Last month. the New York Times ran an article encouraging helmet use by cyclists that was unfortunate in both its tone and the facts it relied upon.
On tone, the conclusion, which health writer Jane E. Brody decides to start with is overly harsh.
Riding a bicycle without wearing a properly fitted helmet is simply stupid.
We don't use the s-word in our house, and if we did, we'd have more to back it up then the "High Priestess of Health" does. The next line "Anyone who does so is tempting fate, risking a potentially life-changing disaster" could just as easily describe a lot of other activities like driving, walking to the store or taking a shower. Yes, there is risk in riding a bike - perhaps more when riding a helmet - but it may be that, due to the dangers of a sedentary lifestyle not riding a bike for want of a helmet is more risky.
Let's look at some of her facts.
Even a careful cyclist is likely to crash about once every 4,500 miles
For this she seems to be relying on the Bicycle Helmet Safety Institute (BHSI) (funded by WABA!). But as Robert Hurst points out in the "Art of Cycling" when Ed Burke repeats the claim, they never define "careful" or "crash" or cite the source for this number. Hurst points out that a 1976 survey of cyclists indicated that they suffered some kind of bicycle crash related injury every 9000 miles, and in a 1996 update to that, LAB determined that experienced cyclists - those with an average of 14 years of experience - wiped out every 30,000 miles. So, I'd take issue with the conclusion about how often a careful cyclist is likely to crash. There's no doubt that cyclists crash, but Brody's willingness to rely on a claim of dubious origin, one she repeats without citation, sets the article off on a disturbing path. But now that it's been in the Times, I expect to see it repeated and repeated, until everyone takes it as "common sense." In fact, even before this article the number had already reached that level of repetition.
But then we get to the main source of her claim about the importance of helmet wearing.
one shattering statistic reported by New York City for cyclists in general stands out: 97 percent of cycling deaths and 87 percent of serious injuries occurred to people who were not wearing helmets.
In this case she's relying on a 2006 New York City Departments of Health and Mental Hygiene, Parks and Recreation, Transportation, and the New York City Police Department study. It is a pretty shattering statistic. It also doesn't mean what she thinks it does.
For one thing, according to that same study only 74% of all fatal crashes involved a head injury. So somehow not wearing a helmet is also causing deaths that don't involve a head injury. Even if we assume that every head injury death involved an unhelmeted cyclist (which is a ludicrous assumption), it would mean that 88% of non-head injury deaths also involve an unhelmeted cyclists. And since helmet wearing rates are, by most estimates, higher than 12%, it would somehow imply that cyclists who don't wear helmets are more likely to die from crashes involving head injuries AND those that don't.
The reason why the percentage is so high, is vast misreporting. As helmet researcher Dr. Richard Keatinge points out:
The figures for dead cyclists are based on the U.S. Department of Transportation's Fatality Analysis Reporting System (FARS). The forms used by FARS do not in general have a convenient box for recording helmet use, which if done at all is done in free text. Thus data entry does not record helmet use accurately after fatalities, and many deaths where helmets were in fact worn will be recorded as "helmet not used"
And cyclehelmets.org expands on this
California data from the StateWide Integrated Traffic Records System (SWITRS) indicates that at least 13.2% of fatally injured bicyclists were using a helmet during the period 1994-98 (since SWITRS combines 'unknowns' and 'not used' into a single category, the helmet use rate is actually a minimum estimate and could be much higher, depending upon the relative number of true 'unknowns' and how biased the distribution might be) (Cal Highway Patrol), but only 3.4% supposedly were doing so according to FARS
Continuing to rely on BHSI, Brody also states that
Head injuries account for three-fourths of the roughly 700 bicycle deaths that occur each year nationwide, and helmets can prevent or reduce the severity of these injuries in two-thirds of cases. This protection holds even in crashes with motor vehicles, researchers from the University of Washington in Seattle reported as long ago as 2000, a statistic verified many times since.
This stat comes from a 1999 review, updated in 2006. But in contradiction to her claim about how often it has been verified, that review has itstead been criticized because the reviewers mostly included studies that were the work of the reviewers themselves, and because they omitted studies that contradicted their own.
As part of his re-analysis of Attewell, Glase and McFadden, 2001, Elvik, 2011 considered the same studies used in the Cochrane Review and also more recently published studies. Later studies show no net benefit from helmets with regard to injuries to the head, face and neck.
She then notes that she has, in the past, often ridden without a helmet, but no more because she was in a crash where she was wearing a helmet and hit her head, and those suffering a concussion with memory loss, her "helmet prevented a serious brain or facial injury." Which is a claim she can't possibly back up. We simply don't know what would've happened without a helmet. And if she had a standard bicycle helmet, it's hard to imagine how that would have prevented facial injury. I was in a crash in January, and I suffered a serious facial injury despite the fact that I was wearing a helmet.
She then promises to "never again mount a bicycle without the helmet on my head where it belongs". That's likely a good idea. But it's a long way from declaring that anyone who chooses not to is "simply stupid." And it's certainly not a reason to advocate for adult bicycle helmet laws, as she seems to do. The rest of the article, about how to buy and fit a helmet is fine, and she would've been better off focusing on that.