Cycle safety

Cycling is a fabulous way to keep fit and active. At Headway, we are passionate about promoting safe cycling, while supporting calls to make it safer for people of all ages to take to their bikes and get pedalling.

In this section:

• Use your head - use a helmet
• What does the evidence say about cycle helmets?
• Key cycle helmet facts
• Expert comment
• Further information

Headway urges cyclists to stay safe and wear a helmet as government kickstarts cycling revolution

Headway – the brain injury association has relaunched its campaign to encourage people to wear cycle helmets after the government announced ambitious plans to boost cycling rates.

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'Use your head - use a helmet'

Sadly, we know how easy it can be to sustain a life-changing brain injury as a result of a cycling accident. Many Headway service users sustained their injuries as a result of cycling accidents. Some were experienced riders, others novices. Young or old, on a busy main road or a quiet countryside lane, the reality is that an accident can happen to anyone at any time.

At Headway, we believe that all cyclists should wear helmets, particularly vulnerable road users such as children who do not possess the same level of competency or experience as adults. We believe helmets should be compulsory for all child cyclists while supporting calls for a range of additional measures to improve cyclists' safety, including more dedicated cycle lanes and educational campaigns aimed at both cyclists and motorists.

Cycle helmets should always be fitted and worn correctly, be free of any damage, and marked with the safety standard EN 1078 (for adults) or EN 1080 (for children).

What does the evidence say about cycle helmets?

Cycle helmets save lives and can prevent people sustaining lifelong brain injuries.

This fact has been proven by numerous peer-reviewed, published scientific studies and is shared by well-respected professional bodies including the British Medical Association, the Association of Paediatric Emergency Medicine, the Bicycle Helmet Initiative Trust and numerous doctors and neurosurgeons across the UK.

A 2019 study into the impact of cycle helmet use on severe traumatic brain injury and death in a national cohort of over 11,000 pedal cyclists, using data from the NHS England Trauma Audit and Research Network dataset, found that cycle helmet use was associated with a significant reduction in severe traumatic brain injury (TBI). 47.6% of patients who were not wearing a helmet sustained a severe TBI, compared to 19.1% of patients who were wearing a helmet (Dodds N, Johnson R, Walton B, et al, 2019).

A study from 2016 collected data from over 64,000 cyclists around the world, and found compelling evidence that wearing a cycle helmet reduces risk of serious head injury by almost 70% and fatal head injury by 65%. It is the largest review on cycling and helmets to date. The study also found that the risk of sustaining a general head injury is reduced by 51% and facial injury by 33%, when a helmet is used (Olivier, Creighton, 2016).

The study was led by the University of New South Wales in Australia, and published in the International Journal of Epidemiology. The full research paper (Bicycle injuries and helmet use: a systematic review and meta-analysis) can be found in the related resources section. 

Further evidence is offered by a meta-analysis into cycle helmet efficacy, which found a protective effect of helmets, leading the authors to conclude that helmet use for all riders should be encouraged (Attewell, Glase & McFadden, 2001). Helmet use has also been associated with a reduced risk of head injury of up to 74% (Bambach, Mitchell, Grzbieta & Olivier, 2013). 

A Cochrane review (Thompson, Rivara & Thompson, 2000) considered five case-control studies from the UK, Australia and the USA. The study, published in the Cochrane Database of Systematic Reviews, found a large and consistent protective effect from cycle helmets for cyclists of all ages, reducing the risk of brain injury by up to 88% and facial injury by 65%. This paper (Helmets for preventing head and facial injuries in bicyclists) is also available in the related resources section. 

Research into this area has also been conducted by the Transport Research Laboratory (TRL), the country's leading independent research institution. Commissioned by the government in 2009 to look at all the evidence - for and against the effectiveness of cycle helmets - this well-respected authority reported that cycle helmets are effective at reducing the risk of skull and brain injuries.

TRL conducted a subsequent study in 2014, which was commissioned to inform the policy decision of mandatory cycle helmets in Jersey on the effectiveness of cycle helmets. The report drew the following conclusions:

1. Legislation requiring the wearing of cycle helmets in Jersey can be expected to have a beneficial effect on the injury rates of those impacted by the legislation, especially in collisions that do not involve motor vehicles.
2. Such legislation seems unlikely to have a major impact on cycling activity in Jersey.

Both TRL reports, which include detailed information on the research used to reach these conclusions, can be downloaded from the related resources section.

A review was also published in 2007, which collated evidence from three previously published systematic reviews in the Cochrane Database on cycle helmet research. It concluded that research into this area provides overall good evidence that cycle helmets are effective in reducing head and facial injury in the event of a crash (Ivers, 2007). 

