Cyclists without helmets three times more likely to die of head injuries

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October 15, 2012
Wendy Gillis
Staff Reporter

Cyclists who ride a bike without a helmet are three times more likely to die of a head injury than those who wear the protective headwear, a Toronto researcher probing cycling deaths in Ontario has concluded.

In a new study published in the Canadian Medical Association Journal, University of Toronto family doctor lecturer and St Michael’s Hospital associate scientist Navindra Persaud concludes that helmets help prevent fatalities — something he says until now was “controversial.”

He hopes the study will eliminate the thinking that helmets are not useful in serious collisions.

“Previous studies have demonstrated that helmets prevent non-fatal head injuries,” he said. “But this is the first study to demonstrate that helmets prevent fatal head injuries.”

“The conclusion was that bicycle helmets save lives,” he said.

The conclusions are based on data from the Ontario coroner’s report into the 129 accidental cycling deaths that took place in the province between January 2006 and December 2010.

Among the fatalities, 86 per cent were men and 77 per cent involved a motor vehicle. The ages of those killed ranged from 10 to 83.

Persaud and fellow researchers separated deaths due to head injuries and deaths due to other injuries (such as the abdomen or chest). For each group, they determined what fraction of those people were wearing helmets and which were not.

They found that a cyclist not wearing a helmet was three times more likely to die of a head injury than a cyclist wearing a helmet. The results stood up whether or not the cyclist had sustained other serious injuries.

Persaud hopes the study will stimulate policy changes that promote helmet use, including awareness campaigns and financial incentives, such as giving away free helmets.

He also hopes that Ontario will extend its mandatory helmet law to adults; currently, the province only forces cyclists 18 and under to wear a helmet.

“That 88 per cent of (those who died) in our study were older than 18 . . . suggests a gap in public policy,” the research paper concludes.

Mandatory helmet legislation was a key recommendation of the province’s coroner’s June report into the same 129 cycling deaths.

Jared Kolb, director of marketing at Cycle Toronto, an organization which advocates for cycling rights, said the group supports Ontario’s requirement that cyclists under 18 wear helmets.

It encourages adults do the same, but stops short at calling for mandatory helmet legislation. The problem with mandatory helmet laws, he said, is that they can discourage people from riding altogether.

“For us, the most important thing is creating safe cycling infrastructure,” such as bike lanes, he said.

Persaud agrees that improvements to cycling infrastructure in the province must be made, but says they should be made in tandem with increased helmet use.

“Even if we had a perfect infrastructure, there are still going to be collisions and falls, and that’s why helmets would be useful,” he said.

He adds that while wearing a helmet might seem inconvenient right now, so did other safety initiatives that have become common practice, like wearing sunscreen.

“Over time, it’s changed and hopefully this will be part of that,” he said.

In provinces with mandatory helmet laws, such as Nova Scotia, wearing helmets is more common, according to the paper.

The study also cites Victoria, Australia as an example of successful legislation. Helmet use in the city increased from 31 per cent to 75 per cent after the introduction of mandatory helmet legislation, and cycling fatalities decreased by 48 per cent.

Cycling death figures

Total number of cycling deaths in Ontario between January 2006 and December 2010: 129

Ages of those killed: 10 to 83

Total number of those not wearing a helmet: 94 of 129

Number who died of head injuries: 71

Number of head injury deaths where cyclist was not wearing a helmet: 58 (of the 71)


In my opinion:  

I’ve said it a thousand times.  I’ll say it again.  Quebec, too, should heed the warning from this latest study and enact province-wide helmet legislation for all ages.  Lives will be saved.  Injuries will be prevented or diminished. 

Locally, Cote Saint-Luc is a national leader in helmet legislation – the first city in Canada to do so 20 years ago.  

Today, we are expanding our fledgling “CSL Cycles” initiative by encouraging cycling, off-road, through our largest parks, on marked bike lanes where possible and by alerting motorists to our bike routes.  We must still create a safer environment for the underpasses.  Those lanes aren’t wide enough for protected bike lanes and therefore we have exceptionally granted permission to using the sidewalks at these locations.


