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Bicycle helmet

Bicycle helmet
A bicycle helmet is a helmet intended to be worn while riding a bicycle. They are designed to attenuate impacts to the cranium of a cyclist in falls while minimizing side effects such as interference with peripheral vision.[1] The debate on whether helmet use should be compulsory is intense and occasionally bitter, often based not only on differing interpretations of the academic literature, but also on differing assumptions and interests on the two sides.[2][3] A cycle helmet should be light in weight and should provide adequate ventilation, because cycling can be an intense aerobic activity which significantly raises body temperature and the head in particular needs to be able to regulate its temperature.

A man wearing a bicycle helmet.

About helmets
History of designs

A cross-country bicycle helmet.

"Hairnet" helmet The dominant form of helmet was the leather "hairnet" style, mainly used by racing cyclists. This offered minimal impact protection and acceptable protection from scrapes and cuts. In countries with long traditions of

A carbon full-face bicycle helmet intended for downhill racing.

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utility cycling, nearly all cyclists did not and still do not wear helmets. The use of helmet by non-racing cyclists began in the U.S. in the 1970s. After many decades when bicycles were regarded as children’s toys only, many American adults took up cycling during and after the bike boom of the 1970s. Two of the first modern bicycle helmets were made by MSR, a manufacturer of mountaineering equipment, and Bell Sports, a manufacturer of helmets for auto racing and motorcycles. These helmets were a spinoff from the development of expanded polystyrene foam liners for motorcycling and motorsport helmets, and had hard polycarbonate plastic shells. The bicycle helmet arm of Bell was split off in 1991 as Bell Sports Inc., having completely overtaken the motorcycle and motor sports helmet business. The first commercially successful purposedesigned bicycle helmet was the Bell Biker, a polystyrene-lined hard shell released in 1975. At the time there was no appropriate standard; the only applicable one, from Snell, would be passed only by a light open-face motorcycle helmet. Over time the design was refined and by 1983 Bell were making the V1-Pro, the first polystyrene helmet intended for racing use. In 1984 Bell produced the Li’l Bell Shell, a no-shell children’s helmet. These early helmets had little ventilation. In 1985 the Snell B85 was introduced, the first widely-adopted standard for bicycle helmets; this has subsequently been refined into B90 and B95 (see Standards below). At this time helmets were almost all either hard shell or no-shell (perhaps with a vacuumformed plastic cover). Ventilation was still minimal due mainly to technical limitations of the foams and shells in use.

Bicycle helmet
Around 1990 a new construction technique was invented: in-mould microshell. A very thin shell was incorporated during the moulding process. This rapidly became the dominant technology, allowing for larger vents and more complex shapes than hard shells. Hard shells declined rapidly among the general cyclist population during the 1990s, almost disappearing by the end of the decade, but remain popular with BMX riders as well as inline skaters and skateboarders. The late 1990s and early 2000s saw advances in retention and fitting systems, replacing the old system of varying thickness pads with cradles which adjust quite precisely to the rider’s head. This has also resulted in the back of the head being less covered by the helmet; impacts to this region are rare, but it does make a modern bike helmet much less suitable for activities such as unicycling, skateboarding and inline skating, where falling over backwards is relatively common. Other helmets will be more suitable for these activities. Since more advanced helmets began being used in the Tour de France, Carbon Fiber inserts have started to be used to increase strength and protection of the helmet. The Giro Atmos and the Bell Alchera are among the first to use carbon fiber. Some modern racing bicycle helmets have a long tapering back end for streamlining.

History of standards
In the United States the Snell Memorial Foundation, an organization initially established to create standards for motorcycle and auto-racing helmets, implemented one of the first standards. The American National Standards Institute (ANSI) created a standard called ANSI Z80.4 in 1984. Later, the United States Consumer Product Safety Commission (CPSC) created its own mandatory standard for all bicycle helmets sold in the United States, which took effect in March 1999. In the European Union (EU) the currently applicable standard is EN 1078:1997. In the UK the current standard is BS EN 1078:1997, which is identical to the EU standard, and which replaced BS 6863:1989 in 1997.[4] In Australia and New Zealand, the current standard is AS/NZS 2063:1996. The

A Giro Atmos helmet, showing seamless inmould microshell construction.

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performance requirements of this standard are slightly less strict than the Snell B95 standard but incorporate a quality assurance requirement. As a result, the AS/NZS can be argued to be safer.[5] However this is not to be confused with the standards marketing program run by SAI Global in which manufacturers pay royalties and fees to afix a "5 ticks" sticker on helmets deemed of suitable standard. The AS/NZS 2063:1996 only requires compliance, and not the optional 5 ticks symbol. The CPSC and EN1078 standards are lower than the Snell B95 (and B90) standard; Snell helmet standards are externally verified, with each helmet traceable by unique serial number. EN 1078 is also externally validated, but lacks Snell’s traceability. The most common standard in the US, CPSC, is self-certified by the manufacturers. It is generally true to say that Snell standards are more exacting than other standards, and most helmets on sale these days will not meet them (currently, Specialized is the only bicycle helmet brand in the world to meet the Snell standard. All of their helmets are Snell certified.) In 1990 the Consumers’ Association (UK) market survey showed that around 90 % of helmets on sale were Snell B90 certified. By their 1998 survey the number of Snell certified helmets was around zero. Hard shells declined rapidly among the general cyclist population over this period, almost disappearing by the end of the decade, but remained more popular with BMX riders as well as inline skaters and skateboarders. Although helmet standards have [6] there is no data on weakened over time which to base an assessment of how this has affected the design goal of mitigating minor injuries. Minor injuries are substantially under-reported and it is difficult if not impossible to effectively measure such injuries on a meaningful scale. Helmets exploit two fundamental physical realities in their functioning. Firstly, kinetic energy increases with the square of speed, which means a doubling of speed translates into an injury potentially four times as severe. However, concurrent with this is the need to consider the direction in which the forces act. A cyclist travelling along a horizontal roadway at a given rate of speed will incur a much more severe head injury if he/ she flies straight into a solid brick wall than

Bicycle helmet
if he/she simply falls and dissipates the kinetic energy by sliding and scraping along the roadway. Two things are key here: the roadway must be clear, with no obstacles to forward sliding on the pavement, and secondly, the helmet must slide without gripping the roadway and exerting rotational forces on the head. The second fundamental physical reality germane to helmet functioning is embedded in Newton’s Second Law, i.e. F=ma (force = mass multiplied by acceleration). Since acceleration is defined as the change in velocity divided by the change in time, what a helmet effectively does is increase the time over which the forces act. Because time is in the denominator, more time equates to a lower peak force exerted on the brain as the head is decelerated by the helmet. And, since velocity is defined as the rate of change of distance per unit time, effectively what this means is that more deceleration distance (i.e. more distance over which deceleration occurs) translates into a gentler deceleration for the brain. (The same fundamental physical principles are exploited in automobiles, where crumple zones and airbags work together to enable people to survive even headon collisions at highway speeds.) A helmet’s ability to absorb energy could be improved by increasing the volume of expanded polystyrene, but this would make it thicker, heavier, and hotter to wear. Another concern is that a thicker helmet increases the risk of rotational-type brain injuries (discussed in more detail below). Ultimately, every helmet design represents some sort of compromise. The trend is towards thinner helmets with many large vents. This trend to lower standards has been noted in some of the studies[7] It is relatively common for helmets to fail on test, and some helmets on sale are not certified to any accepted standard.[6] The most widely-cited pro-helmet studies were conducted when most helmets were of a hard-shell construction; these are now rare outside of niche applications such as BMX.

