Who are all these self-harming Dutch helmet wearers?

Martin Porter mentions a fun fact about helmet wearing:

Hans Voerknecht has been to a Velo-City conference in Vancover to explain why mandatory helmet laws are not such a great idea.  One of his statistics is that In the Netherlands, where cycling is ubiquitous, 13.3 per cent of the cyclists admitted to hospitals with injuries wore helmets — even though just 0.5 per cent cent of Dutch cyclists wear helmets.

This statistic is both utterly useless and extremely important. It tells us nothing about whether helmets are effective, ineffective or dangerous, but it does brilliantly illustrate the fact that the helmets issue is far from being a simple “no brainer”, and hints at one of the major flaws in the scientific studies of helmet efficacy.

Martin speculates on the reason for the interesting 30 times higher rate of hospitalisation amongst helmet wearers:

Maybe tourists from Anglo Saxon nations wearing helmets are disproportionately represented in the hospital statistics.  Maybe also those with helmets are perceived by motorists or perceive themselves to be less vulnerable.

In fact, it’s obvious who the helmet wearers are in the Netherlands.

Here’s a cyclist wearing a helmet:


while this bicycle user is helmet free:


These cyclists, ready for Saturday morning training, are wearing helmets, but the woman who has just passed them isn’t:


This cyclist is wearing a helmet:


This family out for a ride isn’t:


This cyclist is wearing a helmet:


This chap just has a cap:

tram in the trixie

This guy is wearing a helmet:


This one isn’t:


These cyclists are wearing helmets:


These folks aren’t:


These cyclists are wearing helmets:


And these aren’t:

bicycle path

Can you spot the difference? All of the helmeted cyclists are racing around, head down, feet firmly clamped to the pedals on fragile lightweight skinny tired bicycles — except for the one on a muddy knobbly tired mountainbike. Most of the helmet photos were taken at the weekend. Some of the others were too: a couple of gents leisurely touring the sand dunes in a nature reserve, and a family crossing Nesciobrug, perhaps off for a picnic in the country. But mostly they’re just people making everyday journeys: commuters in Amsterdam, shoppers in Utrecht, school kids in Houten. They’re on sturdy steady bicycles, rarely doing more than 15mph. Their environment is not completely without hazards, but even if things do go wrong, they’re extremely unlikely to find themselves hospitalised. The racers and mountainbikers, meanwhile, are far more likely to fall off or hit something, and at the sort of speeds where that breaks things.

The Dutch wear helmets — and get injured — when they’re doing sports. The Dutch don’t wear helmets when they’re using transport.

This is one of the major flaws in much of our research on helmets, and in much of the British approach to cycling. It fails to account for the differences between using a bicycle and participating in (extreme) sports.

Edited to add, in case it wasn’t clear — for I fear that too frequently in these posts I leave all of the background as taken, having been over it many times before — in the Netherlands these racers wearing helmets are the same people riding utility bikes without them. The folk who get dressed up in lycra and helmets to ride sports bikes at the weekend will, during the week, be riding a utility bike in normal clothes and no helmet, because that’s what the Dutch do. All of them. I mean, they don’t all do the racing, but they all have a utility bike. We don’t expect folk who enjoy a bit of rock climbing at the weekend to continue wearing their helmet all week, or people whose hobby is diving to keep the scuba tank on for the Monday morning commute.


55 thoughts on “Who are all these self-harming Dutch helmet wearers?”

  1. Commuting to work is an extreme sport, given the behaviour of a lot of cyclists. I tend to not wear a helmet and favor the cycle routes, but a lot of guys still race the hell out of their morning commute. I much rather chill? i guess it has to do with your life approach?

    1. That’s why they end up in hospital: they think the helmet is giving protection, so they take risks and neglect to protect their heads in falls. In practive the “helmet” is merely a polystyrene hat with holes in it, and pretty ineffective against any serious impact.

  2. Interesting, though as always it needs to be taken on a case-by-case basis. When it is you or someone you love you’d hate it to be counted as a “statistic.” When I worked as a trauma nurse I took care of a few sad people who crashed at low speeds (definitely <15mph) on commuter bikes sans helmets and are now in lifetime nursing care. Which reminds me… you are leaving out a major factor beside speed in bicycle crashes: alcohol or other impairment. I'm sure people drink in the Netherlands… right?

