In a bid to combat viral bicycle helmet promotion that continuously emerges as paternalistic 'we-know-best' edicts in journals and other 'spin' portals, I've offered this blog post to WA journalist Chris Gillham.
Chris has been the author of Mandatory Bicycle Helmet Law in Western Australia for the past 15 years, and today he is determined to repair some of the damage caused by inaccurate media reporting all-too-commonly observed in our media.
Chris Gillham reporting:
There's been yet another example of how the public is constantly misinformed by the media about the reality of Australia's bicycle helmet legislation.
In the December 2011 issue of its Horizons magazine, the Western Australia branch of the Royal Automobile Club prominently published the following:
Heading for Trouble
In 1992, Western Australia introduced mandatory helmet-wearing for cyclists. Following the enactment of this legislation there was a 40 per cent reduction in head injuries to cyclists - yet, despite this, many continue to ride without a helmet.
RAC Patrol and employee of the year Leigh Bavin is out on the roads every day and sees many cyclists riding without helmets. There's one group in particular that he believes really needs to start wearing their helmets: parents.
"The thing that really irks me is seeing family groups riding where the kids are wearing the helmets but the parents aren't. It doesn't set a good example and makes kids think that helmets are something that adults don't need," Mr Bavin said.
It isn't just a lack of helmets that bothers him: kids wearing ill-fitting helmets is another bug bear.
"Oftentimes you'll see a kid without the helmet done up, or pushed right to the back of the head. You also see kids wearing helmets that aren't the right size for them."
To get the right helmet, your child needs to try it on before purchase. Most cycle shops will let you sample a few different products for comfort and fit to ensure you get the right one. The KidsafeWA website gives detailed information on bicycle safety, including advice on choosing the right helmet: visit www.kidsafewa.com.au to learn more.
The Horizons magazine is circulated by snail mail to almost half a million RAC members - most vehicle owner in WA - so many people in that state will believe cyclist head injuries in WA fell by 40% when the helmet law was enforced in 1992.
OK, we can have a look at WA government figures on bicycle injuries in the years before and after the helmet law was introduced in Bicycle Crashes and Injuries in Western Australia, 1987-2000 - Road Safety report RR131, commissioned by the WA Road Safety Council and published in 2003.
So these WA Health Department figures show that in the four years from 1988 to 1991 before the helmet law was enforced in July 1992, there were an average 178 cyclist head injuries in WA per year. In the four years after law enforcement from 1993 to 1996, the annual average was 144.
That's a 19% reduction, not 40%. It's less than half what the RAC says it is.
Let's look a bit further. All the pre and post law road surveys in WA show bicycle use fell by somewhere between 30% and 40% (see WA figures and example).
Hmmm, even 19% doesn't look so good anymore. How can there be 30% less cyclists and only 19% less head injuries?
Look a bit closer at the figures in the charts above. The overall hospital admission rate for cyclist injuries didn't go down after 1992, despite the huge drop in cycling numbers.
The road surveys suggest that cyclist numbers in WA had recovered to pre-law levels by 2000 (which only sounds "good" if you ignore the 20% increase in WA population during that period).
Again, look at the total injury figures above. After the RR131 study period to 1998, WA had 862 total cyclist hospital admissions in 1999 and 913 in the year 2000. So there were about 30% more cyclists hospitalised each year in WA from about the same number of cyclists on the road.
If there are more hospital casualties per cyclist on the road but there's been a 19% drop in head injuries, where on the body are all the extra injuries happening? Check upper extremity numbers in the charts above and you'll get a pretty good clue (arms, shoulders, etc). The same disproportionate increase in upper body injuries can be seen in all states and countries that have enacted all age bicycle helmet laws (i.e. just Australia and New Zealand since Israel repealed its adult helmet law in 2011).
OK, we have to do something to prop up the helmet law argument and justify the last 20 years of putting so many extra people in hospital,
Let's look at the charts above and consider head injuries in the late 1990s when, as mentioned, cyclist numbers on WA roads were recovering to where they were before the law.
In the four years from 1995 to 1998, there were an annual average 155 cyclist head injuries, compared with 178 from 1988 to 1991 - a 12% reduction. Truth is, the road surveys show cyclist numbers in WA were still well down from 1995 to 1998 and if you consider the 862 and 913 total hospital injuries in 1999 and 2000, there wasn't much reduction in head injuries by the time cyclist road numbers had recovered to where they were in the good old days.
So there's the win for the bike helmet law! Despite increasing the per capita number of cyclist injuries/hospital admissions by about 30% and slashing the number of people keeping fit riding their bikes, helmets worked so well they kept head injuries to about the same level they were before 1992 when cyclist road numbers were about the same.
Through media hypnosis, this is the result that justifies helmet laws!
Why are there obviously more accidents/injuries per cyclist on the road? There are numerous reasons and, ironically, the RAC story identifies one of those when it complains about children wearing helmets that aren't done up, pushed to the back of the head or are simply the wrong size.
Guess what? Helmets can increase the risk of injury when worn improperly or with the wrong fit, if only because they offer little or no head protection despite increasing the confidence of the rider to cycle faster or more dangerously because they feel protected (better known as risk compensation).
So even when the helmet law successfully forces cyclists to wear a helmet, is it protecting or endangering the rider? Much as it might wish to, the government can't control the actions of individuals and many will ignorantly endanger themselves to avoid a fine. A similar technique to avoid a fine is to dangle your helmet from the bars, which provides fantastic balance and greatly improves the safety of the cyclist!
The RAC can't be accused of being disinterested in cycling safety as in May 2011 the club published a media release pointing out in its opening sentence that "Cyclists are increasingly at risk on Western Australian roads with the number of riders killed and seriously injured rising by 56 per cent between 2000 and 2009".
Well, it doesn't sound like a particularly good outcome in a mandatory helmet jurisdiction but maybe the RAC can claim the bad results are because since the year 2000, many West Australians have been defying the law and cycling without a helmet. In fact, they're the main reason for the "boom" in WA cycling numbers for the past decade.
Trouble is, the RAC published a PowerPoint in June 2011 showing that lack of helmet contributed to 19.5% of deaths and serious injuries in single vehicle crashes, and 22.4% in multiple vehicle crashes between 2000 and 2009. i.e. an average 21%.
In 2001, Royal Perth Hospital (WA's largest) reported that 16% of cyclist admissions were not wearing a helmet and in 2004, RPH records showed that 20% of cyclists admitted for trauma injuries were not wearing a helmet.
The last known official survey of helmet wearing rates among WA cyclists was in 1995 (Market Equity) when 23% were estimated to be cycling without. It's been obvious that WA's bare-head cycling percentage over the past decade has been somewhere between 30% and 40%, even higher in Perth's middle to outer suburbs.
In other words, the data suggests that cyclists not wearing helmets are less likely to end up in hospital. Most other real-world analyses of helmet law results come to the same conclusion.
The Horizons magazine story will cause plenty of West Australian helmet law supporters to proudly boast about its 40% success and, in the meantime, this public health disaster will continue to unfold.
The sad thing is that another journalist might read the RAC story as part of their two hours of research into the helmet issue. And guess what will be written the next time bike helmet laws are praised in the mainstream media?