After years of conflicting studies have thrown its results into question, both the Center for Disease Control and the National Highway Traffic Safety Administration will no longer promote the conclusion that bicycle helmets reduce head injury rates by 85 percent in light of meta-analyses of similar studies that found lower and inconclusive results.
The often-cited and influential 1989 study was conducted in Seattle by Robert Thompson M.D. for Group Health. It has been heavily influential in discussions about municipal all-ages bicycle helmet laws. Not surprisingly, King County is among the only major metropolitan areas on the planet to have such a law. After all, if you could reduce head injuries by 85 percent just by wearing a helmet, then of course we should make them mandatory!
However, subsequent studies have not been able to repeat the 85 percent figure found in the Seattle study. Results vary, but have consistently been lower. After urging from the Washington Area Bicyclist Association in DC, the CDC and NHTSA will no longer be promoting the 85 percent conclusion.
Bicycle helmets and helmet laws are incredibly controversial and divisive. Navigating all the conflicting and sometimes untrustworthy studies on either side of the debate can drive you crazy. Elly Blue wrote an excellent story for Grist looking at tons of studies and arguments about helmets out there and concluded that, at best, support for or against helmet promotion and laws is inconclusive. Her conclusion: “The great helmet question is the wrong one entirely to be asking.”
The biggest problem with a study that only looks at people who have been in a serious bicycle collision or accident is that it does not take into account other much more important bike safety factors, such as those that prevent collisions from happening in the first place. The single most important one: Safety in Numbers.
It is indisputable that the more people biking in a city, the lower the collision rate. This has been conclusively shown in cities all across the globe including Seattle.
It is also indisputable that bike share is extremely safe, perhaps the safest way to get around in an urban environment. Systems in cities from London to Dublin to Minneapolis have found that the rate of serious injuries or deaths on bike share bikes are very low. In fact, people using a bike share have significantly lower injury rates than people riding their own bikes (there are likely many reasons for this, including higher safety in numbers in bike share areas, bikes share bikes being designed to go slower, lower likelihood for extreme riding like BMX, road race training or mountain biking, etc).
Bike share is so safe that a Barcelona study recently found that their bike share system likely saves 12 lives every year once you factor in the health benefits of cycling and the relative safety of their bike share system compared to other modes of transportation, such as driving.
And there’s the rub.
There are serious concerns that King County’s all-ages helmet law could have a negative impact on use of the upcoming Puget Sound Bike Share system. Bike share is dependent on people choosing spontaneously to use the system for a short trip here or there. But it is very unlikely that many potential users will carry a helmet with them at all times. PSBS and vendor-operator Alta Bike Share have plans for a helmet vending solution, but this has not yet been successfully implemented anywhere in the world and will add cost to the system and individual users. This cost and reduced ridership due to the helmet law was factored into the system’s plan.
I do not actually care a whole lot about the helmet debate outside of the context of bike share. I choose to wear a helmet, and while I am not a supporter of helmet laws, it’s really not that hard to keep a helmet with your personal bike. There are much more important bike safety issues facing Seattle, like investing in safe bike facilities and encouraging the use of bike lights at night.
But bike share could revolutionize the way Seattle gets around. Our city is perfectly set up for it, with express transit routes moving people into urban centers where people are often dropped off within a short bike ride to their destinations.
That’s why the city/county should modify the bike helmet law for adults (not children). There is very little political will to repeal the law, but there is room for a compromise: Make it a secondary offense (or maybe even make it a secondary offense for bike share users only). Adults who are biking safely and obeying all traffic laws are not a public safety hazard, either to themselves or others. The city should support the success and safety of bike share by doing what they can to encourage the highest use of the system possible. Again: Safety in numbers is 100 percent certain to lower the collision rate for people on bikes.
The compromise here is that people who are not obeying traffic laws and are biking dangerously would get double-ticketed if they do so without a helmet on. So this law change would put an extra emphasis on lawful, safe riding while also allowing bike share to flourish. That’s a politically-palatable win-win that I think most people can agree on.
Comments
112 responses to “Feds no longer back 1989 Seattle helmet effectiveness study – City should modify its helmet law before bike share launches”
I would like to add that it’s my birthday today. As a present to me, let’s try to have a respectful and thoughtful conversation about this. Too often, helmet conversations devolve into unproductive fighting. Thanks!
Happy late birthday, and thanks for your great work!
Any timelines being discussed for political action on getting the law changed before the bikeshare rolls out, or is that impossible right now?
Happy Birthday Tom! Thx for creating such a fantastic blog!
Was gonna say, birthday boy, careful what you bait here…cause them helmet-hating trolls wait for posts like these.
The helmet debate is surrounded by trolls on both sides. I’m trying to extricate one aspect of the helmet law from the eternal Internet helmet warfare and start an actual discussion about it…
Happy Birthday / great post. I just wish you could look for the win-win when it comes to the tunnel as well. For instance, have tolls on single occupant vehicles on I5 and the tunnel set high enough to eliminate regular backups, then use the money to build out bike infrastructure and transit :)
Well written, Tom! I’m generally opposed to “nanny laws”, as requiring a helmet would probably be categorized. However, I’d still like to see a bike sharing solution that includes dispensing helmets, even if the law is repealed. Why? Because if I am to rent a bike somewhere, I’d like a helmet available. Seattle can set the precedent and other cities can follow.
Good point! I agree.
“nanny laws”
This term in realtion to law is only true if the action has only harm to yourself. We will treat you at tax payer expense if they take you to Harborview and you can’t afford to pay. The state will also pay to keep you alive in a home if you can no longer take careof yourself. So an injury caused by not wearing a helmet has consequences beyond the individual.
Did you bother to read the post at all? Helmet laws have an inconclusive effect, the author suggested they be a secondary offence.
Just because you don’t like a word doesn’t make its usage wrong. Your healthcare missive is basically a FUD strawman.
Yes I read the post. I object to the derogitory term “nanny laws” in regard to helmet laws. It’s not a nanny law if the rest of us have to pay for your mistake. It’s a cost law.
If you want to argue just general health issues, how to get more people healthier for the least cost, I’d be glad to do that. But not on this post.
Limitations of rights should not be based solely on some theoretical monatary impact on society.
Everything we do could be said to potentially impact society monatarily.
