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Editor,—I read with horror the British Medical Association's Board of Education and Science conclusion that legislation to make helmets for cyclists compulsory would reduce the number of cyclists and not be in the interests of health.1
As an accident and emergency consultant for over 20 years, I have seen far too many head injuries in cyclists, some fatal. The main factor in causing most accidents is human error. I agree, as the article suggests, that cycling proficiency should be taught in all schools and the driving test modified for awareness of cyclists to other road users. The government, as suggested, should subsidise cycle helmets and promote them through the media by advertising. The car driver is not interested, but we need better cycle routes nationwide.
Our government is committed to reduce injuries from accidents (see Our Healthier Nation). The main cause of death in children is trauma. But I have personally discussed at length the benefits of wearing a helmet with children who, unhelmeted, have suffered a fractured skull in a cycle accident. Many children still remain unconvinced! Parental control is weak. So voluntary action to increase the wearing of cycle helmets in this age group is unlikely to succeed.
My answer is that the compulsory wearing of cycle helmets is needed now. This should be introduced as part of an overall cyclist's programme—teaching, better routes, helmet subsidies, and increased awareness through publicity. The number of cyclists may well reduce initially but more importantly head injuries will become fewer too! However, in the future, the population of cyclists naturally will then increase as cycling at last becomes safer and so even more enjoyable.
There has been successful government legislation concerning road traffic accident prevention and injury protection—for example, the breathalyser laws, compulsory crash helmets for motorcyclists, and the seat belt laws. These are still supported by publicity. The legislation could be expanded.
We as an emergency specialty, however, have a responsibility in accident prevention and injury protection. We all need to be active, as I have been, in the local press recently highlighting, for example, the need for cyclists to wear helmets. We recognise this problem only too well.
Our department has a nurse who travels round schools talking about accident prevention and injury protection—particularly cycle helmets. Such programmes need to be national not local. Government money is available from the Health Improvement Programme. Have you put a bid in? We have.
Our specialty needs to wake up to its responsibility of prevention and be active. Prevention is the best treatment for any condition.
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