France proposed bicycle helmet law for kids under 12

[Steady rider]

France - good intentions going wrong – with proposed bicycle helmet law for children under 12
http://www.lemonde.fr/securite-routiere ... 55513.html

France is trying to improve road safety and intends to have a bicycle helmet law for children under 12 . In 2015 France had 3461 road deaths, including 7 cyclists and 19 pedestrians younger than 14 years of age . Approximately 93% of cyclists head injuries are considered minor, 5% moderate, 2% serious and 1% severe.

Some results from when helmet legislation has been introduced raises serious concerns. Robinson's 1996 report provided injury data for children from Australia. In Victoria, the equivalent number of injuries for pre-law levels of number of cyclists increased by 15% from 1990 to 1992. Robinson provides data in Table 2 for children in New South Wales. The equivalent number of injuries increased from 1310 (384 head + 926 other injuries) pre-law in 1991 to 2083 (488 head + 1595 other injuries) in 1993. The relative injury rate increased by 59%, from 1310 to 2083. The relative increase in 'other' injuries of 72% and 27% for 'head' raises serious concerns. The proportion of head injuries decreased from 29.3% to 23.4% and would give the impression of a benefit if viewed in isolation.

Robinson 1996 also refers to the incidence of hitting their head/helmet in a cycling accident was "significantly higher for helmet wearers (8/40 vs 13/476, i.e. 20% vs 2.7%, p 0.00001)". A bare head width of approximately 150mm may avoid contact compared to a helmeted head at approximately 200mm width. Helmet wearers often report hitting their helmets and the 7 fold increase may have long term effects that may not show up in accident reports.

Erke and Elvik 2007 examined helmet research from Australia and New Zealand and stated: "There is evidence of increased accident risk per cycling-km for cyclists wearing a helmet. In Australia and New Zealand, the increase is estimated to be around 14 per cent." The findings were based on six reports, four from when legislation was in place.

A recent report indicated that cyclists wearing helmets had more than twice the odds of suffering an injury than cyclists not wearing helmets, whether riding for transportation or recreation, see Porter AK, Salvo D, Kohl HW, Correlates of Helmet Use Among Recreation and Transportation Bicyclists, AJPM 2016

Dr Mayer Hillman from the UK's Policy Studies Institute calculated that life years gained by cycling, due to exercising, outweighed life years lost in accidents by 20 times. New Zealand has national data on injuries and hours cycled, so provides a good guide for considering the overall effects from helmet legislation.
It was reported for New Zealand;
H) Increased risk of injury per cyclist since helmet laws were introduced
Several analyses have compared numbers of injuries with the numbers of cyclists. They all suggest that injuries per cyclist have increased from what would have been expected without helmet laws.
In New Zealand, from 1989 to 2011, average time spent cycling (on roads and footpaths) fell by 79% for children aged 5-12 (from 28 to 6 minutes per person per week) and 81% for 13-17 year olds (52 to 10 mins/person/week).
Adult cycling declined from 8 to 5 minutes/person/week then trended back up to 8 minutes. Graphs of cycle use over time provide strong evidence that the requirement to wear a helmet discouraged cycling. The reductions in cycling were accompanied by increased injury rates. Between 1989 and 2012, fatal or serious injuries per million hours of cycling increased by 86% for children (from 49 to 91), 181% for teenagers (from 18 to 51) and 64% for adults (from 23 to 38).

For Edmonton, Canada it was reported;
Surveys in Edmonton in 2000 (pre-law) and 2004 (post-law) suggest that cycling by children and teenagers has been significantly reduced compared with adults (59% children, 41% teenagers) (Hagel et al, 2006) . and
There are in fact sharp falls in cycling after legislation evident in the data, which the authors do not draw attention to.

Australia provided strong evidence of cycling reducing in parts of the country following legislation, e.g. In Melbourne, road surveys revealed 30 more teenagers wearing helmets compared with 623 fewer cycling. In NSW, surveys showed 569 more children were wearing helmets compared with 2658 fewer cycling. Cycle helmet laws have discouraged large numbers of children from cycling in countries with helmet legislation but often they do not wish to admit there is this negative side to legislation.

The fine for not wearing a helmet for French children is set to be 135 Euros. In Victoria, Australia they started with a fine of $15 in 1990 but this has increased to $185 in 2016 .

Cycling provides health benefits to children and later as they grow into adults. Cycle training to avoid accidents and good infrastructure provisions for cycling can lead to fewer serious injuries. Cycle helmet laws result in fewer children cycling and involve the police stopping cyclists and questioning.

Please sign the petition below to oppose the proposed legislation.(petition needs writing).

