Buckle Up a Helmet to Save a Life

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Personal Health

I will start this column with its conclusion: Riding a bicycle without wearing a properly fitted helmet is simply stupid.

Anyone who does so is tempting fate, risking a potentially life-changing disaster. And that goes for all users of bike-share programs, like New York’s Citi Bike, who think nothing of pulling a bike from its station and cycling helmetless on streets, with and without bike lanes, among often reckless traffic on foot and wheels.

Even a careful cyclist is likely to crash about once every 4,500 miles and, based on personal observation, many city cyclists are anything but careful. Although reliable details are lacking on bike share accidents in New York or elsewhere, one shattering statistic reported by New York City for cyclists in general stands out: 97 percent of cycling deaths and 87 percent of serious injuries occurred to people who were not wearing helmets.

Head injuries account for three-fourths of the nearly 700-plus bicycle deaths that occur each year nationwide, and helmets can prevent or reduce the severity of these injuries in two-thirds of cases, according to the Bicycle Helmet Safety Institute, a nonprofit organization based in Arlington, Va. This protection holds even in crashes with motor vehicles, researchers from the University of Washington in Seattle reported as long ago as 2000, a statistic verified many times since.

I’ve been a cyclist for more than 70 years, most of them before anyone thought about wearing a helmet (protective helmets for recreational cyclists didn’t even exist until 1975). Although I’ve owned many helmets in the last four decades, I admit to occasionally not wearing one to avoid “helmet hair” before an evening out.

But a few weeks ago I learned firsthand how foolish it was to worry more about my hair than my head. Luckily, my helmet was securely in place when, for reasons unknown, I fell forward over the handlebars while riding slowly uphill a few houses from home. Although I suffered a mild concussion and have no memory of the accident (I also sustained a nasty cut on my chin, badly bruised ribs and a scraped knee), my helmet prevented a serious brain or facial injury.

I will never again mount a bicycle without the helmet on my head where it belongs, not in my backpack, bike basket or, worse, at home.

There are laws requiring young cyclists to wear helmets in 21 states and Washington, D.C., and at least 200 localities, but very few cover adult riders. A common sight in my neighborhood: Fathers riding helmetless with their helmeted child on a bike seat behind them.

There are many reasons besides helmet hair that keep people from wearing helmets. One of the most frequent excuses: “I’m only going to the store (or the gym).” Yet, as with car accidents, the majority of bike accidents happen close to home, as mine did, and not necessarily in traffic or at high speeds. Even low-speed falls on a bike trail can scramble brains.

“A very low-speed fall can be just as dangerous as a fall at higher speeds,” said Randy Swart, director of the consumer-funded Bicycle Helmet Safety Institute. “All it takes is gravity – the distance to the ground – to cause a head injury.”

Teenagers seem especially resistant to wearing helmets, yet with their still-developing brains they probably incur the greatest risks and have the most to lose from a head injury. “There’s often a rebellion aspect among teens,” Mr. Swart said. “They say, ‘All through childhood, my parents forced me to be safe. Now I want to make my own decisions about risk.’” College students and young adults often also think similarly, he said.

I worry too about younger children, even those whose parents insist that they wear a helmet when riding a scooter, tricycle or bicycle. I see many such riders with parents in tow in my Brooklyn neighborhood, and in at least half the cases I’ve observed, the helmet is too big or is not on correctly and likely to provide little protection in a serious fall or crash.

The most common error is positioning: If the helmet sits too far back on the child’s (or adult’s) head, it will not protect the most vulnerable part of the brain in a hard fall, especially if the skull fractures. When the straps are too loose (or, as I’ve often seen even among adults, the chin strap is not clasped), the helmet will fly off in a fall and offer no protection whatsoever.

The helmet should sit on the head straight, front to back, and not move when you shake your head. The straps extending from the helmet to the chin strap should each form a V right under the ears.

“A bike helmet is a like a seatbelt – it should feel snug, not tight, when you first put it on, but when you start riding, you should be able to forget all about it,” Mr. Swart said.

Another excuse I’ve heard, perhaps from those familiar with concussions among football players, is that helmets do not prevent concussions. And that is true. You don’t even have to actually hit your head to get a concussion. A concussion results when the gel-like brain sloshes violently or slams into the unyielding bony skull, and this can happen with almost any significant impact to the head. What the helmet can do is reduce the energy of the impact and the likelihood of a skull fracture or brain bleed.

If cost is a deterrent, Mr. Swart gleefully noted that many inexpensive helmets perform just as well as expensive ones. His organization had three “extremely cheap” helmets ($15 to $20 range) tested along with three “very expensive” ones ($150 and above) and, he said, “their performance level was almost identical.”

So if you’re not overly concerned about fashion or brand names, you can feel confident purchasing inexpensive helmets for every rider in the family at a chain or big-box store, he said. They all must meet the standards set by the Consumer Product Safety Commission.

After determining a proper fit for head size and comfort within your price range, my advice is to select a helmet that is brightly colored; one of mine is red-orange and the other lime-yellow, the same as the colors of the jackets and backpacks I wear with them.

Now, don that helmet, enjoy the ride and come home safe and sound.