more likely to take risks, claims study

People disobeying helmet law may be more inclined to flout other laws, says academic

by Simon_MacMichael   February 5, 2013  

White cycle helmet

Cyclists who don’t wear helmets are more likely to take risks than ones who do, claim the authors of a new study from Australia into bike riders who were admitted to hospital with a head injury after a collision with a motor vehicle. The country where the research took place is significant, given its compulsory cycle helmet laws.

“Someone who is willing to disobey the law by not wearing a helmet might be more willing to disobey other laws,” said one of the report’s co-authors, Raphael Grzebieta, with the study published in the latest issue of the journal Accident Analysis and Prevention, which came out yesterday.

Examples of perceived risk-taking by non-helmet wearing cyclists included riding while drunk and disobeying traffic laws.

The conclusion that helmetless cyclists may be more prone to disobey such laws may of course not be directly applicable outside Australia in countries where helmets are not compulsory.

Researchers claimed that riders not wearing a helmet were more than 3.9 times more likely than those sporting one to suffer a head injury.

Wearing a helmet was said to reduce the risk of sustaining moderate head injury by 49 per cent, and of suffering a serious head injury by 62 per cent and a severe one by 74 per cent.

Another co-author of the study, Dr Jake Olivier, said: ''Having an opinion is one thing, but if you are going to make policies, such as repealing mandatory helmet laws, you have to look at evidence.

''The evidence says helmets work: they minimise the risk of injury. As the severity of the injury increased the benefit of wearing a helmet increased, which is very hard to ignore I think,'' he added.

The study was carried out by academics from the University of New South Wales's Transport and Road Safety Research Group and its School of Mathematics and Statistics, and has been published in the latest issue of the journal Accident Analysis and Prevention, which came out yesterday.

According to the article's abstract:

There has been an ongoing debate in Australia and internationally regarding the effectiveness of bicycle helmets in preventing head injury. This study aims to examine the effectiveness of bicycle helmets in preventing head injury amongst cyclists in crashes involving motor vehicles, and to assess the impact of ‘risky cycling behaviour’ among helmeted and unhelmeted cyclists. This analysis involved a retrospective, case–control study using linked police-reported road crash, hospital admission and mortality data in New South Wales (NSW), Australia during 2001–2009.

The study population was cyclist casualties who were involved in a collision with a motor vehicle. Cases were those that sustained a head injury and were admitted to hospital. Controls were those admitted to hospital who did not sustain a head injury, or those not admitted to hospital. Standard multiple variable logistic regression modelling was conducted, with multinomial outcomes of injury severity.

There were 6745 cyclist collisions with motor vehicles where helmet use was known. Helmet use was associated with reduced risk of head injury in bicycle collisions with motor vehicles of up to 74%, and the more severe the injury considered, the greater the reduction. This was also found to be true for particular head injuries such as skull fractures, intracranial injury and open head wounds. Around one half of children and adolescents less than 19 years were not wearing a helmet, an issue that needs to be addressed in light of the demonstrated effectiveness of helmets. Non-helmeted cyclists were more likely to display risky riding behaviour, however, were less likely to cycle in risky areas; the net result of which was that they were more likely to be involved in more severe crashes.

As a result of the country’s compulsory helmet laws, introduced in 1991, the issue of the effectiveness or otherwise, contentious enough elsewhere, is particularly heated among academics in Australia.

Professor Chris Rissel of Sydney University, a vociferous opponent of compulsion, has regularly published on the subject and has said that he believes factors other than the introduction of compulsion in 1991 lay behind a reduction in the rate of head injuries among cyclists, which he asserts was already in decline.

Like campaigners such as CTC and Sustrans in the UK, both of which are opposed to compulsion and believe that it should be an individual choice, he also insists the wider health benefits of cycling as part of an active lifestyle outweigh any arguments in favour of making riders wear a helmet.

In December 2011, Professor Rissel said that the number of bike riders in Sydney could be doubled if the law were repealed.

It has been estimated that levels of cycling in Australia fell by as much as 30 per cent after helmets were made compulsory, and the law has also previously been cited as a factor behind low usage of cycle hire schemes in Melbourne and Brisbane.

A study published in 2006 by Dr Ian Walker of Bath University found that motorists gave more space to cyclists without helmets when overtaking, compared to the room they gave those wearing one. 

Famously, he donned a blonde wig to establish whether drivers also gave extra room when they thought they were overtaking a woman. They did.

25 user comments

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Seems like more pro helmet stuff...

posted by northstar [945 posts]
5th February 2013 - 1:41

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If pedestrians wore a helmet, I'm sure the levels of head injury would fall. Indeed, motorists would experience a drop as well. I recommend full face helmets be worn at all times. Think of the kids; get a helmet on those toddlers. You are an irresponsible parent, if you don't! (Let's get hysterical while we are at it!) It's child abuse.

Still smiling politely at a persistently flat chain.