    1. So the logic is, wear a helmet if you are racing or drinking! Sound advice. Which I am sorry to say has some correspondence to my accident history! Although I would add that it can help you if someone knocks you off with their car door too. Or if it is icy.

  3. Here’s another thought, but I’m not sure where it takes us.

    You remember those UK/Dutch accident comparisons? If the only people in NL wearing helmets are racing/training (which I suspect is about 99% right), then 13.3% of accidents are sport related. And as you say, that’s a completely different thing altogether – if you race, you are guaranteed to have a few crashes (see Matt Seaton – Escape Artist).

    I suspect that a higher proportion of cycling is here is sport related – if not hard core racing, then people trying to go fast/get fit. In NL, while there may be more racing, I guess it’s a tiny proportion of the total. Does that make Dutch (non sport) cycling even safer than we thought? Or do we need to know how much injuries in UK are sport related?

  4. Joe, his site seems to be accepting posts now. (I did a test as I was interested for unrelated reasons in whether Blogspot works, and have managed to make an eejit of myself.)

  5. I’d be interested in seeing if there is any correlation between number and seriousness of injuries and whether the rider is riding clipless.

  6. The fundamental problem it seems to me about doctors, and I think your excellent prevous analysses of the helmet debate probably illustrate this, is that they deal in sickness, not in health. It is as fundamental as the distinction between road safety, and road danger reduction, if not more so.

    You go to your doctor when you are all, and he goes through a process of diagnosis and treatment of your illness. If you are not often ill, you will not often see your doctor – I haven’t been for some years and even then it was only for a tetanus booster after a garden accident.

    By and large, doctors don’t interact with you at all about how to stay healthy, and if you were to suggest to them that they should, they would probably tell you (and they would probably be right) that that is not what they are paid for. They could in principle circulate newsletters or useful advice to everyone on their patient lists but they don’t. They could hold clinics to provide advice on healthy eating or exercising, but they don’t – they would probably say you should join a health club/gym for that.

    And history shows that any form of medcal praticioner or para-medical who approaches his profession holisticially is likely to be condemned by the mainstream medical profession as a quack – no doubt many are, but many others are not

    So, I don’t think it is any surprise that doctors, trauma surgeons, the BMA etc see things only in terms of medical interventions, and while wearing a helmet is arguably a medical intervention, not choosing to wear one, or even choosing not to wear one, definitely isn’t. Therefore all the liver, kidney, cardiovascular, diabetes, etc practicioners will not have much to say because their work only starts when it is already too late to prevent a crisis, you just have to treat it.

    Ultimately, the views of trauma surgeons are formed by the cases which get wheeled into the emergency rooms, and while they have a great deal more evidence than the “I had an accident and a helmet saved my life” assertion, their views or still purely anecdotal. But because they are doctors, we are all too deferential to what they have to say , and positions of authority either just accept their arguments without proper scrutiny, eg judges hearing compensation claims rejecting or reducing awards, or are in danger of doing so eg government introducing helmet compulsion.

    1. Indeed, though plenty within medicine do get this, and the profession has been wrestling with exactly these issues — of prevention and cure, of “health service” versus “illness treating service”, of medicine’s place in politics… — for more than three decades. And it’s as much an issue with what society and politicians have decided medicine should be as with what doctors have decided medicine should be — government decides whether to legislate for and allocate resources to prevention or cure. And of course, doctors who specialise in public health and epidemiology are as likely to oppose helmets as those who specialise in trauma surgery are likely to favour them, precisely because the former have both a better grasp of science and a more healthy view of what medicine should be.

      The problem with the quacks who throw around words like “holistic” is that they rarely offer anything like “holistic” treatment. They offer magic pills and miracle cures, a cargo cult imitation of the same bits of real medicine that they criticise.

  7. OK, 13% of cyclists admitted to hospital in the Netherlands were wearing helmets. I’m tempted to ask “so what?” Given, racers probably do 2-400miles a week on average,that’s probably about 25 – 30 times the amount of mileage than the average weekend or occasional cyclist. Therefore, do the math, and that equates to almost exactly the same probability of being involved in an accident requiring hospital treatment per mile travelled as the non-helmet wearing brigade.