Design intentions and standards
There are two main types of helmet: hard shell and soft/micro shell (no-shell helmets are now rare). Both are intended to reduce acceleration to the head due to impact, as a stiff expanded polystyrene liner is

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crushed.[8][9] Standards involve the use of an instrumented headform which is dropped, wearing a helmet, onto various anvils. The speed of impact is designed to simulate the effect of a rider’s head falling from approximately usual riding height, without rotational energy and without impact from another vehicle.[10][11] As noted earlier, collision energy varies with the square of impact speed. A typical helmet is designed to absorb the energy of a head falling from a bicycle, hence an impact speed of around 12mph or 20 km/h. This will only reduce the energy of a 30 mph or 50 km/h impact to the equivalent of 27.5 mph or 45 km/h, and even this will be compromised if the helmet fails. As a subsidiary effect, they should also spread point impacts over a wider area of the skull. Hard shell helmets may do this better, but are heavier and less well ventilated. They are more common among stunt riders than road riders or mountain bikers. Additionally, the helmet should reduce superficial injuries to the scalp. Hard shell helmets may also reduce the likelihood of penetrating impacts, although these are very rare. The above figures assume a standard bicycle with a diamond-framed frame, which places the rider’s head roughly 1.5 to 2 metres above ground level. Injury severity from a fall might be less if the cyclist is riding a recumbent-type bicycle, in which the rider reclines and has his/her head about 1 metre from ground level.

Bicycle helmet
the impact attenuation test... As the results in Figure 15 illustrate, the child skull is far from being solid and will deform readily on impact. This fact is well known in the medical field and is largely why a child who has had a rather modest impact to the head is usually admitted to hospital for observation. The substantial elastic deformation of the child head that can occur during impact can result in quite extensive diffuse brain damage."[14] In real accidents, while broken helmets are common, it is extremely unusual to see any helmet that has compressed foam and thus may have performed as intended. “Another source of field experience is our experience with damaged helmets returned to customer service... I collected damaged infant/toddler helmets for several months in 1995. Not only did I not see bottomed out helmets, I didn’t see any helmet showing signs of crushing on the inside.” [15] A new design of liner, the "cone-head", now being manufactured for motorcycle helmets but not yet available for bicycle helmets, has been designed in response to the 1987 study. It may provide better impact absorption.[16] Most helmets provide no protection against rotational injury and may make it worse. "The major discovery is that the skull plays an important role in protecting against rotational acceleration," says Phillips. He says almost all head injuries involve not just a direct blow to the skull but also damage to blood vessels caused by the brain rotating within the skull. In mechanical terms, the head is an elliptical spheroid with a single universal joint, the neck. It is therefore almost impossible to hit it without causing it to rotate. The head tries to dampen these forces using a combination of built-in defences: the scalp, the hard skull and the cerebrospinal fluid beneath it. During an impact, the scalp acts as rotational shock absorber by both compressing and sliding over the skull. This absorbs energy from the impact." [17] The Phillips head protection system, also only available in motorbike helmets at present, is designed to reduce rotational injury.[18]

Criticism of current standards; new designs
Helmet liners may be too stiff to be effective. Some standards require the use of headforms heavier and more rigid than the human head; these are more capable of crushing foam than is the human head. [12] [13] In real accidents "very little crushing of the liner foam was usually evident... What in fact happens in a real crash impact is that the human head deforms elastically on impact. The standard impact attenuation test making use of a solid headform does not consider the effect of human head deformation with the result that all acceleration attenuation occurs in compression of the liner. Since the solid headform is more capable of crushing helmet padding, manufacturers have had to provide relatively stiff foam in the helmet so that it would pass

Proper fit
It is important that a helmet should fit the cyclist properly – in one study 96 % [19] were

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found to be incorrectly fitted. Efficacy of incorrectly fitted helmets is reckoned to be much lower; one estimate states that risk is increased almost twofold[20]. Most manufacturers provide a range of sizes ranging from children’s to adult with additional variations from small to medium to large. The correct size is important. Some adjustment can usually be made using different thickness foam pads. Helmets are held on the head with nylon straps, which must be adjusted to fit the individual. This can be difficult to achieve, depending on the design. Most helmets will have multiple adjustment points on the strap to allow both strap and helmet to be correctly positioned. Additionally, some helmets have adjustable cradles which fit the helmet to the occipital region of the skull. These provide no protection, only fit, so helmets with this type of adjustment are unsuitable for roller skating, stunts, skateboarding and unicycling. In general, the more skull coverage a helmet provides, the more effectively it can be fitted to the head and hence the better it will remain on the head in an accident. The helmet should sit level on the cyclists head with only a couple of finger-widths between eyebrow and the helmet brim. The strap should sit at the back of the lower jaw, against the throat, and be sufficiently tight that the helmet does not move on the head. It should not be possible to insert more than one finger’s thickness between the strap and the throat.

Bicycle helmet
turning point in helmet policy was the March 2003 death of Kazakh Andrei Kivilev. The new rules were introduced on May 5, 2003[22], with the 2003 Giro d’Italia being the first major race affected. The 2003 rules allowed for discarding the helmets during final climbs of at least 5 kilometres in length;[23] subsequent revisions made helmet use mandatory at all times. No studies have been published yet into whether injuries have reduced as a result.

The helmet debate
Is cycling risky enough to require helmets?
There is no one agreed way of presenting risk. Proponents of helmet compulsion may tend to quote figures for the (large) total number of head injuries or injuries of any kind; opponents may be more likely to produce estimates for the (low) risk of serious injury per cyclist. One pro-helmet website gives its "own pick of Basic Numbers from many sources": 773 bicyclists died on US roads in 2006, down just 11 from the year before. 92% (720) of them died in crashes with motor vehicles. About 540,000 bicyclists visit emergency rooms with injuries every year. Of those, about 67,000 have head injuries, and 27,000 have injuries serious enough to be hospitalized. Bicycle crashes and injuries are under-reported, since the majority are not serious enough for emergency room visits. 44,000 cyclists were reported injured in traffic crashes in 2006. [24] In a campaign to make helmets compulsory for child cyclists, it has been stated that "in a three-year period from 2003, 17,786 children aged 14 and under were admitted to NHS hospitals in England because of injuries incurred while cycling"[25] Overall, cycling is beneficial to health – the benefits outweigh the risks by up to 20:1.[26]. To cycling activists, the major problem with helmet promotion is that in order to present the idea of a "problem" to match the solution they present, promoters tend to overstate the dangers of cycling.[27][28] Cycling is no more dangerous than being a pedestrian.[29][30] A UK opponent of compulsion has pointed out that it "still takes at least 8000 years of average cycling to produce one clinically severe head injury and 22,000 years

Helmet compulsion in cycling sport
Historically, road cycling regulations set by the sport’s ruling body, Union Cycliste Internationale (UCI), did not require helmet use, leaving the matter to individual preferences and local traffic laws. The majority of professional cyclists chose not to wear helmets, citing discomfort and claiming that helmet weight would put them in a disadvantage during uphill sections of the race. The first serious attempt by the UCI to introduce mandatory helmet use in 1991 was met with strong opposition from the riders.[21] An attempt to enforce the rule at the 1991 Paris–Nice race resulted in riders’ strike, forcing the UCI to abandon the idea. While voluntary helmet use in professional ranks rose somewhat in the 1990s, the

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for one death."[31] Ordinary cycling is not demonstrably more dangerous than walking or driving, yet no country promotes helmets for either of these modes.[32] "The inherent risks of road cycling are trivial... Six times as many pedestrians as cyclists are killed by motor traffic, yet travel surveys show annual mileage walked is only five times that cycled; a mile of walking must be more "dangerous" than a mile of cycling..." The proportion of cyclist injuries which are head injuries is essentially the same as the proportion for pedestrians at 30.0 % vs. 30.1 %.[33]

