Does having to wear a helmet turn you off riding your bike?

The anti-bike helmet movement held protests in Australian capital cities as well as Wellington over the weekend calling for an end to mandatory helmet laws.

In Melbourne, about 50 turned up, and in Sydney seven police cars shut down the ride, and two bare-headed cyclists were fined $330 each.

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Whatsapp The Melbourne protest.

Note a huge turnout, but this low attendance may be deceiving - there seems to be a popular movement for change, at least within Australia's largest bike-riding organisation. Late last year Bicycle Network held a survey of members views on helmet laws. This itself was a big move - the Network has backed mandatory helmet wearing for more than 30 years, but it now said it was open to changing its position, and it was looking to members to help guide its decision.

Currently under the law, it's compulsory to wear a helmet whenever riding a bike in Australia, excluding the Northern Territory.

Almost 20,000 answered the survey:

58.3 per cent said there should be a change to helmet laws

41.8 per cent said helmets should be mandatory all the time

40.7 per cent said helmets should only be mandatory when the risk is high

30 per cent said they would ride more often if helmets weren't mandatory

Almost everyone who currently wears a helmet said they would continue to wear a helmet even if the laws changed

Bicycle Network says it aims to complete its policy review by next month.

Bicycle Network CEO Craig Richards said late last year: "Understandably, there are people that feel safer wearing a helmet. But there are situations where some people have told us they would feel safe without a helmet, like riding on a trail next to the beach."

Then only last month ACT Road Safety Minister Shane Rattenbury said it was a good time to revisit discussions about whether bike helmets were necessary.

"If removing the requirements for helmets actually encourages more people to cycle, and the overall health benefits that come from that outweigh the risk of immediate trauma from an accident ... [then] it's a question worth asking and worth examining," he said.

"This is a tricky area to weigh up."

The anti-helmet arguments: safety and participation

The anti-helmet movement tends to argue the protection offered by helmets is outweighed by the downside of people cycling less. The arguments mostly boil down to:

Helmets offer less protection than most people realise People would cycle more if they didn't have to wear helmets

Do mandatory helmet laws reduce head injuries?

Most public health experts are pro-helmet - they point to numerous studies showing wearing helmets save lives. An evaluation of helmet laws in Victoria, for example, showed that two years after the legislation was introduced, there was a 16 per cent reduction in head injuries in Melbourne, and a 23 per cent reduction throughout Victoria.

We asked the triple j textline. You were pretty unforgiving: Absolutely stupid. Think about the high number of traumatic head injuries. Australia isn't like other countries with their culture of bike riding (see: Amsterdam). Helmets save lives, that's a fact.

What a heckin' First World problem. Get over yourselves cyclists.

I bought a helmet the other day. $12. C'mon mate, they save lives.

How about the extra strain and cost born by the health system from no stackhats?

If you stack it and end up with brain damage for not wearing a helmet, who pays the lifelong bill to look after them. Keep the brain bucket on just in case.

I ride four kinds of bikes. I'm also very pro- personal responsibility. But I'm a doctor in a neurotrauma centre and see the huge cost of head injury, both to the individual and the health system. Let people decide whether they wear a helmet - but let them also forego their right to an ICU bed...?

A 2013 review by the University of New South Wales found helmet wearing significantly reduced the risk of moderate, serious and severe head injury by 74 per cent.

University of Sydney Professor of Public Health Chris Rissel is one of the few public health experts who are anti-helmet.

He says that in the first three months of London's public bike share scheme, share bikes were used more than six million times and the injury rate was 0.0023 per cent.

The reason there was such a reduction in head injuries after helmet laws were introduced? That was due to the road safety program introduced in the 1980s, Professor Rissel says. These laws made the roads safer for all users, but helmets took the credit, he says.

But studies of bike helmet laws in other countries appear to show bike helmets reduce injuries where there is no road safety campaign.

In 2016, UNSW Associate Professor Jake Olivier published the largest review of bike helmet use ever undertaken. The research was a meta-analysis of 40 studies worldwide covering 64,000 injured cyclists.

It concluded that helmets reduce the chances of a serious head injury by nearly 70 per cent and of fatal head injuries by 65 per cent.

Do mandatory helmet laws reduce participation?

Professor Rissel points to studies that show the 1991 mandatory helmet laws oversaw a 30 to 40 per cent decline in the number of people cycling.

In 2011, he conducted a survey of 600 Sydney residents aged 16 and older:

23.6 per cent of Sydney adults said they would cycle more if they didn't have to wear a helmet

19 per cent of non-cyclists said they would get on a bike if they didn't have to wear a helmet

From these results, he concluded that relaxing the helmet laws would double the number of people who were cycling in Sydney.

"The ill effects of not being active - diabetes and obesity - the public health benefits of people not cycling outweigh the risk," he told Hack.

"Not wearing a helmet is the winner."

Assoc. Prof. Olivier told Hack he's currently doing a second systematic review of the impact of helmet legislation on the number of cyclists.

Market research undertaken by VicRoads along with a review of the Victorian road rules found perceptions of safety and safe infrastructure, rather than mandatory helmet laws, were a greater barrier to improving cycling participation rates.

A 2016 comprehensive Senate committee review of this question found there wasn't enough good quality data to know if helmet laws affect cycling participation.

It recommended federal and state governments work together to create a national dataset. There is currently no national dataset. The committee concluded:

"The committee recognises that the ongoing debate regarding the relationship between [mandatory helmet laws], cycling participation rates and road injuries ... will continue until such time as nationally consistent data is available."