    Moreover, I think the choice of vocabulary reveals much about the mindset at work here: “racing around, head down, feet firmly clamped to the pedals on fragile lightweight skinny tired tires”. The implication being that they are in their own little world, oblivious to everyone else. Hardly surprising, therefore, they have so many accidents. In fact, from what I can see, while many have adopted the flat back racing posture, their head position indicates they are well balanced with their eyes firmly trained on the road ahead.

    1. “racers probably do 2-400miles a week on average,that’s probably about 25 – 30 times the amount of mileage than the average weekend or occasional cyclist.”

      A very British idea of cycling. You think the non-helmeted are “weekend cyclists” doing 10 miles a week? They’re mostly everyday utility cyclists, doing several — many, frequently more than 10 — miles every day as they go to work and run their errands. And then perhaps some of them are sometimes also doing those 10 miles (and more) of “weekend cycling” on top of the many miles they’ve already done during the week just as part of their normal way of getting around.

      The racers are, of course, the same people. Perhaps they’re doing 100 miles on their sports bikes at the weekend, but during the week they’re riding the same useful sturdy steel bicycles, sans helmet, for their normal everyday journeys.

      Interesting that you manage to interpret all this as some sort of moral judgement of sports cycling.

  8. I would seriously challenge your “stat” of 0.5% of Dutch cyclists wear helmets. If that were the case, I would expect to see 199 photos of non-helmet wearing cyclists to 1 helmet wearer. In fact, I see about 50-50. This tells me that those who wear helmets are obviously doing far more of the cycling than those who go helmet-less, or the stat is seriously flawed. You can’t have it both ways I’m afraid. Moreover, I can assure you that 400miles/wk is easily achievable for an amateur racing cyclist, equating to about 18-20 hours. While I accept that some of those who don’t wear helmets clock up some serious miles don’t overlook the fact the figure you quote is for the whole population, so is bound to include those who perhaps cycle once a month or less,and will therefore bring the average mileage down for the non helmet wearers.

    As to my finding your blog a “moral judgement”, perhaps I misinterpreted you. Obviously when you described helmet wearers as “racing around, head down, feet firmly clamped to the pedals”, you were being complimentary and not implying that they were accidents waiting to happen.

    1. “I would seriously challenge your “stat” of 0.5% of Dutch cyclists wear helmets. If that were the case, I would expect to see 199 photos of non-helmet wearing cyclists to 1 helmet wearer. In fact, I see about 50-50.”

      Are you serious??

  9. 50/50? Have you even been to NL? Its possible to go for days without seeing a helmeted cyclist if you limit yourself to a highly urbanised environment.

  10. Gareth, I’m talking about the ratio of photos of helmets to non helmets on this blog, as the previous sentence makes clear!

    1. Shock new research finding: a blog post showing cyclists had exactly half of the pictures featuring people on bicycles wearing helmets. The other half of the photos showed people riding bicycles without helmets. The road safety world is turned upside down!!

    2. You have perhaps heard the advice regarding “say nothing and have people suspect you are an idiot, or open one’s mouth and leave no doubt?” If someone is comparing things A, B, A, B, A, B, you will find A’s and B’s in a 50-50 ratio.

      From my own experience cycling, when I was younger I raced for a few years, and it affected both my cycling style and the choice of bicycle/geometry (as well as the choice of roads, etc). I had several accidents, including two requiring a trip to the hospital, and three others where I was very badly bruised. In recent decades, practically nothing; a scraped shin (on an SPD pedal, riding on a narrow unpaved trail, where I had to do a fast and graceless stop) and a bloodied hand (slid on gravel exiting a MUP, put hand down to catch myself and caught some sharp bits). And as utility cyclists go, I am still somewhat on the aggressive side.

  11. Lol. You want 199 photos of non-helmet wearing Dutch folk on bicycles?

    How about these?

    Really, you want me to go on? I could go on.

    But it might be easier just to watch one of Mark W’s videos:


    This is one of the few videos in which you’ll spot a helmet:


    Obviously I specially picked out photos of people in helmets — the only photos, all the photos, I have of Dutch helmeted cyclists, compared to the hundreds of helmetless photos — for a post about helmets. Of course you see 50:50. They’re a series of one to one comparisons. I thought it was a pretty obvious editorial decision.

