Statistical errors in anti-helmet arguments

Bicycle helmets are designed to mitigate head injury during a collision. In the early 1990's, Australia and New Zealand mandated helmet wearing for cyclists in an effort to increase helmet usage. Since that time, helmets and helmet laws have been portrayed as a failure in the peer-reviewed literature, by the media and various advocacy groups. Many of these criticisms claim helmets are ineffective, helmet laws deter cycling, helmet wearing increases the risk of an accident, no evidence helmet laws reduce head injuries at a population level, and helmet laws result in a net health reduction. This paper will demonstrate the data and methods used to support these arguments are statistically flawed.

[1]  M B Walker Law compliance and helmet use among cyclists in New South Wales, April 1991 , 1990 .

[2]  C. Rissel,et al.  The effects of bicycle helmet legislation on cycling-related injury: The ratio of head to arm injuries over time , 2010 .

[3]  Andrew S McIntosh,et al.  Bicycle Helmets: Head Impact Dynamics in Helmeted and Unhelmeted Oblique Impact Tests , 2013, Traffic injury prevention.

[4]  Bicycle Helmets , 2001, Pediatrics.

[5]  Scott R Walter,et al.  Long term bicycle related head injury trends for New South Wales, Australia following mandatory helmet legislation. , 2013, Accident; analysis and prevention.

[6]  D S McNally,et al.  MADYMO simulation of children in cycle accidents: a novel approach in risk assessment. , 2013, Accident; analysis and prevention.

[7]  Rajiv Bhatia,et al.  "Safety in Numbers" re-examined: can we make valid or practical inferences from available evidence? , 2011, Accident; analysis and prevention.

[8]  Raphael Grzebieta,et al.  The impact of compulsory cycle helmet legislation on cyclist head injuries in New South Wales, Australia. , 2011, Accident; analysis and prevention.

[9]  Raphael H. Grzebieta,et al.  On the use of empirical bayes for comparative interrupted time series with an application to mandatory helmet legislation , 2013 .

[10]  D. L. Robinson Safety in numbers in Australia: more walkers and bicyclists, safer walking and bicycling. , 2005, Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals.

[11]  David Rojas-Rueda,et al.  [Bicycle helmet law in urban areas. Is it good for public health?]. , 2013, Gaceta sanitaria.

[12]  John Adams,et al.  Seat Belt Laws — Repeal them? , 2007 .

[13]  Rune Elvik,et al.  Publication bias and time-trend bias in meta-analysis of bicycle helmet efficacy: a re-analysis of Attewell, Glase and McFadden, 2001. , 2011, Accident; analysis and prevention.

[14]  P deJong,et al.  The health impact of mandatory bicycle helmet laws. , 2012 .

[15]  Sean Burns,et al.  Is the three-foot bicycle passing law working in Baltimore, Maryland? , 2012, Accident; analysis and prevention.

[16]  Raphael H. Grzebieta,et al.  Retraction of the Voukelatos and Rissel paper on bicycle helmet legislation and injury , 2011 .

[17]  D S McNally,et al.  A computational simulation study of the influence of helmet wearing on head injury risk in adult cyclists. , 2013, Accident; analysis and prevention.

[18]  P. Trégouët Helmets or not? Use science correctly , 2013, Journal of Medical Ethics.

[19]  R G Attewell,et al.  Bicycle helmet efficacy: a meta-analysis. , 2001, Accident; analysis and prevention.

[20]  D. Thompson,et al.  Cochrane Review : Helmets for preventing head and facial injuries in bicyclists , 2017 .

[21]  Brent E Hagel,et al.  A critical examination of arguments against bicycle helmet use and legislation. , 2006, Accident; analysis and prevention.

[22]  Joanna Wang,et al.  A Comparison of Statistical Methods in Interrupted Time Series Analysis to Estimate an Intervention Effect Transport and Road Safety (TARS) Research , 2013 .

[23]  D. L. Robinson,et al.  Changes in head injury with the New Zealand bicycle helmet law. , 2001, Accident; analysis and prevention.

[24]  Delia Hendrie,et al.  An economic evaluation of the mandatory bicycle helmet legislation in Western Australia , 1999 .

[25]  Rune Elvik,et al.  Corrigendum to: “Publication bias and time-trend bias in meta-analysis of bicycle helmet efficacy: a re-analysis of Attewell, Glase and McFadden, 2001” [Accid. Anal. Prev. 43 (2011) 1245–1251]. , 2013, Accident; analysis and prevention.

[26]  Frederick P Rivara,et al.  Arguments against helmet legislation are flawed , 2006, BMJ : British Medical Journal.

[27]  P. Jacobsen Safety in numbers: more walkers and bicyclists, safer walking and bicycling , 2003, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[28]  J J Jiménez-Moleón,et al.  Risk compensation theory and voluntary helmet use by cyclists in Spain , 2003, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[29]  D. L. Robinson No clear evidence from countries that have enforced the wearing of helmets , 2006, BMJ : British Medical Journal.

