US study claims 20 per cent lower rate of child cyclist deaths in states with compulsory helmet laws

Researchers analysed data from 1,612 fatalities of under-16 bike riders from 1999 to 2010

by Simon_MacMichael   May 28, 2013  

White cycle helmet

A new study from the United States claims that states that have introduced compulsory helmet laws have seen a 20 per cent reduction in deaths and injuries among children who have been involved in a collision with a motor vehicle while riding their bike.

The study, carried out by three researchers from the Boston Children’s Hospital and one from the Beth Israel Deaconess Medical Center and published in the Journal of Pediatrics, compared fatality rates between January 1999 and December 2010 among cyclists aged up to 16 years in states that have compulsory helmet laws with those that have no such legislation.

Analysing data from the national Fatality Analysis Reporting System (FARS), they identified 1,612 fatalities among cyclists aged 16 or under across all 50 states and the District of Columbia.

In those states with compulsory helmet laws – 16 at the start of the study period – the fatality rate was found to be “significantly lower” compared to those without, after adjusting for variable factors between states relating to age and licensing of drivers, blood alcohol limits, and median household income.

"Past research shows that laws can be an important factor in helping parents adhere to best practice guidelines," said one of the researchers, William P Meehan III from Boston Children’s Hospital.

"For parents who feel like there is conflicting information related to child health, this evidence supports the fact that helmets save lives and that helmet laws play a role."

Meehan and his colleagues noted that since FARS data only capture injuries leading to a fatality within occurring within 30 days of a collision, the data were likely to understate the benefits of cycle laws.

Rebekah C Manix, also of Boston Children’s Hospital, said: "As a result of the data only capturing deaths, rather than all injuries, our findings likely underestimate the effects of the mandatory helmet laws, because we did not capture all pediatric bicycle-related injuries."

While the study firmly backs the implementation of compulsory helmet laws for children, critics will point out that it does not analyse head injuries alone, nor does it seek to analyse issues such as the impact of legislation on levels of cycling, although it does acknowledge some existing literature on the subject.

“Our findings are in contrast with a recent review of pediatric trauma patients in Los Angeles County that concluded that the statewide helmet law had no significant effect on helmet use or on the proportion of pediatric head injury patients who were helmeted,” the researchers acknowledge, before going on to outline some other studies that have similar conclusions to their own study.

In the UK, national cyclists’ organisation CTC opposes compulsory helmet laws on the grounds that any potential benefit that reducing head injuries might bring about – and there is far from universal agreement among doctors and academics on that point – is offset by the effect on general public health of having fewer people cycling in the first place.

The latest study comes less than a fortnight after a study published in the British Medical Journal (BMJ) and conducted by a PhD student at the University of Toronto, claimed that the introduction of compulsory helmet laws in parts of Canada had only had a “minimal” effect in reducing hospital admissions for cyclists suffering from head injuries.

 

24 user comments

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Between 1999 & 2000. Using data that is 13 years old? Shurely shome mishtake?

Did Nightrider 2013 for Parkinson's UK, doing it again this year just for the fun of it and to raise more money.

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posted by jova54 [583 posts]
28th May 2013 - 9:38

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Quote:
... nor does it seek to analyse issues such as the impact of legislation on levels of cycling ...

Talk about the elephant in the room!

So head injuries are reduced - but we don't how how much of that may be because all children are ferried around in SUVs

posted by mad_scot_rider [533 posts]
28th May 2013 - 9:39

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jova54 wrote:
Between 1999 & 2000.

Sorry Jova, 2010

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posted by Simon_MacMichael [7792 posts]
28th May 2013 - 9:47

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For transparencies sake, who commissioned/sponsored/paid for the study.

Sometimes these things have a bearing on the findings, although actually I don't dispute the findings. I think wearing a helmet is going to provide some protection.

posted by Colin Peyresourde [1038 posts]
28th May 2013 - 9:57

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The data in this study is normalised per child, not per mile or hour cycled. This instantly invalidates the conclusions unless the author can prove that cycling rates were unaffected by the introduction of helmet laws.

posted by Mr Will [88 posts]
28th May 2013 - 11:03

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What Mr Will said. If you don't scale injuries by some measure of the amount of cycling actually taking place, then it's all guff.

