Bicycle helmet laws still a tough sell despite support from medical community

A call by the Canadian Paediatric Society for mandatory bicycle-helmet laws across the country has me conflicted.

I understand some people's arguments that demanding adults put on dorky-looking skid lids before getting on their bikes smacks of nanny-statism and will discourage many from taking up this healthy activity.

But common sense and personal experience points me in the other direction. Helmets are a good idea, though legislation may be hard to enforce.

In a position paper posted Friday, the society said helmets help reduce the number and severity of traumatic brain injuries and there's evidence legislation increases helmet use.

"Evidence for unintended consequences of helmet legislation, such as reduced bicycling and greater risk-taking, is weak and conflicting," says the paper's abstract.

"Both research evidence to date and recognition of the substantial impact of traumatic brain injuries support the recommendation for all-ages bicycle helmet legislation."

[ Related: Bike helmet mandate for all sought by pediatricians ]

According to The Canadian Press, only British Columbia, New Brunswick, Nova Scotia and P.E.I. currently require riders of all ages to wear helmets. Alberta, Manitoba and Ontario make helmets mandatory only for minors, while Saskatchewan, Quebec, Newfoundland and Labrador, Yukon, N.W.T. and Nunavut allow cyclists old and young to feel the wind in their hair.

Brent Hagel, the paper's co-author and an injury-prevention epidemiologist at the University of Calgary, told CBC News it's not only kids who are at risk of brain injury.

"Children see adults and often adopt similar behaviours, so if we can get helmets on adults then children and adolescents will be more likely to wear them too," he said.

Hagel told The Canadian Press he understands some adults resent being told what to do.

"There are always people that will say that it's an adult's right to choose whether or not they want to use a helmet but my perspective . . . is that bike helmets have been shown to reduce injury risk in all age groups," he said.

The comment thread attached to the CP story posted on the CTV News web site reflected the split among Canadians.

"My god make it mandatory to have everyone bubble wrapped before they leave the home," said commenter Scott. "It's an unsafe world out there and we can get injured, walking, running, driving and biking."

"To anyone negatively posting about this proposal I say feel free to forfeit your free tax payer funded health care should you decide not to wear a helmet," said Justin.

A number of people endorsed mandatory helmet use based crashes they'd had. A commenter with the handle Purple Rain said he was the victim of a hit-and-run accident.

[ Related: 5 tips when buying a protective helmet ]

"I suffer with traumatic brain injury amongst other things and lost job house friends etc . My helmet cracked in two pieces. It SAVED my life!!!! Happy to be on this side of the grass rebuilding. PLEASE WEAR A HELMET."

Another commenter who pointed out laws are meaningless without enforcement was onto something.

In British Columbia, which pioneered all-age mandatory helmet legislation, CTV News reported the vast majority of the more than 13,000 tickets issued between 2008 and 2012 were unpaid as of last June, according to a report by the Insurance Corp. of B.C. (ICBC). The total of unpaid $29 tickets – which ICBC is supposed to collect – was 11,097, worth roughly $321,000.

A backlash has developed against the helmet law, the Globe and Mail reported last year. Vancouver cyclist Chris Bruntlett has stopped wearing his helmet all the time, citing the relative safety of the city's 400 kilometres of bike routes compared with his former home of Toronto.

“Vancouver is light years ahead of Toronto,” Bruntlett told the Globe. “The infrastructure is so good here that I felt a helmet was completely unnecessary.”

The British Medical Journal polled its readers in 2011 and 68 per cent of the 1,439 respondents said helmets should not be compulsory. Commenters argued legislation reduce the number of cyclists and discourage bike sharing (a point being debated in B.C.), that many riders don't wear their their headgear properly.

[ Related: Bicycle helmet crackdown in Charlottetown ]

Proponents see the issue in the same terms as push-back against mandatory automobile seatbelt legislation. The same arguments about personal freedom and safety benefits (some people even insisted it's better to be thrown from a crashing vehicle) were in play. But three decades later, seatbelt compliance is in the 90 per cent range.

The comparison isn't completely valid, though, since cyclists aren't licensed and bicycles can be ridden off public roads.

Here's my take, for what it's worth. The evidence that helmets cut the risk of brain injury seems conclusive. If a law, coupled with an intensive education campaign, encourages a few more people to don helmets, then I think it's worth passing even if enforcement is difficult.

I had my own epiphany a few years ago on an urban bike path when I slammed into a roller-blader at a blind curve. He was on one side and his leashed dog on the other. I had nowhere to go.

I went over the handlebars and landed head-first on the hard-packed gravel, making that exploding-watermelon sound as I hit. I saw stars but walked away with a broken finger and skid marks on my face and hands.

So dorky-looking or not, I'll be wearing a helmet.