Bicycle helmet
original papers (neither of which meet the criteria for inclusion in Robinson’s review) and concludes that "Bicycle helmet legislation appears to be effective in increasing helmet use and decreasing head injury rates in the populations for which it is implemented. However, there are very few high quality evaluative studies that measure these outcomes, and none that reported data on an (sic) possible declines in bicycle use."[39] There are many other studies. The largest, covering eight million cyclist injuries over 15 years, showed no effect on serious injuries and a small but significant increase in risk of fatality.[40] Although the head injury rate in the US rose in this study by 40 % as helmet use rose from 18 % to 50 %,[40] this is a timetrend analysis with the potential weaknesses mentioned above; the correlation may not be causal. Association with increased risk has been reported in other studies.[41] Different analyses of the same data can produce different results. For example, Scuffham analysed data on the increase of voluntary wearing in New Zealand to 1995; he concluded that, after taking into account long-term trends, helmets had no measurable effect.[42] His subsequent re-analysis without accounting for the long-term trends suggested a small benefit.[43] Scuffham’s later cost-benefit analysis of the New Zealand helmet law showed that the cost of helmets outweighed the savings in injuries, even taking the most optimistic estimate of injuries prevented.[44]

Are helmets useful? Desirable effects of helmet use
No randomized controlled trials have been done on the subject. The evidence comes from two main types of observational study. Most of the literature that mentions helmets refers back to a small number of these studies, rather than itself providing primary evidence. Overall, according to CTC, the UK’s national cyclists organisation, "the evidence currently available is complex and full of contradictions, providing at least as much support for those who are sceptical as for those who swear by them."[34]

Time-trend analyses
Time-trend analyses compare changes in helmet use and injury rates in populations over time, most validly where helmet laws have resulted in large changes in a short time. Potential weaknesses of this type of study include: simultaneous changes in the road environment (e. g. drink-drive campaigns); inaccuracy of exposure estimates (numbers cycling, distance cycled etc.), changes in the definitions of the data collected, failure to analyse control groups, failure to analyse long-term trends, and the ecological fallacy. Robinson’s review of cyclists and control groups in jurisdictions where helmet use increased by 40 % or more following compulsion concluded that "enforced helmet laws discourage cycling but produce no obvious response in percentage of head injuries".[35] Some of the data for this publication is available at [34]. This study has been the subject of vigorous debate.[36] [37][38] Authors do not agree on how studies should be selected for analysis, nor on what summary statistics are most relevant. A more recent review, by Macpherson and Spinks, includes two

Case-control studies
Known potential problems with this type of study design include confounding (attributing benefits from unmeasured differences in behavior to differences in helmet choice), and recall bias (people incorrectly reporting helmet use).[45] Such studies consistently find that cases of head injury report a lower rate of helmetwearing than controls who have injured other parts of the body.[46] This has been taken as strong evidence that cycle helmets are beneficial in a crash. The most widely-quoted case-control study, by Thompson, Rivara, and Thompson, reported an 85 % reduction in the risk of head injury by using a helmet. There are many criticisms of this study,[47] including use of a control group with very different risks. Re-analysis of the Thompson, Rivara and Thompson data, substituting helmet wearing rates from co-author Rivara’s

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contemporaneous street counts[48], reduces the calculated benefit to below the level of statistical significance. This has been taken as evidence of confounding. In another study, helmet users also seemed to be protected against severe injuries to the lower body; "helmet non-use is strongly associated with severe injuries in this study population. This is true even when the patients without major head injuries are analyzed as a group".[41] It is possible that at least some of the ’protection’ afforded helmet wearers in previous studies may be explained by safer riding habits rather than solely a direct effect of the helmets themselves.[49] Other case-control studies exist, all showing similar results. In Victoria, Australia, during 1977-1980, bicyclist casualties, then unhelmeted, sustained head injuries including severe head injuries, more than twice as frequently as the helmeted motorcyclist casualties[50].

Bicycle helmet
their bicycles frequently.[53] The reduction in the number of cyclists is likely to harm the health of the population more than any possible protection from injury.[54] The long term health benefits of bicycle use are manyfold and extensively documented, and so any reduction in bicycling will likely have a negative impact on the overall health of a population.[55] It has been suggested that a fall in the number of bicyclists in the 1990s may reflect an increase of in-line skating or other recreational activities,[37] or the evidence that helmet promotion deters cycling has been simply denied.[39] A reduction in cycling may lead to an increased risk for the cyclists remaining on the road, due to a "safety in numbers" effect.[56] According to one source, the probability of an individual cyclist being struck by a motorist declines with the 0.6 power of the number of cyclists on the road.[32] This means that if the number of cyclists on the road doubles, then the average individual cyclist can ride for an additional 50% of the time without increasing the probability of being struck. It is thought that the increased frequency of motorist-cyclist interaction creates more aware motorists. Several mechanisms by which cycle helmet promotion or compulsion may deter cycling have been suggested. Helmets and their promotion may reinforce the misconception that bicycling is more dangerous than traveling by passenger car.[57] Referring to the use of "human skull" images in a campaign,[58] the CTC suggests that "this macabre imagery, with its associations of hospitals and death, is likely to reduce cycle use, thereby undermining efforts to realise the health and other benefits of increased cycling".[59] Bicycle helmets cost money and may make cycling less convenient; they are bulky and often cannot be stored securely with bikes. However, a well-designed bicycle helmet can last for a good number of years, if it is not involved in an accident. Both the shell and the polystyrene liner will deteriorate with protracted exposure to ultraviolet light (from sunlight), which means that helmet lifespan is much more a function of hours worn rather than years elapsed since the date of manufacture. Since fluorescent indoor lighting also contains some ultraviolet rays, it is appropriate to store a helmet in a dark location. Similarly, when a bicycle is parked outdoors, it is wise to take the helmet indoors for storage.

Anecdotal evidence
A common misunderstanding is to assume that a broken helmet has prevented some serious injury. "the main impact was to my head. So much so, that my helmet broke in two (as it is designed to do). Without the helmet, it would have been my head that was broken and I wouldn’t be writing this blog entry! I’d be dead..."[51] Helmets are designed to crush without breaking; expanded polystyrene absorbs little energy in brittle failure and once it fails no further energy is absorbed. "cracks developing partly or fully through the thickness of the foam-slab renders it useless in crushing and absorbing impact forces"[52] To prevent overt fragmentation, the foam in most helmets is reinforced inside with plastic netting to keep the foam together even after cracking.

Are helmets harmful? Undesirable effects of helmet use
Concerns have been raised that mandatory bicycle helmet laws lead to a reduction in the number of cyclists, and increased helmet use may lead to increased risks.

Less bicycle use
When mandatory bicycle helmet laws were enacted in Australia, slightly more than one third of bare-headed cyclists ceased to ride

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Bicycle helmets are seen as incompatible with some hairstyles, forcing bicycle users to recreate their hairstyle after each journey. Finally, bicycle helmets and other "safety" equipment have, in the past, occasionally been seen as vexatious and ridiculous.[60] For example, in the 2006 film The Benchwarmers, the character Clark—played by Jon Heder—sports a bicycle crash helmet as an accessory prop to highlight his lack of social skills and physical coordination.

Bicycle helmet
45 km/h. The rotational accelerations were found to be 30 percent higher than those found in similar tests using a full face polymer motorcycle helmet."[68] Accordingly, compared to a traditional bicycle helmet, a bicycle helmet of full-face design would be expected to bring an added margin of safety in the form of reduced rotational forces exerted on the brain. This is in addition to the direct facial protection and greatly improved retention security provided by such a helmet design. However, full-face bicycle helmets are uncommon in the general cycling population, despite the advent of well-ventilated designs. The shell material of the helmet plays a key role in enabling the helmeted head to slide along a surface (e.g. a roadway surface). Harder shells are less likely to be gripped by a rough surface, and might therefore be less likely to impart massive rotational forces to the brain. However, the major determinants of the rotational forces on the brain are the details of the accident itself -that is, the magnitude and location of the forces exerted on the helmet and transmitted to the head inside it.