[30]  Catriona Bonfiglioli,et al.  Science, media and the public - the framing of the bicycle helmet legislation debate in Australia: a newspaper content analysis , 2011 .

[31]  D. L. Robinson,et al.  Bicycle helmet legislation: can we reach a consensus? , 2007, Accident; analysis and prevention.

[32]  W J Curnow,et al.  Bicycle helmets and brain injury. , 2007, Accident; analysis and prevention.

[33]  Aslak Fyhri,et al.  Emotional reactions to cycle helmet use. , 2013, Accident; analysis and prevention.

[34]  W J Curnow,et al.  The efficacy of bicycle helmets against brain injury. , 2003, Accident; analysis and prevention.

[35]  Marilyn Johnson,et al.  In defence of mandatory bicycle helmet legislation: response to Hooper and Spicer , 2013, Journal of Medical Ethics.

[36]  S. Tin Tin,et al.  Injuries to pedal cyclists on New Zealand roads, 1988-2007 , 2010, BMC public health.

[37]  M Hillman,et al.  The risk compensation theory and bicycle helmets , 2001, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[38]  Ian Walker,et al.  Drivers overtaking bicyclists: objective data on the effects of riding position, helmet use, vehicle type and apparent gender. , 2007, Accident; analysis and prevention.

[39]  L. Povey,et al.  Cycle helmet effectiveness in New Zealand. , 1999, Accident Analysis and Prevention.

[40]  Tim Churches,et al.  Data and Graphing Errors in the Voukelatos and Rissel Paper , 2010 .

[41]  D. L. Robinson,et al.  Head injuries and bicycle helmet laws. , 1996, Accident; analysis and prevention.

[42]  Chris Rissel,et al.  The impact of compulsory cycle helmet legislation on cyclist head injuries in New South Wales, Australia: a rejoinder. , 2012, Accident; analysis and prevention.

[43]  Colin F Clarke Evaluation of New Zealand's bicycle helmet law. , 2012, The New Zealand medical journal.

[44]  Rebecca Ivers,et al.  The effectiveness of helmets in reducing head injuries and hospital treatment costs: a multicentre study , 2013, The Medical journal of Australia.

[45]  Jake Olivier,et al.  Bicycle Helmet Wearing Is Not Associated with Close Motor Vehicle Passing: A Re-Analysis of Walker, 2007 , 2013, PloS one.

[46]  Stephen C Newbold Examining the health-risk tradeoffs of mandatory bicycle helmet laws. , 2012, Risk analysis : an official publication of the Society for Risk Analysis.

[47]  Joanna J. J. Wang,et al.  An evaluation of the methods used to assess the effectiveness of mandatory bicycle helmet legislation in New Zealand , 2013 .

[48]  Jean-Louis Martin,et al.  Bicycle helmet wearing and the risk of head, face, and neck injury: a French case–control study based on a road trauma registry , 2011, Injury Prevention.

[49]  A. McIntosh,et al.  Response to Rissel and Wen: 'the possible effect on frequency of cycling if mandatory bicycle helmet legislation was repealed in Sydney, Australia: a cross sectional survey'. , 2012, Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals.

[50]  Till Koglin,et al.  Journal of Transport & Health , 2014 .

[51]  M White,et al.  Evaluation of the compulsory helmet wearing legislation for bicyclists in South Australia , 1994 .

[52]  M B Walker LAW COMPLIANCE AMONG CYCLISTS IN NEW SOUTH WALES, APRIL 1992; A THIRD SURVEY , 1992 .

[53]  Agathe Backer-Grøndahl,et al.  Bicycle helmets - A case of risk compensation? , 2012 .

[54]  Luke Turner 'Australia's Helmet Law Disaster' , 2012 .

[55]  Fridulv Sagberg,et al.  Risk Compensation and Bicycle Helmets , 2011, Risk analysis : an official publication of the Society for Risk Analysis.

[56]  Chris Rissel,et al.  The possible effect on frequency of cycling if mandatory bicycle helmet legislation was repealed in Sydney, Australia: a cross sectional survey. , 2011, Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals.

[57]  Craig R Ramsay,et al.  INTERRUPTED TIME SERIES DESIGNS IN HEALTH TECHNOLOGY ASSESSMENT: LESSONS FROM TWO SYSTEMATIC REVIEWS OF BEHAVIOR CHANGE STRATEGIES , 2003, International Journal of Technology Assessment in Health Care.

[58]  D Montoya Cycling and transport policy in NSW , 2010 .

[59]  M R Bambach,et al.  The effectiveness of helmets in bicycle collisions with motor vehicles: a case-control study. , 2013, Accident; analysis and prevention.

[60]  Raphael Grzebieta,et al.  The impact of compulsory helmet legislation on cyclist head injuries in New South Wales, Australia: a response. , 2013, Accident; analysis and prevention.