    I really recommend going through the whole Bicycle Dutch site, as well as A View From The Cycle Path. Everything in your comments screams British niche cycling culture — “400miles/wk is easily achievable for an amateur racing cyclist” (yes, but a Dutch one would be on a utility bike, sans helmet, for half of those); “those who perhaps cycle once a month” (that’s a British thing) — and the alternative model really is a revelation.

    “racing around, head down, feet firmly clamped to the pedals” — yes. Streamlined; using SPDs. i.e. fast. Speed is a factor in the severity of damage were anything to go wrong. Noting that something affects risk should not imply moral judgement. Why do people think it does? Life is a non-stop series of subconsciously and consciously calculated risks.

  12. Well yeah, those photos were selected to be contrasting pairs. How do you infer from that who does how much cycling? Ignoring the obvious point raised earlier that a helmet-less cyclist during the week can be a helmeted one on the weekend.
    As a kid in NL I must have done about 30km a day, going back and forth to school 4 times (its common in many junior schools to cycle home for lunch) as well as to after school activities, friends houses etc. If anyone is boosting the national average, its young people.

  13. From an innocent and non-informed point of view, can I ask why racing cyclists wear helmets at all? If the answer is that the controlling bodies insist on it then the question is “why do they insist?”

    Personally I habitually wear a helmet because it seemed like the right thing to do when I started cycling regularly 30 years ago. Occasionally I have been pleased to have an overhanging branch deflected on a country road.

    My only A&E “slight” injury was after an evening at University studying for my MSc in Social Research Methods so I do have a reasonably well-developed sense of the value of data, statistics, uncertainty, probability, information, anecdote, knowledge and wisdom. I certainly don’t wear my helmet because of “evidence”, nor can I imagine any “evidence” that would remove my uncertainty.

    But I’m still curious to know why all the cyclists on the Tour de France will be wearing helmets again this year, apart from the obvious reason that it helps manufacturers to display their wares to a huge and relevant audience.

    1. Very good question. The simple answer is that cyclists on the TdF wear helmets because the rules say that they have to. But the Tour de France riders were only required to wear helmets since 2003, they were strongly resisted by most competitors before then. Even now riders are allowed to remove their helmets on longer climbs to a finish, if they wish.

      As for evidence, the effectiveness of helmets at absorbing impact energy is actually very well understood, and helmets are designed to meet well-defined standards. A good write-up in layman’s terms, written by a helmet testing laboratory, can be found here (from the CTC magazine): http://cyclehelmets.org/papers/c2023.pdf

      What is less well understood are the issues about rotational injuries (to brain and neck) – motorbike helmets are tested for this, but cycle helmets aren’t. This is almost certainly because polystyrene hats would fail any reasonable tests because for cycling they have to be very lightweight and have good ventilation.

      I suspect that the huge sums of money involved selling mass-produced polystyrene hats enable the helmet industry to influence decisions, as you suggest. If you can sell a safety product to people who fear for their safety, you can make a fortune with very little marketing effort. Most people won’t bother investigating the details of what they’re buying, or how effective it might be. I think for racing types the helmet helps them to look fast and macho, too: “look at me, I take serious risks!”.

    2. They are substantially more likely to crash while racing, and they are moving at substantially higher speeds almost all the time. A racing posture is somewhat more conducive to headers, since your body and head are positioned relatively low and forward. Racers frequently draft just a few inches behind one another, creating additional opportunities for crashes through wheel touches or simple pileups. My own experience is consistent with this, and so are the Dutch stats quoted above.

      Utility cycling is much slower and safer — we can simply observe Dutch statistics to see this — and though it may be true that wearing a helmet usually makes you safer (*), if you are already very safe, the additional safety provided by a helmet is not large. So for example, we do not expect pedestrians to wear helmets, even though per-mile, walking is more dangerous than cycling. We do not expect drivers to wear helmets (and if you are not asking exactly the same questions about drivers and helmets — race car drivers wear helmets, and auto crashes are the leading cause of serious head injuries in the US — then you’re being more than a little inconsistent). We might ask, why don’t we require car drivers to wear flameproof suits? Race car drivers wear flameproof suits. Why don’t we require five-point seat belts? Race car drivers use five-point seat belts.

