The research that I have seen, and the studies quoted, are not clear. There are too many variables to be considered from proper usage of the helmet to the riding style of the wearer.

Going back to the car industry, when ABS brakes first came out studies showed that there was no difference in the accident rates. However, the industry agreed that ABS brakes are safer. The same thing occurred when drum brakes switched to disc brakes.

To prove this point, the car industry crashes cars. A lot of them. Over and over again. We know exactly what happens when a Toyota Camry is rear ended at 25 mph. The same thing should be occurring for helmets of all types (motorcycle, skateboard, bicycle). Then, and only then, will a clear piece of data be provided.

The social response is important because cycling is so beneficial for health – the benefits are far greater than all the accidents. Inconvenient and uncomfortable items tend to discourage people from doing things. It’s not good to tell scary stories that discourage people from getting on their bikes.

1) The question is, “Do helmets work?” not do they deter people from riding. By bringing up the second issue they are clouding the discussion. We should focus on the question, and once we have an answer to the efficacy of helmet usage, then we can discuss the social aspects.

2) If the current tests for the helmets are misleading (inelastic versus elastic skulls, does not simulate real world situations) then let’s create a new test. Maybe the testing should be like car crash testing with dummies having built in accelerometers. But don’t just discredit the tests and cal it a day, but create a test that will prove your point and maybe will even help design a helmet that does work.

In a related note I work in the construction industry and every day I hear arguments against hardhats, safety harnesses, and the like. How the worker would be safer without that gear. It may be an inconvenience at times, but it does save lives. And that is what the underlying argument seems to be for people who don’t want to wear a bicycle helmet, the fact that they perceive it to be an inconvenience.

Stories not based on reality just aren’t very useful. Yours may frighten a few people into not cycling, which is a shame. In a free country you’ve every right to believe and tell any stories you like, but actually moving a rational debate forwards does require careful attention to the evidence.

You can be a cautious biker all you wish, keeping a close eye on the road and cars, but that will NOT protect you from what you are not expecting. If you have the right of way through an intersection, or are passing an alleyway, you do not expect anyone or anything to be emerging perpendicular to you. In the case that this does happen, there is little chance that you will remain seated on your bike, if you are not wearing a helmet, it’s your very own head that will be meeting that pavement, hard on.

For those who do not partake in this form of city biking, and tend to stick to either calmer, less dense areas, or designated pathways, other unexpected situations can easily arise. You may not notice an imperfection on the surface, the rider ahead of you may stop abruptly, or your judgement of a given situation may be off. It is for these reasons, the unpredictable occurrences that helmet usage is heavily advocated. As I said, you do not expect to have an accident.

Discouraging helmet usage is just plain foolish. Helmets save lives everyday, they are the seatbelts of bike riding, contrary to the opinion in a post above. True, you cannot make a direct comparison, but one does not wear a helmet while riding in a vehicle, the situation is simply not the same. Seatbelts are highly uncomfortable for many people to wear, yet riding in a vehicle is accompanied by several dangers, which seatbelts offer a safeguard against. In many US states, seatbelts are mandatory, I doubt that many people would advocate against the use of seatbelts while riding in a vehicle, due to the fact that it makes certain riders uncomfortable, and they no longer wish to ride in a car.

While it is true that mandatory helmet laws may reduce the number of cyclists, due to certain potential riders having comfort or other issues with them, this is not a valid argument against helmet usage. If you are partaking in the form of cycling quoted as being “not too far, not too fast”, I believe most riders would find common ground in saying that helmets are not necessary. Fact is, that most riders do not practice, nor enjoy this form of cycling, but more extreme, higher risk riding, where wearing a helmet is often a matter of life or death.
The road vehicle equivalent of this ‘danish biking’ would be to encourage everyone to drive at very low speeds, thus not requiring the usage of safety devices, such as seatbelts and airbags.

There is no denying that riding in a vehicle is dangerous, and you just accept the fact that you must buckle-up when partaking in that activity. That being said, it is not uncommon for people to choose to not wear seatbelt. Unfortunately for these people, their chances of injury if involved in road collision gravely increase. You can be the most cautious driver on the roads, yet find yourself in a crash, due to the negligence of others. It is the same with bike riding, no matter how skilled or cautious you are, it does not do anything to protect you for the errors of others, or that which you cannot influence, or miscalculate.

I would now like to share with you two real-life examples pertaining to helmet usage;

A good friend of mine never wore a helmet while biking. His reason, was that when he was involved in a previous bike accident, his helmet did nothing to protect him. In response to this, I asked him which part of his body was involved in the crash, needless to say, that it was not his head. It is of course obvious that if the accident you are in does involve your cranial area, the helmet will not do much for you. However, if you do end up in a crash where your head is involved, wearing a helmet could be your saving grace.

