There is a lot of debate surrounding the use of cycle helmets. Do they really provide vital protection – or do they just give cyclists a false sense of security, that leads to more accidents? The eternal question is – do they really save lives?
In March last year, cyclists in Australia risked police fines by cycling without helmets in a protest ride against the country’s mandatory helmet laws. These laws, however, were introduced after a campaign led by the Royal Australasian College of Surgeons, which indicates that many health professionals believe the use of helmets has positive outcomes for cyclists involved in accidents. Here in the UK, a Government review is taking place this year – also considered forcing all cyclists to wear helmets. Transport minister, Jesse Norman, tweeted that the mandatory wearing of helmets was ‘sure to be raised in the consultation’ which was a wide-ranging look at road safety for cyclists. However, there are strong lobbies both for and against the wearing of helmets.
The arguments against helmets:
Those against making helmets a legal requirement believe it is an ineffective safely measure which discourages people from cycling and creates an image of a high-risk activity. They argue cycling is a healthy, cheap and environmentally friendly form of transport and that many of the risks that cyclists face should be reduced through improvements to infrastructure, signage, education and training.
Another argument against helmets arises from research at the University of Bath that demonstrated cyclists wearing protective helmets did have an effect – but a negative one. The research showed that car drivers passed, on average, 8.5cm closer when overtaking cyclists wearing helmets, than when overtaking those without. This effect is known as ‘risk compensation’ and can increase the likelihood of a collision.
Interestingly, as many cyclists are perceived to be young and male, the same research discovered that motorists gave more space to a cyclist who wore a long flowing wig to look female. Research demonstrates ‘risk compensation’ also affects people participating in a range of sports who tend to take more risks once they are wearing protective clothing, including helmets, as they are lulled into a false sense of security. However, it maybe that it is the nature of the sport being undertaken that increases the risk rather than the act of putting on a helmet.
Studies also suggest those wearing helmets are more susceptible to injury, both due to an increase in head size due to the size of the helmet, and the fact they are less aware of their surroundings due to muffled hearing.
The arguments for helmets:
There is much evidence to support the wearing of helmets and the crucial safety role they play for the wearer. The National Highway Traffic Safety Administration (NHTSA) view helmets as: “the single most effective way to reduce head injuries and fatalities from bicycle crashes.” Both Transport for London and the Highway Code both currently recommend wearing a helmet when cycling too. And although The Royal Society for the Prevention of Accidents (RoSPA) doesn’t call for compulsory cycle helmet laws, it strongly recommends cyclists wear a cycle helmet. Helmets might not prevent crashes or guarantee survival, but they are an important secondary safety feature and can reduce the risk of a serious brain or head injury in an accident. Read more here: https://www.rospa.com/rospaweb/docs/advice-services/road-safety/cyclists/cycle-helmets-factsheet.pdf
Figures compiled by RoSPA show head injuries are very common injuries to cyclists: data from hospitals show 40% of cyclists and 45% of child cyclists suffer head injuries and three quarters of cyclist fatalities have major head injuries. Meanwhile, a Cochrane review suggested helmets reduced the risk of injury to the head and the brain by a substantial 65%-88%; and the upper and mid-face by 65%.
Safety benefits:
The safety benefits seem to be more pronounced for children: tests on children’s bicycle helmets show helmets offer up to 87% reduction in the acceleration experienced by the skull during an impact and can help the skull resist forces up to 470 pounds in a crush accident. According to a US study helmets cut the risks of severe traumatic brain injury by half, when riders suffer a brain injury. The report, in the American Journal of Surgery, also concluded that riders with helmets were 44% less likely to die from their injury, and 31% less likely to break facial bones.
There is no doubt helmets cannot resist substantial impact and cannot save everyone. Nevertheless common sense suggests surrounding your head with some degree of protection must offer some cushioning from head impact – a view which neurological studies definitely support. At First Aid for Life we understand the importance of knowing exactly what to do, should you be involved in a bicycle accident – or be the first to arrive at the scene of one. As such, we offer hands on, practical first aid courses, as well as a tailored, online course specifically for cyclists, a course is designed as an introduction to basic first aid in a cycling environment.
For a more comprehensive course please see First Aid for Cyclists which includes CPR, spinal injuries, when to move them, asthma and breathing problems, heat exhaustion and much more. First Aid for Life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made, or actions taken based on this information. It is strongly advised that you attend a First Aid course to understand what to do in a medical emergency.