Go for a hike, could get mauled by a bear, or fall down a cliff.
Take a swim at a beach, get sucked out to see and instigate a coast guard search.
Your reasoning would force us all into cacoons of 10 feet of cotton.
Be careful in assuming that there’s a financial cost. For instance, cigarette smoking has been found to not have a financial cost for society, as the cost of lost productivity from disease and death is offset by the benefit of not having to care for smokers when they’re older. See “death saves you money” by Planet Money.
Helmets don’t do anything for you in “serious collisions”, which is why it’s so stupid when you read about a guy who gets creamed by a huge truck and all anybody wants to know is “was he wearing a helmet?”, which would have protected him about as much as a bigger wristwatch. But, you know, wearing a helmet or not is always framed this way, as a moral issue of some kind, which should be reserved for the more important question of “was he wearing bright clothing and a ton of big-ass lights?”
But “serious collisions” with motor vehicles are a relatively small part of the incidents that cyclists are likely to be involved in — there are also collisions with other bikes, pedestrians, walls, or even nothing at all (ask me why I don’t wear clipless pedals!). Helmets can, in fact, save your life then. Even if all you’re doing is toppling over, smacking your pan on the curb can put you in a coma you never come out of. I’ve seen it. It’s not pretty.
For that reason, I wear a helmet, and I think other people should, too. I’ll be honest, I worry about bike-share users who may tend to be more inexperienced riders who are more likely to have problems — not “wiped out by a speeding garbage truck” problems but “got wedged at 3 MPH and fell over” ones.
I appreciate the argument that getting more people riding reduces the accident rate, even when helmets aren’t worn, but I’m not as sanguine as some about how we get there.
So you know right here in Seattle, a kid racing a fixie was smashed by a garbage truck right? Google search that term and see how often it happens, including trucks and semis or lorries. Just last month we had a truck and cyclists collision on a road I ride daily. Tossing around descriptors of death conjures up the most trolling of arguments in helmets and the response from me is FU and your opinion. Also why I refuse to host these “debates.” Good on you Tom for trying, but man.
Some people get in arguments because they want to get in arguments, not because they’ve read anything that was written. I honestly have no idea what you’re so angry at me about. If you take the time to read what I actually wrote, maybe you’ll relax a minute, Mr. FU. Do you even know what “my opinion” is? I don’t think so. I’m not trying to start an argument here; why are you?
Yes, I am aware of the kid who crashed into the truck. That’s why I mentioned it. A helmet would not have mattered there, and the people whose only interest is whether he was wearing one or not are ghouls. It does matter in other cases, however. I think wearing a helmet is a good idea even if it won’t save your life from a speeding vehicle.
Fnarf is pro helmet law because people shouldn’t have a choice, and if we save one life its worth it.
Hey Vince were you wearing a helmet when you got creamed on Dexter?
You are correct when you say I don’t think people should have a choice — I think public health trumps personal responsibility or rights. But I’m not sure I believe in a helmet law. I lean that way but I want to know more about effectiveness. In particular, the effectiveness of helmets in the kind of riding bike-share is likely to involve.
I would never ride without one, myself. I definitely think it should be illegal to ride at night without extremely bright front and rear lights and side reflectors, with lumen requirements written into the law, but then I am an extremist bike light Nazi.
I agree 100% on helmets for “non-serious” collisions and other accidents, and I think wearing a helmet is essential for avoiding injury in those and should be considered as a risk factor. I’ll personally never not wear a helmet after the time I skid out on a trail and it saved my face and nose from being smashed into the ground. It probably wouldn’t have killed me, but my face would have been pretty messed up.
No comment on legislation.
I agree with you, and I actually hate wearing a helmet — but there is no way in hell I wouldn’t. I don’t really care about the percentages–a helmet saved me once, and once is all it takes.
Yes, there is certainly safety in numbers, but I think the real safety is in infrastructure, and we none of that here in Seattle.
Still, I don’t think there should be helmet laws. I do think bike share should have the helmet vending, despite the added cost. Let the individual decide if they want to risk it or not. Some folks would choose not to ride because they can’t rent a helmet. Having the option will increase ridership, I think.
I bike pretty much every day of my life, but I do not argue with people who say they won’t bike in this city because it’s dangerous. I’ve had enough close calls, and friends of mine have been hit or doored–one nearly killed.
Oh, and happy birthday!
I for one can’t get my head around why this would be such a divisive issue. It’s like bickering about sneakers vs boots. I personally own both.
Unless a cyclist is inebriate, the only real danger involved in riding a bike is automobile traffic. Enforcing existing automobile laws would decrease this danger and makes more sense than ticketing people who are not creating this danger themselves. This isn’t a question of helmet or no helmet, but one of creating and fostering a safer and more pleasant public environment for everyone.
The brother of my boss back in ’78 was killed, riding alone, he hit a storm grate and did a head plant on the curb. Not quite instant death from the split skull but he didn’t make it past the emergency room.
So yes, a helmet can save you even without a car being involved.
The relevant question is not whether a helmet can be effective in a collision or fall (they can). The question is whether it makes sense from a public health point of view to diminish one proven safety endeavor (bike share and safety in numbers) in order to put in place one that is less conclusively effective (adult helmet laws). It’s the difference between the macro and micro point of view, and public health decisions need to stay focused on the macro.
You can also trip walking or in your bathroom, which are far more likely.
Anecdotes and fear make for really bad policy.
Let me add to your argument, Gary.
A good friend of mine had a commuting accident in SLU last week, most likely because of streetcar rails (she can only remember waking up in the ambulance). According to witnesses, no other vehicle involved. She was knocked unconscious and suffered a skull fracture…with a helmet.
She ended up in the ICU at Harborview; but that plastic and styrofoam is probably the only reason she is alive today.
I claim that your data on “reduced riders due to helmet requirements” is flawed. AFAIK, there is only one city which made the claim that their bikeshare program failed due to a helmet requirement and that’s Melburne Australia. I claim that the data is far less conclusive that there could have been other reasons and that they have been ignored.
In anycase we will have the experiment of Vancouver BC to watch to see if this is true.
Ok, short of inebriation or inattentive riding. Keep up the nitpicks, internets.
Automobile/Truck traffic is the killer issue. And yes, a helmet may not save you from the garbage truck, flying SUV etc.
