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Call for mandatory cycling helmets from children's hospital consultant

"We would love to see it become a requirement in Ireland"...

An Irish children's hospital consultant has spoken out making the case for cyclists to be legally required to wear a helmet, arguing accident and emergency units see a spike in crash-related injuries during the summer months.

Speaking on RTÉ's Radio 1 programme Dr Carol Blackburn, a paediatric emergency medicine consultant at CHI Crumlin, argued that the data from Australia is "well demonstrated" and said a mandatory helmet law would likely see "hospitalisations for significant head injuries reduced".

"The data that we have would demonstrate that the safety of bicycle helmets for cycling collisions can reduce the instance of serious brain injury by up to 80 per cent and can reduce facial injuries by around two thirds, and that's in children and young people colliding with other vehicles or just falling off their bicycle," she said.

Asked if she wished to see Ireland follow Australia's lead and introduce a requirement for cyclists to wear helmets, she said: "I think so. We know there is data in Australia that after the wearing of bicycle helmets was made a legal requirement, hospitalisations for significant head injuries reduced so there is an impact of it.

"Also compliance increases and it is a good thing for children to see and a good habit to get into. In many ways it is a simple intervention, helmets are not expensive any more, I think for most people if they can afford a bicycle a small additional cost for a bicycle would not impede them. The benefits are really quite well demonstrated internationally, so yes we would love to see it become a requirement in Ireland."

As the weather improves through spring and into May, Dr Blackburn reports "we start to see children who come in having sustained injuries from road traffic accidents where they've come off their bicycles or scooters, but mostly bicycles".

"Some of these injuries would include fairly significant head injuries; like moderate severity concussions, perhaps skull fractures or indeed facial lacerations and other injuries, a certain number of which would certainly be prevented if these children and young people have been wearing properly fitted bicycle helmets.

"On a bicycle a child is very exposed, there really is nothing protecting them from the elements if they are to collide with something or to come off their bicycle."

The helmet debate is a well-trodden path, the science around wearing helmets complicated. A 2017 review by statisticians at the University of New South Wales found that, based on 40 separate studies, helmet use significantly reduced the odds of head injury, and that the probability of suffering a fatal head injury was lower when cyclists wore a helmet although, the authors noted, helmets cannot eliminate the risk of injury entirely.

Another study from the same year, from Norway's Institute of Transport Economics, concluded – based on an overview of almost 30 years' worth of analysis – that bike helmets reduced head injury by 48 per cent, serious head injury by 60 per cent, traumatic brain injury by 53 per cent, facial injury by 23 per cent, and the total number of killed or seriously injured cyclists by 34 per cent.

However, while they are certainly useful when it comes to lessening the potential severity of a serious head injury, helmets have proved markedly less effective when it comes to preventing concussion, a reality of their protective limitations recognised by only one in five competitive cyclists, according to a recent study.

"Our conclusions are not that cycling headgear doesn't afford protection, but that more independent research underpinning new technologies marketed for reducing concussion is needed," said the study's lead, and former racing cyclist, Dr Jack Hardwicke last year.

In 2020, Eric Richter, the senior brand development manager at Giro also spoke out clarifying some of the "many misconceptions" about helmets, explaining how they "do not design helmets specifically to reduce chances or severity of injury when impacts involve a car".

Away from the science of injury and helmets' effectiveness, campaigners have argued that in the hierarchy of methods to protect cyclists, legal requirements for personal protective equipment should not be prioritised over reducing dangerous driving and building safe cycle routes, Chris Boardman in 2014 calling helmets a "red herring".

Speaking to road.cc he suggested widespread use of helmets spreads the wrong message and "scares people off".

"We've got to tackle the helmet debate head on because it's so annoying," Boardman said. "I think the helmet issue is a massive red herring. It's not even in the top 10 of things you need to do to keep cycling safe or more widely, save the most lives."

Research from Dr Ian Walker also found that drivers gave cyclists wearing helmets less room when overtaking, while last week we reported a new study from Australia that found that cyclists wearing helmets were seen as "less human" than those without.

> "Not at all surprised": Cyclists react to research showing riders wearing helmets and high-visibility clothing seen as "less human"

That research came just days before Conservative MP Mark Pawsey raised the question of mandatory helmets in Parliament, suggesting: "If mandatory safety measures are acceptable for car drivers, they should surely be acceptable for cyclists."

