JFJones
2004-11-24 17:37:42 UTC
Article today in the national Post at:
http://andrewcoyne.com/
One of the dutiful journalistic clichés of our times requires
reporters to note, in any story in which a cyclist is injured or
killed, whether or not he was wearing a helmet at the time, lest the
opportunity for a teaching moment be allowed to pass unrealized.
Because -- all together now -- helmets save lives.
To most people, this is obvious. The helmet is made of something hard,
harder than a skull. It stands to reason, right? Common sense, really.
And, after all, "studies show" that helmets prevent "up to" 85% of all
head injuries.
"Studies show" is another great journalistic cliché that, once
deployed, absolves the user of any obligation to offer anything
further in the way of serious argument. But before we can proceed from
the common-sense observation, that a helmeted head is less likely to
sustain damage from a blow than an unhelmeted one, to the conclusion
that every cyclist, adult or child, should be required by law to wear
a helmet at all times -- as in a private member's bill now before the
Ontario legislature -- we should first be prepared to answer a number
of inconvenient questions.
Such as: Does a cyclist who wears a helmet behave differently than a
cyclist who does not? Do those studies purporting to show that
helmet-wearers suffer fewer head injuries allow for the possibility
that those cautious enough to wear a helmet would be less likely to
get into an accident in the first place? Conversely, might the
imposition of helmets on cyclists who would not ordinarily choose to
wear them induce them to take more chances while riding, in the belief
they were now invulnerable? These are difficult questions to answer;
that does not avoid the need to take them into account.
What is easier to determine is: How great is the risk of death or
injury on a bicycle? It would certainly save lives if every pedestrian
wore a helmet, but most people would consider that a foolish
precaution for such a slight risk. In a previous column I noted that
the number of deaths from cycling is extremely small, relative to the
number of cyclists on the road: fewer than 80 per year, nationwide,
out of an estimated 10 million active cyclists. Some portion of these,
about two-thirds, are conventionally attributed to injuries to the
head, and some much smaller proportion of these might have been
prevented had the victim been wearing a helmet: the 85% figure,
remember, refers to all head injuries, including minor scrapes, not
the kind of massive traumas, usually with the help of a car or truck,
that lead to death. So we are talking about perhaps 20 preventable
deaths every year: one for every 500,000 cyclists.
Yes, yes, yes, say the critics: but what about the far greater number
of non-fatal head injuries? Very well. Let's look at the figures. For
2001-02, the Canadian Institute for Health Information's National
Trauma Registry records a total of 933 cases of cyclists with head
injuries severe enough to require hospitalization. Assuming no more
than one head injury per cyclist, that works out to fewer than one
cyclist in 10,000. To put it another way, you are likely to be
hospitalized with a head injury, on average, once in every 10,000
years of cycling. Again, that is without knowing how many of these
injuries would have been prevented had the victim been wearing a
helmet, or how many of them in fact were.
Fine, so the risk of even serious head injury is infinitesimal. But
isn't even one injury too many? And isn't it worth any amount of
expense to prevent such injuries? In a word, no, for the same reason
we do not drive around in cars made of titanium. That's especially
true when it comes to requiring helmet use by law, where the costs are
measured not only by the price of a helmet, but in the policing time
required to enforce it. By cost, moreover, I do not mean only the
monetary cost, but the alternative uses to which those scarce funds
might have been put. Consider, for example, how many lives might be
saved, and injuries avoided, at a fraction of the cost, by the simple
expedient of a line of paint, creating separate lanes for bicycles and
cars.
But that doesn't begin to count the real cost of helmet laws. The
experience of Western Australia, where helmets have been the law for
13 years, is instructive. While a greater number of cyclists wore
helmets, by far the most dramatic result was a catastrophic decline in
ridership: in excess of 30%. The cost and inconvenience meant fewer
people rode their bikes, and those that did took fewer, shorter trips.
What are the social costs of deterring cycling on this scale? Higher
rates of obesity, for starters, with the associated health effects. In
addition, some number of those trips that would previously have been
taken by bike are instead taken by car. That means more congestion,
more pollution, and more accidents -- some of these involving
collisions with cyclists. It is entirely possible that the law has
cost more lives than it has saved. The Perth-based journalist Chris
Gillham calls it "one of Australia's worst-ever public health
disasters."