No children have died at all whilst cycling on motorways. Therefore I conclude that cycling on motoroways is safer than round the local park.

posted by Darkerside [57 posts]
28th May 2013 - 12:26

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I agree with will, the data is extremely dodgy, I don't see how any solid conclusions have been drawn from it. Theyve basically taken a bunch of places that do and don't have helmet laws and found a correlation between that and the number of child cyclists killed. BUT, they have 'normalized' the data with regards to other UNKNOWNS, this basically means they could sway it whatever way they like... Also, since they've done it per capita, they haven't factored in that when forced to wear a helmet, the kids just cycle less.

posted by Osprey [18 posts]
28th May 2013 - 12:29

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In other news, top scientists have found after extensive studies and large grants that banning bicycles reduces cycling injuries substantially.

Angry

posted by kie7077 [412 posts]
28th May 2013 - 12:32

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[edit: oops, I see that one half of this has already been mentioned, sorry]

From a skim-read of that PDF (so I may be off the mark and will happily stand corrected):

They appear to have shown a lower fatality rate in children involved in a collision with a motor vehicle.

Fine.

I didn't see anything related to a helmet's effect on the likelihood of the collision occurring in the first place. There are two recognised factors in that: firstly the tendency for drivers to impose higher risk on helmeted riders and secondly the tendency for the helmeted rider to carry more risk themselves as a result of their faith in the helmet. What's more I wouldn't be at all surprised if there's an age-related factor in the latter, which would be pertinent in this case.

So we have a conclusion based on the effect of outcomes a certain subset, but no information on the effect of the rate of population of that subset (ie any reduction in number of miles cycled per child, or any increase in the rate of collision per mile cycles).

And therefore no conclusion is possible in terms of helmet legislation, which is the precisely conclusion they're claiming. (Well, actually, to be fair, the conclusion as written in that PDF does include that qualification, but it would/should have been obvious to the authors that that would be overlooked by all and sundry.)

So, yes, it's data and it shows something - but, unless I've missed a bunch of stuff, it doesn't show that compulsion reduces fatality rates in the population as a whole.

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posted by Bez [360 posts]
28th May 2013 - 12:53

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To concur with an earlier comment. This is a fairly superficial, pure fatality rate based study which doesn't factor out the effect of reduced rates of cycling of helmets laws, which we know such laws produce.

Less cycling will obviously lead to fewer fatalities, of course.

posted by Paul J [508 posts]
28th May 2013 - 12:54

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All studies based around stats can be manipulated to what you want to see/believe, reading the comments it pretty easy to see the comments from pro helmet and anti helmet people.

Bottom line is they are trying to say that wearing a hemet is "generally" safer, those people on this site who agree will like the article, those who don't or are indifferent won't.

It's just a shame that we read this and try to pick holes in it because we genrally don't like the idea of helmets, personal choice is good eh.

posted by mikeprytherch [193 posts]
28th May 2013 - 14:57

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mikeprytherch wrote:
All studies based around stats can be manipulated to what you want to see/believe, reading the comments it pretty easy to see the comments from pro helmet and anti helmet people.

Bottom line is they are trying to say that wearing a hemet is "generally" safer, those people on this site who agree will like the article, those who don't or are indifferent won't.

It's just a shame that we read this and try to pick holes in it because we genrally don't like the idea of helmets, personal choice is good eh.


You know something? I'd actually like to see a survey that categorically shows wearing a helmet is worthwhile. Because I almost always wear one (ironically, except when I'm on a Boris Bike and most vulnerable), and I'd like to know that I'm not wasting my time.