Helmets save skiers, snowboarders: review

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Helmets save skiers, snowboarders: review

‘We encourage the use of helmets,’ researchers say

Last Updated: Monday, February 1, 2010 | 4:04 PM ET   CBC News

Wearing helmets to ski and snowboard helps reduce the risk of head injury without increasing the risk of neck injury, Canadian researchers say.

Helmet use reduced the risk of head injuries among skiers and snowboarders by 35 per cent, a review of 12 studies published in Monday’s issue of the Canadian Medical Association Journal found.

Traumatic brain injury is the leading cause of death and serious injury among skiers and snowboarders, the researchers said. Estimates from several countries suggest head injuries account for up to 19 per cent and neck injuries for up to four cent of all injuries reported by ski patrols and emergency departments.

But between two and five out of every 10 head injuries could be prevented by wearing helmets, the reviewers concluded.

“The use of helmets significantly protects against head injuries among skiers and snowboarders,” Brent Hagel of the departments of pediatrics and community health sciences at the University of Calgary and his co-authors concluded.

Wearing a helmet reduces the risk of head injury regardless of age and to both backcountry and prepared ski runs. But one study had raised a concern that helmets may increase the risk of neck injury, particularly among children because of their greater head-to-body ratio compared with adults.

Neck risk discounted

The results of the individual and combined studies from Canada, the U.S., Japan and Europe showed no major link between helmet use and increased risk of neck injury, according to the study published Monday.

“When we look at models like the bicycle helmet legislation that’s been implemented in a number of provincial jurisdictions across Canada and, really, all over the world, I think it’s probably moving in that direction,” said Hagel.

“But from an epidemiologic point of view, I think that helmets reduce the risk of head injuries and we encourage their use.”

More rigorous research is needed to determine which types of helmets provide the best protection, and head gear is not a panacea, Hagel added.

Canadian standard in the works

The highly publicized death of actress Natasha Richardson after a fall at a ski resort in Quebec last March added to the debate over whether helmets should be mandatory for the winter sports, as they are for children in some European countries.

Mandatory helmet use would require helmet safety standards. The Canadian Standards Association (CSA) tests helmets for alpine skiing and snowboarding and has developed such a standard. This certification is voluntary, and no manufacturers have applied to receive it, said Anthony Toderian, a spokesman for CSA in Montreal.

“There may be product out there that meets European and American standards,” said Toderian. “There’s currently no product out there that meets the CSA standard, and there’s also product available out on the market that doesn’t meet any standards whatsoever.”

The CSA standard calls for multiple-impact testing of alpine skiing and snowboard helmets. (Courtesy CSA) Unlike the U.S. and European standards, the CSA standard calls for multiple-impact testing, which means a helmet that passes the test may remain functional after it has suffered a blow as long as it is not damaged. The CSA standard also requires an independent lab — rather than the manufacturer — to test and certify the helmets.

Health Canada requires certification of hockey helmets and is reviewing comments on establishing a similar standard for the sale of ski and snowboard helmets, a spokesperson for the department said.

There is demand for certified helmets, said John Tustian, director of operations at the Lakeridge Resort in Uxbridge, northeast of Toronto.

Some other ski operators have opposed mandatory helmet use, saying they would have to police their guests, including foreigners who might not be aware of the requirements, and would face costs from providing helmet rentals.

On the slopes at Lakeridge, snowboarder David Bonder said he thinks helmets are a good idea.

“I wear when I dirt-bike,” said Bonder, adding that he started donning a helmet after breaking a few bones dirt-biking, but he does think he takes more risks when he’s wearing one. “Why wouldn’t I wear one here?”

Fellow snowboarder Jed Johnston agreed, saying he didn’t wear a helmet for about 10 years, but now thinks it’s a good idea because it “keeps people out of the hospital.”

More on my blog on helmets