Helmets – Expectation and Inconsistency

One of the most baffling aspects of the fixation on bicycle helmets as a way of attempting to protect cyclists from harm is the extraordinary inconsistency with which helmets are advocated. Setting aside the vexed issue of how effective helmets actually are in preventing the injuries cyclists most commonly suffer in collisions with motor vehicles, it is deeply odd how the logic used to urge helmets onto cyclists is never applied to other road users, particularly pedestrians and car drivers.

Perhaps the greatest absurdity is that a compulsory helmet law would force those of us cycling to the shops at less than 15 mph to wear a polystyrene hat, while people in convertible sports cars remain free to drive at over 70 mph with absolutely no protection to their bodies whatsoever should their cars roll over in a collision, beyond a seat belt which may or may not hold them in the car. Yet as far as I am aware, Headway, BHIT and other bodies which advocate a compulsory bicycle helmet law have absolutely nothing to say about crash helmets for the users of convertible cars.

Shockingly dangerous behaviour.

Of course, the ‘fragile skulls’ of people in cars (for this is the phrase of choice for groups like Headway and BHIT) are not just at risk in convertibles. It is commonly established that head injuries are the most common type of severe or fatal injury sustained by car occupants in crashes. Of vehicle occupants taken to hospital in Australia, the head was usually the most severely injured body region. [pdf]

This same paper notes that, for car occupants,

a bicycle style soft shell helmet could provide a large degree of protection for the head very cheaply. A simpler form of headwear, in the form of a headband covering mainly the forehead, where most impacts to the heads of car occupants occur, could offer almost as much benefit without as much bulk and even less weight. Protective headwear also has the very considerable advantage that it could be available within a matter of months for use by those who wish to reduce their risk of sustaining brain damage if involved in a road crash.

However, the logic that polystyrene helmets could offer protection to car occupants in precisely the same fashion that they could to bicycle users is routinely discarded. A search for ‘helmets’ on the Headway site only produces 68 results almost entirely related to bicycle helmets – nothing about the potential benefits of protecting the ‘fragile skulls’ of car occupants.

Drivers, we are told, have seatbelts, and a protective shell around them, and there is no need for them to protect their ‘fragile skulls’ in the same way that a bicycle user might with a polystyrene shell. This despite the evidence that the most common severe or fatal injury to car occupants is to the head.

Counts, and proportions, of serious injuries to body regions, Australia 2003-4. From this paper [pdf]

Similarly, a UK study of data from 33 hospitals between 1996 and 2003 found that around 25% of car occupants who had suffered a head injury did not survive [pdf].

Plainly the heads of car occupants are susceptible to serious damage. Yet lobbying for car occupants to wear helmets is non-existent, even if, to use the emotive language of bicycle helmet advocacy, ‘they might just save one life’. Or that ‘wearing a helmet is surely better than not wearing one’.

I wrote earlier this year about a tragic local case in which a young car driver, Toby Woolford, died from his head injuries after he crashed into a lorry on the A27 near Arundel.

Although Toby died of severe head injuries – thankfully very quickly – the inquest did not discuss how Toby’s life might have been saved by something he could have been wearing, but was not, at the time of the collision. This is quite proper, of course; it would be unseemly to suggest or imply that Toby was somehow responsible for his own death by failing to use protective equipment while inside his car – a crash helmet, for instance. Such a helmet, similar to those worn by motorcyclists or racing drivers, could possibly have saved Toby’s life. On the other hand, it might not have. We simply don’t know. And it would be wrong to speculate about it. Especially because no driver, or any occupant of a car, would ever see fit to wear crash helmets while using their car for ordinary, day to day activities. It would be quite improper to talk about how Toby wasn’t wearing a crash helmet, even if there was a remote possibility it could have saved his life, because drivers are not expected to wear them.

This, I think, is the essence of the matter – the expectation that bicycle users should wear helmets, and that car drivers shouldn’t have to. Because bicycle helmets are now increasingly seen as a ‘normal’ piece of equipment, it becomes ‘irresponsible’ not to wear one. Conversely, because nobody drives a car with polystyrene strapped to their head, you might look like a bit of a lunatic if you chose to do so – even though, by doing so, you might actually be acting just as ‘responsibly’ as a cyclist wearing the same item. Attitudes to bicycle helmets, in other words, seem increasingly to be framed by custom, and expected behaviour, than about actually preventing harm.

Just like car occupants, pedestrians aren’t expected to wear helmets. That is why, in the case of this unfortunate man airlifted to hospital with life-threatening head injuries after being struck by a car in Brighton just a few days ago, there is no mention of the man’s lack of helmet. Nor should there be; he was walking along, and he was struck by a car. We don’t expect people walking about to be wearing helmets, and so we don’t mention the absence of one when they are struck by motor vehicles.

The glaring inconsistency of this attitude leapt out at me from a report into the recent inquest of the death of a teenager, Joshua Dale, in Nottingham in January this year. He was using a pedestrian crossing when he was struck by a car; traffic was stationary in the right-hand filter lane, held at a red light. However, traffic progressing straight on still had a green light, and Joshua was hit by a car he had failed to anticipate coming (the driver might also have been expected to anticipate people attempting to cross). The Coroner had this to say –

Recording a verdict of accidental death, Notts Coroner Mairin Casey said: “It’s imperative if we are to learn anything that children must be educated further and become more aware of the safety aspects of wearing helmets.”

This is utterly bizarre, because Joshua was using the crossing in precisely the same way as a pedestrian might have been, and he was struck by a car in precisely the same way he would have been if he had been walking across. No mention of a helmet would have been made if he had been hit while using the crossing on foot. But because he was on a bike, the absence of a helmet suddenly becomes relevant, despite making no tangible difference to the outcome. Again, it is the expectation that people using bicycles should wear helmets that is colouring attitudes, even when those bicycles are being used to convey people in a manner very similar way to walking.

The final recent example of expectation producing absurd statements about helmets comes from Tamworth, where a man on a bicycle was struck by an HGV coming off a sliproad from the M42 motorway. He suffered serious leg injuries. A spokesman for West Midlands Ambulance Service said

Fortunately the cyclist was wearing a helmet which undoubtedly helped to minimise his injuries.

I doubt this ambulance service spokesman would, on reflection, genuinely believe that a polystyrene hat ‘undoubtedly’ minimised the injuries of a man plainly run over by an HGV. This statement is not really a rational assessment of the abilities of bicycle helmets to protect their users. It’s a product of the belief that people on bicycles should wear helmets, regardless of the actual extent of protection a helmet would offer in the particular circumstances. A belief that disregards the fact that bicycle helmets could be equally ‘useful’ to people on foot when they might be hit by a car or a lorry, or to the occupants of motor vehicles.

What’s in action here is the subtle reinforcement of expectation.