As misleading helmet-promoting “research” continues to appear, and to be promptly debunked, the possibility that helmets may yet have some benefit for our most vulnerable population, children, seems to be going unexplored.
2014 was a rough year for the bicycle helmet industry. The failure of helmets to produce a significant “net protective effect”, a result once confined to science journals, repeatedly found its way into the mainstream media. Bicycling Magazine reported that helmets do not reduce concussions. The Washington Post reported that the National Highway Traffic Safety Administration was forced to reverse claims of efficacy because of the Data Quality Act, a law that requires federal officials to avoid claims based on debunked science.
In recent years, researchers have generally failed to find convincing proof of helmet efficacy. According to the book City Cycling, “The dramatic difference in injuries between helmeted and bareheaded cyclists reported in the earliest studies has not been seen in population level research.”
City Cycling is a collection of research summaries written for the lay public and co-edited by Ralph Buehler of Virgina Tech. City Cycling goes on to describe studies of jurisdictions where a helmet law suddenly increased helmet use among the general population as well as studies of helmeted versus bareheaded cyclists. In the former, no effect is found. In the latter, bareheaded cyclists suffer not only more head injures, but more injuries of all types. Further, “intoxicated cyclist rarely wear helmets.” In other words, risk-takers tend to both forgo helmets and get injured.
Other key findings come from Rune Elvik of the Institute of Transport Economics, who showed that helmets are correlated with an increase in neck injuries, which can be lethal, and from researcher W. J. Curnow, who showed that current helmets do not protect users from the violent rotational motions that cause concussions.
While bicycle helmets are clearly not a magic bullet, there is a vulnerable population that may yet benefit from them. Children may be more vulnerable to head injuries than adults. According to the Center for Disease Control, little is known. According to the CDC, “The difficulty of measuring the effects of the injury in the context of naturally occurring developmental changes contributes to the challenge of assessing outcomes of [traumatic brain injury] in young people.” By focusing on this more-vulnerable population, helmet research may yet deliver on promises of public safety.
In one troubling example, researchers seem to be promoting helmets, even to the point of misleading the public. In this case, Washington State University researcher Janessa Graves compared bicycling injuries before and after various cities, including Washington, DC, implemented bikeshare systems.
Based on past research, one can guess the results. Bikeshare systems encourage more people to ride, so injuries of all types are likely to decrease, a well-known effect called “safety in numbers.” Bikeshare users tend not to carry helmets everywhere they go, so helmet use tends to be lower, another well-known result. With fewer helmets, head-injury percentages increase while the neck-injury percentages decrease, even as both types of injuries decrease in number. In fact, this is exactly what was found. Sadly, and misleadingly, the researchers focused only on the “bad news” head-injury percentage in their summary and in their press releases. The good news, that injuries generally decreased, was not emphasized at all. If science can predict climate change and give us smart phones, it can do better with public safety.
As it stands, helmet design emphasizes comfort and style while ignoring science, a point discussed at length by Curnow. At the very least, we should follow Curnow's recommendations to a) reduce head and neck injuries by designing helmets that do not grip the road during a crash and b) to abandon helmet mandates that discourage cycling. At best, we should be supporting effective, fact-based science to protect our most vulnerable citizens.