Medical study calls for mandatory helmets for children

Wearing helmets should be mandatory for children riding a bike, a report in the Malta Medical Journal has proposed. According to the report, bicycle helmets can reduce the risk of head and brain injuries and death. 

But the report falls short of recommending making helmets compulsory for adults, calling for a robust educational campaign instead. This is because the scientific report confirms that mandatory helmet legislation may deter adults from cycling altogether, forgoing beneficial personal health gains.

The study, ‘Cyclist Safety in Malta, a Review’ is authored by Jason Attard, Michelle Deguara, and Mariella Borg Buontempo.

Most EU Member states have no requirement in legislation for bicycle helmets: mandatory helmet legislation for children is in effect in seven European Union Member States.

Mandatory legislation exists in provinces in parts of Canada and states in Australia where it resulted in a decrease in head injury rates but also in the number of cyclists. In Ontario, Canada deaths decreased for children under 16 years by 52%.

In Australia mandatory helmets led to the decline of between 20% to 40% in the number of cyclists and a decrease in injuries among cyclists. In Melbourne helmet use was cited as the most common reason for not using a bike-sharing scheme, with 36% saying it was hard to find a helmet and 25% not wanting to wear a helmet 

Mandatory helmet legislation for children is in effect in seven European Union Member States

In Malta there were three deaths due to cycling between 2006 and 2015. But in 2013, there were 173 registered injuries among cyclists.

Two in five registered injuries occurred in children under 15 years of age or less. Overall, just over one in four registered injuries involved the head.

Although young people aged between 10 and 14 years are the most prone to incidents, the study notes that the number of these incidents is decreasing while among 20 to 59 year olds the number is rising. 

The study calls or an educational campaign to encourage the use of helmets among adults. It also calls on the authorities to consider the introduction of mandatory helmet legislation (MHL) in children, noting that children who grow up cycling with a helmet are probably likely to become adults who spontaneously use bicycle helmets. 

The report also calls on the authorities to implement infrastructure measures: to separate cyclists and motor vehicles, including cycling lanes, wherever this is possible.

Focus should be on infrastructure: BAG

The Bicycle Advocacy Group (BAG) welcomed the study’s observation that mandatory helmet laws discourage the use of bicycles as a means of transport. 

Bicycle advocacy groups worldwide fear that all-ages helmet laws might actually make cycling more dangerous, by decreasing ridership. Research shows that the more cyclists there are on the road, the fewer crashes occur. Academics theorize that as car drivers become used to seeing bikes on the road, they watch out more closely for them. Advocacy groups insist that increasing the number of cyclists should be a national priority.

“Cycling is currently the most viable short-term solution to Malta’s traffic problem, with buses stuck in traffic and other scenarios of public transport, like any rail-based system, only achievable in the distant future”, BAG spokesperson Holger Mitterer told MaltaToday. 

While BAG encourages the use of cycling helmets, a cost-benefit analysis by German economist Gernot Sieg in 2014 suggestsed that mandatory helmet laws are not economically advantageous. This is because the public health effects of reduced cycling outweigh the benefits of reduced head injury by far. 

The BAG lamented the fact that a study on the broad scope of “cyclists’ safety in Malta” focuses so much on cycling helmets, when the lack of well-designed infrastructure and driving standards are of much more concern. 

According to BAG mandatory helmets for the use of electrically assisted bicycles (so-called pedelecs) has had disastrous effects, with sales dropping by 80%. “This is especially regrettable as pedelecs provide a solution for potential cyclists deterred by Malta’s hilly landscape.”