Canadian study say compulsory cycle helmet laws have had "minimal" effect on number of cycling head injury hospital admissions

A study published in the British Medical Journal (BMJ) says that the introduction of compulsory helmet laws in parts of Canada only appears to have had a “minimal” effect on reducing hospital admissions for cyclists suffering from head injuries.

The authors, led by Jessica Dennis, a PhD candidate at the University of Toronto, say that the rate of admissions to hospitals among cyclists was already falling before compulsory helmet laws were introduced in certain provinces, and that “the rate of decline was not appreciably altered on introduction of legislation.”

They added: “While helmets reduce the risk of head injuries and we encourage their use, in the Canadian context of existing safety campaigns, improvements to the cycling infrastructure, and the passive uptake of helmets, the incremental contribution of provincial helmet legislation to reduce hospital admissions for head injuries seems to have been minimal.”

In all, hospital admissions data for 66,716 cycling related injuries in Canada between 1994 and 2008 were studied. Between 1994 and 2003, the rate of head injuries among young people fell by 54.0 per cent in provinces that have helmet legislation, compared to 33.1 per cent in those without such laws.

Among adults, in provinces where helmets are required by law, the rate fell by 26.0 per cent, but stayed constant in provinces that have no compulsory helmet legislation.

However, the authors say, “After taking baseline trends into consideration… we were unable to detect an independent effect of legislation on the rate of hospital admissions for cycling related head injuries.”

The BMJ article is the latest academic contribution to a debate that continues to burn fiercely, particularly in countries that have such laws, including Australia, where all cyclists including adults must wear a helmet, and Canada, where legislation varies from province to province.

Between 1995 and 1997, the provinces of British Columbia, New Brunswick, Nova Scotia and Ontario each introduced laws requiring either all cyclists, or those under the age of 18, to wear a helmet while cycling.

In 2002, Alberta made helmets compulsory for riders aged under 18, while the following year, Prince Edward Island made them compulsory for cyclists of all ages. This month, Manitoba became the latest province to introduce a compulsory helmet law, in this case fro under-18s.

Currently, there are no compulsory helmet laws for cyclists of any age in the United Kingdom, nor are there any plans to implement such legislation.

Quoted in the Guardian, road safety minister Stephen Hammond said:"We encourage cyclists – especially children – to wear helmets to protect them if they have a crash. However, we believe this should remain a matter of individual choice rather than imposing additional regulations which would be difficult to enforce.

"To improve cycle safety we want to see more innovative measures being put in place to help prevent collisions. For example, we have made it easier for local authorities to introduce 20mph zones in built-up areas and authorised a trial of trixi mirrors in London which, if successful, could be used elsewhere in the country to make cyclists more visible to drivers."

Opponents of helmet compulsion, such as national cyclists’ organisation CTC, argue that any benefit that might be achieved by reducing head injuries –itself a matter of debate, as the latest study shows – is greatly outweighed by the negative impact that compulsory helmet laws bring about by deterring people from cycling in the first place.

A study carried out by a PhD student at the University of Alberta after helmets were made compulsory for cyclist aged under 18 in that province in 2002 found that participation in cycling among that age group had dropped by around half from 1999 to 2006, but the rate of head injuries had increased by 11 per cent. Levels of cycling participation among adults, not subject to the law, rose during the same period.