As recently as December his own government had shut down similar talk, the Department for Transport saying it has "no intention" to make wearing a helmet while cycling a legal requirement.

Dan is the road.cc news editor and has spent the past four years writing stories and features, as well as (hopefully) keeping you entertained on the live blog. Having previously written about nearly every other sport under the sun for the Express, and the weird and wonderful world of non-league football for the Non-League Paper, Dan joined road.cc in 2020. Come the weekend you'll find him labouring up a hill, probably with a mouth full of jelly babies, or making a bonk-induced trip to a south of England petrol station... in search of more jelly babies.

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108 comments

Avatar
cmedred | 1 year ago
7 likes

Why not just skip to the ultimate solution and ban kids from riding bikes? That will eliminate ALL bicycle related injuries. 

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Owd Big 'Ead | 1 year ago
2 likes

I'll assume the photo at the top of the article is the consultant in question?

For a woman of significant intelligence to reach the level of consultant you'd imagine that she would ensure her helmet was fitting properly when being photo'd.

Such loose straps as that would do the square root of fuck all in keeping her polystyrene life saving equipment in place in the event of an accident.

You might be a consultant, but that doesn't offer you leeway to not doing it right.

Some people really should put their brain into gear before opening their mouths.

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grOg replied to Owd Big 'Ead | 1 year ago
0 likes

You assume wrong.. that photo is not of the consultant.

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LookAhead | 1 year ago
16 likes

As I've said before:

- Even if it's true that helmets somewhat reduce the harm from some collisions/falls, it's definitely true that by far the most important thing for increasing cycling safety is improving infrastructure/attitudes/enforcement related to road usage. If you really care about the safety of cyclists, focus on those things; helmets are just a distraction.

- As a matter of personal choice, it's probably a good idea to wear a helmet, as 1) they can likely reduce the harm from some collisions/falls and have little downside *when chosen to be worn on an individual level*, and 2) even if infrastructure/attitudes/enforcement related to road usage *should* be improved, I think we can all agree that *in reality* they are woefully inadequate--and, after all, the way things should be doesn't protect us from dangers that actually are.

(However, if for whatever reason you personally don't want to wear a helmet, go ahead and cycle anyway! Although cycling isn't as safe as it should be, it's still easily safe enough that your mental and physical health will be better overall for doing it.)

- As a matter of public policy, it's not a good idea to insist on helmets, because 1) since helmets are nowhere near the most important thing for increasing cycling safety, helmet requirements simply divert our limited resources (including attention) away from the most useful improvements and toward relatively trivial ones, 2) helmet requirements have a negative impact *when enforced at a policy level* due to point number 1 above plus the likelihood that helmet requirements decrease the amount of cycling overall, which has a number of drawbacks for city design, the environment, public health, and the safety of the remaining people who do cycle, and 3) it's none of your fucking business what I choose to do on a personal level in this case because it doesn't relevantly affect you on a public level--and if you don't want my helmet-less head to get splattered all over the pavement, then maybe don't drive like a fucking asshole, and focus your attention on making sure other people don't either and that cycling infrastructure gets improved instead of worrying about what I do as a matter of personal choice.

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HoldingOn replied to LookAhead | 1 year ago
3 likes

Eloquent and well thought out points, that took a sudden sweary turn at the end.

Made me chuckle.

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LookAhead replied to HoldingOn | 1 year ago
3 likes

Of course, according to the police I'm a very naughty boy who's just committed an offense worse than running someone over with a 2 ton killing machine. Good to know they've got their priorities straight.

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mattw | 1 year ago
7 likes

Wouldn't it be more effective just to ban bicycles, rather than mandate helmets?

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brooksby replied to mattw | 1 year ago
5 likes

mattw wrote:

Wouldn't it be more effective just to ban bicycles, rather than mandate helmets?

Ah, but they don't want to be seen to ban bicycles,  They'd rather just put a situation in place where the number of cyclists reduces whilst being able to say, "But it's all to do with safety!"

