Comment 81758

By John Neary (registered) | Posted October 16, 2012 at 15:16:53

Not wearing a helmet while cycling was associated with an increased risk of dying as a result of sustaining a head injury (adjusted odds ratio [OR] 3.1)

Cyclists less than 18 years of age are required by law to wear a helmet in Ontario. That 88% of decedents in our study were older than 18 years (and 18% were > 60 yr) suggests a gap in public policy.

Although I agree that the authors are missing the big picture on bicycle safety (and that the OR overestimates the RR), it is nevertheless true that their study provides strong evidence that helmets do prevent death from head injuries. (At least within our current transportation system.)

However, I completely disagree with their argument re: public policy.

If we assume that the average person in Ontario drives an automobile for one hour per day, then here's my reinterpretation of their data:

Operating a motor vehicle was associated with an increased risk of cyclists dying as a result of sustaining a head injury (odds ratio 100)

Persons less than 16 years of age are required by law not to operate a motor vehicle in Ontario. That 77% of decedents in our study were killed in collisions with motorists over 16 years of age suggests a gap in public policy.

Now, no one is going to argue based on the results of this study that motor vehicle use should be banned, even though three quarters of cycling deaths occur because of collisions with motor vehicles. So why should helmet use be mandatory?

(Disclaimer: I wear a helmet every time I cycle, and I encourage others to do the same. But I think that helmet laws can do more harm than good by sending a message that cycling is dangerous and by making it impossible to set up bike-share programs.)

[Edited for typos]

Comment edited by John Neary on 2012-10-16 15:17:28

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