Why you should dismiss the CARRS-Q bicycle helmet research

In 2011 the Centre for Accident Research & Road Safety – Queensland (CARRS-Q) produced a publication called Bicycle Helmet Research. The publication relies on some new research carried out by CARRS-Q, but mostly reviews and re-analysed selected existing research in order to support mandatory helmet laws in Queensland. It has not been published in any peer reviewed journal and has only been published by CARRS-Q itself. Despite this lack of academic rigour, many politicians and government policy makers opposed to repealing or amending mandatory bicycle helmet laws now rely on this publication to dismiss any criticism of this law. If you have recently written a letter to the Queensland Government (or even other Australian state governments) on this subject you may be wondering about this new CARRS-Q reference.

In the publication CARRS-Q make the following claims:

  • that mandatory helmet laws reduce the likelihood of head injury by 69%, and serious brain injury by 74%,
  • that helmet laws do not reduce the number of people choosing to cycle in Queensland
  • that the economic benefits of encouraging cycling do not outweigh the medical costs involved with cyclists’ head injuries.

In order to reach these headline grabbing conclusions, CARRS-Q disregards some of the actual findings of the original research it re-analyses, ignores a significant amount of research that discredits helmet laws, and uses a significant amount of unreliable data.

If this sounds a bit too conspiratorial, then consider the backdrop to this report being commissioned (we have touched on this before, here and here):

  • CARRS-Q is an initiative of the Motor Accident Insurance Commission (MAIC). The MAIC is the regulatory authority that oversees Queensland’s motor vehicle insurance scheme, and has the responsibility to pay compensation to victims of motor vehicle crashes.  The MAIC’s key objectives are motor vehicle focused.
  • The CARRS-Q publication was commissioned by the Queensland State Government’s Transport and Main Roads Department in response to media reports about the failure of public bicycle hire schemes, introduced by an opposing political party’s local government and failing due to oppressive State government helmet laws.
  • Due to diligent use of Right to Information legislation (RTI), cycling advocates obtained documents proving that the report was reviewed no fewer than three times by the State Government’s Transport and Main Roads Department before its public release, with some significant changes made to ‘strengthen’ the supposedly academic findings.
  • Documents obtained through RTI also showed that, in response to the cycling advocates’ RTI application, the public release of the report was carefully managed through the media to promote the mandatory helmet laws.
  • Annastacia Palaszczuk, the Minister responsible for Transport in Queensland at the time the report was commissioned and subsequently reviewed, has openly declared that she will never repeal helmet laws.

CARRS-Q’s claims are far in excess of the findings of most of the actual, peer reviewed research CARRS-Q relies upon.

CARRS-Q argues mandatory helmet laws are necessary by:

  • Selectively choosing only some of the available research and ignoring research that does not support helmet laws.
  • Putting its own pro-helmet spin on the findings of the research it reviews.
  • Dismissing claims that the health benefits of cycling outweigh the health costs associated with cyclists’ head injuries.
  • Claiming that helmet laws don’t discourage cycling.
  • Applying some very dubious assumptions to incomplete hospital and crash data, to claim the data shows a marked decrease in head injury rates since the introduction of helmet laws.
  • Dismissing the findings of Voukelatos and Rissel (2010) on the grounds that it makes too many assumptions, and uses incomplete data.

This post is the introduction to a series of posts looking beyond the findings of CARRS-Q, and looking critically at the source data and original research CARRS-Q used.

Part Two will look at helmet efficacy research conducted by the Cochrane Collaboration, a Government-funded UK charity that conducts a broad range of medical research.  This helmet research is relied upon very heavily by the CARRS-Q publication, however the Cochrane research included data relating solely to children cyclists, and excluded injuries serious enough to cause death thereby overemphasizing the statistical relevance of minor injuries such as scratches, bumps and bruises.

Part Three post will look at a significant amount of other research used by CARRS-Q, to support mandatory helmet laws.

Part Four will examine the Monash University research also used by CARRS-Q.

Part Five will deal with CARRS-Q’s claim that there are no significant economic benefits to repealing helmet laws.

Part Six will consider CARRS-Q’s claims that helmets laws do not discourage cycling.

The Final Post in this series will review CARRS-Q’s use of existing police and hospital data and available bicycle fatality data.

The analyses of the source data and original research discussed in this series of posts will show that, contrary to the claims of CARRS-Q:

  • Young children are much more likely to suffer ‘head injury’* that can be prevented by helmet wearing, and are much more likely to be discouraged from cycling because of mandatory helmet laws.  This means any research that compares head injury rates to other types of injuries (for example upper limb injuries) will be misrepresent the efficacy of helmets if it does not differentiate between age groups.
  • Mandatory helmet laws reduce the amount of cycling in the community (see here and here).
  • The net social economic advantages from cycling far outweighs the possible economic costs of reduced helmet use. (We have covered this briefly before).
  • There is no clear, unequivocal evidence that wearing a bicycle helmet provides any significant protection from serious or life-threatening injuries including neck injuries.  It is only clear that helmets provide some increased protection from minor injury, such as non-life threatening cuts, bumps and bruises.
* The use of the term ‘head injury’ is misleading to the public without further qualification, despite being technically correct. Most people assume this is means ‘serious brain injury’. The reality is that it includes everything from minor cuts & bumps and dental trauma to brain injury at the extreme…