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hawkinspeter replied to brooksby | 1 year ago
7 likes

brooksby wrote:

Ah, but they don't want to be seen to ban bicycles,  They'd rather just put a situation in place where the number of cyclists reduces whilst being able to say, "But it's all to do with safety!"

I don't think it's even about wanting to reduce cycling, but more of a distraction tactic. Whilst people are arguing about the pros and cons of bike helmets, they forget about all the motorised vehicles that frequently cause death and mayhem and the companies behind them that are destroying our planet in the pursuit of some profits.

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chrisonabike replied to hawkinspeter | 1 year ago
1 like

hawkinspeter wrote:

brooksby wrote:

Ah, but they don't want to be seen to ban bicycles,  They'd rather just put a situation in place where the number of cyclists reduces whilst being able to say, "But it's all to do with safety!"

I don't think it's even about wanting to reduce cycling, but more of a distraction tactic. Whilst people are arguing about the pros and cons of bike helmets, they forget about all the motorised vehicles that frequently cause death and mayhem and the companies behind them that are destroying our planet in the pursuit of some profits.

I don't even think it's a distraction tactic; people "don't see the cars for the traffic" and more-or-less take the current situation as a given *.  Few would really question the status quo any more than they'd ask "what if we just removed all the supermarkets / ready-meals though?"

* In my experience if people think about it at all it's probably seen as a positive - "freedom" / "independence" / "what keeps the economy going".   The negatives are seen as "congestion" - or maybe "smoky exhausts".  Things like "suppression of independent mobility", "vast use of public space (and money)", "increase in centralisation (of amenities)" or "increase in requirement to travel (due to centralisation / because we expect people to be able to)" don't often figure.

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swldxer replied to mattw | 1 year ago
10 likes

First rule of hazard management is to remove the HAZARD - ie cars.  

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ShutTheFrontDawes replied to swldxer | 1 year ago
0 likes
swldxer wrote:

First rule of hazard management is to remove the HAZARD - ie cars.  

"The first rule of hazard management"

Been watching Fight Club have you?

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chrisonabike replied to ShutTheFrontDawes | 1 year ago
2 likes

In the context of road safety, you've got a point! "The first rule of political discussions about road safety is don't talk about engineering. Invert the hierarchy of hazard management and discuss PPE / administrative control measures instead".

Make political sense obviously - cheaper and less change for drivers!

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marmotte27 replied to chrisonabike | 1 year ago
3 likes

Engineering is 3rd level, first is elimination of motorized traffic in our case.
So first rule of road safety fight club is simply: Don't ever question motorized traffic.

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chrisonabike replied to marmotte27 | 1 year ago
1 like

Shh! Don't even think it...

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ShutTheFrontDawes replied to chrisonabike | 1 year ago
1 like

It feels to me like the first rule of political discussions about road safety is "over-simply a complex problem in an absurd manner that suits your agenda while demonstrating a complete ignorance of relevant subject matter".

"Remove the HAZARD - i.e. cars" is a great example, suggesting that an inanimate and unthinking object is in any way a hazard.

Elimination does tend to be the most effective type of control, but eliminating the hazard of collisions between cycles and motor vehicles would be accomplished with far less effort by banning cycling in the roads. Banning cycling would affect far fewer road users than banning motor vehicles, so the effort is lower. People calling for elimination of the hazard should be careful what they wish for.

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AlsoSomniloquism replied to ShutTheFrontDawes | 1 year ago
5 likes

I don't see cycling killing loads of pedestrians every year, most of whom are killed either on or next to the carriageway and who are not told to wear helmets constantly for protection.

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ShutTheFrontDawes replied to AlsoSomniloquism | 1 year ago
0 likes
AlsoSomniloquism wrote:

I don't see cycling killing loads of pedestrians every year, most of whom are killed either on or next to the carriageway and who are not told to wear helmets constantly for protection.

Are you suggesting eliminating the hazard by preventing people walking? Seems to me to be even further beyond a 'reasonably practicable' control than "BAN ALL THE CARS!!!!"

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chrisonabike replied to ShutTheFrontDawes | 1 year ago
3 likes

ShutTheFrontDawes wrote:

It feels to me like the first rule of political discussions about road safety is "over-simply a complex problem in an absurd manner that suits your agenda while demonstrating a complete ignorance of relevant subject matter".

