Tuesday, July 7, 2009

Kids and Bicycle Helmets

In the summer of 1985 I was riding my new Peugeot racing bike along a twisting, hilly road on my way home from my part time job when suddenly the lights went out. I woke up in a hospital with a severe concussion and not sure of who I was. My face was scratched, bloody and bruised. I was 16 at the time. I was very lucky. I had not worn a bicycle helmet.

Illinois law does not require children to where bicycle helmets. Many other states do. A new study, reported on in the New York Times, found that states like Illinois should require helmets. According to the study, "Children who live in states with laws requiring bicycle helmet use are much more likely to wear them than those who do not." When kids wear bike helmets the chance of injury is very significantly reduced. According to Children's Hospital of Illinois, "Wearing a proper fitting helmet can reduce the chances of serious head injuries by 85%." It's hard to argue with statistics like that.

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  1. The trouble with bike helmets is that the figures don't show that they work - helmet laws have stopped a lot of people cycling and have done nothing for head injury rates, see Robinson DL. No clear evidence from countries that have enforced the wearing of helmets. BMJ 2006;332: 722-5. I presume that you are referring ultimately to a certain discredited case-control study. It appears that helmets break easily, but don't absorb the impact, see the engineers quoted at A broken helmet has simply failed, and the widespread anecdotes on the theme of "a helmet saved my life" seem to owe more to wishful thinking than to science. As for "a car ran over my head", see the pro-helmet site; if a car goes over your head, I'm sorry to say you won't be sitting up and praising your helmet. The only known connection is that helmets have strangled a few young children who were wearing helmets while playing off their bicycles.

    I no longer wear a helmet and haven't pressed them on my children. I do check that their brakes work and that they have a good idea of the rules of the road.

    At my moderately advanced age it's far too dangerous not to cycle - regular cycling, Danish style, not too far, not too fast, nearly halves the death rate, see All-Cause Mortality Associated With Physical Activity During Leisure Time, Work, Sports, and Cycling to Work. Andersen et al, Arch Intern Med. 2000;160:1621-1628. Bicycling is good for health, but helmets don't seem to be.

  2. Thank you for your interesting comment Dr. Keatinge. I agree that the best defense against suffering serious injury while biking is to have a properly functioning bicycle and to ride within your limits. However, I have been saved far too many times by a bicycle helmet to adopt your point of view. In one particular incident I was riding my mountain bike across a snowy field when I came upon a stone wall hidden by wind blown snow. My front tire forcefully struck the wall sending me flying forward. The upper part of my forehead hit the top edge of the wall. My helmet, thankfully, took the blow and did not fracture. Did my helmet save my life? That is unknowable. However, I undoubtedly was protected from injury.

    Children should be taught safe riding techniques. A parent should not simply strap a helmet on a child's head and assume he or she is protected against any and all injury. However, the statistics cited by the University of Michigan, as well as reason, command wearing a helmet as a part of a safe approach to bicycling.


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