Risk compensation
A range of theories have been proposed to explain why helmet use might cause more or worse accidents. Under the risk compensation theory, helmeted cyclists may be expected to ride less carefully; this is supported by evidence for other road safety interventions such as seat belts and anti-lock braking systems.[61][62] There is some evidence for risk compensation by children in relation to safety equipment.[63] Anecdotally, many riders report feeling safer with a helmet: "When I wear it, I feel safe..."[64] Motorists may also alter their behaviour towards helmeted cyclists. Recent evidence from England found that vehicles passed a helmeted cyclist with measurably less clearance (8.5 cm) than that given to the same cyclist unhelmeted (out of an average total passing distance of 1.2 to 1.3 metres).[65]

Strangulation by helmet straps
There are a few documented cases of young children, playing on bunkbeds, trees, jungle gyms, and so on, suffering death or severe brain damage as a result of strangulation by the straps of their bicycle helmets.[69][70][71][72][73] One Swedish researcher commented of the Swedish Helmet Initiative: "We knew we’d killed, but didn’t know we had saved anybody".[74]

Rotational injury
Rotational injury "is unleashed when the helmet ricochets along the road, twists sharply and the brain rotates within the skull, causing blood vessels and neurons to rip apart throughout the substance of the brain. Quite often there may be no obvious superficial damage – especially if the rider is wearing a conventional helmet. The damage is done within."[66] The major causes of permanent intellectual disablement and death after head injury may be torsional forces leading to diffuse axonal injury (DAI), a form of injury which usual helmets cannot mitigate and may make worse.[67] Helmets may increase the torsional forces by increasing the distance from the centre of the spine to the outside of the helmet, compared to the distance to the scalp without a helmet: "Bicycle helmet crash simulation experiments carried out as part of this project indicated very high rotational accelerations for a fall over the handlebars at

Positions and arguments
Much of the research is partisan in one way or another. Rodgers re-analysed data which supposedly showed helmets to be effective; he found data errors and methodological weaknesses so serious that in fact the data showed "bicycle-related fatalities are positively and significantly associated with increased helmet use".[75] One report concluding that helmet use was associated with a 60 % reduction in injuries was found to be in error due to a simple statistical error; correcting the error results in a claimed efficacy of 186 %; despite this the authors continue to assert that the results stand.[76] A report commissioned by the UK Government was

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supportive of cycle helmet promotion[77] but dismissed much of the contradictory evidence with minimal examination, and the principal authors were associated with a programme of the Child Accident Prevention Trust (CAPT), which is strongly pro-helmet.[78] Curnow, author of papers on helmets and traumatic brain injury, has also published criticism of pro-helmet research.[79]

Bicycle helmet
with a car, that risk compensation negates their protective effect and because he feels their promotion implicitly shifts responsibility of care to the cyclist.[87][88] He also cautions against placing the recommendations of surgeons above other expert opinion in the debate, comparing it to drawing conclusions on whether it is worthwhile to buy lottery tickets by sampling only a group of prizewinners.[89] The prominent UK-based cycling activist John Franklin is skeptical of the merits of helmets, regarding proactive measures including bike maintenance and riding skills as being more important.[90] Cyclists’ representative groups complain that focus on helmets diverts attention from other issues which are much more important for improving bicycle safety, such as road danger reduction, training, roadcraft, and bicycle maintenance.[91][92] Of 28 publicly funded cycle safety interventions listed in a report in 2002, 24 were helmet promotions. For context, one evaluation of the relative merits of different cycle safety interventions estimated that 27 % of cyclist casualties could be prevented by various measures, of which just 1 % could be achieved through a combination of bicycle engineering and helmet use. In 1998 the European Cyclists’ Federation adopted a position paper rejecting compulsory helmet laws as being likely to have greater negative rather than positive health effects.[91] The UK cyclists’ club, CTC, believes that the "overall health effects of compulsory helmets are negative."[93] The UK minister of transport knew of no evidence to support the claim that helmets saved lives. [94] The British National Children’s Bureau has said "The 2004 BMA statement announcing its decision to support compulsory cycle helmets shows how the uncritical use of accident statistics can lead to poor conclusions."[95] The same report estimated that, at most, universal helmet use would save the lives of three children aged 0 to 15 each year. That figure "assumes universal and correct use of helmets, it assumes that risk compensation does not occur and it assumes that no children die as a result of strangulation or other injuries caused by helmet use. These assumptions are most unlikely to be correct in the real world."

Supporters
Many notable organisations and individuals believe that a helmet can reduce head injuries, and even save a cyclist’s life. The World Health Organisation promote the use of helmets as a strategy for preventing head injuries caused by bicycle crashes or falls.[80] Use of cycling helmets is supported by numerous groups in the United States, including the American Medical Association[81] and the American National Safety Council.[82] By 1991, the League of American Wheelmen described bicycle helmets as a "Mom and apple pie" issue in the US.[83] In 2004 the British Medical Association’s Board of Science and Education adopted a position calling on the UK government to introduce cycle helmet legislation, and this was confirmed at the 2005 Annual Representative Meeting following fifteen minutes of debate.[84][85] The prominent U.S.-based cycling activist John Forester suggests that helmet wearing could save 300 deaths a year in the US, behind Effective Cycling at 500 and ahead of all other interventions, totalling 1,030.[86] Perhaps the most notable proponents of helmet laws are the helmet manufaturers and governments which enact these laws and then reap the financial benefit of helmet tickets. Income from ’failure to wear a bicycle helmet’ tickets in Australia is a million-dollar industry. http://www.cycle-helmets.com/index.html

Opponents
Amongst those who do not support the arguments in favor of helmet use, or helmet compulsion, are many notable academics, practitioners and cyclists’ lobbying groups. Robinson reviewed data from jurisdictions where helmet use increased following legislation, and concluded that helmet use did not demonstrably reduce cyclists’ head injuries.[35] Mayer Hillman, a transport- and road safety-analyst from the UK, does not support the use of helmets, reasoning that they are of very limited value in the event of a collision

Influencing helmet use
There is a long-running argument over the use, promotion, and compulsion of cycle

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helmets. Helmet use has increased significantly in many, but not most, jurisdictions since the 1980s, primarily because of helmet promotion and compulsion laws. Most heated controversy surrounds laws making helmet use compulsory.

Bicycle helmet
Promotion of helmets raises further issues. Bell, the major helmet manufacturer, supports both helmet promotion [108] and legislation.[109]

Legislation
The following countries have mandatory helmet laws, in at least one jurisdiction, for either minors only, or for all riders: Australia, Canada, Finland, Iceland, Israel,[110] Sweden, USA, and New Zealand. In the U.S. 37 states have mandatory helmet laws.[111] Although the link is not causal, it is observed that the countries with the best cycle safety records (Denmark and the Netherlands) have among the lowest levels of helmet use.[112] Their bicycle safety record is generally attributed to public awareness and understanding of cyclists, safety in numbers, education, and to some extent separation from motor traffic. A study of cycling in major streets of Boston, Paris and Amsterdam illustrates the variation in cycling culture: Boston had far higher rates of helmet-wearing (32 % of cyclists, versus 2.4 % in Paris and 0.1 % in Amsterdam), Amsterdam had far more cyclists (242 passing bicycles per hour, versus 74 in Paris and 55 in Boston).[113] Cycle helmet wearing rates in the Netherlands and Denmark are very low.[88][114] An Australian journalist writes: "Rarities in Amsterdam seem to be stretch-fabric-clad cyclists and fat cyclists. Helmets are non-existent, and when people asked me where I was from, they would grimace and mutter: "Ah, yes, helmet laws." These had gained international notoriety on a par with our deadly sea animals. Despite the lack of helmets, cycling in the Netherlands is safer than in any other country, and the Dutch have one-third the number of cycling fatalities (per 100,000 people) that Australia has."[115] The UK’s CTC say that cycling in the Netherlands and Denmark is perceived as a "normal" activity requiring no special clothing or equipment.[116]