Refs
http://www.lemonde.fr/securite-routiere ... 55513.html accessed 27.12.2016
http://www.securite-routiere.gouv.fr/la ... e-routiere accessed 27.12.2016
Robinson DL; Head injuries and bicycle helmet laws; Accid Anal Prev, 28, 4: p 463-475, 1996
http://www.cycle-helmets.com/robinson-head-injuries.pdf
Erke A, Elvik R, Making Vision Zero real: Preventing Pedestrian Accidents And Making Them Less Severe, Oslo June 2007. page 28 https://www.toi.no/getfile.php/Publikas ... 7-nett.pdf
Porter AK, Salvo D, Kohl HW, Correlates of Helmet Use Among Recreation and Transportation Bicyclists, AJPM 2016. https://www.ncbi.nlm.nih.gov/pubmed/27866599
Robinson DL, Submission, No 411 Senate Inquiry into personal choice and community impacts http://www.aph.gov.au/Parliamentary_Bus ... ubmissions
http://www.cyclehelmets.org/1032.html accessed 7.10.2016
https://www.bicyclenetwork.com.au/gener ... vice/2949/ accessed 27.12.2016
http://www.cyclinguk.org/campaigning/vi ... le-helmets
https://ecf.com/sites/ecf.com/files/ECF ... ET2_V2.pdf
http://www.cycle-helmets.com/ctc_child_cycling.pdf

[The utility cyclist]

done deal, Euro 135 fine. no fines for kids without helmets walking or in motors, typical BS!

UK child cycling deaths in 2014, 6 (not all solely to head injuries)

Child deaths in UK due to head trauma, circa 3000, mortality rate of 6.1% from circa 50,000 cases.

In the UK, 50,000 children a year are admitted to hospital with head injuries (about 10% of all childhood hospital admissions) (Reed et al 2005), and mortality has risen from 6% in 1990-1993 to around 7% in 2002-2005 (Bayreuther et al 2009). Data from the TARN registry (2014) show that in children aged under 16 years with severe head injury mortality was recorded at 6.1% (n=952).

https://rcni.com/emergency-nurse/eviden ... dren-59896
http://www.rospa.com/road-safety/advice ... s-figures/

[Cyril Haearn]

Does the child have to pay the fine from it's pocket money? And buy a helmet?

[landsurfer]

Proposed ?????

How does Mdm Le Penn feel about this crisis .......

[mjr]

France is trying to improve road safety and intends to have a bicycle helmet law for children under 12 . In 2015 France had 3461 road deaths, including 7 cyclists and 19 pedestrians younger than 14 years of age . Approximately 93% of cyclists head injuries are considered minor, 5% moderate, 2% serious and 1% severe.

So of those 7 cyclists under 14, could we expect 6 to be under 12 and none to have died from a head injury?

So just like Jersey, this makes no sense for improving road safety. It's more likely about stamping out cycling at an early age. I'm stunned that this isn't failing a laugh test in France.

[Steady rider]

http://www.securite-routiere.gouv.fr/la ... e-routiere

May have more info by year and age group, 2015 report.

[Bez]

So of those 7 cyclists under 14, could we expect 6 to be under 12 and none to have died from a head injury?

I doubt it.

Grab the French data, get the dates and locations of those incidents as well as the ages of the casualties (their data recording is comparable to Stats19 as far as I recall), search news reports, find out what the collision scenario was and see if the reports state whether a helmet was worn or not. Also try to find any reports of general helmet wearing rates for children in France for context.

Obviously that only tells you about fatalities.

For serious injuries you won't have the detail of news reports so you'd have to go on numbers (helmet usage rates become fairly essential here). You probably also won't have data for unreported single-party injuries, which I would expect to be significant in the case of children riding in locations away from the highway. I'm not sure you'd get adequate hospital admissions data, but it might be worth a look.

Fortunately Jersey's figures were so small there was no need to search news reports or do anything complicated with statistics, but that won't be the case with France.

http://beyondthekerb.org.uk/2014/07/23/ ... e-unicorn/

[Steady rider]

2015 France had 3461 road deaths, including 7 cyclists and 19 pedestrians younger than 14 years of age

The TRL report had a figure of 10-16% could be saved by wearing helmets, if I recall correctly,
Roughly one life may be saved by this approach.

Other reports suggest the accident rate may double with helmet use, so more than 1 life may be lost due to helmet use.
Assuming 64 million for the French population, http://countrymeters.info/en/France
Assuming 14% under 12 years of age, about 9 million, assume 25% cycle less due to a helmet law, 2.24 million would probably be negatively affected. As they grow older they may also cycle less due to being discouraged as children.

Malta is also on the same path.
http://www.maltatoday.com.mt/lifestyle/ ... Hz0w1OLRtt

In part this all comes about by misleading claims promoting helmet laws.

[Bez]

The TRL report had a figure of 10-16% could be saved by wearing helmets, if I recall correctly.

What assumptions did that make about efficacy?