Shurely "the first rule of political discussion...?"

ShutTheFrontDawes wrote:

"Remove the HAZARD - i.e. cars" is a great example, suggesting that an inanimate and unthinking object is in any way a hazard.

Quite right - the semantics have it.  Cars don't kill people, people kill people - so we just need to remove the drivers. On the other hand, all those cars now sitting motionless everywhere (barring a few under the control of our future robot successors) do get in the way a bit.

I'm sure banning road cycling has been regularly considered since cars were on the horizon (IIRC Carlton Reid dug up some quotes from ministers in the 1930s along those lines during his research).  However once the direction of travel became clear most sensible politicians probably assumed it would naturally disappear.  Which it essentially did in the UK.

Having mentioned the machine intelligences though perhaps we should eliminate people full stop?  They seem to be both the source of many issues affecting the world and also complaints about it.  The internet need not be troubled though - we've got enough data there so that AI can continue to fill it with similar content.

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ShutTheFrontDawes replied to chrisonabike | 1 year ago
1 like
chrisonatrike wrote:

ShutTheFrontDawes wrote:

It feels to me like the first rule of political discussions about road safety is "over-simply a complex problem in an absurd manner that suits your agenda while demonstrating a complete ignorance of relevant subject matter".

Shurely "the first rule of political discussion...?"

ShutTheFrontDawes wrote:

"Remove the HAZARD - i.e. cars" is a great example, suggesting that an inanimate and unthinking object is in any way a hazard.

Quite right - the semantics have it.  Cars don't kill people, people kill people - so we just need to remove the drivers. On the other hand, all those cars now sitting motionless everywhere (barring a few under the control of our future robot successors) do get in the way a bit.

I'm sure banning road cycling has been regularly considered since cars were on the horizon (IIRC Carlton Reid dug up some quotes from ministers in the 1930s along those lines during his research).  However once the direction of travel became clear most sensible politicians probably assumed it would naturally disappear.  Which it essentially did in the UK.

Having mentioned the machine intelligences though perhaps we should eliminate people full stop?  They seem to be both the source of many issues affecting the world and also complaints about it.  The internet need not be troubled though - we've got enough data there so that AI can continue to fill it with similar content.

People don't kill people. The number of drivers that have been involved in a collision involving a death is vanishingly small. The number that have caused a death (e.g. due to their own negligence) is even smaller. The number of drivers on UK roads is huge.

It's far more true to say that people don't kill people.

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hawkinspeter replied to ShutTheFrontDawes | 1 year ago
2 likes

ShutTheFrontDawes wrote:

People don't kill people. The number of drivers that have been involved in a collision involving a death is vanishingly small. The number that have caused a death (e.g. due to their own negligence) is even smaller. The number of drivers on UK roads is huge. It's far more true to say that people don't kill people.

Statistically, only about 93% of all humans have died...

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chrisonabike replied to hawkinspeter | 1 year ago
2 likes

hawkinspeter wrote:

Statistically, only about 93% of all humans have died...

Amazing isn't it?

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chrisonabike replied to ShutTheFrontDawes | 1 year ago
2 likes

ShutTheFrontDawes wrote:

People don't kill people. The number of drivers that have been involved in a collision involving a death is vanishingly small. The number that have caused a death (e.g. due to their own negligence) is even smaller. The number of drivers on UK roads is huge. It's far more true to say that people don't kill people.

Another good point - we should certainly have some perspective on this.  For what it's worth I'm as much interested in all the other negatives of mass motoring and how to reduce / mitigate those.  But then I've not known anyone who died in a car crash - I'm sure that might have an effect on my perspective.

Anyway, your statement is true - in exactly the same way as helmets don't save lives *runs for cover*.

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ShutTheFrontDawes replied to chrisonabike | 1 year ago
2 likes
chrisonatrike wrote:

ShutTheFrontDawes wrote:

People don't kill people. The number of drivers that have been involved in a collision involving a death is vanishingly small. The number that have caused a death (e.g. due to their own negligence) is even smaller. The number of drivers on UK roads is huge. It's far more true to say that people don't kill people.

Another good point - we should certainly have some perspective on this.  For what it's worth I'm as much interested in all the other negatives of mass motoring and how to reduce / mitigate those.  But then I've not known anyone who died in a car crash - I'm sure that might have an effect on my perspective.