The issue is one of who pays for those who are seriously injured by an accident which could have been midigated by wearing a helmet. Since we won’t leave you to die if you don’t have insurance all of us have a vested interest in riders taking “reasonable” hence the argument, precautions.
No. “who pays for those….” is a lousy argument. Hikers, tubers down cedar river, joggers, walkers. Heavy duty numbers that cost taxpayers to find and fix. I agree with the poster who pointed out the “nanny” mentality as well as the “taxpayer healthcare” arguments are red herrings and would lead to us living in a “cocoon”. Jog, walk, ride a bike, play hopscotch (very dangerous), play on the jungle jim (death trap) WITHOUT a goofy helmet if you wish. Or wear one. (there are some VERY dangerous jogging shoes causing serious accidents- new nanny law MUST be required by do good-ers)
I feel like you do Tom. I wear a helmet myself but I am not one to preach to others about the need to wear a helmet or think we need laws requiring them. It becomes a personal choice at some point and I just feel strange without one.
A great benefit to not having a mandatory helmet law is we might lessen the all-to-common victim blaming response in bike/car collision about cyclists not wearing helmets. I would be happy to hear less of that noise.
Happy Birthday!
Happy Birthday Tom! Thanks for your great site, and boundless energy.
As far as helmets are concerned; law or no law wearing a helmet is a personal choice.
It is my choice to wear one. It keeps the rain off in February. I like getting up after a spill without the double vision and week long concussion headache. It makes your hair look awesome when you take it off, and are lucky enough to have a full head of hair. Personally, it makes me feel safer when I look to my left and see a driver talking on the phone, applying eyeliner and sipping a coffee while driving using a Jedi mind trick.
My two cents.
I actually find the “personal choice” argument to be a less convincing argument against helmet laws. After all, that’s the argument against motorcycle helmet laws, which unlike bicycle helmet laws, have been proven to be somewhat effective: http://www.huffingtonpost.com/2013/05/30/michigan-motorcycle-injuries-helmet-law_n_3359586.html
The point is that motorcycles go a lot faster than bikes, and the thus the issue becomes a public health issue (same with car seat belt laws). However, the same does not go for bicycles, which are not inherently more dangerous than other modes of transportation. From a public health point of view, it is actually better to have more people bicycling, so the way we make decisions about them should take that into account.
Tom:
I see your point. However, maybe the skateboard park model would work. For the bike share aspect; helmets should be available if not mandatory. In privately held skate parks they tend to be required along with a waiver. For riders using their own bikes it should be strongly suggested, but not legally required.
I agree about the safety in numbers. The more riders the better.
As far as inherently not being more dangerous it really depends on the drivers around you, your personal experience and probably a bit of luck. I learn so much from the great bunch of riders here in Seattle every day; it is great to see more people riding every day.
I would suggest that there should be a differentiation in uses of bicycles. For example, BMX, mountain biking, road racing and training are all much different activities than hopping on a clunky upright bike for a ten-minute jaunt to a nearby restaurant. Yet the law treats all these users the same, which is silly. We don’t hold drivers to the same safety restrictions as NASCAR drivers, who wear helmets and safety harnesses. Yet the laws for someone bombing a hill at 50 mph on a road bike are the same as the laws covering people going 10 mph down a bike trail. That doesn’t make a whole lot of sense.
“it doesn’t make much sense”
That’s because it isn’t the fall from going 25mph that can kill you as much as the fall from 6ft. ie, just falling flat on your head with no forward motion onto concrete is sufficient to crack your skull.
But, Gary, that doesn’t seem to be happening in the many cities across the globe that have bike share systems. They are upright, slow-moving step-through bikes designed to fit everyone. They don’t have clip-in pedals, and the tires are not super skinny. All these elements combine to make for a reasonably safe ride.
See the points above about bike share being remarkably safe (see particularly the Barcelona study, which is rather interesting). I think your fear of the 6-foot fall just doesn’t have large-scale support. I’m sure some people get hurt that way, but not very many.
The real killer to your argument to having helmets for riders to these slow clunky bikes, is that any collisions/accidents these riders are likely to have, would be midagated by wearing a helmet!
I think the whole helmet thing could be easily fixed by a machine that makes a helmet for you on the spot. Afterall, t’s just some foam with a strap. With 3D printers coming up fast, this is going to be child’s play. And think of the sales, “design your own helmet!”… “Have your team name on it!”… “Birthday helmets!”.. “Clothing matched helmets”.
Also, motorcycle helmets are vastly different than bike helmets. A person not wearing a good helmet on a motorcycle is flat-out crazy, but so is requiring a full-face motorcycle helmet on a bicycle, which would be the other extreme.
3D-printed helmet machines! I’ll admit that would be pretty damn cool.
What makes a safe ride is not the a bike share program without bicycle helmets. Fix the dam roads so that it’s safe to ride then repeal the helmet law. Just look at the intersections in Copenhagen, the bike lanes, the timimg of the lights etc etc. This city needs to fix the potholes so we don’t crash as well as set up some North/South through the city safe routes.
Whose going to rent a bicycle to ride on these unsafe roads?
Forget Copenhagen, Gary. Let’s talk London. More and crazier traffic than almost any other western city, bike infrastructure closer to America than Denmark, and bike share with no helmet requirement and very low helmet wearing rates. Injury rates in the bike share system are ridiculously low.
Happy Birthday Tom!
Why did you do this to yourself? Take one over the bars without a helmet? (Just kidding!)
The conclusion I drew from this is MIPS and AIM helmets (only available at this time from POC or Scott) can reduce the rotational forces to levels below what causes a concussion. Its long but worth a read.
http://www.bicycling.com/senseless/
Happy Birthday Tom! And what a fantastic post! Thank you so much for your incredibly sensible and savvy suggestion. Brilliant. Who should we be writing to to urge this minor change in the law?
The Council will consider a package pertaining to bike share. Could be part of that, though I bet PSBS might not want to complicate that effort (they have stated that they have no interest in repealing the helmet law, though that doesn’t mean we can’t modify it anyway!).
The public health argument that would discourage mandatory helmet laws is counterintuitive but wholly convincing to me. No helmet mandate = more people biking = more people biking more safely = more general awareness = fewer (not zero) serious collisions + sharply improved general public health.
