National Transportation Safety Board Recommends Mandatory Helmet Laws for Cyclists

Why stop there? Helmets for everybody!

Let's say it right up front: I always wear a bicycle helmet. I put it back on after my mother missed a stair, fell and hit her head and we lost most of her. Her injury was avoidable; had the stair been built to modern standards and had there been a proper handrail, the fall probably wouldn't have happened.

NIOSH/Public DomainIn the Hierarchy of Controls published by the National Institute for Occupational Safety and Health, that is the first thing you are supposed to do: remove the hazard. But because there are broken sidewalks, substandard steps, and dangerous intersections everywhere, I think it should be mandatory that all senior citizens, no, let's get serious, all pedestrians, wear helmets whenever they go outside.

This is kind of the logic used by Jennifer Homendy of the National Transportation Safety Board, which just recommended that mandatory bike helmet laws be passed in all 50 states.

National Transportation Safety Board/Screen capture

The NTSB had just seen a presentation demonstrating that the vast majority of bicyclist fatalities were caused by motorists overtaking cyclists in mid-block locations. This is the kind of crash that is almost eliminated by removing the hazard, by building proper separated bike infrastructure.

According to Gersh Kuntzman of Streetsblog, staff analyst Dr. Ivan Cheung "made it clear — as did his report — that the real way to protect cyclists is to make roadways safer and to reduce speed limits on drivers rather than worrying so much about cyclist behavior."

National Transportation Safety Board/Screen capture

However, Dr. Cheung also made a presentation about mitigating head injury, which clearly showed that when a cyclist does get in a crash, helmets do reduce the risk of head injuries. Board member Homedy kept focusing on this:

"I understand there are concerns in the bicycle community that this could reduce the number of bicyclists,” she said, “but the NTSB’s mission is not about bicycle use. Our mission is safety. It’s the National Transportation Safety Board. Our goal is zero deaths. The way we go about doing that is by issuing recommendations that prevent crashes, that prevent injuries and that save lives."

When she directly asked Dr. Cheung, “What is the leading cause of bicyclist deaths?” Cheung replied, “Motor vehicle crashes.”

Wearing a helmet doesn't prevent crashes. And as NIOSH would tell Homedy, it is the least effective measure one can take to reduce injuries. Kuntzman reports that bike activists are outraged.

“At one point, Sumwalt said, ‘In the event that a bicycle crash cannot be prevented, we know that the best possible protection for a bicyclist is always wearing a helmet,’ but that conclusion is untrue,” said lawyer Steve Vaccaro, who works exclusively with victims of road violence. “To label crashes as inevitable is to accept some level of traffic violence as the norm. NTSB should adopt Vision Zero as its policy instead, and make meaningful policy recommendations aimed at ending traffic violence, rather than leaving cyclists to armor themselves against essentially unregulated drivers.

It's not that helmets are ineffective that's the issue here. The problem is that they are a distraction from the real issue of infrastructure. When people go for a walk, nobody demands that they wear a helmet, even though according to studies like Head Injuries As a Cause of Road Travel Death in Cyclists, Pedestrians and Drivers, researchers found that people walking or driving had way more head injuries in actual numbers and and pretty close when measured per unit of distance or time.

Lloyd Alter/ data from Head Injuries As a Cause of Road Travel Death in Cyclists, Pedestrians and Drivers/CC BY 2.0

Head injuries in cyclists are often considered to be an important cause of road travel death, but this depends on the metric used for assessing importance. Pedestrians and drivers account for five and four times the number of fatal head injuries as cyclists. No one is calling for pedestrians to wear helmets, although the fatal head injury rates are similar for cyclists and pedestrians. The rate is higher for cyclists than pedestrians by time travelled and is higher for pedestrians than cyclists using distance travelled.

Helmets are a nuisance, but they also scare people. They make people think cycling is dangerous, which drives down participation numbers, but when you have proper infrastructure, it's not. And when you drive down numbers, you reduce the demand for proper infrastructure, which is why drivers all yell at cyclists to "get a helmet." They are really yelling "get off my road."

As Dr. Cheung noted, not very many people wear helmets in the Netherlands.

“The Netherlands has been committed to making bicyclists part of their complete street and part of the overall transportation strategy — and they have tens of thousands of protected bike lanes and protected intersections,” he said. “Not to shame the U.S., but we are 20 or 30 years behind. As a result, bicycling as a percentage of the mode share is very, very high... Our team thinks helmets are important, but the difference between the Netherlands and the U.S. is infrastructure.”

To reiterate, I wear a helmet. I wish my mom had worn a helmet. Every driver should wear a helmet. But stop picking on the cyclists. The real answer is to fix the steps that tripped my mom, to fix the infrastructure for the cyclists, to fix our road designs to slow down cars, and not to think a helmet is a solution to anything.

UPDATE: Peter Flax at Bicycling Magazine did a brilliant analysis of this report that suggested that cyclists wear helmets and be more conspicuous:

When combined with these two exercises in victim blaming, the NTSB’s missives speaking directly to cyclists—about observing signals and rules—speak volumes about the lens with which the agency is viewing the issues. The collective message is that riders often are naughty and need to take greater responsibility for their own safety. Instead of seeing what cyclists really are—the victims of systemic problems that desperately need fixing—the NTSB frames riders as the agents of their own demise. This is the essence of victim blaming....
In short, the NTSB could have focused its report on more of the things that are actually killing cyclists. Instead, the organization tasked with troubleshooting transportation disasters left us with a train wreck. Rather than use its considerable muscle and resources to increase public and congressional awareness about the cultural and systemic forces that are causing record numbers of riders to die, the agency took the laziest possible look at the issues, merely repeating stereotypes and tropes and naïve assumptions in a manner that actually makes cyclists less safe.