About us
First Aid for Life provide award-winning first aid training tailored to your needs – Please visit our site and learn more about our practical and online courses. It is vital to keep your skills current and refreshed. Book onto our First Aid for Drivers course for more information about how to assist in road related medical emergencies.
It is strongly advised that you attend a fully regulated Practical or Online First Aid course to understand what to do in a medical emergency. Please visit https://firstaidforlife.org.uk or call 0208 675 4036 for more information about our courses.
First Aid for Life is a multi-award-winning, fully regulated first aid training provider. Our trainers are highly experienced medical, health and emergency services professionals who will tailor the training to your needs. Courses for groups or individuals at our venue or yours.
First Aid for life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made, or actions taken based on this information.
Never miss out on vital updates – 
The debate over wearing a helmet for cycling is much the same as for horse riding, skiing and I’m sure many other sports too. What is seen all too often on the ski slopes, are people skiing well beyond their abilities, way too fast and possibly because they are wearing a helmet, think they will be safe if they fall / have an accident / etc. Rock climbing most certainly will protect a climber from a rock falling from above, onto their head, but this is different to other activities.
They are likely to be wrapped up in a bubble of a false security. Whether horse riding, cycling, skiing etc, if the person falls, it is very unusual they land head first. If they do land head first, it is more likely they land face first and a helmet will offer little protection in those incidents.
What is necessary is a responsibility of the person partaking in the activity to be competent to the level at which they wish to go / ride / ski / etc and in control and safely AND wear a helmet if they wish. Wearing a helmet does not automatically put a participant at a higher skill level, these must be learnt first. It should be understood that the helmet is a device for slowing down the moving of the brain by a rapid deceleration and therefore shock damage. Being aware of your surroundings is the best protection a participant will have to protect themselves in all situations.
Ian
Dear Ian, Thank you for your excellent comments. I agree completely. Best wishes Emma
As your head is the heaviest part of your body, and because of gravity and the speed at which you fall it is of course going to be the first part to strike the ground.I have seen for myself the damage done to a helmet when a child came off his bike, in this case if there had been no helmet there would be no more child!
You strike me as someone that doesn’t understand Galileo’s experiment on falling objects. While I don’t doubt the anecdote, your “of course” reasoning is fallacious
i am i cyclist and i have an accident. luckily i was wearing
my helmet and i had no injuries. Wearing a helmet is extremely important
We agree! Glad you were ok
I judge the environment.
Most of my cycling is on the canal, the park and quiet residential roads, so I don’t wear the helmet, I also find it restrictive.
There is a short main road, but if its too busy, I go on the pavement.
I cycle for pleasure exercise, so I choose safe places, but have been fortunate to cycle to work via canal.
I have just had an accident on my mountain bike were my head took a severe sharp impact to the left side. The shock for me was when I looked at the damage to the helmet. There is a large fracture radiating through from the outside to the to the inner part of the lining. Had I not been wearing my Helmet I’m convinced I would have suffered major head trauma.
That just goes to show how important wearing cycle helmets are! Very glad that you were wearing a helmet and didn’t get seriously injured.
“Figures compiled by RoSPA show head injuries are very common injuries to cyclists. Data from hospitals show 40% of cyclists and 45% of child cyclists suffer head injuries”.
Are you sure about that? Cycling UK estimates 2.3-2.8 million people over the age of 16 cycle at least once per week. By your statistics that would equate to around 1 million head injuries…
It is referring to those attending hospital. It is data from hospitals
I wonder if there are measures we can take to reduce the number of cyclists presenting at hospitals? Surely this would save on all injuries not just the 65% of 40% prevented by helmets.
If only these measures would see the same amount of campaigning vigor. But easier to push the onus on to cyclists than do anything to inconvenience motor vehicle drivers. See also excellent post from Peter Clinch.
PS I normally wear a helmet, especially where a fall is more likely such as off road or riding in a group
My son went head first over the handlebars onto asphalt. He suffered a serious traumatic brain injury and required six months to recover.
His helmet saved his life.
Thank You for your information.
