This is a summary of an article by William J. Curnow published in Health Promotion Journal of Australia 2008 : 19 (1) 10-15
The Federal Government adopted the policy of compulsory bicycle helmets in 1989 to minimise the public cost of accidents and it induced the states and territories to pass the world’s first laws for it. This article evaluates effects on public health in Australia.
Contrary to official views, risk to cyclists was falling in the late 1980s: Figure 1.
Figure 1. Serious casualties compared with the strong growth in cycling, Australia
Governments in Australia ignored Australian research in 1987 which showed that helmets have potential to aggravate fatal and disabling brain injury. Instead, reliance was placed on a decline in head injuries to cyclists in Victoria while the wearing of helmets was increasing. But Figure 2 shows a similar trend for pedestrians; the decline was not due to helmets.
Figure 2. Most severe injury, per cent to head, Victoria
The Australian Transport Safety Bureau (ATSB) and the Cochrane Collaboration claim that helmets reduce the risk of brain injury, but articles by Curnow in Accident Analysis & Prevention rebutted this. In an ensuing debate in AA&P in 2007/8, Curnow had the last word; ATSB declined even to participate.
Compulsory wearing in practice
Official surveys before and after the helmet laws found declines in cycling: Table 1.
Table 1. Participation in cycling, Australia
|State/territory %||Class of cyclist||Decline pre-to post-law|
|NSW 33||Children <16||36% in 1st yr of law, 43% by 2nd yr|
|Victoria 24||ChildrenTeenagers||36% in 1styr of law in Melbourne46% by 2nd yr, in Melbourne|
|Queensland 19||Schoolchildren||> 22%, in 1st yr of law|
|W. Australia 11||SchoolchildrenAll crossing 2 bridges||20%, 1991-93; > 50%, 1991-9638% on Sundays, in 1st yr of law|
|S. Australia 8||Schoolchildren||38%, 1988-94|
|Tasmania 2||No data||No data|
|Aust. Capital Terr.||All on bicycle paths||33%, 1st yr week days, 50% weekend|
|Northern Territory||Children, teenage||45% in 1st yr|
Australia-wide, the decline in cycling by children is estimated as 40%. The data are insufficient for a similar estimate for adult cyclists, but 29% fewer were observed in Melbourne after the first year of the law and declines in all-age cycling occurred in Western Australia and the ACT. Also, censuses show a 47% decline from 1986 to 1991 in cycling to work in the five States with helmet laws – a reversal of the rising trend of Figure 1.
Less cycling results in loss of the benefits of the exercise for health, which the British Medical Association estimated would outweigh the loss of life due to accidents. Also, studies indicate that motorists seeing fewer cyclists make less allowance for them, thus increasing their risk of casualty.
Table 2 shows serious casualties (fatal and hospitalised) to adults (16+) and children from 1989, before any helmet laws, to 1993, when all were in force.
Table 2. Serious casualties to road users, Australia 1989 – 1993
|Year||Total road users Adult Child||Pedestrians Adult Child||Bicyclists Adult Child|
|1989||27323 3938||2882 1083||898 760|
|1990||23921 3371||2664 1050||950 707|
|1991||21824 2817||2325 866||768 502|
|1992||20734 2752||2316 862||775 464|
|1993||21325 2634||2262 752||805 442|
|Change, 1989-93||-24% -33%||-22% -31%||-10% -42%|
Clearly, adult cyclists did not share commensurately in the general improvement in safety. Nor did child cyclists; the fall in casualties only matched their lower numbers.
In Victoria, cyclists’ claims for head injuries decreased more than non-head. Authorities ascribed this to helmets, but pedestrians showed a similar trend – see Figure 3. This suggests other causes; it is not evidence of efficacy of helmets.
Figure 3: Per cent head injury, of accepted TAC no-fault claims, Victoria
Efficacy of helmets would be shown if casualties had lower wearing rates than the whole population of cyclists, but Table 3 shows this not to be so.
Table 3. Helmet wearing of casualties and whole population
|State Year||Casualties, helmet worn||Casualties, not worn||Casualties, % worn||Population, % worn, year|
|NSW, 1993||192||56||77||74, 83* (1993)|
|Sth Aust. 1994||67||4||94||86, 91* (1993)|
* child, adult ** range of primary and secondary school students and adults
Deaths in Australia by head injury decreased from 1988 to 1994 by 42% for all road users and by 38% for pedestrians. But for cyclists, the decrease was only 30%. Considering the decline in their numbers, this suggests greatly increased risk to them.
Compulsion to wear a bicycle helmet is detrimental to public health in Australia, but authorities have obfuscated evidence that shows this.