Promotion
Significant helmet promotion preceded epidemiological studies evaluating the effectiveness of bicycle helmets in bicycle [96][97] Received opinion in some crashes. English-speaking countries is that bicycle helmets are useful and that every cyclist should wear one; helmets had become a ‘ “Mom and apple pie” issue’ in the United States by 1991 according to the League of American Bicyclists.[98] Professional bodies elsewhere have agreed, such as the Swiss Council for Accident Prevention.[99] The Dutch Institute for Road Safety Research (SWOV) advocates helmet use and helmet laws to further improve cycling safety.[100] This is not the only view in the Netherlands; a pro-cycling paper states: "The Dutch cycling experts and planners interviewed for this paper adamantly opposed the use of helmets, claiming that helmets discourage cycling by making it less convenient, less comfortable, and less fashionable. They also mention the possibility that helmets would make cycling more dangerous by giving cyclists a false sense of safety and thus encouraging riskier riding behavior."[101] Dismissing concerns in 1996 that helmets should be shown to actually reduce injury rates, two pro-helmet doctors asked "How robust must the evidence be when the benefits of wearing helmets are so patently obvious? What is the downside to wearing a helmet, other than the mussing of Minerva’s hair?".[102] One of these, himself a cyclist, started his "career of advocacy" in 1972 and is now editor of an academic journal on injury prevention.[103] In this position he has found "tiresome" academic argument that helmet wearing is useless.[104][105][106][107] Rivara was already engaged in surveying and lobbying for helmet use before the influential Thompson, Rivara and Thompson casecontrol study was commenced in 1989,[48] while the report by Thompson, Rivara and Thompson for the Cochrane review has been criticised for being dominated by their own work.

See also
• • • • Cycle chic Car headband Motorcycle helmet Bicycle helmets in New Zealand

Notes
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From Wikipedia, the free encyclopedia

Bicycle helmet
Journal of Surgery, Vol.16, No.3, (May/ June 1992), pp. 389–397. • McDermott, F.T., "The Effectiveness of helmet wearing on reducing bicyclist head injuries and mandatory legislation in Victoria, Australia. Annals of the Royal College of Surgeons of England. 1995; 77:38-44.

Case studies
• Thompson, R., Rivara, F. and Thompson, D. (1989), A Case-Control Study of the Effectiveness of Bicycle Safety Helmets, New England Journal of Medicine, 25 May, 320:21, 1361–67 Abstract — (The most widely cited pro-helmet study.) • Scuffham Trends in cycle injury in New Zealand under voluntary helmet use, Langley. Accident Analysis and Prevention, Vol 29:1, 1997 — (Showed no benefit from large-scale increases in helmet use.) • FT McDermott, JC Lane, GA Brazenor & EA Debney. The effectiveness of bicyclist helmets: a study of 1710 casualties. J Trauma, Vol 34, pp834-845, 1993.

References
[1] Consumer Product Safety Commission. "Safety Standard for Bicycle Helmets" (PDF). Final Rule 16 CFR Part 1203. http://www.cpsc.gov/businfo/frnotices/ fr98/10mr98r.pdf. Retrieved on 2006. [2] Department of Transport (UK) 2002. Road safety research report. Bicycle helmets: review of effectiveness (No.30). Elizabeth Towner, Therese Dowswell, Matthew Burkes, Heather Dickinson, John Towner, Michael Hayes. November 2002. "In terms of tone, the bicycle helmet debate can best be described as sour and tetchy. Neither side seems willing to concede that there can be alternative points of view." http://www.dft.gov.uk/pgr/roadsafety/ research/rsrr/theme1/ bicyclehelmetsreviewofeffect4726 Section 7: Opinion Pieces. [3] Horton D. Fear of Cycling. pp 133-154 in Rosen P, Cox P, Horton D (eds.) Cycling and Society. Ashgate Publishing, Aldershot, UK, 2007. "The 2004 Parliamentary Bill was unanimously opposed by the cycling establishment, with every major cycling organisation and magazine rejecting helmet compulsion". [4] "BS EN 1078:1997: Helmets for pedal cyclists and for users of skateboards and roller skates". BSi. http://www.bsiglobal.com/en/Shop/Publication-Detail/ ?pid=000000000030082421. [5] Gibson T, Cheung A (2004-01-01). "CR 220: Assessing the level of safety provided by the Snell B95 standard for bicycle helmets". http://www.atsb.gov.au/ publications/2004/Bic_Crash_6.aspx. [6] ^ Brian Walker (June/July 2005). "Heads Up". Cycle (magazine of CTC): 42–45. [7] e. g. Vulcan, A.P., Cameron, M.H. & Watson, W.L., "Mandatory Bicycle Helmet Use: Experience in Victoria, Australia", World Journal of Surgery,

Risk
• John Adams, 1995, Risk, Routledge, ISBN 1-85728-068-7 — (Authoritative reference on risk compensation theory.)

Compulsion Laws
• BikeBiz (industry journal), "Helmet battle flares up in BMJ", March 24, 2006 • BikeBiz (industry journal), "Let’s fight for our rights to the road, argues CTC", Feb 27th 2006 • D Hendrie, M Legge, D Rosman, C Kirov, "An economic evaluation of the mandatory bicycle helmet legislation in Western Australia", Road Accident Prevention Research Unit, Department of Public Health, The University of Western Australia. • Merton, R.K., "The Unanticipated Consequences of Purposive Social Action", American Sociological Review, Vol.1, No.6, (December 1936), pp. 894–904. (see Unintended consequence) • Scuffham, Alsop, Cryer, Langley, "Head Injuries to Cyclists and the New Zealand Cycle Helmet Law", Accident Analysis and Prevention, 2000, 32: 565–573 • Vulcan, A.P., Cameron, M.H. & Heiman, L., "Evaluation of mandatory bicycle helmet use in Victoria, Australia", 36th Annual Conference Proceedings, Association for the Advancement of Automotive Medicine, Oct 5–7, 1992. • Vulcan, A.P., Cameron, M.H. & Watson, W.L., "Mandatory Bicycle Helmet Use: Experience in Victoria, Australia", World

11

From Wikipedia, the free encyclopedia
Vol.16, No.3, (May/June 1992), pp. 389–397. [8] Brian Walker, of helmet-testing lab Head Protection Evaluations. Heads Up. Cycle magazine, June/July 2005, pages 42-45:"Cycle helmets protect the head by reducing the rate at which the skull and brain would be accelerated or decelerated by an impact." [9] Jim G Sundahl, Senior Engineer, Bell Sports. 19th January 1998. Letter to the U. S. Consumer Product Safety Commission, c/o Scott Heh, Project Manager Directorate for Engineering Sciences Washington, D. C, 20207 [1] accessed 18th February 2008. (Errors as in original.) "any number of liner materials could absorb energy better than contemporary helmet liners but in fact produce a very poor helmet, A couple of good energy managers are soft lead sheet and modeling clay. impacting either of these produces negligible rebound velocity. In other words, they absorb .virtually ail of the impact energy. None of us are advocating these materials for helmet liners because energy absorption is not very important for helmets. I think that any discussion of helmet test criteria that includes the word “energy’ is suspect and might be misleading. Acceleration management is what helmets are about. All helmet standards measure acceleration and enforce a pass/fail criteria that includes a maximum acceleration rate...” [10] [2] Requirements for Bicycle Helmets 16 C.F.R. Part 1203 [11] U.S. CONSUMER PRODUCT SAFETY COMMISSION Office of Compliance. Requirements for Bicycle Helmets 16 C.F.R. Part 1203 [3] [12] Jim G Sundahl, Senior Engineer, Bell Sports. 19th January 1998. Letter to the U. S. Consumer Product Safety Commission, c/o Scott Heh, Project Manager Directorate for Engineering Sciences Washington, D. C, 20207 [4] accessed 18th February 2008. [13] DEPARTMENT OF TRANSPORT, FEDERAL OFFICE OF ROAD SAFETY. Report No. CR 55 Date May, 1987 Pages 160 f xi ISBN 0 642 510 431 ISSN CR = 0810-770 Title: MOTORCYCLE AND BICYCLE PROTECTIVE HELMETS: REQUIREMENTS RESULTING FROM A