Anyway, your statement is true - in exactly the same way as helmets don't save lives *runs for cover*.

Me too. I'm pro segregated infra, although i wouldn't use it unless it was more convenient and a better overall solution that using the road. I'm pro mass transit. I'm pro driver training. I'm pro enforcement of driving laws. I'm pro helmet use. There are lots of reasonably practicable things that we can do to improve the safety of human beings on highways (and in general) and I think it's gross negligence that the government doesn't utilise developments in processes and tools available to reduce risk.

When we deal in absolutes like "cars are hazards" or "people kill people" (and yes, "helmets save lives") we oversimplify the issue to the point is not helpful. We could say "people don't get KSI'd crossing the road" (they don't far more often than they do, after all) and do away with crossings, traffic lights, etc. I don't think anyone is suggesting that.

And yes, the benefit of helmets is small. They reduce/prevent only some injury to only part of the body in only some circumstances; the reduction in the quantum of risk is small. But the quantum of effort to use one is also small, in general at least. I put my helmet on as part of the routine of getting my bike out. It adds maybe 10s to my routine. It's there and it didn't cost a lot (to me). And I don't mind at all it being on my head. For me, it's worth it. Low reward yes, but also very low cost.

For some people the quantum of effort is higher. Some people can't afford a helmet (though in many cases they also can't afford a bike) and some people just straight up don't like having a helmet in their head.

The issue I have is when people quote the hierarchy of controls as though PPE is worthless. The fact is that PPE in the workplace is sometimes necessary and indeed if the quantum of risk reduction is not disproportionately small compared to the effort required, the PPE is necessary to comply with UK Law (HSAWA 1974 s 2(2)).

Yes, PPE rarely the only control applied but it is sometimes a necessary control to comply with UK law.

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marmotte27 replied to ShutTheFrontDawes | 1 year ago
3 likes

"The number of drivers that have been involved in a collision involving a death is vanishingly small."

That's quite an astonishing argument coming from a helmet advocate, who per definition is willing to oblige everyone to do things for infinitesimal gains.

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ShutTheFrontDawes replied to marmotte27 | 1 year ago
0 likes
marmotte27 wrote:

"The number of drivers that have been involved in a collision involving a death is vanishingly small."

That's quite an astonishing argument coming from a helmet advocate, who per definition is willing to oblige everyone to do things for infinitesimal gains.

It's not an astonishing argument at all. The benefit outweighs the cost, for me at least. I'll say it again for you:

ShutTheFrontDawes wrote:

"And yes, the benefit of helmets is small. They reduce/prevent only some injury to only part of the body in only some circumstances; the reduction in the quantum of risk is small. But the quantum of effort to use one is also small, in general at least. I put my helmet on as part of the routine of getting my bike out. It adds maybe 10s to my routine. It's there and it didn't cost a lot (to me). And I don't mind at all it being on my head. For me, it's worth it. Low reward yes, but also very low cost."

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marmotte27 replied to ShutTheFrontDawes | 1 year ago
5 likes

Ok, so lets get going with motor traffic reduction. The benefits will be huge since motoring is an enormous net cost to society.

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chrisonabike replied to ShutTheFrontDawes | 1 year ago
1 like

ShutTheFrontDawes wrote:

...Elimination does tend to be the most effective type of control, but eliminating the hazard of collisions between cycles and motor vehicles would be accomplished with far less effort by banning cycling in the roads. ...

Again you're correct - and that is exactly what has happened in some places in NL.  Sounds like a terrible imposition!  But before put-upon UK cyclist  / angry "vehicular cycling" roadies shouting "over my flat 18mm tyres!" get triggered - in NL a) this is only compulsory where better infra for cycling on has been provided and b) it turns out that far from being an impediment cycling can actually be faster thereIt doesn't stop the roadies or those going even faster.

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marmotte27 replied to ShutTheFrontDawes | 1 year ago
4 likes

Common good not your forte. But then we knew that.

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ShutTheFrontDawes replied to marmotte27 | 1 year ago
0 likes
marmotte27 wrote:

Common good not your forte. But then we knew that.

Reducing risk not in the common good? My mistake.

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