But hours ago, I was out cycling with a friend of mine, we had chosen to stick to recreational bike paths, where of course other like-minded exercisers are the common sight, and your exposure to road hazards is greatly reduced to a minimum. One would think that this may be the perfect environment to ride helmet-free, due to a lower exposure to hazardous situations. You may no longer have to worry about as many out-of-your-control factors, which was remains one of my main arguments towards wearing a helmet, but there is still very much potential risk of collision. Not only could you find yourself staring the back or front of another cyclist in your face, but you may also make contact with the inanimate surface around you.

Picture this, you are cycling down the path at a moderate speed, trailing your cycling partner ahead of you. You are riding smoothly along, worry-free, perhaps sparing a few seconds to daydreaming every now and then, perhaps dodging those biking at a slower pace than you, or imperfections in the surface, branches etc. You are approaching a fork in the road, your partner decides to hang right, without much need to slow down. You approach the curve repeating the actions of your partener. Next thing you know, your front tire is scrapping the edge of the raised surface to your left, you are ejected from the comfort of your seat, scrapping across this surface, as your head thumbs downwards HARD, your body continuing it’s path forward.

Ahead you see your friend slowing down and rushing back to find out what happened. You lay there motionless for a while, as your get over the shock of what has just occurred, and attempt to examine the damage to your body. Passers by rush over, and lean down to offer their assistance, making sure that you are alright as they witnessed your treacherous fall. Luckily you have not suffered many injuries, and are conscious. After a few moments, you gather the energy and strength to sit up and better inspect your person. Those around you question your state, and offer kind advice as to what to do next.

You do your best to recall what has just happened, and remember smashing your head against the pavement as you made contact with the ground. You quickly unstrap your helmet and notice two large cracks in the styrafoam structure towards the rear of the helmet. You realize that the portion of helmet between these two cracks is where the impact occurred, and was absorbed by the foam barrier. Had you not been wearing a helmet, it would have been your very own skull making contact with the rock hard concrete and suffering the cracks en lieu of your helmet!

You then try and think back to discover what went wrong, and arrive at the conclusion that your took the curve way too fast, and should have been better prepared. Your cycling partner then admits to the fact that they were going to tell you to both slow down, and lean hard as they have already passed by the exact same spot previously. Since you were following your partners lead, and they were so swift in their maneuvering, you did not expect anything to go wrong as such. Of course they failed to reveal the secret of the curve, which was essential to making it through at the speed you both were going unscathed.

It was not entirely your fault that you crashed, not was it fully in your control, you believed you had everything under control, and were re-assured by your partner’s swift taking of the turn. It was what you didnt know and didnt expect that created the recipe for disaster. No matter how much you do to protect yourself against the dangers of cycling, you cannot prevent the unexpected from occuring. Had you not been wearing that helmet you would not have faired so well.

This is exactly what happened to me but hours ago, I was doing everything in my power to cycle safely, but did not realize just how dangerous the turn ahead was, and being reassured by my friend’s inherent mastery of the curve seconds before, I had nothing to worry about. What I did not know was that he had been down this way before, slower that first time, and was ready to lean in hard this time around, holding previous knowledge of the turn. Fact is, accidents occur unexpectedly, and are not within your control, that is why helmets are there, to save your life, in case something does happen.

Fact is, helmets work. You just have to find yourself in the wrong situation for them to be of use. Biking down a residential street at the pace of a tortoise, won’t expose you to that many risks. But baumbing around a corner way too fast, under false presences will. It is for those situations that we advocate the sporting of protective headgear.

It’s not rocket science to understand that anything that can distribute energy away from the target (e.g. the head) is a good thing.

If people don’t want to wear helmets in ignorance of local laws is fine with me. I can only hope I don’t come up on them lying on the side of the road with their brains spilling into the gutter. Frankly, I’ll call 911 and keep riding…with my helmet on.

To pick up a couple of points, there are several claims around that helmets have saved lives after a car or van has gone over someone’s head. After seeing what actually happens when a small car is lowered slowly onto a helmet, those claims lack credibility. They are an extreme example of the common anecdotes, which are less easy to disprove without going into the figures.

Yes, I’m a doctor, it’s of limited relevance, and I certainly wouldn’t use it as authority for any argument. A qualification in epidemiology would give more credibility than a plain medical one, but I generally prefer to let the science speak for itself.

If you want to wear a helmet, carry on with my blessing! People do much sillier things without upsetting me. The problems with pushbike helmets are the scaremongering and the compulsion. Those discourage cycling, which impacts on the health of my patients, and they are very annoying to people who find helmets uncomfortable and inconvenient.