Bicycle helmet
POST CRASH STUDY AND EXPERIMENTAL RESEARCH. Authors: J.P. Corner, C.W. Whitney, N. O’Rourke, D.E. Morgan CR 55: Motorcycle and bicycle protective helmets requirements resulting from a post crash study and experimental research (1987) [5] [14] DEPARTMENT OF TRANSPORT, FEDERAL OFFICE OF ROAD SAFETY. Report No. CR 55 Date May, 1987 Pages 160 f xi ISBN 0 642 510 431 ISSN CR = 0810-770 Title: MOTORCYCLE AND BICYCLE PROTECTIVE HELMETS: REQUIREMENTS RESULTING FROM A POST CRASH STUDY AND EXPERIMENTAL RESEARCH. Authors: J.P. Corner, C.W. Whitney, N. O’Rourke, D.E. Morgan CR 55: Motorcycle and bicycle protective helmets requirements resulting from a post crash study and experimental research (1987) [6] [15] Jim G Sundahl, Senior Engineer, Bell Sports. 19th January 1998. Letter to the U. S. Consumer Product Safety Commission, c/o Scott Heh, Project Manager Directorate for Engineering Sciences Washington, D. C, 20207 [7] accessed 18th February 2008. [16] Radio Australia. Innovations. Cone-Head Helmet. A helmet designed to reduce motorcycle fatalities and injuries. Transcript 4th February 2008. Contact: Don Morgan 33 Kingsley Parade, Yeronga, QLD 4104 Email: donmorgan@optusnet.com.au [8] [17] Graham-Rowe, Duncan (2001-02-13). "Soft hat". New Scientist. http://www.newscientist.com/article/ dn418-soft-hat.html. Retrieved on 2008-05-01. [18] Phillips Helmets Ltd - inventors of the Phillips Head Protection System [9] [19] Bicycle Helmet Assessment During Well Visits Reveals Severe Shortcomings in Condition and Fit. Parkinson GW and Hike KE(2003) PEDIATRICS Vol. 112 No. 2 pages 320–323 [20] Rivara et al. (1999) Injury Prevention 5: 194–197 [21] Death of cyclist Andrei Kivilev: declaration by the International Cycling Union [22] Union Cycliste Internationale (2003-05-02). Mandatory wear of helmets for the elite category. Press release. http://www.uci.ch/english/news/

12

From Wikipedia, the free encyclopedia
news_2002/20030502i_comm.htm. Retrieved on 2008-05-01. [23] "Article 1.3.031" (PDF). Union Cycliste Internationale. 2003-05-02. http://www.uci.ch/english/news/ news_2002/20030502i.pdf. Retrieved on 2008-05-01. [24] Bicycle Helmet Safety Institute [10] accessed 11th February 2008 [25] Mr Peter Bone, MP for Wellingborough, Hansard Volume No. 464 Part No. 142. House of Commons Debates 16 October 2007. [11] [26] Hillman M., 1994, Cycling: Towards health and safety. BMA, London [27] Burdett, Avery. "The Vehicular Cyclist". Who should wear helmets?. Ontario Coalition for Better Cycling. http://www.vehicularcyclist.com. Retrieved on 2008-01-09. "Of 2500 Major Head Injuries Annually in Ontario 49 % motor vehicle involvement—including pedestrians, excluding cyclists 35 % falls, 6 % homicide, 2 % suicide, 6 % other causes less than 2 % Cycling Source: Canadian Institute For Health Information 2001/2002)" [28] Burdett, Avery (December 2007). "Cycling safer than golf". Ontario Coalition for Better Cycling. http://www.vehicularcyclist.com. Retrieved on 2008-01-09. "The April 2005 edition of the Journal of Neurosurgery: Pediatrics carried a review of patients under age 19 seen by pediatric neurosurgeons at the Medical College of Georgia in Augusta between 1996 and 2002. Sixty four of the total of 2,546 head injured patients treated had sports-related injuries. Less than 1 % (17) treated had cycling-related injuries. (Apparently the authors consider cycling to be a sport rather than a mode of transportation.) Fifteen were golfrelated. The review did not attempt to compare relative risks by estimating exposure rates, but since children participate in cycling activities in vastly greater numbers than they do in golfing activities, it is abundantly clear that children are much safer riding their bikes than they are doing many other ordinary activities considered by most as benign and virtually harmless. This review provides more evidence that safety advocates’ obsession with

Bicycle helmet
protecting our young cyclists through use of helmets is enormously out of proportion to the low risk involved in cycling. To these advocates, we say, "Cycling is a safe, fun, healthy activity. Stop exaggerating its risks. That discourages the uptake of cycling and from a health point of view is extremely counterproductive."" [29] "Key facts about injury when cycling in perspective". Bicycle Helmet Research Foundation. http://www.cyclehelmets.org/ mf.html?1034. Retrieved on 2007-08-26. [30] Burdett, Avery (August 2006). "About the OCBC". Ontario Coalition for Better Cycling. http://www.vehicularcyclist.com/ contacts.html. Retrieved on 2008-01-09. "Unfortunately, this enjoyability and low risk is threatened by various politicians, bureaucrats, safety lobbyists, and misguided members of certain cycling organizations who would have cyclists ghettoized into bike lanes and onto bike paths, and slap foam hats on everyone’s head!" [31] Wardlaw M. British Medical Journal 2000;321(7276):1582 (23 December), doi:10.1136/bmj.321.7276.1582 [12] [32] ^ M. Wardlaw (December 2002). "Assessing the actual risks faced by cyclists". Traffic Engineering & Control 43: 352–356. http://www.cyclinginstructor.com/ cyclinginstructor.nsf/($Category1)/ E0A4E09F5D74812F80257177004D9A87/ $FILE/c2014.pdf?OpenElement. [33] Data supplied to CTC by UK Department of Health [34] CTC position paper on helmets [35] ^ Robinson DL (2006-03-25). "No clear evidence from countries that have enforced the wearing of helmets". BMJ 332: 722–725. doi:10.1136/ bmj.332.7543.722-a. PMID 16565131. http://bmj.bmjjournals.com/cgi/content/ full/332/7543/722-a. Retrieved on 2007-08-30. [36] [13] Rapid Responses to D L Robinson [37] ^ [14] BMJ 2006;332:725-726, doi:10.1136/bmj.332.7543.725 Arguments against helmet legislation are flawed. Hagel B, Macpherson A, Rivara FP, Pless B.