To get a figure for people "saved" you'd have to work out:

- the number of fatalities (easy)
- whose sole cause of death was head injury (for which you'd need access to, and read, the conclusions of all post mortems)
- who were not wearing a helmet at the time (for which you would need access to the investigating officer's report from each incident)
- and who would be affected by the law (easy)
- and who would obey the law (tricky but can be estimated, albeit with large error bars)
- and for whom a helmet would make the difference between a fatal and a non fatal injury (very difficult even with access to full post mortems, and highly contentious)

Only then can you determine the number of fatalities you'd convert to slight or, far more likely, serious injury.

Then you have to ask further tricky questions. The obvious one relates to health effects from pollution and reduced activity, but there are others such as whether being left alive with massive injuries, arguably likely including major head injury given that the only reduction in protection is a polystyrene hat, is better than being dead.

For most of the population I suspect the gross benefit, ie not accounting for secondary effects, is negligible. However for children it's probably not, and the matter of being put off or not is different for children, too. When it comes to fatalities, from what I can see, helmets may make reasonable sense for the elderly: a handful of deaths a year of people over 70 do occur from low speed single party falls. But then the health effect of discouraging the elderly from cycling is surely very large: it's an activity which can be continued into advanced years, often even after waking becomes difficult.

And then, the elderly also due from falls and minor collisions while walking. And back we go to the usual points: when you look at the data, it makes little sense to advocate cycling helmets but not walking or driving helmets.

[profpointy]

If I recall correctly the TRL paper estimated how may would be saved IF certain assumptions on effectiveness were made. Thus the 16% isn't in any sense intended as a real prediction. Change the assuptions, you'd get another figure. Nothing wrong with this approach, per se, but what is wrong is to put credence on the 16%

[Steady rider]

Some deaths to young cyclists are the result of the cyclist failing to give way to oncoming traffic and a proportion of these cases occurred at intersections. The better approach to road safety is for young cyclists to receive good road safety instruction and for motorists to pass with more care and clearance. Helmet promotion is the wrong approach.

[The utility cyclist]

Reported numbers I saw for France were 281 TBIs per 100,000 population circa 2010, based on the population of the time that gives you about 172,000 TBIs annually covering all aspects of life.
This I found from the US: https://www.cdc.gov/traumaticbraininjur ... facts.html

Among TBI-related deaths in 2006–2010:

Men were nearly three times as likely to die as women.
Rates were highest for persons 65 years and older.
The leading cause of TBI-related death varied by age.
Falls were the leading cause of death for persons 65 years or older.
Motor vehicle crashes were the leading cause for children and young adults ages 5-24 years
Assaults were the leading cause for children ages 0-4.

Among non-fatal TBI-related injuries for 2006–2010:

Men had higher rates of TBI hospitalizations and ED visits than women.
Hospitalization rates were highest among persons aged 65 years and older.
Rates of ED visits were highest for children aged 0-4 years.
Falls were the leading cause of TBI-related ED visits for all but one age group.
Assaults were the leading cause of TBI-related ED visits for persons 15 to 24 years of age.
The leading cause of TBI-related hospitalizations varied by age:
Falls were the leading cause among children ages 0-14 and adults 45 years and older.
Motor vehicle crashes were the leading cause of hospitalizations for adolescents and persons ages 15-44 years.

[BennettH]

Does the child have to pay the fine from it's pocket money? And buy a helmet?

In the US, the fines for anything a child does are the responsibility of the parents/guardians.

I would assume it would be the same in France.

The whole thing is just to make sure that parents are raising their kids right. If the parents can't pay the fine and then buy a helmet, I am pretty sure the state would use that as justification to take the kids into their protection. (Never heard of that particular story happening, but it does seem to be how these types of laws are used).

These things seem to be more about determining unfit parents then they are about safety. (Or perhaps it could be said that they are more about child safety than they seem).

[mjr]

These things seem to be more about determining unfit parents then they are about safety. (Or perhaps it could be said that they are more about child safety than they seem).

How does it determine unfit parents? It looks like it forces parents to choose between a greater chance of obesity by making cycling/exercise less normal and less attractive or greater injuries through helmet-wearing, if they can afford helmets. So if they don't force a helmet on their child, they can be fined/imprisoned and then their children taken into state care, or if they do force a helmet on their child, they're helping to injure them and so their children can be taken into care.

Either way, a child helmet law is basically state-forced child abuse, isn't it?

[Steady rider]

Between 1989 and 2012, fatal or serious injuries per million hours of cycling increased by 86% for children (from 49 to 91), 181% for teenagers (from 18 to 51) and 64% for adults (from 23 to 38).

see above 28 Dec for full details.

A lot of people do not understand the helmet topic, so they assume helmets are a worthwhile safety product, see http://worldtransportjournal.com/wp-con ... eb-opt.pdf

Weaknesses with a meta-analysis approach to assessing cycle helmets