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• The Health Hazards of Safety Legislation
  STEPHEN J WATKINS
  Published on: 10 July 2013
• A better understanding of cycle helmet disadvantages is needed
  Colin F Clarke
  Published on: 13 March 2012

• Published on: 10 July 2013

  The Health Hazards of Safety Legislation

  • STEPHEN J WATKINS, DIRECTOR OF PUBLIC HEALTH

  The paper by Hooper & Spicer and some of the responses to it raise an important debate about the hazards of safety legislation. It is wrong to assume that safety legislation will cause no harm and in line with principles of medical ethics public health professionals are obliged to take such harm into account. The first level of harm may arise when the legislation actually mandates an unsafe act because all the consequences of...

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  The paper by Hooper & Spicer and some of the responses to it raise an important debate about the hazards of safety legislation. It is wrong to assume that safety legislation will cause no harm and in line with principles of medical ethics public health professionals are obliged to take such harm into account. The first level of harm may arise when the legislation actually mandates an unsafe act because all the consequences of the act have not been taken into account. Although it is self evidently true that cycle helmets have a protective function in certain accidents the benefit that would be expected from the physics of the situation has not been demonstrated in population studies. What is offsetting it? Is it an increased risk of neck injuries? Is it that car drivers drive closer to cyclists who look less vulnerable? We need to know this before legislation could be regarded as ethical. The second level of harm may arise when the legislation creates a false sense of security resulting in risk compensation. Cycle helmets do not offer anything like the degree of protection that is sometimes assumed so this is a serious potential problem. It is unethical to mislead. The third level of harm may arise when people act in a dangerous or unhealthy way in response to legislation. This is an issue with cycle helmets because the evidence shows that the introduction of legislation will lead to a fall in cycling rates resulting in deaths from diabetes, heart disease, osteoporosis and mental illness. Excessive rail safety requirements can have the effect of reducing rail travel and substituting less safe road travel. For young men, who are safer cycling than driving, this issue arises with cycle helmets as well. It is unethical to create a situation which leads people to harmn themselves. The fourth level of harm arises when we lose a sense of proportion in safety legislation so that people lose the capacity to weigh risks. In the Paddington rail disaster a large number of people were killed in a head on collision between two trains one of which had passed a signal at danger. This signal was badly sited and had been passed at danger a number of times previously but nothing was done. Nobody had convened a meeting of the Signal Sighting Committee. At this time the rail network was engaged in a major campaign to reduce deaths to zero and as part of this was developing safety cases about risks like passengers falling off the edge of station platforms. THSG asks a simple question - in the course of this process did the system lose sight of what is important, lose the capacity to prioritise and as a consequence of that neglect a major risk. The case for cycle helmets is weaker than the case for helmets when playing football and on a par with the case for helmets when driving. The added risks of cycling rather than driving on a local journey for a middle aged adult are comparable to the added risks of taking the car instead of the train or driving on an all purpose road instead of a motorway. If society attempts legislative control of risks of this order it will fail, and in doing so its failure will impact on much more significant issues as well. It is unethical to set up systems which will fail in such a way as to damage lifesaving activities. The fifth level of harm comes when the legislation conveys a false message and as a result people make poor decisions. Cycling is a safe activity which benefits health. Yet the commonest reason given for not cycling is safety. If we compel cyclists to wear helmets we give out the message that it is on a par with riding a motorcycle or with working on a building site. It is unethical to mislead people into making harmful choices. We must understand that safety legislation is not a free good. We can only handle so much of it and we must prioritise. We must reach out for a safe society, in which people who climb mountains use the right equipment, check the weather and tell people what route they are taking, not a risk averse society where people do not climb mountains. A morbid preoccupation with the dangers of normal safe activities limits lives and can kill people. STEPHEN J. WATKINS Chair, Transport and Health Study Group.

  Conflict of Interest:

  THSG has a policy of opposition to compulsory cycle helmets based on its understanding of the scientific evidence

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  Conflict of Interest:
  None declared.

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• Published on: 13 March 2012

  A better understanding of cycle helmet disadvantages is needed

  • Colin F Clarke, Retired

  Dear Editor,

  Cycle helmet law for children not justified

  The paper about bicycle helmets and legislation, ‘Liberty or death; don't tread on me’ (1) provides a quite traditional view and assumes helmet legislation may be appropaite for children.

  A recent report, 'Evaluation of New Zealand's bicycle helmet law’(2) provides some data that may assist in considering cycle helmets. The Conclusions stated, ”...

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  Dear Editor,

  Cycle helmet law for children not justified

  The paper about bicycle helmets and legislation, ‘Liberty or death; don't tread on me’ (1) provides a quite traditional view and assumes helmet legislation may be appropaite for children.

  A recent report, 'Evaluation of New Zealand's bicycle helmet law’(2) provides some data that may assist in considering cycle helmets. The Conclusions stated, ”This evaluation of NZ's bicycle helmet law finds it has failed in aspects of promoting cycling, safety, health, accident compensation, environmental issues and civil liberties. It is estimated to cost about 53 lives per year in premature deaths and result in thousands of fines plus legal aspects of discrimination in accident compensation cases."

  It mentions a number of concerns;

  Survey data from Australia indicated legislation was a poor approach as it discouraged cycling--e.g. child cycle use fell 44% by the second year of the helmet law in New South Wales.

  The NZ Ministry of Transport stated 'The travel surveys show that from 1989/90 to 2005/08, the average time spent cycling per week decreased from 28 minutes to 8 minutes among those aged 5-12 years and from 52 minutes to 12 minutes among those aged 13-17 years.'

  Of particular concern are children and adolescents who have experienced the greatest increase in the risk of cycling injuries despite a substantial decline in the amount of cycling over the past two decades.

  Erke and Elvik (Norwegian researchers) 2007 stated: 'There is evidence of increased accident risk per cycling-km for cyclists wearing a helmet. In Australia and NZ, the increase is estimated to be around 14 percent.'

  Imposing a helmet law on to children or any cyclists is simply not justified.

  References

  1. Hooper C, Spicer J, Liberty or death; don't tread on me’, J Med Ethics doi:10.1136/medethics-2011-100085

  2. Clarke, CF, Evaluation of New Zealand’s bicycle helmet law, NZMJ 10 February 2012, Vol 125 No 1349; http://www.cycle-helmets.com/nz-clarke-2012.pdf

  Conflict of Interest:

  None declared

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  Conflict of Interest:
  None declared.

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