      From a public health point of view, the results are unambiguous: to promote helmet use in bicycling, is to kill people. Most people do not get enough exercise. The benefits of exercise are very large, and helmet shaming and helmet laws cause some people to avoid cycling, and hence to avoid a very practical form of exercise, and through that effect, kills people. Diseases of the unfit are widespread and deadly, and it does not take a small change (more or less) in those deaths to completely swamp changes in the bicycle crash death/injury rate.

      (*) I find most of the “explanations” for how bicycle helmets are more dangerous in crashes to be a little far-fetched, though “larger target” makes some sense.

      1. Thanks dr2chase. My reading so far suggests that in collisions at speed or with motor vehicles helmets offer no clear advantage. The suggestion that wearing a helmet encourages closer passes is interesting but seems less relevant to the urban contexts of recorded cycle collisions, namely someone not looking/not seeing and an incautious manoeuvre by someone at junction. There seems to be some rationality in wearing a helmet for pottering about, as my son was doing when his helmeted head eventually hit the tarmac.There was no injury to his head but his helmet did the expected thing and collapsed on impact. No conclusion can be drawn as to whether the absorbed energy was relevant to his being uninjured or, indeed, whether egg boxes sellotaped to his head might have been just as useful.

        What I conclude, I suppose, is that being drawn into debates about cycle helmets is probably best avoided. I am happy to cope with the scorn of those who see my continued helmet wearing as merely superstitious.

        There is a danger I think, for campaigners on any side, in being seen as dogmatic and fixed when “reality” is essentially blurred. The very assertive don’t often win arguments. That prize tends to go to those with the power. The organisers of the Tour De France, for example.

      2. It is not superstitious to wear helmets for safety, it is just not as effective as widely believed — unless you are racing or mountain-biking. Compared with other behaviors, it is also evidence of massive ignorance about actual risks.

        What is “wrong” with helmets is when people promote them as being crucially necessary for bicycle safety, to the point of advancing legislation, affecting assignment of fault in crashes, and publicly shaming or ridiculing people for not wearing them. THAT behavior kills people.

        Helmet advocates would have you believe that as safe as the Dutch are, they would be even safer if helmets were required, because then they would have all those exercising cyclists, and they would also be wearing helmets. That is a world where pigs fly. In the real world with real people, with helmets required, fewer people would cycle, and more people would die early for the lack of time spent on bicycles.

        And do note, I write from the USA — together with Australia, we are the world’s experts at not-cycling.

  14. Basically, this post is spot on: helmet wearers in the Netherlands are doing something different from normal everyday cyclists when they are wearing their helmets, which massively increases their chances of being hospitalised. Helmet weraing is implicated in behaviour which is far more likely to end you up in hospital than the cycling you do when not wearing a helmet.

    Racing cyclists are far more likely to be in collisions requiring treatment – including for head injury – than everyday cyclists, even in this country, and certainly in the Netherlands. (The correct unit of exposure, BTW, should be in time spent cycling, rather than distance, in my opinion.) To see the truth of this, take a look at the Tour de France and make calculations of collisions per time spent cycling.

    Now, I’m not against people doing cycle sport – far from it. I used to do it myself and still do semi-sporting cycling (cyclosportifs, audaxes etc.). I am just saying that we need to look at these people as: using helmets, their high level of bike handling and the protection form immediately available high level specialist medical care IN ORDER TO FACILTIATE THEIR HIGHER LEVEL OF RISK TAKING.

    To put it another way, the SAFETY BENEFIT TENDS TO BE COMSUMED AS A PERFORMANCE BENEFIT. This has been written about at length by Gerard Wilde, John Adams and myself in “Death on the Streets: cars and the mythology of road safety” (1992). I repeat, I’m not against people putting themselves at risk by doing this – but I do think they cannot argue that helmet wearing reduces the chances of head (and certainly not other) injury.

    On top of this question of risk compensation/adaptive behaviour by cyclist when they wear helmets, we have another question (a minor one, in my view, but worth remarking on) of less care taken by motorists of the helmet wearers. More important than that – in my view the most important issue of all – is the diversionary effect of helmets in debate about cyclist safety – the red herring issue.

    All of the above tends to be missed out in discussion about cycle helmets.

