Helmets help if you crash
There is not much controversy about helmets in case of a crash. Helmets have been shown to reduce the risk of severe head injury. In fact, studies show that new developments in helmet technology continue to reduce the chances of traumatic brain injuries. The conversation gets interesting when thinking about other effects of helmet use. There is one particularly appealing hypothesis called “risk compensation.” It says that wearing a helmet makes cyclists feel too safe and they compensate by taking more risks. As a result, cyclists with helmets crash more often and helmets end up doing more harm than good.
A bike-delivery company bans their employees from using helmets
One British start-up took the risk-compensation hypothesis so seriously that they decided to ban helmet use entirely. Their bicycle couriers are not allowed to wear helmets. They explained some of their reasoning on Twitter.
“People who are taking risks that are sufficient that they feel they need to wear helmets are not welcome to work for us.”
“We know that increasing helmet-wearing rates makes cycling more dangerous per mile – although there are confounding factors here, this indicates that overall, they do not provide a strong protective effect in the round – otherwise the opposite effect. Extensive reading of the literature suggests that this is because while helmets definitely help in the event of a crash, that risk compensation results in more collisions. So riders wearing helmets take greater risks, and those driving around them take greater risks too.”
We welcome the positive and informed discussion which will follow from this. 😅
Pete @ratracecycles you're just down the road from me – I'll pop in for a coffee and a chat about bicycles tomorrow if you're about!
— Pedal Me (@pedalmeapp) February 4, 2022
Do seatbelts make roads less safe?
The idea that increasing safety causes risky behaviour has been proposed in the past in discussions around road or child safety. Even though some people take on more risk when they feel safer, data shows that safety features lead to positive outcomes overall. A study that analysed outcome data for a variety of risk-compensation cases confirmed this. It showed that after the introduction of seatbelts, airbags or ABS brakes, road safety improved despite concerns that it will cause drivers to behave more recklessly. Similarly, the introduction of safety caps on medication packaging reduced the number of accidental child poisonings despite worries that parents will be more careless around medication as a result of this invention.
Cyclists tend to behave safer with helmets
Does the same apply to helmet use? A large systematic review was carried out in 2019. The authors looked at all studies done on the topic and found 23 relevant ones. Their conclusion was that overall, there is little to no evidence to support the risk-compensation theory for helmet use. In fact, 10 of the included studies found the opposite. They showed that helmet use was associated with safer cycling behaviour. For example, cyclists who regularly wear helmets have a higher perceived risk of injury, lower risk for crash injury, and decreased crash fault. They also found that there was no association between helmet wearing and increased cycling speed.
It is worth adding that people who willingly wear helmets tend to be more cautious in general. The included studies were not able to account for the self-selection bias. So, it’s hard to say based on these studies whether someone who is forced to wear a helmet would behave the same way.
Wearing a helmet doesn’t increase the overall risk of injury
The data speak clearly, helmets don’t turn cyclists into crazy risk-takers who get into more accidents. If anything, it seems that helmet wearing makes them more careful. A similar effect was observed in snow sports too. The authors concluded that helmets do not seem to increase risk-compensation behaviour, neck injuries or cervical spine injuries among skiers and snowboarders.
In light of the evidence, it seems irresponsible for any bicycle-delivery company to ban helmets for their couriers. What do you think? Would you work for a company like that? And how would you feel and behave on your bike without a helmet?