Compulsory cycle helmets - what's the proof

To wear or not to wear - that is the question

Doctors are applauding members of the Northern Ireland assembly for voting in favour of a bill to make the wearing of cycle helmets compulsory.

The British Medical Association believes it is a great way to prevent injuries and save lives.

But opponents say such a move could be detrimental to the nation's health, arguing it will put people off using their bike and getting much-needed exercise.

So who is right when you look at the available evidence?

The most obvious reason to wear a helmet is that doing so protects you in the event of an accident. But by how much?

Back in 2001, Australian experts set out to determine just this by trawling medical literature published in the past decade.

Their analysis found that wearing a helmet cut the risk of head injury and brain injury by half, and facial injury by nearly a third.

For some, this may seem like a good reason to wear a cycle helmet all the time.

Many, however, use a selective approach based on their own estimation of risks. Take one cyclist, for example: "I'll wear a helmet if I'm cycling in heavy traffic or plan to go fast, otherwise I won't bother."

UK researchers for the Department of Transport found many cyclists appear to use this approach.

Their surveys show that helmet-wearing rates are typically higher on major roads than on minor roads, and are used more often during peak commuting hours.

But are people making accurate risk assessments?

Evidence from workshops would suggest not, as many cyclists who say they rely on their own judgement, when quizzed, have uncertainties and doubts about when, and whether, helmets actually would afford protection.

In particular, a number who said they only wore helmets when riding fast or in traffic doubted if helmets would provide them any protection in the sort of high-speed or heavy-traffic situations that were prompting their use.

Similarly, some agreed that a cycle helmet would only be useful for the kind of minor fall that could occur during the rides for which they never usually chose to wear a helmet for.

Rebellion

The findings suggest that, for some, wearing a helmet is less about calculating risk, and more about having a way of feeling safer in situations that feel risky - whether or not it actually would make them safer.

Others appear to be ditching their headgear for fashion's sake.

The same workshop with 62 cyclists found many were concerned that wearing a helmet made them look stupid and messed up their hair.

Some even admitted that their non-wearing was partly a rebellion against their parents' previous instance when they were a child that they had to wear one.

Head trauma can cause serious bleeds

Currently, a third of adult cyclists opt to wear a helmet. This is an increase compared with the rate nearly two decades ago when only 16% of adults wore one.

But do we know whether, if helmets were made compulsory, it would put many of the non-wearing cyclists off riding their bikes altogether?

Research from Canada suggests not. This study looked at cycling behaviour across Canadian provinces before and after different policies about cycle helmet use were introduced.

Legislation did not appear to affect cycling frequency. Yet Australian research suggests it might.

Cycling is an activity that has been on the decline over the last half century as more and more people opt to use a car instead.

Indeed, in response, England's government in 1996 set targets to quadruple the number of journeys made by bicycle by 2012.

But one of the barriers to taking up cycling is a perception of the physical danger posed by motor traffic.

However, experts say the health benefits of cycling far outweigh the risks by a factor of around twenty to one.

Perhaps making cycle helmets compulsory will make people feel safer about taking up cycling?

Either that or ministers will have shot themselves in the foot by turning people off the very sport they want us to do more of. Only time will tell.