To wear or not to wear?

With the recent arrival of the Dublin bikes scheme, the compulsory helmet debate is firmly back on the agenda

THE IMPRESSIVE beginning to the Dublinbikes scheme and the tragic death of a cyclist on Dublin’s quays in the same week has focused attention on the issue of bicycle helmets.

Though for many the usefulness of cycle helmets is so self-evident that they should be made compulsory, it is an issue that provokes fierce debate in the cycling community.

There is a strong opposite view – somewhat counter-intuitive but deeply held – that helmets actually increase the possibility of a serious accident.

The argument goes that cyclists who wear helmets are more inclined to take chances and motorists are more likely to treat them differently. If helmets are made compulsory, the number of cyclists will decline and people will choose less healthy means of transport. The net result will be a decline in public health.

It is a “thin argument”, says emergency consultant Dr Conor Egleston, who practises at Our Lady of Lourdes Hospital in Drogheda.

Dr Egleston says he was surprised at the negative reaction he got on cycling blogs following his letter to this newspaper two weeks ago in response to comments made by Andrew Montague, the Dublin city Labour party councillor who initiated the capital’s new bike rental scheme. Cllr Montague had said on the day the scheme began he would not be “overly concerned” about cyclists not using helmets.

Dr Egleston says he had treated people who had fallen off their bicycles and the medical evidence was such that the use of helmets should be made compulsory by law.

He has since referred to a number of studies into the efficacy of cycle helmets and believes, if there is no public clamour for them to be made compulsory, they should at least be mandatory for children.

The most comprehensive study, carried out by the University of Washington, found that helmets provide a 63 per cent to 88 per cent reduction in the risk of head, brain and severe brain injuries.

An Australian study of worldwide bicycle use between 1987 and 1998 found statistically conclusive evidence that wearing them prevented brain injury, facial injury and death.

Dr Egleston says cyclists shouldn’t need academic studies to prove that using bicycle helmets is intuitive. He has treated both adults and children who have suffered basal skull fractures as a result of falling off bicycles when not wearing helmets.

“Motorists wear seatbelts, motorbicycle riders wear helmets, why not cyclists? There seems to be a ‘wind in the hair brigade’ who think that helmets will deter people from cycling. I think it is ridiculous,” he says.

His stance has been supported by fellow emergency consultant James Binchy at University College Hospital Galway, who is also the honorary secretary of the Irish Association of Emergency Medicine.

“I would agree with him totally and so would most of my colleagues,” he says. “Everyone who works as an emergency consultant has treated someone with head injuries. It won’t protect you if you get hit by a car at 60mph, but it will if you fall off a bike of your own volition.

“All the professional cyclists wear them, people who do serious cycling wear them, so why not ordinary cyclists?”

Acquired Brain Injuries Ireland has also backed the wearing of helmets, pointing to research carried out by the World Health Organisation which found that helmets reduced the chances of serious brain injury by two-thirds.

Its chief executive Barbara O’Connell says: “Wearing a helmet not only reduces the risk of brain injury, but it can also reduce the severity of the injury and reduces the amount of time a victim spends in recovery and rehabilitation.”

For his part, Cllr Montague says he is happy to encourage people to wear helmets, but cites contrary evidence to suggestions that they are of real benefits to cyclists.

Motorists, he says, afford cyclists who wear helmets less time, citing evidence from London where cycling has undergone something of a renaissance.

He is not the only helmet sceptic to cite evidence from Brisbane in Australia where the introduction of compulsory helmets led to a decline in the number of cyclists.

“It is too much hassle for a lot of people. Some people just don’t want to wear a helmet. Some children think if they have to wear a helmet, they would rather not do it,” he says.

Cllr Montague says proposals for a 30kph speed limit in the city centre would be of greater benefit to cyclist safety than any move towards compulsory helmets.

The move was approved unanimously by the council’s transport committee and is likely to be given the go-ahead by the full council next month.

The heavy goods vehicle (HGV) ban, which came in last year, has also reduced the risk to cyclists. Eight of the 11 cyclists who have been killed in Dublin since 2002 were killed by HGVs.

The number of HGVs in the city centre has been reduced by between 80 per cent and 90 per cent, but the recent death of the 51-year-old cyclist who was hit by an articulated truck shows there is still a threat and one which helmets cannot fully ameliorate.

Dr Mike McKillen of the Dublin Cycling Campaign says he was agnostic about bicycle helmets and “all organised cycling groups take that view”.

He argues that the wearing of helmets stops cycling being seen as normal a pursuit as walking and therefore acts as a deterrent.

He claims to have been one of the first to wear a helmet in the city. “People used to gawk at me,” he says.

“I wear a helmet to protect myself against my own mistakes, but we know from international studies that helmets do not protect cyclists if they are hit by any vehicle going at any speed.”

Dr McKillen says the real issue was the behaviour of motorists towards cyclists. “There is a secret wish among motorists that cyclists, if they are hit, would just bounce back up and be intact.”