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posted by velophilia [38 posts]
5th February 2013 - 1:58

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I will read this fully in the morning, but I just saw it on twitter as I was about to shut down for the night.

“Someone who is willing to disobey the law by not wearing a helmet might be more willing to disobey other laws,”

That's like saying, someone who is willing to disobey the law and kill someone might be more willing to disobey the helmet law........

Good night Devil

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posted by Gkam84 [8197 posts]
5th February 2013 - 2:01

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northstar wrote:
Seems like more pro helmet stuff...

As alluded to in the article, it's an area of heated academic debate in Australia, and usual suspects pop up regularly giving one view or the other with no middle ground.

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posted by Simon_MacMichael [7517 posts]
5th February 2013 - 2:04

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velophilia wrote:
If pedestrians wore a helmet, I'm sure the levels of head injury would fall. Indeed, motorists would experience a drop as well. I recommend full face helmets be worn at all times. Think of the kids; get a helmet on those toddlers. You are an irresponsible parent, if you don't! (Let's get hysterical while we are at it!) It's child abuse.

In that case, there's a very responsible parent where I live. Kid (aged maybe 4 or 5) on scooter, full face helmet...

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posted by Simon_MacMichael [7517 posts]
5th February 2013 - 2:05

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This research is surely overriden by the fact that in Holland 98% of cyclists do not wear helmets yet they have some of the lowest accident rates in the world. It is motorists that need to change their behaviour, not cyclists.

posted by londonplayer [671 posts]
5th February 2013 - 3:38

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That may be true, but which do you think is more likely?

I've had two spectacular falls in many years of riding; one in the old days without a helmet where I had a head injury, the second with a helmet, where I had a headache and had to buy a new helmet to replace the split old one.

I know why I wear a helmet: I'm not invincible and want to improve my survival chances, no matter who's at fault.

For the same reason, I wear a parachute while gliding.

Gerard the Kiwi

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posted by GerardR [81 posts]
5th February 2013 - 5:28

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Can someone please explain why there is such opposition to helmets on this and many other cycle forums. Genuine question not a a troll.
Coming from a MTB background it makes perfect sense to me to wear a helmet and I carry this attitude when on the road bike also

posted by bauchlebastart [82 posts]
5th February 2013 - 9:32

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Correlation is not causation. E.g. not wearing a helmet, and being drunk - it's hardly the lack of a helmet that made the person go "you know what, I'll ride my bike drunk!".

Indeed, because drunk-riders are such a different group, with obvious cognitive impairment (at the time), from other cyclists, it is important to at least provide figures which exclude drunk riders. The Canadian helmet study reported on here before which found helmeted riders slightly safer, e.g., was one study flawed in this way. Likely some part of that result is down to drunk riders and their correlation with lack of helmet, rather than anything intrinsic to helmets.

Consider that in the Netherlands, drunk-riding is ALSO a significant factor in cycling fatalities (and also in USA). However, in the Netherlands, it doesn't correlate with lack of helmets - because no one wears them.

posted by Paul J [431 posts]
5th February 2013 - 9:39

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It's not an oppostion to wearing them;; it's an opposition to being forced to wear them based on the dramatic drop in cycling that has happened anywhere that such laws have been introdued (such as Australia) as it massively puts utility cyclists off, leaving just the hardcore of sports cyclists.

posted by Al__S [423 posts]
5th February 2013 - 9:40

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There is opposition to compulsion. Particularly when the compulsion is based on pretty dodgy evidence. And when it applies only to cyclists.

The compulsion also often looks like victim blaming. It is ok to hit a cyclist with your car, because the magic helmet will save them or if they aren't wearing a helme they brought the injury on themselves.

Edgeley

posted by Edgeley [152 posts]
5th February 2013 - 9:46

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Bad population to survey, surely? They only seem to be looking at those who have failed - crashed. It might tell you something about the effect of helmets on various injuries, but that seems to have got lost in an attempt to score points which can't be supported by this experiment.

posted by a.jumper [657 posts]
5th February 2013 - 9:46

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Sounds like non-helmet wearers could be terrorists then. Stop them with armed Police and lock them up quick. Better safe than sorry.

Dodging the saccadic masking

posted by notfastenough [2621 posts]
5th February 2013 - 10:18

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Al__S wrote:
It's not an oppostion to wearing them;; it's an opposition to being forced to wear them based on the dramatic drop in cycling that has happened anywhere that such laws have been introdued (such as Australia) as it massively puts utility cyclists off, leaving just the hardcore of sports cyclists.

It's a pity for your argument that there actually wasn't the much quoted "30% drop in cycling" when the helmet laws were introduced. There was one study, in Melbourne, which concluded that there had been a drop in the number of teenagers riding, but no other effect on cycling numbers.