It’s good that the Goldacre/Spiegelhalter editorial is picked out, and also that it is acknowledged that there is quite some controversy. Having said that…
Quoting hospital admissions is a loaded way to look at it, because you’re looking at people who’ve already had accidents and that’s not representative of the population as a whole. It’s also the case that if you look at hospital admissions then the things you see the most of for head injuries are car crashes followed by trips and falls, and yet nobody is recommending helmets against those. Why not? As the BMJ editorial points out, it’s about culture, not actual risk. My daughter ended up in hospital with concussion and blurred vision after a fall on foot in a playground: nobody criticised her or her parents for not wearing a helmet, had she had exactly the same injury falling off her bike with the same lack of protective headwear we’d have never heard the last of it! The actual bone-breaking, brain-shaking energy in a fall comes from the vertical acceleration from gravity because that’s the direction one stops suddenly in, and it’s just the same for a fall from feet as from a bike. We know from countless school playground falls that an entirely appropriate response is TLC and a sticker, it really needn’t have a different emphasis just because a bike is involved.
I don’t want to dissuade anyone from wearing helmets if that’s what they want to do, but the common claims of life saving just don’t stack up. if they did then places where they don’t bother with helmets would have significantly higher serious brain injury rates (but they don’t) and we’d see a relative decrease in serious head/brain injury relative to pedestrians as increasing numbers of cyclists took up helmet wearing (but we don’t).
The Cochrane Review is generally good thing, but for cycle helmets it is not reliable. It has a small selection of very dated papers dominated by the work of the editor, and it concentrates on just the sort of hospital study that Goldacre and Spiegelhalter point out large methodological problems for. It is not a credible resource for cycle helmet research.
I would strongly suggest a perusal of Tim Gill’s “Cycling and Children and Young Children”, which has a lucidly argued annex from a children’s risk specialist who admits he wears a helmet to cycle… and concludes that the case has not been properly made to require *or even to recommend them*. Free download at https://timrgill.files.wordpress.com/2010/10/cycling-rpt-gill-05.pdf
The main problem with helmets isn’t the helmets themselves, it’s the loaded discussion about them (as suggested by the BMJ editorial). In the UK they’re felt important because everyone goes on about them, and everyone goes on about them because they assume they’re important. But the lack of clear improvement in numbers since their uptake increased, or in comparison to places where they’re little used, show that they’re not. So we end up with huge amounts of energy spent on something of little real safety effect across a population, at the expense of stuff that makes a genuine difference.
What they were designed for is a “better hairnet” for sports riding. Not to save lives, but so if you fall in a race it might mean the difference between abandoning with a sore bump and seeing stars or getting back on and finishing your race. That’s a worthwhile thing for people doing that sort of riding, but it’s been extended in to a culture of belittling and shaming people who, entirely reasonably, choose to ride without one. (I’ve had abuse shouted at me in the street by strangers and any time Cycling UP show a picture of an unhelmeted rider there’s a pile-on saying how irresponsible they are, even though they have an excellently researched briefing on the subject, see https://www.cyclinguk.org/campaigning/views-and-briefings/cycle-helmets). This puts people off of cycling which is an own goal for public health. Maybe a little less work for first aiders, but a lot more work for their colleagues in the cardiac and diabetes wards!
Helmets for cycling for utilitarian transport should be a strictly personal choice with no pressure at any level (including Rule 59 of the Highway Code). The evidence really isn’t up to any more.
Typo above: “Cycling UK”, not “Cycling UP”
The first time I wore a ski helmet a skier “took me out” he/she (they didn’t stop) was going at speed on the flat rock hard snow near the lifts. I apparently went up in the air several feet, travelled forward some distance and landed on my head on the concrete hard snow. Out cold! My helmet did what it was supposed to do and cracked right through the entire shell. I remember the impact of the border hitting me felt like hitting an invisible solid wall at 70 amp. I couldn’t make sense of it at the time as I was hit from behind. Cycling helmets don’t cover your entire skull and leave the fragile part below and behind the ear (where the cricketer was struck and died) dangerously exposed. I skied on that day. My ski helmet was later replaced free of charge as per manufacturers sales agreement! Cycling helmets seem to concentrate on the top of the head (the least likely area to be hit) and do the visor projections crumple sufficiently? I’m working out whether to buy one and of course which one?
This is so true, I hope this reaches as many people as possible!
I have been trying for to persuade the government minister for transport to bring about the compulsory wearing of cycle helmets for all cyclists. My son owes his life to a cycle helmet. I can not believe that the government think that by better signage and better facilities on roads will make cyclists safer. They also state that cycling helmets give a false sense of security. Then it must also be the case for seat belts and motor cycle helmets, and yet they are compulsory. I too am a cyclist, my son is a member of a cycling team. i never cycle without a helmet on, nor does my son and his team mates, as it compulsory for him being a team member. Statistics show that cycle helmets do save life and definitely reduce more serious injuries. I have not given up on my quest to get cycle helmets made compulsory, but i am finding it hard to convince those in power this is a safety issue worth pursuing.
