'It looked awful. I hated wearing it. But it saved my life'

SUMMERTIME in London, and people are taking their bicycles on to the streets. The health and environmental benefits of cycling are clear - in theory. Keeping fit and helping to preserve the ozone layer are powerful reasons to pedal, although the rain, cabbies and couriers take the edge off the pleasure.

Debate has long raged about whether wearing helmets makes cycling safer.

It might seem a self-evident truth that helmets reduce the risk of injury, disability and death, but some maintain that helmets lull wearers into a false sense of security, leading them to cycle carelessly and that helmets are themselves dangerous if incorrectly worn.

While the London Cycling Campaign concedes that "correctly wearing a helmet in good condition reduces the risk and/or severity of head injury in an accident", it continues, "there are serious problems in assessing some of the statistical evidence and some critics have suggested that the safety benefits are more illusory than real."

This view is not shared by senior London neurologist and former medical director of the Royal Free Hospital, Peter Harvey, who frequently sees patients whose lives have been devastated by head injuries. "The evidence," he says, "is that wearing a proper safety helmet saves lives, but also, and this is vitally important, reduces disability following some kinds of injury, such as the risk of epilepsy after skull fractures. Cycling is fun, healthy and practical but cyclists are vulnerable."

The latest research, from Imperial College, London, demonstrated clearly that helmets are a good idea for children and adults; they offer "significant protection," says research statistician Adrian Cook.

Sceptics fall into two main groups. Some simply dispute the statistics, although Cook's study, published in the British Medical Journal, convincingly addressed these concerns.

Others insist, however, that wearing helmets encourages cyclists and drivers alike to be less cautious, making the helmet as good as useless. It's what's called "risk homeostasis".

Twenty years ago, when I started cycling to escape the Tube, helmets were just appearing in the shops, and very occasionally on the heads of the fashion-challenged. I didn't want one - I wanted free-flowing locks and of course I had an invincible skull. Then a friend spent three months in a coma after a road accident. Suddenly a helmet seemed like a good idea, and I invested in the most Kite- marked monstrosity I could afford.

It looked awful. I hated it, lost it, dropped it and, on warm days, it spent more time dangling from the handlebars than strapped to my head. But it felt like an insurance policy. And indeed, one day four years ago when I happened to be wearing it, it saved my life.

Pedalling slowly home, enjoying the last bit of evening sun in a blossom-filled back street in Notting Hill, I was mugged. A bunch of powerful men wrestled me to the ground, determined to get the laptop computer case from my basket, little knowing that it contained no more that a few bits of evening reading and a pair of dirty running shorts.

When the police found me in a mild stupor in the gutter, they asked if I had hit my head. "Oh, no," I replied firmly, picking up my cycle helmet, which promptly fell into three pieces.

The point of the story is that I don't think I'd be writing it if I hadn't been wearing a helmet.

Debate over risk homeostasis is, frankly, irrelevant when your head hits the Tarmac.

Helmets may be expensive (although VAT was removed from them on 1 April) and bizarrely unattractive - but I'd still rather be seen alive in one than dead without it.

* London Cycling Campaign; 020 7928 7220; www.lcc.org.uk

How to protect your head

HELMETS reduce head injury (by 63 per cent to 88 per cent for head, brain and severe brain injury) by distributing the force of impact over a large area and absorbing some of its energy. They should meet European Standard CEN1078 and be replaced following a severe blow even if damage is not obvious. They usually have pads, straps or adjustable sections. Use these to hold the helmet in place, snugly and comfortably, level on the head and covering the forehead without obscuring vision.

Adapted from: Headway (www.headway.org.uk), the head injury association, which campaigns for helmet use to be mandatory.

Copyright 2001
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