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Canadian research claims cyclists with helmets three times less likely to die from head injury

Researchers analysed coroner's records for fatalities of cyclists in Ontario...

New research published in the Canadian Medical Association Journal claims that cyclists wearing a helmet are three times less likely to die from head injuries than those who are not.

The researchers say that their study supports calls for the introduction of compulsory helmet laws across Canada for all age groups.

However, concerns have been raised locally regarding the validity of the methodology employed, based on an adjusted odds ratio, which does not take account of relative risk, and which it is said may significantly exaggerate the effect of the claimed findings.

The team studied Ontario Chief Coroner’s records relating to 129 people who died in bicycle-related incidents in the province from 2006 to 2010, three in four of whom had been involved in a collision with a motor vehicle.

The other fatalities resulted from an incident involving another cyclist, a pedestrian or other object and, in 10 per cent of cases, a fall. Males accounted for 86 per cent of the victims, with ages ranging from 10 to 83.

“Helmets save lives,” insists Dr. Nav Persaud of St. Michael’s Hospital in Toronto, who led the research.

“There are about 70 cycling deaths in Canada every year, and based on our study, we estimate we could prevent about 20 of them with helmets.

“We found that 88 per cent of people who died were 18 years of age or older, which is important because the helmet legislation in Ontario currently only applies to those younger than 18 years,” he added.

While Alberta also requires only under-18s to wear a helmet, in the provinces of British Columbia, New Brunswick, Nova Scotia and Prince Edward Island, all cyclists must wear one, irrespective of age.

He acknowledged, however, that making road conditions safer for cyclists in the first place would also lead help reduce casualties.

“Helmets only prevent injuries after a collision takes place,” he explained. “It would be better to prevent the collision from taking place at all. And infrastructure changes like building separated cycle lanes prevent collisions from taking place.

“That being said, even if we had a perfect cycle infrastructure, cyclists would still interact with cars at intersections, for example, so helmets would still be important.”

Opponents of compulsory helmet legislation, including organisations in the UK such as Sustrans and the CTC, believe it should be left to the individual to choose, pointing out that in places where they have been made mandatory, the number of cyclists has reduced, and that the general health benefits of regular cycling mean it is preferable to encourage more people to ride bikes rather than enacting laws that may deter them.

The CTC also cites several research papers published that found no link between the proportion of cyclists wearing helmets and any the safety of cyclists.

In a description of the background to the research in the Canadian article’s abstract, it was claimed: “Cycling fatalities [are] a leading cause of death among young adults worldwide.”

According to a report published earlier this year in partnership with The Lancet, Unicef said that “in middle- and high-income countries, cars are the biggest killers” among young people aged 10-19.

In Great Britain, an average of 10 children under 16 years have been killed while cycling during each of the past five years.

There’s no way of knowing how many of those fatalities involved head injuries, nor how many of the children were wearing a helmet and if they weren't, whether one may have possibly helped prevent the fatality.

During the same period, four times as many child pedestrians – 42 in an average year – were killed in Britain in road traffic collisions, according to Department for Transport figures.

While Unicef cites injury as the leading cause of death for adolescents worldwide, it’s a broad category that includes “road traffic injuries; injuries such as falls, burns, poisoning and drowning; and injuries from violence, including armed violence.”

Simon has been news editor at since 2009, reporting on 10 editions and counting of pro cycling’s biggest races such as the Tour de France, stories on issues including infrastructure and campaigning, and interviewing some of the biggest names in cycling. A law and languages graduate, published translator and former retail analyst, his background has proved invaluable in reporting on issues as diverse as cycling-related court cases, anti-doping investigations, and the bike industry. He splits his time between London and Cambridge, and loves taking his miniature schnauzer Elodie on adventures in the basket of her Elephant Bike.

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