From a public health perspective this would leave us with a better community, but it wouldn’t remove the very real sting of the odd person here or there who lands on the front page of the Times with a split skull.
But the “if it saves even one life it’s worth it” argument is anathema to me. Indulging that argument as the basis for public policy leads us to silly things like soda bans and ethic profiling and taking off our shoes at airports. At some point we have to admit that what we’re giving up is worth more than what we’re trying to save. We live our lives swimming in assumed risk from every angle, and though I believe that publicly we should maximize utility for the greatest number of people (and thus not require helmets), privately I would say wear a damn helmet already.
*ethnic
Tom:
I like the differentiation idea. Additionally, perhaps some age requirements for kids should remain in place.
Absolutely. This would not change the law for minors, who I’m pretty sure can’t use bike share, anyway (you’ll need a credit card, right? Don’t quote me on that).
Also, a recent study suggests that there is a small-but-measurable benefit to helmet laws for children: http://www.bikeradar.com/beginners/news/article/make-bike-helmets-compulsory-for-kids-report-37280/
The difference, of course, is that kids fall a lot and don’t have a full grasp of traffic, etc. There are no such studies with similar support for adult helmet laws.
On two wheels “it’s not *if* you’ll crash, but *when*.” I’m a year-round bicycle commuter between the Eastside and Fremont. In my experience this saying holds true, and not just because cars don’t see us. None of my crashes were vehicle involved, and I’ve got a few crashes (and helmets) under my belt: once when my chain broke; once when I got off balance trying to pull a leaf out of a buddy’s brake; once when I got surprised by an uprooted curb; once when a guy in front of me started then suddenly stopped. None of these crashes were in traffic due to inattentive car drivers, but a couple would have made me a vegetable or at least put me in the hospital for a few days if I’d not donned a helmet. Even with a helmet, which was destroyed, they “rang my bell” but I walked away.
I have no desire to legislate common sense, nor do I think it’s even possible. But heaven help those who don’t have it. Freedom IS messy. You can run but you can’t hide, and on two wheels a crash will eventually find you.
Just don’t make me scrape up the mess or pay higher taxes to have the government to change your diapers.
Are there figures available for the number of citations written per year/month/etc for biking without a helmet? I really have no firm idea of how vigorously this is enforced. My anecdotal sense is that it’s already kind of a secondary offense — if you’re busted doing something dumb or riding like a jerk, then maybe you also get written up for no helmet, but I don’t think I’ve ever seen anyone get pulled over solely for not wearing one. I’m sure that it’s happened, but for the amount of effort that would have to be expended to actually change the law, I’m just not sure it’s worth whatever the benefits might be.
I’m also not really clear on whether this is something the city could actually do, or whether the change would have to come through the county. Can the city simply decide to repeal the law or to make it a secondary offense, even though it’s a county law?
I think the idea that you could get a ticket would be an impediment to many. I don’t have the data. It happens, but probably not a ton.
Imagine you’re a public official with a bike-share program on a limited budget and you have to insure against crashes. You should be able to determine the difference in the health care cost (savings) for those wearing vs. not wearing helmets. If it is great enough, that official should be able to justify their position for helmets being required, and subsidized or free helmets made available to riders.
Otherwise, for a bike-share program, helmetless riders should be forced to accept a strict liability limitation which only covers the maximum allocated to a helmeted rider.
Feel free to laugh at this, but: If you think people could be deterred, maybe we could just not explicitly tell them? Let’s just not put a big sign up saying “You are required by the King County Public Health Code to wear a helmet” next to the bike share stations. We presumably won’t advertise all of the other Seattle/King County/Washington-specific bicycle laws we have. Maybe we just brush this under the table too.
There’s another issue at play here, which is that it’s not just a question of changing the law as it applies to cyclists. The same helmet law also specifically prohibits renting a bike to someone who is not in possession of a helmet. So, there’s an issue of liability for Alta and PSBS if someone not wearing a helmet is injured while riding a bike share bike, regardless of whether the Seattle police would treat the lack of a helmet as a primary or secondary offense. I think you’d have to address this not just on the Seattle executive/enforcement side, but on the legislative side as well, if you wanted to get buy-in from Alta and PSBS (and their insurers, presumably).
If safety in numbers is 100% guaranteed to save lives, and mandatory helmets reduce ridership and create the false perception that cycling is dangerous, then why on Earth would you support mandatory helmets for children? Aren’t children’s lives worth saving?
Stop making kids wear helmets and more kids will ride, and then fewer kids will get hit. Right? If you’re going to drink this Kool Aid, drink it all. Don’t stop just for children. If what you’re prescribing is 100% guaranteed to make my kid safer then I want some!
Do bicycling activists realize that they have adopted exactly the same reasoning as the beer-swilling, gun-toting, Harley-Davidson-riding ABATE/outlaw biker subculture of motorcycling? Bicyclists have literally copied the same arguments that hairy baby boomer bikers used to repeal motorcycle helmet laws in ever red state in America, resulting in spiraling rider deaths every year since.
Much like Portland’s rejection of fluoride, it’s a sad confluence of hippies and Teabaggers arriving at the same destructive conclusion starting from opposite points of the compass. Same damn people who won’t vaccinate their kids.
Your overall line of reasoning appears to be that because sometimes we have laws that make children do things for their own good, we should never repeal any law that makes adults do something for their own good. Is that really what you believe?
The general approach of most cycling organizations throughout the nation, is that mandatory helmet laws for children are a good idea. Aside from being more vulnerable to head injuries, children generally do not have the judgement to do the careful balancing as to whether a trip is worthwhile even if you have to make it without the helmet. Children are far more likely to not wear a helmet, if given the option, simply because they do not want to or, perhaps, because someone else isn’t wearing a helmet. Moreover, if parents are irresponsible or ill-informed, children might not have the chance to wear a helmet.
I don’t know what the point of the third and fourth paragraph is, butif you are trying to dehumanize motorcyclists and people with right-wing points of view, and at the same time discredit cycling activists who happen to be disturbed at some of the same things that they notice, I hope you will consider where that type of thinking leads.
I believe Dennis was just trying to ruin my previously-stated birthday wishes with an outrageous trolling comment. Well it won’t work!