Boardman CX Team '14 | Cannondale CAAD8 '12 (written off, SMIDSY) | Scott Sportster '08

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posted by Gizmo_ [700 posts]
28th May 2013 - 15:29

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"All studies based around stats can be manipulated to what you want to see/believe,"

You can say the same about using words to make an argument. Your reason for disregarding the statistics you don't like is not a good one.
Statistics (and words) have a legitimate use in trying to reach the truth.
If they are manipulated the correct course is to show how the manipulation has led to a poor conclusion.
This is why scientific papers have to show the workings.
In this case posters above have shown why the statistics are misused, perhaps to show the result the authors desired.

posted by felixcat [204 posts]
28th May 2013 - 15:36

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mikeprytherch wrote:
... it pretty easy to see the comments from pro helmet and anti helmet people.

It's just a shame that we read this and try to pick holes in it because we genrally don't like the idea of helmets, personal choice is good eh.

It's emphatically not a shame that we read this and try and pick holes in it. It's a perfectly normal and correct scientific approach to test conclusions drawn from data. In this case there are a couple of sizeable holes which certainly should be picked.

Reading stuff and picking holes in it is the scientific approach; reading stuff and believing it is the religious approach. Take your pick, but that - not any perceived "pro/anti helmet" split - is the problematic dividing line.

Don't assume that someone questioning what you take at face value has adpoted an opposing position to you: they may well not have; indeed they may well not have adopted a position at all, because they more likely understand that it's unwise to do so in the absence of good quality evidence.

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posted by Bez [360 posts]
28th May 2013 - 15:41

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You can listen to Roger Geffen of the CTC discussing this report on BBC Radio 4 here:
http://www.ctc.org.uk/media-coverage/bbc-radio-4-pm-7-may-2013

posted by ChairRDRF [96 posts]
28th May 2013 - 18:02

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"There are lies, damn lies and statistics" - Mark Twain

posted by Some Fella [702 posts]
28th May 2013 - 18:27

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Colin Peyresourde wrote:
For transparencies sake, who commissioned/sponsored/paid for the study.

Sometimes these things have a bearing on the findings, although actually I don't dispute the findings. I think wearing a helmet is going to provide some protection.

See the paper for details:

Meehan et. al., 2013 wrote:
W.M. is supported by National Institutes of Health (T32HD040128-06A1). The authors declare no conflicts of interest

The NIH is the USA's equivalent of the Medical Research Council.

posted by Henz [40 posts]
28th May 2013 - 18:47

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Is the fall because 30% less people are cycling in those states Thinking

Howl Like a Bianchi

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posted by HLaB [54 posts]
28th May 2013 - 19:05

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The only interesting thing about this research is that the authors decided to publish it, given that any researcher with any knowledge whatsoever about helmets would have realised that the conclusions are utter nonsense.

I don't know who paid for it, but if it wasn't the helmet manufacturers, they ought to be asking for their money back.

Never mind, another piece of shoddy research with completely unsupportable conclusions will be available for the helmet zealots to point to whilst chanting their helmet mantra.

burtthebike

posted by burtthebike [66 posts]
28th May 2013 - 19:19

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Please employ someone with Mr Will's grasp of statistical analysis on bollox tests such as these.
He is plainly more qualified than anyone they employed.

posted by Phytoramediant [23 posts]
28th May 2013 - 19:48

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Oh- and employ Bez too.
Heck - did these helmet manufacturers employ ANY actual cyclists?

posted by Phytoramediant [23 posts]
28th May 2013 - 19:51

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Speaking from the state that invented the helmet law, I can verify the claims that it works only by reducing the number of cyclists.
Thats the singular truth of the whole thing. There is nothing else in it.

posted by Pjrob [21 posts]
28th May 2013 - 22:55

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Pushing cycle helmets puts people off of cycling, dangerous roads put people off of cycling, if we want to improve public health then we need to tackle the roads and the bad drivers.

If you wanted people to go out more, would you promote anti stab vests?

If you don't like cycling then promote cycle helmets.

Reminder: pedestrians have as many accidents as cyclists, no one is insisting they wear helmets are they.

posted by kie7077 [412 posts]
29th May 2013 - 8:19

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HLaB wrote:
Is the fall because 30% less people are cycling in those states Thinking

The figures are normalized per child, so.. no.

posted by Yemble [22 posts]
30th May 2013 - 11:02

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