These days the stance on helmet compulsion is getting crucial as a wave of helmet laws seems set to roll over Europe.
We in LHM were recently ( February 2005 ) woken up from near ignorance on the matter, when the Association of Icelandic Insurance companies (SÍS) put forward a motion to the Ministry of Transport, urging them to extend the law on helmet compulsion to adults. Yes, there already exists a law on helmet compulsion for all cyclists younger than 15 years in Iceland, I'm afraid, and at the time (1997) when the law was passed, the Cyclist Organizations were not really awake. Or rather, because of the seemingly self evident merit of helmets for reducing injuries, people seem to have been mostly all for it. The lack of contact with international Bicycle advocacy groups, like the CTC or The European Cyclists' Federation, meant that the counterarguments practically did not surface.
In fact, the law grants the Ministry to set rules about helmet compulsion at its own discretion. And seemingly it can be extended to adults, without the Parliament ( Alþing ) knowing, even. The rules making it illegal for children to enjoy a healthy bike ride without a helmet came into effect in 1999, but have not been enforced. One of the strong arguments against compulsion is that it will probably not be enforced, and very probably the police can save many more lives by stopping cars with irresponsible drivers. Traffic law enforcement is recognized to be way too lax, and if the police were more visible in traffic, dealing with speeding and drunk drivers, that has the potential to save many lives in itself.
The stance of the current president, is that the knowledge-base promoters are suggesting that be used as grounds fro helmet compulsion is very one-sided and seemingly of a poor scientific standard.
Much more evidence is needed before one can go to the step of making it illegal to cycle without a helmet. In Iceland the statistics on the number of people cycling and how _serious_ head injuries occur are virtually non-present. Comparisons to head injury prevalence in pedestrians and motor vehicle occupants ( from other countries ) has been shown to be very sobering, but such a comparison is never done by promoters of helmet compulsion.
Having read many reports on bicycle helmet efficacy, especially the experience of Australia and New Zealand with helmet laws, critique of such reports and articles published in peer-reviewed international journals, it is my clear impression that the value of helmet compulsion is grossly overestimated, and probably helmet compulsion is gravely negative, not least in the larger context of public health. Suffice it to say that the reduction in head injuries after the helmet law in AU and NZ seem after statistical analysis, to have stemmed from 1) the reductions in cyclists 2) better law enforcement that lead to a safer general road environment. Pedestrians and motor vehicle occcupants had similar reductions in head injuries over the same period as did cyclists.
For helmet compulsion has a strong tendency to reduce the numbers of cyclist very significantly, and research correlated from many countries point to decreased safety for the individual cyclist when cyclist numbers are reduced. Besides it has been showed that the health benefits of cycling is many times more healthy ( on a population level, and in the long run for cyclists ) that what traffic accidents on cyclists account for, be they helmet users or not.
What cyclist really need and what societies really need is lower speed, better skills and courtesy for drivers of cars and bicycles. Also we need increased respect for existing laws we already have against speeding and driving under the influence of alcohol, narcotics, sleep deprivation etc. And we need competent planning and engineering that take the rights and needs of pedestrians and cyclists into account. And because the professional knowledge about what works to increase the safety of pedestrians is very rare, local planners, law enforcement bodies and politicians must seek to upgrade their knowledge. Why not ask bicycle advocacy groups for help in finding relevant contacts among politicians and engineers ? Look for instance to the Netherlands and Denmark. They have the lowest casualty rates for bicyclists, but generally do not use helmets. Instead they work with and for the "soft" traffic and put their planning and lawmaking efforts in traffic safety for cyclists where it really helps. The USA is on the other end of the scale in both respects.
Reykjavik, January 2006
One of many discussions on helmets efficacy in promoting health that have taken place in the British Medical Journal can be found online in the following issue BMJ 1997;314:69 (4 January) : http://bmj.bmjjournals.com/cgi/content/full/314/7073/69