And if helmets deter cycling, it's hard to understand why the roads are now so crowded with cyclists and why it's been estimated that in 5 people in the inner northern suburbs ride to work.

posted by Sakurashinmachi [48 posts]
5th February 2013 - 10:24

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The sample is flawed, because the sample population is compelled by law to wear a helmet. By definition the population who suffer serious injury through being involved in a motor accident are already a self-selecting sample of law breakers, who by definition will be a small percentage of the overall population and are more likely to be risk takers than the population as a whole. As others here have said, this provides ammunition for the pro-cycle lobby. But please don't dress this up as science, cos it ain't.

posted by woollee23 [90 posts]
5th February 2013 - 10:29

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It seems, if anything, to underline the pointlessness of compulsion.

They have a law saying you have to wear a helmet. A proportion of people cheerfully ignore that law and are mostly fine, but sometimes get hurt.

We don't have a law that says you have to wear a helmet, just a body of evidence that if you crash you're probably somewhat better off wearing one. A proportion of people cheerfully ignore that evidence and are mostly fine, but sometimes get hurt.

The difference between the two systems is that in Australia you get nagged at occasionally by policemen if you don't wear a helmet, which must be fairly irritating.

posted by BigDummy [267 posts]
5th February 2013 - 10:47

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Were you, by any chance, aware of the Thudguard (see http://www.thudguard.com/product-info) when you were getting hysterical about toddler helmets?

Another great case of "let's come up with an answer and bludgeon the reality about a bit until it makes sense". Sigh.

Pete Clinch
often seen riding a bike around Dundee...

posted by pjclinch [50 posts]
5th February 2013 - 11:13

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bauchlebastart wrote:
Can someone please explain why there is such opposition to helmets on this and many other cycle forums. Genuine question not a a troll.
Coming from a MTB background it makes perfect sense to me to wear a helmet and I carry this attitude when on the road bike also

The chances of you banging your head on a passing low branch, or just of falling off, on a "proper" MTB trail are relatively high. So, as you say, it makes fair sense to wear a lid.

The chances of an A to B cyclist on the road scraping their head on a passing tree is roughly zero. Their chance of sustaining a serious head injury is, mile for mile, slightly less than a pedestrian's. In other words, it's a solution to what is basically a non-problem for a lot of cyclists. Furthermore, there is plenty of evidence that encouraging helmets discourages cycling, and since cycling is good for overall health that means encouraging helmets is actually a public health own-goal.

Does that mean you shouldn't wear one? No. It's up to you, and if you feel better with it on then put it on. But the government, and cycling organisations, are shooting themselves in the foot if they go out of their way to promote helmets. Take a look at CTC's stuff on it for more detail.

Pete Clinch
often seen riding a bike around Dundee...

posted by pjclinch [50 posts]
5th February 2013 - 11:22

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Simon MacMichael i like your style - nothing like a good old arguement to get the blood pumping and for people to dig out pathetic excuses by both sides.

It's the riders choice and THEY and THEIR family have to live with the consequences.

If you must break the law, do it to seize power: in all other cases observe it. Gaius Julius Caesar.

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posted by stumps [2450 posts]
5th February 2013 - 11:27

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Simon_MacMichael wrote:
northstar wrote:
Seems like more pro helmet stuff...

As alluded to in the article, it's an area of heated academic debate in Australia, and usual suspects pop up regularly giving one view or the other with no middle ground.

Actually, it's a lot like climate change: there's a scientific consensus and there's others, usually not qualified in the field, with opinions.

posted by Sakurashinmachi [48 posts]
5th February 2013 - 12:04

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Gkam84 wrote:
I will read this fully in the morning, but I just saw it on twitter as I was about to shut down for the night.

“Someone who is willing to disobey the law by not wearing a helmet might be more willing to disobey other laws,”

That's like saying, someone who is willing to disobey the law and kill someone might be more willing to disobey the helmet law........

Good night Devil

Or, "Someone who is willing to disobey the law by speeding might be more willing to disobey other laws." Twaddle.

posted by Chuck [300 posts]
5th February 2013 - 12:18

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How about considering the increase in risk taking behaviour shown to be associated with wearing a helmet?

Ps. I wear one (risky!)

posted by noah [2 posts]
5th February 2013 - 12:22

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Don't worry - I've just had a word with the Cambridge Cycling Campaign and they're gonna fly out to Australia tomorrow to give the authors of this report a jolly good talking to.

posted by jarderich [79 posts]
5th February 2013 - 14:01

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pjclinch wrote:
The chances of an A to B cyclist on the road scraping their head on a passing tree is roughly zero.

Or it was, until Tory cuts(!) meant they no longer cut back trees on minor roads or cycle tracks. Which is the main reason I almost always wear a hat now. Sucks.

I don't believe it'll do me much good in most crashes, though. They're only tested for a fall to the floor, after all, not a crash at speed involving others.

posted by a.jumper [657 posts]
5th February 2013 - 14:10

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In other news, a recent study indicated that “Someone who is willing to waste educational resources by doing a social "science" degree might be more likely to come up with bullshit nonsense like this,” said one of the report’s co-authors...

posted by ubercurmudgeon [168 posts]
5th February 2013 - 19:16

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