I have written in other forums questioning the wisdom of mandatory helmet laws. I’ll state right up front so nobody gets me wrong — I think bicycle helmets are good. I wear one. I encourage others to wear one. But when the state thinks about saying “You have to wear one” it should really think it through.
I happened upon a new document from the Brain Injury Association of Florida. In it is a table on causes for traumatic brain injury (TBI). It compares motor-vehicle-related traumatic brain injuries.
I think that the state’s interest in such a matter should be to reduce the overall number of brain injuries, not to target the activities it thinks are most likely to result in those injuries. One might be able to argue (though I don’t think you can) that cyclists are more likely to experience traumatic brain injury than automobile occupants, motorcyclists or pedestrians, but if the actual number of cyclist injuries is low, the state isn’t affecting many lives with its law. And making cycling appear riskier than it is.
The table on page 22 shows that there are 1.5 times as many pedestrian traffic emergency room traumatic brain injuries as for bicycling. Three times as many deaths for pedestrians. 2.3 times as many hospitalizations. Comparing motor vehicle occupants: 32 times as many emergency room visits; 13 times as many deaths. Comparing motorcycles: twice as many emergency room visits; 2.6 times as many deaths.
But there’s a wrinkle in the data. This data only applies to motor-vehicle-related injuries. A solo motorcycle crash is a motor-vehicle-related injury. Pedestrian head injuries that don’t involve motor vehicles are rather rare. But bicyclist head injuries that don’t involve motor vehicles are fairly common and wouldn’t be included in this table.
In another data source — the Florida Dept. of Health — we see that cyclist hospitalizations which do not involve motor vehicles outnumber those that do involve motor vehicles about 2-to-1. So I inflated the bicyclist TBI numbers accordingly. (Granted — this only a guess…) With that adjustment, bicyclist traumatic brain injuries are about equal to pedestrians and motorcyclists. (BTW, motorcyclists account for only about 1.4 times as many TBIs as pedestrians.) But comparing to motor vehicle occupants, there are still nearly 11 times as many emergency room visits and 3.7 times as many deaths compared to bicyclists.
There’s some data that suggests mandatory helmet laws reduce cycling. In metro Orlando, child cycling injuries plummeted during the years the helmet law was debated, passed and initially implemented. That’s all injuries, not just head injuries. Reduced child cycling is the best explanation (though video games and “stranger danger” could also be blamed; not just the helmet law). Similar results were seen in Australia.
Assuming my estimates and assumptions are correct (and for now I won’t insist they are), a mandatory helmet law should be passed for motor vehicle occupants. It would probably both reduce excessive motor vehicle use and substantially reduce traumatic brain injuries.