Interesting article and good to have all the arguments – for and against – set out succinctly in one place.
I cycle occasionally in a professional capacity for work, I commute by bike (and have done, off-and-on for almost 20 years including in London), and my children aren’t allowed on their bikes or scooters without a helmet. I’m a ski instructor and never ski without a helmet and strongly recommend one to everyone I’ve instructed. On the few occasions I have perched on a horse (I wouldn’t dignify it by calling it riding!) I’ve worn a helmet, as I did when I dinghy sailed as a youngster and when I rock or mountain climb.
Why? Two reasons: first, no matter how careful and competent you are (as a cyclist on the road, atop a horse or on a slope) what you can never control is ‘the other person’, the consequence of an unthinking moment, incompetence, stupidity or catastrophic accident. It would, of course, be great to live in an urban Utopia with a network of cycle route entirely separate from all other road users and surrounded by lush vegetation – but we don’t, and even if we did, I’d suggest that the behaviour of other cyclists, especially in dense cycle traffic, still creates a risk.
And secondly, whether it’s in Utopia, cycling along a country lane or down the Victoria Embankment (or skiing down to the last beer of the day) if the worst does happen and you get knocked off/over, get smashed into or otherwise come acropper, if having a helmet on increased your risk of survival even a little bit, even by 5%, I’d rather have that 5% working for me, thank you very much. I dare say my wife, parents, children and friends would as well.
The frankly absurd debate for and against helmets seems to miss this dual point: we don’t live in Utopia, are never likely to, and so taking steps to maximise your safety against risks you can’t control is just sensible.
I find my view on this reinforced even more so when you see the way a small minority of cyclists behave, especially in London, disregarding all road signs, traffic lights etc and decrying anyone who objects to that as “anti cyclist” … I’m sorry but if you decided that for some reason you can wizz through a red light because your on a bike and it wouldn’t hurt anyone, without a helmet on (or, better yet, with your helmet dangling from your bag), and then find a car/van/bus/HGV seeking to occupy the same space as you at the same time but with greater force (as they had a green light) would you not want to stack the (admittedly not very good odds) ever so slightly in your favour?
And if compulsory helmet laws mean that is less likely to happen; that even one family doesn’t have to be told their loved one isn’t coming home ever again – I, personally, think that’s worth it.
It’s a trade between a life definitely lost now; and the potential future adverse consequences of public health as a whole later.
I’d save the life today thanks
Is there any evidence that cycle helmets can prevent dental injury
I haven’t been wearing a helmet in the city as I was told serious studies show that it actually increases your risk of collision with risk compensation. I can’t believe now reading what those studies (study) are I put my life/ brain at risk for a bloke dressed as a woman in a wig on a bike and polishing up the figures to get over the embarrassment. That is not a scientific study. Many further studies would be required to confirm and ascertain evidence of the reasons why cars might have dodged that person, including location, the different drivers that went by etc. and certainly into the reasons of why someone dodged him on that study, one might dare to wonder the reason cars steered clear is merely the fact they did infact notice grown man dressed in a frock and female wig and took a wide birth…?
Thank you @firstaidlife for this useful report I’ll definitely purchace a decent helmet now.
I was hit from the left at a mini roundabout may 2020. I suffered no head injury, however I would have been crushed to death if the car had not braked at the moment of impact and ran over me. I have had numerous crashes as a child and teenager on my bike before helmets came into the general populus. not being clipped into the pedals and being able to roll when landing (my ex aikido training kicking in?) most certainly helped. I would these days wear a helmet if I was doing the speeds I used to do as a teenager. However as I’m at 20 mph tops I don’t. I wear large headphones but don’t have them plugged in and that seems to give me more space when I’m cycling as drivers feel I’m a bit riskier to pass?
Cycling helmets work, the scientific reports show this to be true. The evidence is not loaded at all. the report on closer vehicles passes for helmet wearers has been rebutted repeatedly.
There was bias from the authors and the methods used were questionable to put it mildly.
Helmets do the job they are supposed to and getting better at it with new designs and material.
The science says they work.
The hospital numbers show they work.
Life experience of many people show they work.
All the studies are from hospitals. The aim is not to land up in hospital in the first place. Invest in infrastructure, and make helmets optional. I have cycled for 70 years. Fallen off my bike numerous times, but never on my head. So head first is a falacy. And data from hospitals that the helmet saved someone is no more than a guess.