  15. In conclusion then, the people who could benefit from a helmet – the gentler low impact people who might tumble off at low speed and bump their heads at less than 12mph on a flat surfce don’t wear helmets, while those who take calculated risks at much higher speeds and for longer periods might just as well not bother with them.

    1. Seems about right, unless of course the helmet in question is actually constructed to withstand higher speeds, which a motorcyclist helmet is.

      But good luck trying to convince a roadrace bicyclist to wear a motorcycle helmet or something of a similar construct

      1. A cyclist can’t wear a motorcycle helmet since cycling generates heat. People usually lose their excess heat through the head. Wear a motorcycle helmet while cycling and you’d faint.

    2. No, you have it exactly backwards. Your son’s inadvertent experiment with helmets and falls merely proved that the helmet would not hurt him; the experiment to prove that it was protective is not one that anyone wishes to perform intentionally. Your logic can be used to confirm the effectiveness of elephant repellent (“no elephants here, better keep using it to keep them away”). You don’t know that elephant repellent works unless

      You do not know that a minor bump on an unhelmeted head would have been harmful, and the Dutch statistics suggest that for slow riders crashes are so rare that the incremental safety provided by a helmet is not worth worrying about. In contrast, the high proportion of accidents experienced by racing cyclists suggests that helmets make sense for them.

      The large fraction of head injuries attributed to automobile crashes also suggests that anyone rationally approaching this issue should also be considering the use of helmets for drivers. In the US, their per-hour mortality risk is apparently about the same as for cycling, but the exposure is much higher, AND there is no public health problem if mandatory helmet uses for drivers discouraged driving. It is very likely that it would result in a net reduction in mortality, unlike bicycle helmet laws. Do you wear a helmet while driving? Does your son? Why not?

      1. Dr2chase;

        “In contrast, the high proportion of accidents experienced by racing cyclists suggests that helmets make sense for them.”

        You seem to ignore the fact that the helmets have about zero effect when a crash occurs at speeds above 12-15 mph, it simply isn´t strong enough, to provide any protection

      2. Do you have statistics that directly support that claim? Thus far, I have only seen arguments for “helmets no good above 15mph” that use the same design-oriented reasoning that helmet proponents use to justify the inherent benefits of helmets. Not all accidents are head-on and head-first.

  16. On a similar note to Dr. RObert Davis, I just read in “Traffic” by Tom Wanderbilt, that a Norwegian study showed that the newer the car, the more accidents it gets involved in, the car and the driver maybe safer, even efter taking adjusting to a more risktaking driver profile, due to safer cars, but what about the people outside the car?
    The same book claims no research has ever showen anti lock-brakes to have any real life effect on reducing accidents, though ABS/ALB are universally recognised as a great safety improvement for cars.
    Apparently many use the brakes wrongly, do not brake fully, when you get into an accidents situation, you are prone to fixate on the danger object, and actually steer directly towards it (and steering is better with ABS), finally people tend to take higher risks, the more safe, they are.

  17. I note that comment makers on this piece are not rushing forward to accept the fact of risk compensation/behavioural adaptation to changes in perceived risk.

    The other point – referred to in the last comment – is the relative risk of getting a head injury while cycling compared to whn using other forms of transport. Or: why not wear a helmet when walking or in a car?
    Now, UNLIKE the last comments from dr2chase – there IS a publci health problem that you would get from getting car drivers to wear helmets: as withs eat belts, crumple zones, roll bars, etc. etc. you would have worse driving.

    1. Risk compensation is a real but minor effect, and may safely be ignored when compared with the public health costs of not-cycling. It holds our attention because of its delightful counterintuitiveness, but it fails to score high on any count-dead-bodies metric.

  18. I dispute that risk compensation is “a real but minor effect”. If you read my book (shameless plug) “Death on the Streets: cars and the mythology of road safety” you find many instances which, regrettably, do score on what you refer to as a “count-dead-bodies metric”. Similarly John Adams “Risk” and “Risk and Freedom”. gibes the relevant examples and the long term trends indicated by the Smeed curve.

    Also, it is not “counter-intuitive” – it is evidence based. And saying that better protected drivers adapt by (albeit small) changes in – less – care and attention is not “counter” what those of us outside cars are interested in.

    Nor is it “delightful” or amusing. the fact that it opposes the mythoogy of the “road safety” lobby shows us how wrong the “raod safety” lobby is.It is about reality.