To put some of this in perspective, 22 states have laws requiring children to wear helmets. No state has a law requiring adults to wear helmets (though such laws are proposed somewhere almost every year. Washington is unique in that more of the adult population is subject to a local mandatory helmet law. Outside of Washington State, the only large cities with mandatory helmet laws for adults are Dallas and Oklahoma City.
In 13 states, there are no local helmet laws for adults or children (Arkansas, Colorado, Idaho, Indiana, Iowa, Minnesota, Nebraska, North Dakota, South Dakota, South Carolina, Utah, Vermont and Wyoming)
See Bicycle Helmet Safety Institute
Sometimes people make similar arguments to other people, and sometimes those other people have an image others find it easy to ridicule on a blog. That doesn’t mean they’re wrong. Though, for what it’s worth, I don’t think the typical bikeshare helmet argument is all that similar to the typical motorcycle helmet argument.
The bike helmet law argument, which often centers around a “safety in numbers” argument, is actually based in data. Data from cities where cycling concentration and safety have increased without increases in helmet usage. The utter lack of correlation between cities where cycling is safe and cities where helmet use is common. I’d be a lot more worried about helmetless bikeshare users if it wasn’t for data from London, where helmet use among bikeshare users is very uncommon but bikeshare is extremely, ridiculously safe.
Meanwhile, I don’t think there’s a big contradiction in simultaneously preferring to require helmets for kids. Safety in numbers works by making drivers more aware of cyclists and establishing a set of common practices; that isn’t seriously compromised if kids have to wear helmets. Unless, of course, helmet requirements cause kids to turn away from cycling in such numbers that they erase the safety gains of helmets beyond a certain age, and kids travel in such age-segregated groups that they won’t pick up common practices from adults on the road.
I’m really not sure what the right terms for helmet requirements should be. Any helmet requirement almost certainly shouldn’t cover bikeshare users, and in cities with excellent bike infrastructure, ridership, and practice a requirement clearly doesn’t need to cover adults (imagine imposing a helmet law in Amsterdam — doing so would be ignoring what is clearly working there); it should probably cover young kids riding two-wheeled bikes (especially in a city with lots of hills). Between those points I’m open to be convinced by data, not rhetoric involving other people’s use of beer and guns.
It seems that many people are lumping together a requirement to wear a helmet and whether bike shares should have helmets. Apparently it’s true that having a larger number of bike riders reduces head injuries more than helmets. However, if you are the unlucky fellow to have a head-banging crash, wouldn’t you prefer to have a helmet on? Your chance of having a crash might have diminished, but your chance of injury without the helmet has gone up. Figure that out.
Peri, don’t ask insulting questions. Of course I’d rather have a helmet on if I was involved in a crash where my head was hit. I’m not suggesting we ban helmets for bikeshare users or prevent the development of a rental helmet system! We’re talking about public policy, not the choices of people and companies.
I don’t care one way or the other about whether helmets are provided by the bikeshare system. My main concern is that it’s successful and safe because that will be good for everyone biking in Seattle! Experience around the world shows it can be without helmets. If you want to campaign for helmet availability go ahead, just don’t put a requirement on the system that will threaten its success!
Not meant to be insulting – sorry if it came across that way.
My point is, it’s an illusion that increasing numbers of riders reduces your risk for head injury if you get in an accident. It only reduces the chance of an accident.
Thus, it IS important that bike share facilities offer helmets, regardless of whether they are required. Maybe I’m being too utopian. But I won’t use a bike share unless I have a helmet.
There’s no illusion whatsoever. It’s just a matter of counting the right thing. I don’t understand why you’d discount the importance of decreasing your chances of a collision — that’s pretty much the most important thing there is! My entire set of practices for riding a bike in the city is based around decreasing the chances of a collision! I always wear a helmet when I ride but I’d sooner leave the house without a helmet than without my good judgment.
In short, there’s considerable evidence that having more cyclists on the road decreases the chances you’ll be injured when you get on your bike and ride. That’s the important thing to count. Some serious injuries and deaths can be prevented by protective gear; some can be prevented by better infrastructure; some can be prevented by better practices. If your analysis only considers cases where infrastructure and practices have already failed, of course protective gear comes out looking good!
As for helmet availability, as long as you don’t support it by pushing a helmet mandate, do whatever you want!
Exactly where did I say I am pushing for a helmet mandate?
Just wanted to wish Tom a happy birthday before the day is over and repost his particular point that points out the absurdity of a helmet requirement for all types of bicycling.
“I would suggest that there should be a differentiation in uses of bicycles. For example, BMX, mountain biking, road racing and training are all much different activities than hopping on a clunky upright bike for a ten-minute jaunt to a nearby restaurant. Yet the law treats all these users the same, which is silly. We don’t hold drivers to the same safety restrictions as NASCAR drivers, who wear helmets and safety harnesses. Yet the laws for someone bombing a hill at 50 mph on a road bike are the same as the laws covering people going 10 mph down a bike trail. That doesn’t make a whole lot of sense.”
Wearing a helmet to commute ten miles into downtown is one thing, wearing my helmet to the corner shop is something else.
BTW, if you really knew how dangerous bathrooms and bathtubs are, you would wear your helmet in there all the time as I do, especially if you “go” really fast!
Happy Birthday, Tom! I hope your day is filled with laughter and love.
As a regular commuter, I always wear my helmet. Being pro-choice, my druthers would be that it’s a bicyclist’s choice, not something that’s required by law.
“Safety in numbers”
Fix the roads… that’s widen the bike lane on 4th. It’s a ridiculously 1 meter wide. Or let us ride in the bus lane on the right. Every time I do ride there, it’s mostly empty. I’m even better at letting buses merge back in and out of traffic than the cars are around me. But I don’t think it’s legal.
Fix the roads… that’s give us a safe route South through the city. 2nd is a mence, just look at the accident rate http://seattletimes.com/flatpages/local/bicyclecollisionsinseattle.html
And stop putting trolly tracks in same lane as that used by bicyclists…. Westlake is going to look really bloody with a bunch of newbie bicyclists riding down it with no helmets.
It is legal to bike in the bus lanes. However, I can’t promise that every police officer and bus driver knows that.
Gary:
Totally agree with you on 4th and 2nd Avenues. I think there is an open house this evening at City Hall regarding future plans. Currently the downtown area is tricky to get around in especially for people not accustomed to riding in dense rush hour traffic.
