Should the wearing of helmets by cyclists be made compulsory?

It's a question that one assumes would be simple to answer - but the issues surrounding the UK's stance on cycle helmets are many and varied The British Medical Association, in its most recent policy book (2015/16), promotes cycling as a safe, healthy and sustainable alternative to car use, acknowledges the contribution that cycling could make to addressing the problem of obesity and supports the compulsory wearing of cycle helmets when cycling for both adults and children. But could enforced helmet laws deter people from cycling, thus resulting in the loss of cycling's health benefits? And how much protection do cycle helmets actually give? In March 2015, CTC, the National Cycling Charity, published an overview of the evidence (www.ctc.org.uk) and concluded that those who cycle regularly in mid-adulthood have a level of fitness equivalent to being ten years younger and have a life expectancy two years above average. By contrast, the risks of cycling are not perceived as exceptionally high relative to the health benefits. Cycling is no more dangerous than walking. The government has endorsed estimates that the health benefits outweigh the risks of cycling on Britain's roads by a factor of 20:1. If this is correct, making the wearing of helmets compulsory would result in a net increase in early deaths due to physical inactivity etc - if there was more than one person deterred from cycling, for every twenty who continue. This seems to assume that helmets are 100 per cent effective at preventing all cycling injuries, which they are not. This is because not all serious cycling injuries are head-only injuries and helmets provide limited protection because they are only designed to withstand minor knocks and falls, not collisions with cars or lorries. According to CTC, the experience of enforced helmet laws is that cycling use typically falls by at least 30 per cent, and this percentage is higher among teenagers. There is also evidence that some cyclists ride less cautiously when wearing helmets; that drivers leave less space when overtaking helmeted cyclists than those without; and that cycling gets safer the more cyclists there are. The CTC therefore advocates that the emphasis should not be on enforced helmet laws, but instead on promoting measures such as 20 mph speed limits (www.20splentyforsheffield.org.uk); better designed roads and junctions; and training for both cyclists and drivers. A new 20 mph zone is currently being planned for SW Sheffield. In summary, the CTC argues that the resulting loss of health benefits (let alone cycling's environmental, economic and social benefits) from enforced helmet law would be very much greater than any possible injury prevention benefit. However the safety of cycle helmets is a controversial subject. The foreword to BSI Standard 6863:1987 reads: 'It (the standard) specifies requirements for helmets intended for use by pedal cyclists on roads, particularly by young riders in the 5 years to 14 years age group, but which may also be suitable for off the road½.The level of protection offered½.is intended to give protection in the kind of accident in which the rider falls onto the road without other vehicles being involved.' Cycle helmets could be designed like motorcycle helmets to offer greater levels of protection, but such helmets would be uncomfortably heavy and hot, so few cyclists would want to wear one. Cycling is an athletic activity. Its helmets must therefore be light and well ventilated, even though this restricts the protection they can offer. Those most likely to benefit from wearing helmets might therefore be children, because of their lower riding speeds, lower falling heights and lack of riding skills generally - and adults involved in low speed incidents with no third party involvement, such as due to icy roads or off-road cycling. Importantly, cycle helmets currently sold in the UK generally offer a lower level of protection than previously, due to the adoption of the weaker European EN1078 Standard. Helmets are only required to withstand the sort of impact a cyclist is likely to suffer if falling from a stationary position onto a flat surface, estimated to be a speed of about 12 mph. Market forces dictate that few safety helmets are manufactured to exceed the lowest permitted standard. There is an independent helmet certification by the Snell Memorial Foundation (www.smf.org) which is a more demanding standard, but the availability of Snell approved helmets in the UK is not widespread. Other factors relevant to helmet safety include a correct fit and positioning on the head and whether there has been damage or wear and tear. In terms of cycling head injuries sustained, there are two main types: direct and rotational. Direct injuries are caused by linear acceleration of the skull on impact, commonly resulting in skull fractures, cuts and concussion. Rotational injuries generally describe the movement of the brain back and forth within the skull as a result of acceleration or deceleration, which can cause diffuse axonal injury and subdural haemorrhage. These tend to be the more serious injuries which can cause death or chronic intellectual disablement. In summary, a well-fitted helmet in good condition is likely to afford some protection against direct injuries in low speed impacts (12 mph or less); but there is no evidence to suggest that it will protect against rotational injuries. The Highway Code contains guidance that 'you should wear a cycle helmet which conforms to current regulations, is the correct size and securely fastened', but there is no compulsion for cyclists (apart from in Jersey). By contrast helmets are compulsory for motorcyclists. However, when it comes to a cyclist claiming compensation for injuries suffered in an accident, the Court's starting point will be to accept that a cyclist who fails to wear a helmet runs the risk of contributing to his/her own injuries, which could potentially result in a percentage deduction in the compensation award, perhaps by about 10-15 per cent. It makes no difference that there is no legal compulsion for cyclists to wear helmets, because there can be no doubt, according to the Court, that the failure to wear a helmet might expose the cyclist to the risk of greater injury; such a failure, like the failure of a car-user to wear a seatbelt, would not be sensible; so, subject to causation, any injury sustained might be deemed to be the cyclist's own fault. If a Defendant raises an issue of contributory negligence against the cyclist, the burden is on the Defendant to prove that the failure to wear a helmet was a contributory cause of the injury. This would involve a detailed analysis of the 'causation' of both the mechanism of the crash and the nature of the injury. Three reported cases in the UK civil courts involving the cycle helmet issue are pertinent. In the leading case, reported in 2009, the Judge found that the cyclist hit the ground at a speed greater than 12 mph, so the wearing of a helmet would have made no difference to the injuries sustained. Further, he found that an approved cycle helmet would not have prevented or made less severe the head injury caused by the rapid rotation of the skull as the cyclist was propelled through the air, causing blood vessels to rupture and resulting in a traumatic subarachnoid haematoma requiring surgical evacuation. In the two subsequent cases, similar conclusions were reached in one of them. However, a finding of contributory negligence was made in the other, being an unusual claim against an employer in the context of a cycle race on a track at a team building event. The speed (unspecified in the case report) was found to be within the range where the use of cycle helmets is effective. So, in a compensation claim, a cyclist who fails to wear a helmet runs the risk of a Court finding of contributory negligence, if on the facts of the case a helmet would have made a significant difference to the actual injuries suffered. It is clear that there are many viewpoints and factors which affect whether cycling helmets should be made compulsory. The greatest of these are whether helmets are effective enough in road traffic accidents and whether compulsory use would deter too many people from cycling, thereby reducing the overall health benefits. With regard to the current state of play, it seems unlikely that there will be any change in the law in the near future, so it is down to the individual to familiarise him/herself with all of these factors; to make an informed decision on which helmet to use; and crucially - to choose whether to wear a helmet or not. John Vallance For further information please contact John on 0114 266 6660 or at [email protected]