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From Wikipedia, the free encyclopedia
[38] [15] Rapid Responses to Brent Hagel, Alison Macpherson, Frederick P Rivara, and Barry Pless [39] ^ [16] Macpherson A, Spinks A. Bicycle helmet legislation for the uptake of helmet use and prevention of head injuries. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD005401. DOI: 10.1002/ 14651858.CD005401.pub2 [40] ^ Reducing Bicycle Accidents: A Reevaluation of the Impacts of the CPSC Bicycle Standard and Helmet Use Rodgers GB. 1988. Journal of Products Liability: 1988,11:307–317 [41] ^ ‘A prospective analysis of injury severity among helmeted and non helmeted bicyclists involved in collisions with motor vehicles’. Spaite, D. W., Murphy, M., Criss, E. A., Valenzuela, T. D. and Meislin, H. W. 1991. Journal of Trauma: 1991 Nov;31(11):1510–6 [42] Trends in cycle injury in New Zealand under voluntary helmet use Scuffham PA, Langley JD. 1997. Accident Analysis and Prevention: 1997 Jan;29(1):1–9 [43] Head injuries to bicyclists and the New Zealand bicycle helmet law, Scuffham P, Alsop J, Cryer C, Langley JD. 2000. Accident Analysis and Prevention: 2000 Jul;32(4):565–73 [44] New Zealand bicycle helmet law-do the costs outweigh the benefits? Taylor M, Scuffham P. 2002. Injury Prevention: 2002;8:317–320 [45] Objective observation of helmet use is essential. British Medical Journal [46] [17] Thompson DC, Rivara FP, Thompson R. Helmets for preventing head and facial injuries in bicyclists. Cochrane Database of Systematic Reviews 1999, Issue 4. Art. No.: CD001855. DOI: 10.1002/14651858.CD001855. [47] "Commentary: A case-control study of the effectiveness of bicycle safety helmets". Bicycle Helmet Research Foundation. http://www.cyclehelmets.org/1068.html. Retrieved on 2007-08-25. [48] ^ DiGuiseppi CG, Rivara FP, Koepsell TD, Polissar L. Bicycle helmet use by children. Evaluation of a communitywide helmet campaign. Journal of the American Medical Association 1989;262:2256-61.

Bicycle helmet
[49] "A prospective analysis of injury severity among helmeted and non helmeted bicyclists involved in collisions with motor vehicles". BHRF. unknown. http://www.cyclehelmets.org/ mf.html?1164. Retrieved on 2007-08-28. [50] FT McDermott & GL Klug. Head injury predominance: Pedal cyclists vs motorcyclists. MJA, Vol 143, pp232-234, 1985 [51] The Twit in the Hat. Marcus Farley. What Mountain Bike Blog. Thursday, Feb 7, 2008. [18] [52] Improved Shock Absorbing Liner for Helmets. Morgan D.E., Szabo L.S. July 2001. Australian Transport Safety Bureau. "In an impact situation involving a motorcycle or bicycle helmet, cracking through the thickness of the foam liner (slabcracking) is undesirable as it renders the foam liner of the helmet useless in its ability to further absorb an impact force. As a result the foam is unable to distribute the focal impact over a larger area and to decelerate the blow at the point of impact... The majority of cracking displayed by samples was in the shape of an arc outlining the spherical headform on impact. Arc-cracking has minimal effect, as it is part of the crushing process. However, cracks developing partly or fully through the thickness of the foam-slab renders it useless in crushing and absorbing impact forces." [53] [19] Robinson DL. Head injuries and bicycle helmetlaws. Accid Anal Prev. 1996 Jul;28(4):463-75. [54] Robinson (1996) Accident Analysis and Prevention 28:463–475 [55] [20] Andersen LB, Schnohr P, Schroll M, Hein HO. All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work. Arch Intern Med 2000 Jun 12;160(11):1621-8. [56] [21] Safety in numbers: more walkers and bicyclists, safer walking and bicycling. Jacobsen PL. Injury Prevention 2003;9:205-209 [57] [22]Estimates of Fatal Risk [58] "THINK! Cycle safety". Homepage. Department of Transport. http://www.cyclesense.net/fset.htm. Retrieved on 2007-08-24. [59] "New government helmet promotion could sound the death knell for the

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From Wikipedia, the free encyclopedia

Bicycle helmet

future of cycling". Cycling North Wales. Greater Binghamton, New York. January http://www.cyclingnorthwales.co.uk/ 28, 2008. [27] and search for"eddie pages/cycle_helmets_newgovprom.htm. holewa" Retrieved on 2007-08-24. [70] U. S. Consumer Product Safety [60] McGuinness, Lorraine; Stevens, Irene; Commission. Wear Bike Helmets On Milligan, Ian (November 2007) (PDF), Bicycles - Not On Playgrounds. CPSC Playing It Safe? a study of the regulation Document #5121. of outdoor play for children and young [71] Child deaths from helmet use people in residential care, Scotland’s [72] "Ambulance staff cleared over toddler’s Commissioner for Children and Young death". ABC News (Australia). People, http://www.sccyp.org.uk/admin/ 2004-05-07. http://www.abc.net.au/news/ 04policy/files/ stories/2004/05/07/1103511.htm. spo_264931Playing%20it%20Safe_SCCYP%20200711.pdf, on 2008-05-01. Retrieved retrieved on 2008-05-01 [73] Sam Riches, Police Reporter (April 05, [61] Risk. John Adams, 1995, Routledge, 2007). "Helmet strangles boy, 3.". The ISBN 1-85728-068-7 (Authoritative Advertiser, Adelaide, South Australia. reference on risk compensation theory.) http://www.news.com.au/adelaidenow/ [62] Death on the Streets: Cars and the story/ mythology of road safety, Davis, 1993, 0,22606,21510562-5006301,00.htm. ISBN 0-948135-46-8 [74] Perry, Nigel (1996). "Notes on the 3rd [63] e. g. Mok et al., Risk compensation in International Conference on Injury children’s activities: A pilot study, Prevention and Control". Paediatric Child Health: Vol 9 No 5 May/ http://members.tip.net.au/~psvansch/ June 2004 crag/3icipc.htm. [64] The Twit in the Hat. Marcus Farley. [75] Reducing bicycle accidents: A What Mountain Bike Blog. Thursday, Feb reevaluation of the impacts of the CPSC 7, 2008. [23] bicycle standard and helmet use. [65] [24] Drivers overtaking bicyclists: Rodgers, GB. J. Product Liability. Vol. 11, Objective data on the effects of riding no. 4, pp. 307–317. 1988. position, helmet use, vehicle type and [76] Trends in serious head injuries among apparent gender. Ian Walker. Accident English cyclists and pedestrians, Injury Analysis & Prevention Volume 39, Issue Prevention 2003; 9: 266–267 and 2, March 2007, Pages 417-425 responses doi:10.1016/j.aap.2006.08.010 [77] Bicycle helmets – a review of their [66] What is rotational injury? Phillips effectiveness: a critical review of the Helmets Ltd. [25] literature Towner E, Dowswell T, Burkes [67] The efficacy of bicycle helmets against M, Dickinson H, Towner J, Hayes M. brain injury, Curnow WJ. 2003. Accident 2002. Department for Transport: Road Analysis and Prevention: Safety Research Report 30 2003,35:287–292 [78] "Commentary: Road Safety Research [68] DEPARTMENT OF TRANSPORT, Report No 30". Bicycle Helmet Research FEDERAL OFFICE OF ROAD SAFETY. Foundation. Report No. CR 55 Date May, 1987 Pages http://www.cyclehelmets.org/1067.html. 160 f xi ISBN 0 642 510 431 ISSN CR = Retrieved on 2007-08-25. 0810-770 Title: MOTORCYCLE AND [79] The Cochrane Collaboration and bicycle BICYCLE PROTECTIVE HELMETS: helmets Curnow WJ. 2005. Accident REQUIREMENTS RESULTING FROM A Analysis & Prevention: POST CRASH STUDY AND 2005;37(3):569–573 EXPERIMENTAL RESEARCH. Authors: [80] "World Health Organization Helmet J.P. Corner, C.W. Whitney, N. O’Rourke, Initiative, Bicycle Helmet Resource D.E. Morgan CR 55: Motorcycle and Center". World Health Organization. bicycle protective helmets requirements http://www.whohelmets.org/bhrc.htm. resulting from a post crash study and Retrieved on 2007-08-25. experimental research (1987) [26] [81] AMA [69] Valerie Zehl. After son’s accident, family [82] Protect Yourself... Wear a Helmet! - NSC learns to find joy. Press and Sun-Bulletin,