My strategy is to assume all motor vehicles are not looking for you, and make path choices based on that, take the lane when necessary, be pleasant and thankful when a motorist does allow you right of way, and follow the rules of the road.
Seattle with all of its short comings for safe bike transit is still one of the most beautiful cities to ride in. I am excited to see what the future holds.
Up North on Aurura there are “bus only” signs and right below them, “or bicycles”. As opposed to the one’s on 4th “bus only” on the road, on the signs next to the road. I think I’d have a hard time beating that traffic ticket.
The real problem with helmet laws is that they amount to unequal constraint under the law.
If what we really cared about was “public health” we’d ban skydiving and rock climbing outright, require daily exercise, ban alcohol (tried that recall), tax the amount of time people watch TV, etc. All sorts of things would reduce public health care costs more than bicycle helmets.
Helmets get required by law (as opposed to worn or advocated on the merits) because some political faction can be see to be “serving the public good” and “exerting power” by hassling a relatively small part of the population.
The cynic in me suggests that sometimes helmet laws are meant, perhaps subconciously, to *suppress* cycling. As in “if we hassle the bike nuts enough they’ll leave out city our life will be simpler.”
Also – Happy Birthday Tom – AND – helmets are never an end-all be-all, and we should recall that no credible party has suggested banning or obstructing the use of helmets.
Further, positive examples (lots of different people wearing helmets, looking before entering traffic, stopping at red lights, etc.) probably help more than any law.
Tom, I forgot to mention that I think you are on the right track with the idea of making the helmet law a secondary offense for adults, rather than trying to repeal the requirement outright. If I understand the situation, the law is almost never enforced but it rather in place to convey a social norm. To the extent that it is enforced, it would make more sense to reinforce safety–and telling people to be extra careful when they don’t have a helmet does exactly that.
But I would not make a special exception for bikeshare: “You have to wear a helmet unless you are riding our bikes” just is not a helpful thing to say. Conceivably, it would make sense to require either a helmet or running front and rear lights, since both enhance safety and there is nothing to keep anyone from putting lights on a bike and running them day and night. Maybe some people would get better lights, just so they are covered when they forget their helmet. That said, I doubt this idea would ever fly, while the secondary offense idea might.
Since nobody seems to have done the reading, I want to point out something about all this crowing over slaying the mighty dragon that is the Harborview study showing an 85% reduction in injury. Did you keep readying to find out what the correct number is?
It’s 40 to 70%. Down from 85. What does that mean?
Well, nobody has ever claimed that motorcycle helmets do more than reduce your odds of injury by more than a measly 30%. Thirty percent. That’s all you get from a motorcycle helmet. What’s that translate to?
Read After MI got rid of their motorcycle helmet law, injuries jumped 22%. The cost of medical claims — the average cost of all claims — jumped by $7,000. That’s what a mere 30% means to you.
So you’re crowing that you knocked down the benefits of bicycle helmets from 85% down to 70, or maybe, possibly as low as 40%.
So many people wrong on the internets, so little time ;-)
First – Happy Birthday Tom! The most important comment I have to make is to thank you for your work on the blog – a great addition to the city!
Helmets and public health is a fun subject because of two things:
* How good the question is at revealing the biases of the posters
* How rich and complex the underlying issues are
For example, you hear again and again “if helmets lower the risk of head injury at all – it’s obvious that we should make their use a legal requirement” – what could be simpler really?
Unfortunately, life is a series of tradeoffs. Ask yourself, if helmets are so great, why don’t we wear them while driving (an activity that causes a lot more head injuries to Americans than pretty much anything else)? Because driving, of course, is *normal* and you don’t wear special protective clothing when doing *normal* things – regardless of the risk (and now that I mention it, where *did* I leave my Nomex driving suit – no way I’m getting in a vehicle containing the explosive equivalent of a hundred sticks of dynamite without one, right? ;-)
And while a few of you may have an anecdotal account of someone surviving a bike crash with a helmet, we almost all have anecdotal accounts of folks more near and dear to us not surviving vehicle crashes without them. So given the utter lack of anyone even mentioning motoring helmets here, let’s drop the pretense that we’re being very rational about risk.
That said, what’s a lot scarier than the distant risk of possible head injury? How about the near certainty of a massive wave of premature deaths and disabling medical conditions arising (partially at least) from our increasingly sedentary lifestyles? (There are counties in the most sedentary parts of the US where one in four people of working age are *already * disabled. Think about that for a second.)
So if making cycling seem normal can health slow this tsunami of pain and loss, then we might want to be very careful about doing anything to the contrary. Given that no one has ever in the history of the species (!!! sounds a lot more impressive than lately, no? ;-) made cycling seem normal while requiring helmet use, advocates for helmet laws look like the risk takers here to me.
There are a lot of other interesting questions – someone brought up the Bicycling article on helmets that protect against concussion (our current ones don’t), it appears that drivers may be more likely to hit helmet wearing cyclists, you can be both for helmet use personally while against helmet promotion (because of the public health issues), and let’s face it most of us wear helmets here for the same reasons we don’t in the Netherlands – custom not rational calculation.
And my guess is that the helmet requirement will kill bike share in Seattle. It certainly appears to have done so in Melbourne. That’s a pity because it seems that successful bike share programs disproportionately *normalize* cycling as a transportation mode. And it’s hard to see a future for our country that doesn’t involve an awful lot of broken middle aged and older folks without normalizing active transportation (that and a lot of other things).
Now I will hold a thought out to you helmet law advocates. If you’re really serious about saving folks – then you’d *start* with driving helmet promotion and *then* move to cycling helmets. Given the bad public health effects of driving (on the drivers and everyone else), discouraging driving is a public health plus – so if helmets cut down on car trips everyone gets healthier. Accomplish that (heck even seriously try it) and you can hold your head up in these discussions. Otherwise you just look like you hate America ;-)
“If I was serious about public health”
I’d reduce the amount of sugar in soda pop, and tax the heck out of it. The increase in sugar in our diet is killing more of us than anything else.
But this is a discussion on bicycle helmets, and your post adds no new facts to why bike share failed in Melbourne other than the oft cited claim but not substantiated, that requring helments killed it.
