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Updated: Doctors demand cycle helmets for under-16s

CTC comes out fighting and says it's up to parents to choose...

A debate took place on Channel 4 News at Noon today about cycle helmets after accident and emergency doctors demanded that the government make it illegal for under-16s to cycle without a helmet.

The Association of Paediatric Emergency Medicine voted this morning for a change in the law to help reduce the number of children who suffer serious brain injuries.

Currently, cyclists are not obliged to wear helmets by law, even though doctors claim they reduce direct skull impact. The programme said that studies suggest that helmets reduce head injury by 85%, brain injury by 88% and severe brain injury by 75%.

Dr Ian Maconochie, of the Association of Paediatric Emergency Medicine, said: “The evidence is significant in terms of reducing direct brain injury at low impact velocity. The debate we had was extensive but the medical fraternity voted thee to one in favour of having mandatory cycle helmet wearing.”

Dr Maconochie also went on to say: “It's estimated there are 90,000 accidents on the road every year in the UK involving bicycles and 100,000 off the road, 53% of which involve children. In terms of traumatic brain injury about 52,000 children have suffered significant brain injury which requires additional support from the state so there are elements of how it affects society and individuals.”

On the other side of the argument the CTC are strongly opposed in a statement to road.cc the organisation said: "CTC is strongly opposed to making cycle helmets compulsory for children. Five years ago, together with the cycle industry and others, we lobbied hard to block a Private Member's Bill seeking just such legislation. We will do our hardest to prevent any future attempt to force kids to wear helmets.

We dispute much of the evidence put forward to support this motion - please see www.cyclehelmets.org for a rebuttal.

Chris Peck from the CTC was also on the programme and said that when it was introduced in Australia there was a decrease in cycling, and there was an obesity epidemic that cycling can help combat.

He said: “We believe children should not have to wear helmets. Our position is that parents should have a choice if their children want to wear a helmet. We also want parents to be aware that the element of risk compensation, where children and adults choose to where a safety aid they will take more risks.

“If you look at countries in Europe where cycling is huge – in Holland 27% of trips are made by bike and you would not see a helmet on cyclists, not even kids. And in Copenhagen 55% of people cycle to work and you see very few helmets there. In fact there are a lot of advocates in Holland and Denmark who really strongly object to them. A recent helmet law was defeated in the Danish parliament.

Speaking to road.cc afterwards he added these points to the ones made in the C4 interview: Children injured falling from their bikes result in 4,800 days in hospital each year. By contrast ordinary slips and falls when walking or running result in over 18,000 bed days. Including falls from trees, falls when skating, and other falling injuries, that figure rises to 45,000, almost 10 times the level from cycling. If they want to force kids to wear helmets when cycling, what are they going to do for all those other times when they may hit their head?

Such a law would be currently unenforceable. The law would have to lay responsibility for children wearing helmets on their parents or guardians. This would therefore mean that those individuals would need to accompany their children at all times, or bear responsibility for their child's decision to remove their helmet when away from the parent. Neither of these solutions is practical.

Helmets unnecessarily portray cycling as dangerous, reconfirming in the minds of many that cycling is 'too dangerous' to contemplate. Meanwhile the population becomes less and less fit with all the accompanying health impacts that causes.

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13 comments

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DaSy | 14 years ago
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Well put Dave, it appears to me that the advent of mountain biking, with it's extreme sport moniker, has given the general public the impression that cycling in general is a potentialy dangerous pastime.

The reason no road racers go without them is that it is a requirement to wear one. Look at most of the pro riders in training; a large percentage choose not to wear a helmet.

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dave atkinson | 14 years ago
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Quote:

I hope that compulsory helmets are introduced for all ages of cyclist in the near future.

why? so that the uptake of cycling can decrease leading to increased obesity and strain on the NHS, whilst at the same time the level and severity of head injuries from cycling-related injuries remains the same?

all the large-scale data (look at helmet compulsion in NZ and Australia) suggests that's what'll happen.

On Channel 4 the CTC's Chris Peck was asked whether 'A few cracked heads is a fair price to pay for the choice' - that's divisive, and so is the suggestion that all the brain-injured children in rehab are there because they weren't wearing a bike helmet. perhaps you should take a trip round a fat camp to see the effect obesity has on children. It's a bigger problem (no pun intended) than skull fractures, especially ones caused by cycling accidents.

do you wear a helmet as a pedestrian, or in your car, safe and sane? or when you're up a ladder? or when you're walking up and down stairs? because if you're really worried about your head, you're more likely to sustain a serious head injury doing any one of those things than you are cycling on or off road. Cycling simply isn't that dangerous, and the assertion that we should 'make it safer' merely suggests that it's more risky than it is. Add to that the fact that large scale data doesn't support the hypothesis that more helmets equal less brain damage, and those two pillars are what I base my anti-compulsion stance on.

I wear a helmet when i'm mountain biking, and on long road rides. I don't wear one for commuting or town riding. I make my 4-year-old daughter wear one as she's unlikely to exceed the 12mph that they're tested to be effective for, and she's more likely to fall from her bike at low speed and hit her head, which is what a halmet's designed to protect you from. That's my choice, and i'd like to continue to have the choice. cheers.

