Last evening I heard two cyclists say “not tonight” when their friends asked why they did not have helmets. I’ve written at length already on helmets and risk intuition, but apparently they had not read my blog. This brought two things to mind:
First, the statistics on head trauma and bicycling are simple. Close to 90% of brain injuries sustained from bicycle accidents can be prevented by wearing a hard shell helmet. The National Highway Traffic Safety Administration (NHTSA) puts this into economic terms in their 2008 Legislative Facts document.
Every dollar spent on bicycle helmets saves society $30 in indirect medical costs and other costs.
They also note that while California was the first state to pass a mandatory helmet law in 1986 there are many states that still have no requirement at all:
Arkansas, Colorado, Idaho, Indiana, Iowa, Minnesota, Mississippi, Nebraska, North Dakota, South Dakota, South Carolina, Utah, Vermont, and Wyoming
Second, aside from all the data there are far too many empirical stories and examples that people should be aware of when they ride. One of the most known is the untimely death of Lance Armstrong’s team mate in the 1995 Tour de France.
Born on August 16, 1970 Casartelli probably would be one of the top riders in the world today. He had won an olympic gold medal in cycling at 22 years of age. Just three years later he was representing team Motorola in the Tour when he crashed on the Col de Portet d’Aspet in the Pyrenees and hit his head on the large square concrete blocks on the side of the road. The doctor who examined the injury said a helmet would have helped.
“There was a small but very violent impact to the top of the skull a few centimetres to the left of the central axis. Contrary to several reports, there were no facial injuries. The impact caused several fractures within the cranium, causing blood to emerge from the nose, ears and mouth.” Disteldorf added that had Casartelli been wearing a hard helmet “some injuries could have been avoided”.
One of the reasons to bring up the Casartelli story is also to note how the Tour’s senior doctor and the Motorola team doctor both asked that an autopsy of the injury not be performed. They then conjectured on cause of death without an examination. This lack of interest in safety and security data was echoed by the chairman of the International Cycling Union (UCI) who wanted to avoid helmet requirements at the time.
We have indicated the risk to the riders, but I believe that if you can’t apply certain rules on people it is better to drop them.
The question should not be whether we can find a person who will make a hasty conclusion or disobey a rule. Disobedience to rules without cause has what value? The question instead is whether someone will be able to make an informed and rational decision once they see and understand risks as a whole. An adult rider should think about their head’s vulnerability, the cost of prevention versus medical treatment or worse, and then examine the cost of countermeasures. This formula makes decisions easier and more accurate. It also brings forward arguments against helmets (cooling, fashion), which can then be addressed, proving that properly managed regulations are a way of stimulating innovation and market growth.
I would argue that simple common sense, backed by scientific study, has prevailed since the early 1990s and that is why helmets in races are now mandatory. I expect this to be documented by an improvement in the ratio of death and serious head injury among helmet-wearing riders to overall bicycle accidents. Although it is hard to account for threat variables (animals, other vehicles, terrain-type, etc. all differ greatly by region) the goal is to isolate and thus measure the change to a rider’s vulnerability. This is very similar to the process of assessing information security risks in organizations both large and small.
RIP Fabio Casartelli