My claim is that if bike sharing dies in Seattle it will be from the poor roads and cycling ameneties. Lack of storage, crappy narrow bike lanes, trolley tracks right in the middle of the lane most bicyclists would ride on, on a flat road that toursits would logically take to see the museums at South Lake Union from downtown. etc.
I agree with all those reasons as well, Gary. It’s not as simple as “helmet law=fail, no helmet law=success.” That’s why I’m working as hard as I can to advocate for a safe downtown facility by the time bike share launches. We might just make it, too, if we keep the pressure on. Because it’s definitely a bit hard to imagine sending bike share into downtown as it is today. This was identified int he PSBS plan, as well. The good news is that there’s design work in the budget for this year, and we can definitely keep it on track if we push hard enough.
It would also be a good idea for PSBS to test out different tires with the SLUT tracks and use that as a guide for which ones to purchase. I say, the fatter the better.
[…] are excerpts from a post by Tom Fucoloro on the Seattle Bike Blog that casts more light that heat on a contentious issue directly relevant […]
[…] Tom Fucoloro at Seattle Bike Blog, reflecting on the new data and taking a nuanced stance regarding helmets and the launch of Puget […]
I just wanted to point out that Seattle passed its helmet law independently of King County, in which Seattle is located. That is to say there was a period of time where it was legal to cycle without a helmet in the City of Seattle, but not once you left the city limits.
Well, yeah, kinda. It was wrapped up in a merger of the public health departments. It was one of the conflicts between the two entities, and the Council decided to go with the King County version: http://www.seattle.gov/council/newsdetail.asp?ID=3516&Dept=28
Note the citation of the 85% study in their 2003 press release…
If the injury reduction of helmets isn’t 85%, what do you think it is? 70%? 50%, 30%?
If you’re in the faction that imagines that helmets increase neck injuries to the point where helmets are 0% helpful, or even worse, then can you explain again why you think helmets should be mandatory for children?
Dennis, I have a feeling that you didn’t read this post.
The shortest answer to your question is: Children won’t be able to use bike share, anyway. So it’s irrelevant here.
Because your reasoning is so brilliant that only those who have not been blessed with your sparkling pearls of wisdom could possibly fail to appreciate their everlasting truth? To read Tom Fucoloro is to believe him? Nice.
I’m trying to get you to understand that all of the reasons you give for adults being better off without helmets apply equally to children. Children don’t need a bike share to benefit from safety in numbers — in fact children are vastly better able to switch to bikes from cars because their trip to school is much shorter than an adult’s work commute. Children go from A to B and right back to A. A bike share is great for people making random errands all over town who might not want a bike to worry about for some leg of their journey.
Safety in number is either real or it’s not. Safety in numbers is either of greater benefit to riders than helmets, or it’s not. On the one hand you claim it’s 100% certain to lower the collision rate, but on the other hand you think kids need helmets. Which is it?
And if we grant that the benefits of helmets are not as high as 85%, then what is the number? Do you think it’s 70%? Or 40%? Or 0%? If you think kids are better off with helmets, then you must not think that helmets cause neck injuries? True or not?
I assumed you hadn’t read the post because it never expresses an opinion about helmet laws for children (it simply notes that we don’t need to change it for the sake of bike share). I don’t honestly know if I have a strong opinion either way. I certainly don’t feel that it is anywhere close to being the most important issue facing kids cycling here. Safe streets, social encouragement like recent bike to school events and bike trains, and biking education are way, way higher on my list. Once our streets truly are safer for people of all ages, then maybe…
But regardless of your opinion of helmet laws for kids, there’s also the political reality that no elected official is going to carry the torch for repealing a children’s bicycle helmet law. It’s going to be hard enough reducing the adult helmet law to a secondary offense, and the only reason I could see the city/county taking such an action would be so that bike share succeeds. So, again, children are not relevant to that discussion.
Tom, what do you think the number is? The injury reduction of helmets; how much is it?
You believe it was incorrect to say that helmets reduce injuries by 85%. In spite of testimony from places like Australia, as we have heard. But let’s say it’s less than 85%. How much do helmets reduce injury? Can you please answer? Would you have us believe you haven’t given enough attention to bicycling to form an opinion?
Another question: how did Seattle become one of the top cycling cities in America even though we have a helmet law? Seattle is right up there with New York, Madison, Portland — you can’t talk about the great cycling towns of America without bringing up Seattle. Isn’t that evidence that whether cycling is popular or not isn’t affected by helmets? Would people really refuse to use a bike share because they’re not willing to clip a half pound helmet to their bag as they leave the house? Bike shares have failed due to theft and vandalism. But helmets? Show me.
Because everyone knows they can save your life. They can reduce injuries by at least a third. Maybe half. 85 percent? Probably not. But at least a third. Do you disupte that? What would you put the number at? Please answer.
I’m not sure I’m following you. You state that “the more people biking in a city, the lower the collision rate”. And I think the word “rate” should be stressed here. If 100 people are biking in the city, and 10 of them are in collisions, then the collision rate is 10%. But if we increase the number of people biking in the city to 500, but only 30 people are subsequently involved in collisions, then we can say the collision rate has gone down to 6%. Can we conclude therefore the more people who ride, the safer they are? No, because the actual number of people involved in collisions will surely go up.
Two problems I have then are, you haven’t proven that of that hypothetical 30 people, the injury rate would be lower if they had not worn helmets as opposed to if they had. I believe helmets would do more good than not.
Second, you have no evidence that people would not use bike share with a helmet law in place, other than your assumption that the average bike share user will decline to use it because they are worried about being pulled over. I doubt anyone worries about this, as most people assume (correctly) that SPD has bigger concerns that citing adults, under some obscure county code, on bikes who are otherwise obeying the law. I think in reality, more people will hesitate to use bike share without a helmet because they honestly think they may get injured if they ride without one. I myself think most won’t care either way, and will use bike share if it suits their needs, and helmets won’t have much to do with it.
I agree with Davey. Basically, just because your percent chance of injury goes down doesn’t mean you safety goes up. If you get in an accident without a helmet vs having one, surely your chance of severe injury goes up.
Another analogy would be a terrorist situation. If the crowd around a sniper is larger, the chances you being hit goes down. However, if you’re hit, you’re just as dead as if there had only be you there.