Key cycle helmet facts

• Pedal cyclists accounted for 6% of total road deaths in 2018 (Department for Transport)
  
  
• The number of pedal cyclists killed or seriously injured in Great Britain increased by 21% from 2008 to 2018, despite pedal cyclist traffic increasing by only 17 (Department for Transport)
  
  
• Around 4,000 pedal cyclists were killed or seriously injured on Britain's roads in 2018. There were over 13,000 minor injuries, a reduction of 6% from the previous year (Department for Transport)
  
  
• A study into the impact of cycle helmet use on severe traumatic brain injury and death in a national cohort of over 11,000 pedal cyclists, using data from the NHS England Trauma Audit and Research Network dataset, found that cycle helmet use was associated with a reduction in mortality, severe traumatic brain injury (TBI), intensive care unit requirement and neurosurgical intervention (Evaluating the impact of cycle helmet use on severe traumatic brain injury and death in a national cohort of over 11000 pedal cyclists; Dodds N, Johnson R, Walton B, et al, 2019).
  
  
• An international study led by the University of New South Wales, found that wearing a helmet can reduce the chance of a fatal head injury by 65%, serious head injury by 69%, general head injury by 51% and facial injury by 33% (Bicycle injuries and helmet use: a systematic review and meta-analysis; Olivier J, Creighton P, 2016)
  
  
• Leading independent scientific research experts at the Transport Research Laboratory have concluded that 'Assuming they are a good fit and worn correctly, cycle helmets should be effective at reducing the risk of head injury, in particular cranium fracture, scalp injury and intracranial (brain) injury'. (The potential for cycle helmets to prevent injury - a review of the evidence; D Hynd, R Cuerden, S Reid and S Adams, Transport Research Laboratory, 2009)
  
  
• A Cochrane review considering five case-control studies from the UK, Australia and the USA illustrates a large and consistent protective effect from cycle helmets, reducing the risk of brain injury by up to 88% and injury to the upper and mid face by 65% (Helmets for preventing head and facial injuries in bicyclists, Thompson et al. Cochrane Database Syst Rev. 2000)

What the experts say

“I see first-hand the effect a traumatic brain injury can have. It is my job and that of my colleagues to not only save lives but try to make those lives worth living. Cycle helmets offer vital protection to one’s fragile skull and can save lives and significantly reduce damage to the brain in the event of an impact. If every cyclist wore a helmet the number of cyclists killed or seriously injured each year would be reduced.

"You would never think about taking your laptop about without putting it in a case. Why would you not do the same for your own brain - the most precious computer you will ever own and for which there are no spare parts?”
Dr Andy Eynon, Consultant in Neurosciences Intensive Care, Wessex Neurological Centre

"Medical bodies such as the British Medical Association and the Association of Paediatric Emergency Medicine clearly state that cycle helmets can save lives. As a neurosurgeon at Addenbrookes Hospital in Cambridge and Honorary Secretary of the British Society of Neurological Surgeons, my professional opinion is one of complete agreement."
Peter Kirkpatrick, Consultant Neurosurgeon, Addenbrookes Hospital, Cambridge

"The reality is that even a minor injury can have a major impact. Therefore, anything that can limit damage to the brain by lessening the risk of skull fracture or reducing the amount of energy absorbed by the brain upon impact can have a significant effect on a patient’s outcome. Cycle helmets achieve both of these objectives."
Prof David J Sharp, IHR Research Professor & Consultant Neurologist, National Institute for Health Research

“The SBNS considers that there is sufficient body of evidence to support a public policy promoting the wearing of cycle helmets by children and adults. The SBNS notes that children are particularly vulnerable to cranio-facial injury and recommends that legislation is enacted to make the use of cycle helmets compulsory in children.”
Neil Kitchen, President, Society of British Neurological Surgeons

"The number of West Australians riding bicycles in Western Australia are continuing to rise.

I am advised by the Road Safety Commission that at the end of 2019, bike riding numbers were approximately five per cent higher than in 2011. The COVID-19 pandemic has dramatically increased bike riding rates across Perth with an average growth rate of 50 per cent observed in April 2020, sustained into May and June 2020.

The Western Australian State Government continues to support compulsory helmet legislation for bike riders to reduce road-related death and serious injury. The available evidence is compelling, bicycle helmets help reduce the risks of serious head injury and fatality."
Hon Michelle Roberts BA DipEd MLA Minister for Police, Road Safety, Western Australian Government

Further information