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[83] "LAB Helmet Law Position". League of American Wheelmen. May 1991. http://www.helmets.org/labposit.htm. Retrieved on 2007-09-06. [84] "BMA votes for cycle helmet compulsion (with debate transcript)". BikeBiz. 2005-06-30. http://www.bikebiz.co.uk/ newsitem.php?id=19740. Retrieved on 2007-08-24. [85] "Legislation for the compulsory wearing of cycle helmets". BMA. November 2004. http://www.bma.org.uk/ap.nsf/Content/ cyclehelmetslegis. Retrieved on 2007-08-24. [86] John Forester, M.S., P.E. (2004). "Effective Cycling Instructor’s Manual—Fifth Edition" (PDF). http://www.johnforester.com/BTEO/ ECIM5.pdf. Retrieved on 2007-08-24. [87] [28] A Chain Reaction. The Guardian, Nov. 2nd, 2002. [88] ^ Hillman, M.. 1993. Cycle Helmets: the case for and against, Policy Studies Institute. [89] [29] M. Hillman: "Keep your head". Letter to New Scientist, 2nd September 2002, p. 50. [90] Cyclecraft: Skilled Cycling Techniques for Adults. Franklin J. Stationery Office Books; 4th Ed edition 2007. ISBN 978-0-11-703740-3 [91] ^ Improving Bicycle Safety—Without making helmet-use compulsory, European Cyclists’ Federation 1998 [92] "Helmets CTC policy". Cyclists Touring Club. http://www.ctc.org.uk/ DesktopDefault.aspx?TabID=4688. Retrieved on 2007-08-31. [93] "CTC Policy Handbook". CTC. March 2004. http://www.ctc.org.uk/resources/ Campaigns/ PolicyHandbook_March_2004.doc. [94] Letter from David Jamieson, MP, minister of state for transport, to Michael Jack, MP [95] Gill, Tim (2005) (PDF). Cycling and Children and Young People, A review. National Children’s Bureau. pp. 42–43. ISBN 1-904787-62-2. http://www.cyclehelmets.com/cyclingreport_timgill.pdf. [96] "Injury-Control Recommendations: Bicycle Helmets". Centers for Disease control and Prevention. 1995-02-17. http://0-www.cdc.gov.mill1.sjlibrary.org/ mmwr/preview/mmwrhtml/

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00036941.htm. Retrieved on 2007-07-27. [97] Richard Ballantine (1972). Richard’s Bicycle Book. Ballantine Press. [98] "LAB Helmet Law Position". League of American Bicyclists. May 1991. http://www.helmets.org/labposit.htm. Retrieved on 2007-08-24. [99] bfu Report 41 Stefan Siegrist, Roland Allenbach & Caroline Regli (Bern 1999) Cycling helmets – Survey of wearing behaviour and reasons. [30] accessed 6th November 2008 [100]SWOV Fact sheet: Cyclists" (PDF). NL " Institute for Road Safety Research (SWOV). http://www.swov.nl/rapport/ Factsheets/FS_Cyclists.pdf. [101] ucher and Buehler (2007-11-12) (PDF). P "Making Cycling Irresistible: Lessons from the Netherlands, Denmark, and Germany". http://policy.rutgers.edu/ faculty/pucher/Irresistible.pdf. [102] avis RM, Pless B. (1996-05-18). D "Letters: Evidence shows that cyclists should wear helmets". BMJ 312: 1310. http://www.bmj.com/cgi/content/full/313/ 7057/629/a. [103]IP Editorial Board". Injury Prevention. " http://injuryprevention.bmj.com/info/ edboard.dtl. [104] B Pless (2007). "A chronology of failed I advocacy and frustration". Injury Prevention 13: 73–74. doi:10.1136/ ip.2007.015776. PMID 17446243. http://injuryprevention.bmj.com/cgi/ content/extract/13/2/73. [105] B Pless (2006). "Are Editors free from I bias? The special case of Letters to the Editor". Injury Prevention 12: 353–354. doi:10.1136/ip.2006.014472. PMID 17170177. http://injuryprevention.bmj.com/cgi/ content/extract/12/6/353. [106] orothy L. Robinson (2007). "eLetters D for Pless, 12(6) 353-354: Good data and constructive debate can help resolve controversial issues". Injury Prevention (12). http://injuryprevention.bmj.com/cgi/ eletters/12/6/353#1648. [107] eter W. Ward, GP (2007). "eLetters for P Pless, 12(6) 353-354:: Evidence on cycle helmets is contested, ambiguous and inconclusive". Injury Prevention (12). http://injuryprevention.bmj.com/cgi/ eletters/12/6/353#1617.

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From Wikipedia, the free encyclopedia
[108]For more than 15 years, Bell Sports has " committed its expertise and funding to Safe Kids coalitions across the United States to keep kids safe from bicycle and other wheel-related injury and death" [31] Accessed 1st March 2008. [109]On the legislative front, Bell Sports " supports the annual Safe Kids helmet legislative and enforcement grant program. Through these grants, coalitions are able to conduct advocacy efforts to enact or enforce helmet use legislation for bike riding or other wheeled sports. Numerous coalitions have been able to make strides in the legislative arena and encourage more kids to wear helmets through Bell’s support." [32] Accessed 1st March 2008. [110]Knesset passes controversial law " requiring cyclists to wear helmets". Haaretz. 2007-07-25. http://www.haaretz.com/hasen/spages/ 886072.html. [111]Helmet Laws for Bicycle Riders". " http://www.helmets.org/mandator.htm. [112]Safety in numbers". Homepage. Bicycle " Helmet Research Foundation. http://www.cyclehelmets.org/index.html. [113] sberg, J.S., Stiles, C. (1998). "Bicycle O Use and Safety In Paris, Boston, and Amsterdam". Transportation Quarterly 52(4): 61–76. [114] rian Wilson (2006). "Amsterdam B Bicycles.". http://www.ski-epic.com/ amsterdam_bicycles/.

Bicycle helmet
[115]n the land of the Dutch Black, the cyclist I is king of the road. Debra Mayrhofer. The Age February 11, 2008. [33] [116]Cycle helmet promotion: a dangerous " distraction" (DOC). Cyclists’ Touring Club (CTC). http://www.ctc.org.uk/ resources/Campaigns/ 0305CTChelmetpromotion1.doc. Retrieved on 2007-08-24.

External links
• A synopsis of selected research papers and medical articles—from RoSPA • Bicycle Helmet Research Foundation • John Franklin, Cycle helmet resources • Chris Gillham, Mandatory bicycle helmet law in Western Australia • The Vehicular Cyclist, "Helmet FAQ" • Randy Swart, "Bicycle Helmet Safety Institute" • Snell Memorial Foundation, "Active list of certified helmets" • U.S. Consumer Product Safety Commission, "CPSC publication announcing new US helmet standard" • i-SUC - International Safety Union for Cyclists (spoof, ostensibly pro-compulsion, site) • BikePortland.org, Vancouver Council will go for all-ages helmet law • Cykelhjelm.org - Denmark’s leading website on bicycle helmets

Retrieved from "http://en.wikipedia.org/wiki/Bicycle_helmet" Categories: Cycling equipment, Cycling, Helmets, Safety clothing, Cycling safety This page was last modified on 23 May 2009, at 09:50 (UTC). All text is available under the terms of the GNU Free Documentation License. (See Copyrights for details.) Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a U.S. registered 501(c)(3) taxdeductible nonprofit charity. Privacy policy About Wikipedia Disclaimers

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