Yes, because what comes to mind when thinking about bicycling is “terrorist situation” and “sniper”. Can you see why folks might worry that your helmet promotion is really driving promotion in disguise?
So again, why aren’t you promoting helmets for driving? There’s no countervailing health benefit and there’s a ton of head injuries to car and truck passengers…
Again, there’s a difference between offering helmets and requiring them. Please don’t mix the two up.
You assume the number of collisions will go up significantly. However, Seattle has found that as the number of people biking goes up, the number of collisions stays just about the same: http://www.seattlebikeblog.com/2012/02/20/times-as-biking-in-seattle-grows-dramatically-number-of-crashes-stays-the-same/
Also, my fears about bike share being hurt by a helmet law are mostly due to seeing what happened in Melbourne. That said, I don’t think a system in Seattle would completely fail w/ the helmet law. But I do think it would not be as successful (and, with success comes more people biking, which increases the safety in numbers effect, and on and on).
But also, bike share systems across the planet operate safely without helmet laws, and I have faith Seattle would be no exception to this.
OK, lets assume they stay the same. Lets say Seattle has 50 crashes a year. Again, if more people ride then there will be a reduction in the RATE of crashes, but not the actual number of crashes. Encouraging people to quit using helmets (which repealing our toothless helmet law would do) would most likely lead to more of those 50 (or however many) people to have injuries. Personal choice I suppose, then again we all have to pay for the emergency responders having to come out as a result of these increased injuries.
I’m from Australia where wearing helmets is compulsory, but it hasn’t always been that way. We also keep very good accident statistics, and have a similar road culture to that of the US. So there is a huge amount of before and after data that policy makers in the US could draw upon to make good policy. I find it strange that there is debate over the details of a study that is nearly 25 years old.
In the state that I live in, which its major city is around the size of Seattle, the average number of cycling deaths per year dropped more than 85% once helmets were introduced.
Personally, I have been in two accidents where a helmet saved my life, and I can vouch for the fact that even a low speed fall can has the potential to result in significant head injury or death. In my case I was doing a slow left hand turn into a side street (equivalent of your right hand turn). My front tyre must have gone flat just before that, so when I turned the front wheel gave way and I toppled over. My hip hit the ground hard causing a whip-lash effect which caused my head to hit the concrete gutter at considerable speed. I still remember the sound, and the impact almost knocked me out. My helmet was a throw-away, but my brain was intact. The doctor at the hospital inspected my helmet and said, it was my lucky day. And the estimated speed of my crash…. 5-6km/hr.
Anyone who has had their life saved twice by a helmet, should simply not be cycling. If your promoting helmets as a life guard for cycling then you’re promoting cycling as more dangerous than the reality.
[…] Salt Lake City, adds another component to this debate. While researching this topic, I came across this post from Seattle Bike Blog, which basically advocates for an end to that city’s helmet law. It’s an interesting […]
The whole helmet law issue is a 100% sideshow over the fact that bicycling ammenties, ie bike lanes, pothole free right lanes, clean curb lanes are not maintained. You don’t need to wear a helmet to realize that 2nd Ave & 4th are death traps for a tourist on a slow bicycle.
Fix the roads and drivers and bicyclists will be safer.
It seems most helmet law proponents are driven by a desire to impose their choices on others rather than true concern for lives or health care dollars.
If that is truly their motive then if you stop cycling that must be a good thing, right? Not really as the more cyclists on the road the better it is.
As a direct result of this law I stopped riding a bike. Not because I think cycling is dangerous (the benefits far outweigh any perceived risks) but rather because I got sick of being stopped by the police and sometimes ticketed.
[…] Vancouver’s Bike-Sharing Conundrum (And Three Simple Solutions) | HUSH Magazine – Mentions Seattle’s idea of making helmets a secondary offense for adults (more about that here) […]
[…] flawed “seminal research on the effectiveness of bicycle helmets” in 1989 that has been thoroughly discredited. This 1989 landmark study compared inner city children riding with heavy traffic in commercial and […]
[…] We have suggested several times that the county Health Board should change the helmet regulation to ensure the success of bike share here, which is dependent on people making easy and affordable spontaneous trips. The need to always have a helmet with you or to spend money to check out a helmet for every trip could complicate the system enough to significantly lower usage. […]
[…] We have suggested that if the city/county does not repeal the helmet law or change it to only apply to people under 18, they could at least change it to be a secondary offense. If someone without a helmet is breaking more important traffic laws like blowing through red lights or endangering people using crosswalks, then sure, they can get a double ticket. But if their only offense is not using a helmet, stopping them and giving them a ticket is not a valuable use of officer or traffic court time. […]
[…] discussed the challenges of launching a bike share system in a city with a rare all-ages helmet law […]
Any of you against wearing a helmet, go hang out in the ER for a day in the summer and count how many head trauma’s come in, some left with permanent brain damage, some dead. I did I was in an accident laying on the table in the ER, the first thing they ask is if you were wearing a helmet, I was shocked and said why? They said most don’t and the results are deadly. Then I could hear them talking in the hall way about the many head injuries coming in from non helmet wearing cyclists.
More recently I had a cycling partner go down hard, multiple ribs, punctured lung, fractured back, broken femur, knocked out and his helmet was crushed. The doctors said he would likely be dead had he not been wearing a helmet.
“Any of you against wearing a helmet…”
No one here is against helmet use. It’s the law that people rightfully oppose.
“go hang out in the ER for a day in the summer and count how many head trauma’s come in, some left with permanent brain damage, some dead”
Virtually all of them from motor vehicle accidents no doubt. So how many? The statistics indicate very very few from cycling.
“The doctors said he would likely be dead had he not been wearing a helmet.”
Anecdotal evidence is not considered reliable.
Right on every point. A nonsense law.
Not to me
Anecdotal evidence is reliable to you? Must be joking.
Biking with a helmet is safer but not worth it besides me or my 16 year old daughter have never got a head injury and we have never wore a helmet so I don’t think they are worth it.
Agreed! All we did was stop kids from riding….adding to the fattening of our children with more excuses to sit at video games. When I was young, everyone rode. Great times. We lived through it. Just as trying to fix electrical stuff zapped us and we lived (without a helmet). Statistical nonsense can kill a valuable pastime.