BMJ 1999;318:1505 ( 5 June ) News Cycle helmets should not be compulsory Douglas Carnall , BMJ Cyclists are advised to wear helmets but legislation to make them compulsory is likely to reduce the number of people choosing to cycle and would not be in the interests of health, concludes the BMA's Board of Education and^ Science. International evidence shows that the compulsory use of helmets results in a fall in the number of cyclists. The Australian state of Victoria made the use of helmets compulsory in 1990, and in the following year deaths and head injuries among cyclists fell between 37%and 51%However, 40%fewer adults and 60%fewer children continued to cycle after the introduction of the^ laws. About one in five cyclists in Britain currently wears a helmet. This proportion would have to be increased by promotional campaigns encouraging voluntary action before legislation could^ hope to be^ effective. Some cyclists are opposed to wearing helmets. Research by the European Cycling Federation found that non-cyclists tended to be most in favour of helmets. In fact, a much greater number of^ lives would be saved if pedestrians and car occupants were encouraged^ to wear helmets. The board's previous reports have concluded that the benefit to health of regular exercise from cycling outweighs the British cyclist's comparatively high risk of trauma. In countries such as the Netherlands and Denmark pedestrians and cyclists form a^ much smaller proportion of those injured or killed on the road, though helmets are little used. Instead, these countries have^ concentrated on safety programmes to reduce motor traffic speeds to 30 km/h in urban areas and separate cyclists from fast moving traffic. Properly fitted helmets manufactured to accepted standards can reduce the severity of head injury in a crash, though the tests on which these standards are based mimic a fall from a cycle rather than collision with a fast moving vehicle, which is most likely to harm an adult cyclist. Children are more likely to simply fall off their bicycles and may therefore derive more benefit from wearing a helmet. However, the cost --- between £12 and £90 --- and the necessity of replacing helmets every few years as the child grows may be^ prohibitive. The report recommends that the government should consider subsidising this cost, along with other measures to promote helmets manufactured to the highest standard (Snell B95). It also recommends that every child should be given the opportunity to learn cycling proficiency and that the driving test should be modified to test specifically for awareness of cyclists and other road users. [15287.gif] (Credit: PETE SALOUTOS/THE STOCK MARKET) Children may derive more benefit than adults from cycle helmets _________________________________________________________________ [20]© BMJ 1999 Rapid responses: Read all [21]Rapid responses Falling Cyclists Phillip Brewer bmj.com, 4 Jun 1999 [22][Full text] Broken helmets Chris Gould bmj.com, 4 Jun 1999 [23][Full text] A poor argument to stop head injury Brian Boettcher bmj.com, 4 Jun 1999 [24][Full text] The New Jersey Experience Arthur L Yeager bmj.com, 4 Jun 1999 [25][Full text] Delighted to hear this Anthony Campbell bmj.com, 4 Jun 1999 [26][Full text] Misplaced fears about cycle helmets. Adrian Verrinder bmj.com, 4 Jun 1999 [27][Full text] Online Resource on Helmets Ernst Poulsen bmj.com, 5 Jun 1999 [28][Full text] Legislate or Encourage? Andy Reynolds bmj.com, 5 Jun 1999 [29][Full text] Wearing of helmets in sport may increase the chance of injury Duncan Sim bmj.com, 6 Jun 1999 [30][Full text] Congratulations Giselle Noceti Ammon Xavier bmj.com, 6 Jun 1999 [31][Full text] The Inverse Safety Law David Carvel bmj.com, 8 Jun 1999 [32][Full text] Good but more science needed Avery Burdett bmj.com, 8 Jun 1999 [33][Full text] Why pick on cyclists? Anthony Cartmell bmj.com, 8 Jun 1999 [34][Full text] Saving even a few lives along the way must be worth making helmets compulsory Anna Linden bmj.com, 9 Jun 1999 [35][Full text] Re: Saving even a few lives along the way must be worth making helmets compulsory Andy Reynolds bmj.com, 9 Jun 1999 [36][Full text] speed kills John Rider bmj.com, 10 Jun 1999 [37][Full text] change in attitude, not helmets, reduce accidents involving cyclists Koen De Smet bmj.com, 11 Jun 1999 [38][Full text] Why I Don't Wear a Helmet Ken Kifer bmj.com, 14 Jun 1999 [39][Full text] Re: Donning of Lids - Good or Bad Idea? Dave Duffield bmj.com, 15 Jun 1999 [40][Full text] Compulsory wearing of cycle helmets K Lim bmj.com, 16 Jun 1999 [41][Full text] Cycling and helmets Kranti Kumar bmj.com, 16 Jun 1999 [42][Full text] Helmets and serious brain injury Bill Curnow bmj.com, 18 Jun 1999 [43][Full text] Mandatory helmet laws in Western Australia Chris Gillham bmj.com, 22 Jun 1999 [44][Full text] Compulsory wearing of cycle helmets is needed! A Fraser-Moodie bmj.com, 30 Jun 1999 [45][Full text] I fell, it hurt, it hurt my helmet more Tim Oates bmj.com, 30 Jun 1999 [46][Full text] Author's response Douglas Carnall bmj.com, 8 Jul 1999 [47][Full text] Re: Compulsory wearing of cycle helmets is needed! Chris Gillham bmj.com, 10 Jul 1999 [48][Full text] Policy on bicycle-helmet wearing Robert Ekman bmj.com, 13 Oct 1999 [49][Full text] Re: Policy on bicycle-helmet wearing Chris Gillham bmj.com, 15 Oct 1999 [50][Full text] Tricycles in Winter should be compulsory. Colin Guthrie bmj.com, 17 Oct 1999 [51][Full text] Re: Policy on bicycle-helmet wearing Brent Beach bmj.com, 19 Oct 1999 [52][Full text] Mandatory=No, By choice=Yes Bernard Labelle bmj.com, 29 Nov 1999 [53][Full text] Road Safety Malcolm Manby bmj.com, 22 Dec 1999 [54][Full text] Encouragement Might be Worse Ian Ker bmj.com, 14 Jan 2000 [55][Full text] Re: Encouragement Might be Worse Chris Gillham bmj.com, 8 Mar 2000 [56][Full text] unconstitutional Ward Parker bmj.com, 30 Jun 2000 [57][Full text] Re: unconstitutional Peter Morrell bmj.com, 2 Jul 2000 [58][Full text] Policy on bicycle-helmet wearing: reply from the Swedish Group Glenn Welander bmj.com, 5 Sep 2000 [59][Full text] No. Promote Cycling, not Helmets Malcolm Wardlaw bmj.com, 7 Sep 2000 [60][Full text] Reduction in Risk versus reduction in Freedom Kieran Brennan bmj.com, 4 Oct 2000 [61][Full text]