Drop the Helmet?

bicycle-helmetI need to speak out against a recent recommendation by the Olympic gold-medalist Chris Boardman to discontinue the use of bicycle helmets. During a spot on the BBC morning show he did not wear a helmet while giving cycling safety tips. Not surprisingly, this generated criticism. Boardman later defended himself by saying that “helmets ‘discourage people from riding a bike’ and shift the attention away from what’s most likely to kill a rider—a car”. Boardman rationalized that having more cyclists without helmets on the road would demand that more attention be paid to them.

This struck a strong chord with me because I have seen much good that helmets do for cyclists. I am a board-certified orthopedic surgeon with sub-specialization in traumatology. Unfortunately, as part of my job I see many cyclists with head injuries from crashes with automobiles or from simply falling off their bikes at low speeds.  My experience is consistent with studies showing that helmet use in those with serious injuries is very low.

I am not acquainted with Mr. Boardman and only know of him from his media presence.  There is no question that he is very accomplished professional cyclist, has done much to promote the sport and encourage public health through cycling.  Despite my disagreeing with his overall thesis, Boardman is correct on at least one count. Cars do pose a substantial threat to bicyclists. According to helmets.org, 87 and 92 percent of cycling fatalities in Madison, WI and New York City respectively, are caused by crashes involving an automobile.

However, Mr. Boardman’s assertion that helmets “discourage people from riding a bike” is constructed with faulty logic.  Helmet use will no more discourage riding a bicycle than wearing a seatbelt will inhibit automobile use.  There are no good studies suggesting that helmet wear deters bicycle use.  Use of seatbelts and helmets are simply commonsense, statistically proven ways to most safely transport yourself.

Abandoning helmet use when bicycling in the U.S. is ill-advised and dangerous.   The answer is not to ramrod awareness and respect into the public through an increased presence of unhelmeted cyclists.  We are dealing with a cultural problem. The fact of the matter is that American (and from the sounds of it British) automobile drivers believe they rule the road. Many in the U.S. drive with the unspoken belief that pedestrians, bicyclists and even motorcyclists are second-class citizens who use the roads at their peril. This attitude is evidenced by the numerous “Share the Road” bumper stickers and public service messages that are put out by bicycling and motorcycling organizations.  This culture is clearly quite different in countries such as the Netherlands where the number of bike related “deaths relative to the total distance cycled is incredibly low.”  Mr. Boardman admits this himself.

How do we correct a cultural problem of lack of recognition and respect of cyclists in the U.S.?  This may most effectively be realized through legislation. Before you scoff at this statement, I know all too well that you cannot legislate cultural change.  What I am suggesting is that legislation be passed to encourage this cultural change.  The legislation should require increased education and increased numbers of cycling lanes.  Education needs to come at the time of driver education and permit testing to make sure that nascent drivers have a good understanding not only that they need to share the road but also how to most effectively do this. It may be even better for younger children to have an educational unit concentrating on transportation safety during the health classes they take.  Biking lanes have been shown to decrease bike-automobile crashes and increasing their numbers should continue this trend.

Boardman’s assertion that by flooding the roads with non-helmeted cyclists will lead to greater awareness and respect for cyclists is folly. The only thing this will do is create more severely injured and dead cyclists. The prudent way to achieve what Mr. Boardman seeks is through mandated education and more widespread use of protected bike lanes.