Why Don't Americans Wear Helmets in the Shower?

CC BY 2.0. Kelly Rossiter/ Lloyd Alter practicing safe showering

Way more people get traumatic injuries in the shower than they do on bikes, but almost nobody takes the most basic safety precautions.

My Twitter feed has been full of bicycle helmet tweets for days since I was included in one:

People immediately responded with links to a recent Streetsblog post and a Vox interview of Chris and Melissa Bruntlett, so I didn't feel a response from me was necessary. And besides, last year I wrote My very last post on bike helmets, I promise, really.

A few years ago I put my bicycle helmet back on, after my mother had a traumatic fall on a bit of bad infrastructure. I thought then that everyone should wear helmets, especially pedestrians and drivers. If you look at the data from studies like Emergency department visits for head trauma in the United States, you see that almost a million and a half motor vehicle occupants had head trauma, 110,000 pedestrians, and 140,000 cyclists visited emergency departments. Why isn't anyone thinking of the poor drivers and pedestrians? Where are their helmet advocates?

head injuries

Christopher E. Gaw et al/CC BY 2.0

When you read all the rants and the tweets about people on bikes not wearing helmets, who is writing them? Drivers! Some of them say cyclists deserve to be hit if they don't wear helmets! But I wasn't going to write about it again.

But then another tweet reminded me about relative risk.

According to the Centers for Disease Control and Prevention a few years ago now, 234,000 Americans are admitted to hospital every year because they slipped and fell in the bathroom.

For all ages, the most hazardous activities were bathing, showering, or getting out of the tub or shower. Approximately two-thirds of all injuries occurred in the tub or shower, and approximately half were precipitated by bathing or showering, slipping, or getting out of the tub or shower...

This is actually an infrastructure design problem. Most Americans take their showers in a bathtub, a slippery round piece of metal and plastic to which they add soap and water. Only 19 percent of bathrooms have grab bars in their bathtubs; no wonder it is so deadly. And the problem is only going to get worse as the baby boomers age.

credit: My bright white bath with separate shower/ Craig A. Williams

© Craig A. Williams

They really need separate infrastructure with a non-slip flat floor and separate drain like I have and different controls for their own shower, instead of a faucet. Because they don't have safe and separate showering infrastructure, hundreds of thousands of people have to go to the hospital every year. And yet 81 percent of Americans, knowing full well that they are playing with fire, or at least with soap and water, don't do the minimum – they don't install grab bars.

It's easy to rant about bike helmets. It is also easy for me, an architect who knows a bit about bathrooms, to rant about grab bars, cheap and simple devices that save lives. Thousands of deaths and injuries! To paraphrase Rex Huppke of the Chicago Tribune:


What we really need is a building code change that makes safe and separate infrastructure for showering and bathing mandatory. It is simply too dangerous to take a shower in a bathtub.

And the next time a Rex Huppke complains about helmets or a Rosie Dimanno complains about cyclists demanding separate and safe infrastructure, I will ask them to look in the bathroom mirror, to learn about relative risk, and to wear a helmet in the shower because it is a lot more likely to save their skull. But I bet they actually haven't even done the minimum needed for a degree of safety, which is to put in a grab bar. Because they are hypocrites.