But what about those studies? The ones showing helmets prevent 85% of
all head injuries? There aren't studies. There's one study: the figure
quoted is invariably from the same source. It's 15 years old, its
methodology is under attack, and it is hardly sufficient grounds for
turning millions of cyclists into outlaws for engaging in a perfectly
safe activity.
http://andrewcoyne.com/
One of the dutiful journalistic clichés of our times requires
reporters to note, in any story in which a cyclist is injured or
killed, whether or not he was wearing a helmet at the time, lest the
opportunity for a teaching moment be allowed to pass unrealized.
Because -- all together now -- helmets save lives.
To most people, this is obvious. The helmet is made of something hard,
harder than a skull. It stands to reason, right? Common sense, really.
And, after all, "studies show" that helmets prevent "up to" 85% of all
head injuries.
"Studies show" is another great journalistic cliché that, once
deployed, absolves the user of any obligation to offer anything
further in the way of serious argument. But before we can proceed from
the common-sense observation, that a helmeted head is less likely to
sustain damage from a blow than an unhelmeted one, to the conclusion
that every cyclist, adult or child, should be required by law to wear
a helmet at all times -- as in a private member's bill now before the
Ontario legislature -- we should first be prepared to answer a number
of inconvenient questions.
Such as: Does a cyclist who wears a helmet behave differently than a
cyclist who does not? Do those studies purporting to show that
helmet-wearers suffer fewer head injuries allow for the possibility
that those cautious enough to wear a helmet would be less likely to
get into an accident in the first place? Conversely, might the
imposition of helmets on cyclists who would not ordinarily choose to
wear them induce them to take more chances while riding, in the belief
they were now invulnerable? These are difficult questions to answer;
that does not avoid the need to take them into account.
What is easier to determine is: How great is the risk of death or
injury on a bicycle? It would certainly save lives if every pedestrian
wore a helmet, but most people would consider that a foolish
precaution for such a slight risk. In a previous column I noted that
the number of deaths from cycling is extremely small, relative to the
number of cyclists on the road: fewer than 80 per year, nationwide,
out of an estimated 10 million active cyclists. Some portion of these,
about two-thirds, are conventionally attributed to injuries to the
head, and some much smaller proportion of these might have been
prevented had the victim been wearing a helmet: the 85% figure,
remember, refers to all head injuries, including minor scrapes, not
the kind of massive traumas, usually with the help of a car or truck,
that lead to death. So we are talking about perhaps 20 preventable
deaths every year: one for every 500,000 cyclists.
Yes, yes, yes, say the critics: but what about the far greater number
of non-fatal head injuries? Very well. Let's look at the figures. For
2001-02, the Canadian Institute for Health Information's National
Trauma Registry records a total of 933 cases of cyclists with head
injuries severe enough to require hospitalization. Assuming no more
than one head injury per cyclist, that works out to fewer than one
cyclist in 10,000. To put it another way, you are likely to be
hospitalized with a head injury, on average, once in every 10,000
years of cycling. Again, that is without knowing how many of these
injuries would have been prevented had the victim been wearing a
helmet, or how many of them in fact were.
Fine, so the risk of even serious head injury is infinitesimal. But
isn't even one injury too many? And isn't it worth any amount of
expense to prevent such injuries? In a word, no, for the same reason
we do not drive around in cars made of titanium. That's especially
true when it comes to requiring helmet use by law, where the costs are
measured not only by the price of a helmet, but in the policing time
required to enforce it. By cost, moreover, I do not mean only the
monetary cost, but the alternative uses to which those scarce funds
might have been put. Consider, for example, how many lives might be
saved, and injuries avoided, at a fraction of the cost, by the simple
expedient of a line of paint, creating separate lanes for bicycles and
cars.
But that doesn't begin to count the real cost of helmet laws. The
experience of Western Australia, where helmets have been the law for
13 years, is instructive. While a greater number of cyclists wore
helmets, by far the most dramatic result was a catastrophic decline in
ridership: in excess of 30%. The cost and inconvenience meant fewer
people rode their bikes, and those that did took fewer, shorter trips.
What are the social costs of deterring cycling on this scale? Higher
rates of obesity, for starters, with the associated health effects. In
addition, some number of those trips that would previously have been
taken by bike are instead taken by car. That means more congestion,
more pollution, and more accidents -- some of these involving
collisions with cyclists. It is entirely possible that the law has
cost more lives than it has saved. The Perth-based journalist Chris
Gillham calls it "one of Australia's worst-ever public health
disasters."
But what about those studies? The ones showing helmets prevent 85% of
all head injuries? There aren't studies. There's one study: the figure
quoted is invariably from the same source. It's 15 years old, its
methodology is under attack, and it is hardly sufficient grounds for
turning millions of cyclists into outlaws for engaging in a perfectly
safe activity.