    1. Yet the net road mortality rate is down in the US (and probably other places) — risk compensation has failed to outweigh the effects of the various safety measures, and years of life lost to crash deaths is a fraction of those lost to diseases of the unfit (and in particular, a fraction of the believed-to-be-avoidable portion of those deaths). Risk-compensation-induced deaths are smaller than car crash deaths overall, and car crash deaths are not that numerous when compared to those caused by lack go exercise. THEREFORE, when considering things from a public health perspective, risk compensation effects may safely be ignored.

      It’s not enough to point at deaths and say “bad-bad-bad”. You have to also consider, “compared to what?” Head injuries from cycling crashes are bad, but compared to deaths from lack of exercise, not really worth worrying about.

  19. It is indeed important to consider road crash death numbers when totalled up, as against other numbers of casualties associated with mass motorised cultures. It is an important point I never tire of making.

    However, the whole point about the decline of road crash deaths over time in various countries, as shown in the Smeed curve and decribed at length by John Adams in the works referred to above, is that these declines occurr in countries which have experienced quite different kinds of “road safety” intervention. In other words, the changes appear to be to a large extent spontaneous changes which occurr as nations experience increased motorisation – and adapt to these changes. Risk compensation is another name for this general adaptive change.

    Over a specific period of time with a specific intervention like seat belts, you may find that the number of dead cyclists and pedestrains associated with the intervention is smaller than the number of car occupants who lives have supposedly been saved by the intervention.

    The issue then is: is that morally acceptable ? How many dead pedestrains would make the intervention unaccepatble?

  20. THANK YOU for this article! This is what I’ve been saying all along here in the UK. I have been cycling for 40 years and have never worn a helmet, and I don’t wear spandex either :-D I do go out for long fast rides sometimes on my skinny wheel bike, but I always choose traffic-free routes in the middle of nowhere. I honestly believe that you should not cycle in moderate traffic, let alone heavy traffic. Actually this article misses out photos of the real offenders, who are *not* the spandex brigade racers, much to my chagrin – the worst are in fact the ‘born-again’ cycle commuters with helmets and reflective jackets weaving slowly through heavy traffic, in the middle of the road, thinking they are somehow indestructible because they been on a ‘course’ and are wearing a helmet. Muppets. We have a few of those at work here. In addition, I did try wearing a helmet for a week or so as an experiment and found them very dangerous because of the wind noise they generate when you go at speed – you can no longer hear distant vehicles coming ! With no helmet, I can hear cars coming a long way off or from behind blind corners and junctions which is far far safer.

  21. Sam Saunders remarks above: “What I conclude, I suppose, is that being drawn into debates about cycle helmets is probably best avoided.”.

    On the whole I would have to agree but note that our number two world cycling nirvana, Denmark, is beginning to suffer an onslaught from cycle helmet compulsion campaigners, as reported on Mikael Colville-Andersen’s http://www.copenhagenize.com/2012/07/helmet-law-proposed-in-denmark.html And thsi from two socliaist parties which should surely be alert to the dangers of discouraging a mode of transport which is accessible to all?

    The Northern Irish Assembly only recently fended off an attempt at helmet compulsion for children, following intense lobbying by CTC and other bodies (plus, no doubt, the Ulsterman’s innate libertarianism). The Irish Republic is now looking at something similar, and from time to time there is a skirmish in our own parliament over the issue.

    As Thomas Jefferson might have said “The price of freedom is eternal vigilance”. The discussion needs to be held from time to time to keep us sharp.

  22. I’d say part of the problem is <15 mph just isn't fast enough for "vehicular cycling" as it's generally advocated in the US. The speed differential is too high. That's part of the reason I don't do more of it; I'm just not fit enough to sustain the high speeds required. Speeds that slow require grade-separated facilities or very quiet side streets.

  23. The problem here, as amply demonstrated, is that you cannot compare accident statistics between two different riding populations (sports cyclists, and people getting from A to B) as there are too many other variables. A more interesting statistic would be to compare the number of head injuries in the Tour de France before helmets became compulsory, and after. i.e. if you are a sports cyclist, does wearing a helmet provide an actual benefit?

    Doing the same comparison for utility cycling would also be interesting, but is going to be much harder to achieve.

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