In a notice published this week, Institut national de santé publique (INSPQ) officially abandoned the idea of making bike helmets mandatory. This about-face is in line with the approach advocated by Direction régionale de santé publique de Montréal.
The probability of getting hurt or sustaining a head injury is based first and foremost on exposure to motor vehicles, and this applies to cyclists as well as to other road users. To reduce personal risk of head injury, it is preferable to wear a bike helmet. However, personal protective equipment (PPE) such as a helmet does not prevent accidents, for instance, collisions between motor vehicles and cyclists, nor does it protect against neck, upper body or pelvic injuries.
It is clear that industrialized countries where bicycle use is safest (and most common) have adopted other, more effective strategies than wearing bicycle helmets.
For more than a dozen years, the public health department has been suggesting an environmental approach that fosters the following:
- Less use of cars and reallocation of resources dedicated to active transportation and public transport
- Widespread application of traffic calming measures through physical measures that reduce the probability of collisions and severity of injuries
- Improved pedestrian infrastructure, especially at crosswalks where there are several traffic lanes
- An extended cycle track network, that is, lanes that are physically separated from motorized traffic
In sum, it is preferable to wear a helmet when cycling. However, environmental strategies are usually more effective in preventing injuries. The government needs to develop actions that target structural determinants of road insecurity and infrastructure in addition to specific interventions.
- Patrick Morency, MD, PhD, Direction régionale de santé publique de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal (CIUSSS)