Wednesday, August 17, 2011

Is it Crazy to Ride without a Helmet?

IN a provincial court last Friday morning, Vancouver resident Ron van der Eerden was defending his right to ride a bike without a helmet. Many people have concluded that Mr. van der Eerden is a loon. Yet a surprising fact is that, in a recent poll of British doctors, conducted by the British Medical Association, 68% agreed with him that helmets should not be compulsory for cyclists.

What can account for such craziness -- among doctors of all people?

To begin to find an answer, let’s ask a simple question. Compare an average person who cycles for transport, riding about 300 hours per year, with a typical motorist, also driving about 300 hours per year. Who is at greater risk of injury and death?

Answer: the motorist. This may be surprising, but it is a fact. While certain risks are very slightly higher for the cyclist, namely the risks from road accidents and air pollution, these increases are massively outweighed by lower risks of cardiovascular disease, cancer and diabetes, among other risks. A study published just this week in the British Medical Journal found that the risk-reductions of cycling (in Barcelona) compared with driving outweigh the risk increases by a factor of 77. Other studies have estimated the cost-benefit ratio at 20, or as little as 7, but no study has found that driving is safer. Cycling is far safer than driving.

This is something to bear in mind when thinking that someone is crazy to ride a bike without a helmet. If you’re an average Canadian, then that cyclist’s risk of death and injury is far lower than yours. Who is the crazy one here?

These studies take no account of whether a bicycle helmet is worn or not, since it makes very little difference. To see why, we can describe the situation with some rough, but reasonably accurate, numbers. Let’s compare two people, Chris and Mike. Chris cycles for an hour, while Mike drives his car for an hour. As a result, Chris’s life expectancy is reduced by about 5 minutes, due to the risk of death in a road accident. Mike’s life expectancy is also reduced by about 5 minutes, for the same reason. However, exercise is known to increase life expectancy, so Chris gains about 100 minutes in life expectancy from that. Overall, Chris gains 95 minutes, and Mike loses 5 minutes. Now, what about the helmet? A head injury is the sole cause of death in about 30% of cyclist deaths, and in the recent scientific literature helmets are estimated to prevent about 10-30% of such injuries. Hence wearing a bike helmet might reduce Chris’s chance of death by 3-10%, corresponding to an increase in life expectancy (per hour of cycling) of 9-30 seconds. In comparison with the general gain of 95 minutes, from cycling itself, the further gain of a few seconds from wearing a helmet is trivial.

Looking at these figures, it is little wonder that helmet laws, wherever they have been introduced, have had no noticeable impact on the rates of cyclist injury and death. And that the safest countries to cycle in are those where almost no one wears a helmet. Helmets are a non-issue for cycling safety.

There is also something perverse about fining someone for taking a personal risk, when the majority who take much larger risks are not fined. Given the clear fact that cycling (helmeted or otherwise) is far safer than driving a car, why are cyclists fined? As shown above, leaving one’s helmet at home costs a cyclist a few seconds of life expectancy, per hour in the saddle. If that same cyclist chose instead to drive a car for that hour, he or she would miss out on some 95 minutes of added life expectancy. The law guides us toward the more dangerous action. We should also remember the “second-hand risk” in driving a motor vehicle, i.e. the risk imposed on third parties. Driving for an hour costs other people a total of about 5 minutes of life expectancy as well. The law apparently prefers us to put others at risk rather than exposing ourselves to a much smaller risk.

Now, one might argue of course that even a small gain is a gain, and so wearing a helmet still a smart thing to do. At the same time, however, it’s not something to get worked up over. And it certainly isn’t a matter for legislation.

Monday, June 20, 2011

Is Safety Now a Religion?

For many years I've been bugged by the constant appeals to "safety" in our society. It seems that, if a policy has nothing at all to recommend it, on rational grounds, then it's invariably supported by an appeal to safety. The very word has a kind of magical power, and is almost impossible to resist. "I'm sorry, but it's a safety issue." Who can argue against that?

More recently I've started to wonder about the sources of this practice, and begun to suspect that it has its roots in our post-religious culture. It is, I am starting to believe, the result of a religious impulse, the need for salvation.

The world is a fairly dangerous and unpredictable place. Of course life in Canada is relatively predictable, compared with most other places, and the dangers are relatively few, but it remains true that any of us could be killed, or be permanently crippled, tomorrow. This is scary. And I'm not sure that the fact that these risks are low in Canada helps reduce the fear that much. (I get the impression that we learn to tolerate the level of risk that we're exposed to.)

So what do we do with that fear? Our Christian ancestors had one strategy, and now we have another. The Christian approach (shared by other religions) is to acknowledge that there is no safety in this world, which is arbitrary and chaotic. Yet we have nothing to fear, since our safety is with God, who guards our life and will bring us into his kingdom. "And as surely, sinner, as thou canst put thy trust in God, thou art safe" (Charles Spurgeon, "Salvation and Safety", p. 4) It's this understanding of safety that comforted early Christians as they waited to be eaten by lions, for example.

The present approach is quite different, of course. With no God, our safety cannot reside in another world. We must be safe in this world. And here we see the source of the irrationality in the present safety religion. For the world just isn't safe. The Christians are right on this point: the world is arbitrary, chaotic and unpredictable. Our psychological need for a safe world just doesn't make it so.

I realise that, these days, saying that the world isn't safe (and cannot be made safe) is some kind of blasphemy. Our modern scripture says that there are no accidents, but only "preventable injuries", with the obvious consequence that injury-free living is a real possibility. (We just need more regulations, more inspectors, more safety gadgets ...) By denying the possibility of safety I am saying, to our culture, that there is no heaven.

For some time now I've been following the debate about bike helmets, looking at the arguments for and against. This case provides a very good illustration of the safety religion in Canada (and no doubt elsewhere). The arguments against wearing bike helmets, and especially against legislating their use, are simple and rational. The absolute risk of injury and death from cycling is very low. And wearing a helmet doesn't make much difference to that risk, if any. These arguments would appear to be irrefutable, yet the majority reject them. How do they respond? Judging from various internet discussion forums, that I've been reading, the typical response is emotional, fear-driven, and grounded in the need to be safe.

The human skull is only a quarter of an inch thick! Imagine that smashing into the hard asphalt, or the hood of a truck. You might think you don't need a helmet to ride to the corner store, but that could be the very time disaster strikes. Think about all those dead cyclists, and drooling scores of others with permanent brain damage. Strap on a helmet and be safe! (It sounds eerily like Spurgeon. "There is a hell for the wicked, but none for the righteous.")

I reject all false gods, including the modern idol of safety. I refuse to worship it. I prefer to live in the real world, and worship the real gods of reason, truth and love.

[Caveat: I'm not necessarily against all measures that are justified on grounds of safety. Some can be justified on rational grounds. I don't, for example, eat raw hamburger bought from a supermarket! I am trying to foster the virtue of prudence, in myself and my children. I object only to the worship of safety, and the irrationality that goes with it.]