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Safe and sane c... | 14 years ago
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There seems to be a group of libertarian correspondents on this topic. Perhaps they ought to take trip round the brain injury rehabilitation units to see the effects of skull fractures on children?

At present, there is a great chance of ensuring that children do indeed wear helmets as they are cool and no road racers or serious VTT riders go anywhere without them. Why should we deter children from a form of protection?

I hope that compulsory helmets are introduced for all ages of cyclist in the near future.

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Simon E replied to Safe and sane cyclist | 14 years ago
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Safe and sane cyclist wrote:

Why should we deter children from a form of protection?

Because they haven't been proven to work. If you look at some of the debates and information(e.g. CTC) where those dreadful libertarians who've read the research are you will find that it's not cut and dried. However, what IS conclusive is that where helmet wearing is made compulsory cycling participation drops.

Parents should be able to choose, as they do in many things - I make my two kids wear theirs - but I am absolutely against compulsion.

There is no point in emotional blackmail. I have a friend with a brain injury. I saw the aftermath of his accident (not bicycle-related), the multiple operations and his attempts to speak and walk in rehab, so you can climb down off your moral high ground.

Much more effective would be compelling drivers to take responsibility for their actions and for much harsher penalties for death and injury. Today I heard of a business director who is facing 2 years in prison for fraud, yet so often hear of road killers that get a fine or suspended sentence. When cyclists are knocked off their bikes the police don't want to know unless there is an injury (i.e. hospitalisation). What kind of signal does that send?

We need to fight the right battles, and this isn't one of them.

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Shane2k replied to Simon E | 13 years ago
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I bike to work everyday, and there are a lot of terrible drivers out there. The competence of a biker doesn't determine whether they will get hit by a car or not. Adults can make that decision on their own, but children should be protected by helmets at least.

Shane

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Mike McBeth | 14 years ago
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Why don't doctors demand a law to force all pedestrians to wear helmets? After all, far more pedestrians are involved in accidents with motor vehicles than cyclists! This is typical 'blame the victim mentality; it would be far more powerful if doctors asked for all motor insurance to cover the costs of accidents involving cyclists and pedestrians - that would make the insurance premiums higher and encourage motorists to drive more carefully. Also, don't doctors understand that a requirement to wear helmets would be largely unenforceable and would mean younger people and poorer people would be less likely to cycle? And that's just stupid.

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wild man | 14 years ago
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Don't worry, no one listens to the bow tie- wearing pontificators anyway; Amir Khan's still fighting, you can still by tramp fuel cider for 10p a can at Asda, and missing one of your five a day doesn't mean a ten- stretch in Wormwood Scrubs.

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therevokid | 14 years ago
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I've always worn a lid but making it compulsory ... I
don't think so !

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DaSy | 14 years ago
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The CTC really are a great organisation, and one that manages to have some real bite when it comes to influencing political opinion.

I have been a member for many years, and would encourage everyone to join. Without them, we would be restricted to cyclepaths, whilst covered from head to foot in padding.

I, for one, never wear a helmet and would seriously resist any law that tried to make it compulsory. Introducing a law for the under 16's would be the thin end of the wedge, and make it very much easier to extend that in the future to include all cyclists.

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Keith Matthews | 14 years ago
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Good "old" CTC. Go for it. Who do these doctors think they are? Oh sorry, yes of course. . . God.

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OldRidgeback | 14 years ago
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So the data used in the study is unreliable, great.

My kids wear helmets at the BMX track or mountain biking or on the road. Because they both race BMX bikes, they're well aware of why they need helmets on the track and both have come off a few times. When they're just cycling in the park, they don't wear them. They may be just six and eight, but they're more proficient riders than most doctors.

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dave atkinson | 14 years ago
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As usual, Thompson, Rivara and Thompson's study from 1989 is cited. So, as usual, here are the criticisms of said study:

* The study is non-randomised. [various]

* Cyclists wearing helmets were mostly white and riding in parks or on cycle paths accompanied by adults. Cyclists without helmets were more often black or other races, riding alone on city streets. [D Robinson, M McCarthy]

* The control population had a helmet wearing rate nearly 7 times greater than that confirmed by a concurrent study for children in the Seattle area as a whole. See: Head Injuries and Bicycle Helmet Laws [D Robinson]

* The same methodology can be used on other data in the study to show that helmet use also reduces the risk of injury to other parts of the body by 72%. [P van Schaik]

* The study does not distinguish facial injuries from other head injuries, although helmets would not prevent the former. If facial injuries are excluded, Thompson's 85% reduces to 61%, but the number of cyclists wearing helmets is too small for this to be statistically significant. [McDermott et al, Journal of Trauma]

* In further re-working of Thompson's data, McDermott found that only 40% of head injuries would be reduced using approved helmets, though injury rates increased for the neck, extremities and pelvic region.

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BigDummy | 14 years ago
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Hooray for Doctors! How would we know what to feel guilty about doing if they just shut up and sat down?  1

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