Continuing from Part 1
The Brain
Bucket Bash: 1985 report
There are many reasons for not
wearing a safe helmet
This 1985 report to the United States Cycling
Federation Board of Directors recommended helmet safety standards. [Comments
in italics like this were added when this article was published in Cyclops USA in September
1989.]
To: USCF Board of Directors.
From: Les Earnest, Technical Chairman
Subject:
Helmet safety issues.
The Technical Commission/Board of Control has been
reviewing helmet safety issues for some time and intensively for the last two
years [1] [2]. This is an update of a
report that was reviewed by members of the Commission and the Executive
Committee in November 1984 and that yielded no adverse remarks. It is now presented to the whole Board as
background for possible amendments to helmet regulations.
The toll
As reported in a recent helmet review article [3],
U.S. Government agency estimates that about 500,000 Americans are seriously
injured each year in bicycle accidents and more than 1,000 die from their
injuries [4]. According to an Australian
study, over 80% of all cycling accidental deaths are attributable to head
injuries [5]. There appear to be no data
on the fraction of fatalities that could have been prevented by wearing a
better helmet but based on personal observations I believe that it is more than
half.
[A recent
study indicates that this estimate was low.
The use of safety helmets results in an 85% reduction in the risk of
head injury and an 88% reduction in the risk of brain injury, as reported in a
recent study [R.S. Thompson, et al, “A case-control study of the effectiveness
of bicycle safety helmets,” New
England Journal of Medicine
320:21, May 25, 1989].
On this basis, it appears that something over 400
people are killed each year in this country by being involved in a cycling
accident while wearing an inadequate helmet or no helmet. Licensed bicycle racers account for a
comparatively small number of the annual deaths. I recall hearing of 2 or 3 racers dying in
accidents each year for the 14 years that I have been involved in the sport.
Most serious accidents occur in training rather than
in racing, because riders spend much more time in training and because most
training is done in a less controlled environment than racing. Given that Federation regulations apply only
to races, the USCF lacks jurisdiction over riders most of the time. On the other hand, most riders use the same
equipment in training as in racing, so racing safety regulations tend to carry
over to training programs. Many
non-racers follow the lead of racing cyclists in selecting equipment, so the
influence of racing organizations is actually much greater than their licensed
membership.
The majority of the deaths among both licensed and
unlicensed riders are young people. Of
the many more people who are seriously injured but not killed, quite a few have
permanent disabilities. For example, of
the seven personal acquaintances of the author who experienced serious head
trauma in cycling accidents in the last five years (two of them during races at
which he officiated), two died and four more did not fully recover. Based on direct observations and reliable
reports, all of the survivors would have had substantially reduced injuries if
they had worn a good helmet.
Not all of the disabilities of those who survive are
visible. After physical healing, the personalities of three of the author’s
acquaintances are noticeably different.
Another lost her sense of smell and taste. The one survivor who
apparently recovered fully subsequently ran for the USCF Board of Directors,
which is rather clear evidence of brain damage. And he was elected.
Morbid jokes aside, I am convinced by national
accident statistics and by personal observations that most people who ride
bicycles are doing so without adequate head protection.
Helmet standards
Here is
a brief history of bicycle helmet standards.
When bike racing began in the late
1800’s, there were no helmets, let alone standards. While helmets were developed rather early,
they were not required for bike racing at least into the 1930’s, and
professional riders still do not wear helmets in many events. This macho
tradition and the professionals’ delusions of invulnerability unfortunately
infect the rest of the sport
By
1947, possibly a bit earlier, the USCF (then called the Amateur Bicycle League
of America) required all competitors to wear helmets but without any
construction standards. [Though the ABL Rule
Book required that a helmet be worn, immediately after this rule was adopted,
the League's official periodical began telling riders that this rule would not
be enforced by race officials!] The typical helmet consisted of padded leather
straps and offered limited impact protection.
In the mid-'70s, plastic helmets appeared that offered good aerodynamics
or styling but very little protection.
The USCF regulations included a specification of the maximum distance
between straps of the leather helmet (45 mm) and a requirement that straps go
on both sides of the ears and under the chin.
These requirements were based on helmet specifications of the
International Cycling Union.
While there appears to be increasing acceptance of the
better plastic helmets, some of the relatively unsafe plastic helmets are also
gaining market share, and the padded-leather-strap helmet (sometimes
disparagingly called a “leather hairnet”) remains the most widely used type in
bike racing.
As a result of amendments made by the Board of
Directors in October 1984, USCF regulations now contain no safety standards at
all. The principal helmet rule reads as
follows:
“1I1. Every rider starting a race shall wear
a protective, securely fastened helmet.
It is the rider’s responsibility to select and wear a helmet which
offers sufficient protection against head injury and does not restrict the
rider’s vision [disqualification for failure to wear a helmet or for removing
it during the race].”
In other words, the choice of helmet is strictly up to
the rider.
In parallel with these developments in the bike racing
community, the Snell Memorial Foundation began developing bicycle helmet
testing procedures several years ago, based on their earlier work with
motorcycle helmets, and formulated an industrial bike helmet standard [6]. This organization is a non-profit corporation
that was founded in 1957 for the purpose of conducting research and
establishing standards for helmet safety in various applications.
The Snell work subsequently became the primary input
to a standardization effort by the American National Standards Institute (ANSI)
under its Z90 committee. ANSI is the
primary coordinator of standards activities in the
An appeal against this standard was lodged with ANSI
by a manufacturer (SkidLid) that had a representative
on the committee, but whose products did not meet the standard. After that appeal was denied, SkidLid lodged a higher level appeal that was also
subsequently denied. The ANSI standard
was formally approved in March 1984.
Issues
I advocated the
adoption of the ANSI Z90.4 helmet standard by the USCF at the Board of
Directors meeting in October 1984. The
overwhelming opposition took one or more of the following positions.
1. Riders should have freedom of
choice in helmets – there should be no standards imposed.
2. ANSI standard Z90.4 is unsound.
3. Imposing a helmet standard will
increase the USCF’s liability.
4. Helmets that meet the ANSI
standard are too hot or heavy, or restrict vision.
5. Only inexperienced riders need
good helmets because they crash more frequently.
6. The helmet safety question
should be studied more before the USCF takes a position.
In the subsequent sections I shall argue that each of
these positions was and is fallacious.
Freedom of choice
The idea that riders should have freedom of choice in
wearing a helmet is very appealing and is, I think, the fundamental issue. How can one argue with the principle that
each person should be able to decide questions of personal safety for themselves?
I agree that individuals generally should be permitted
to make informed decisions about all aspects of their lives as long as these
decisions do not detrimentally affect the lives of others. This includes the right of the individual to
decide to wear an unsafe helmet or, more directly, to commit suicide.
Unfortunately, the real world is filled with
uninformed people whose mistakes must be paid for by others. As it turns out, the decision by many riders
to wear unsafe helmets, whether they have informed themselves about this issue
or not, forces others to pay for their foolishness through increased insurance
costs, which are reflected in increased licensing fees. This issue is expanded upon below.
Consider also the analogy of home
construction standards. While the design
and construction of houses could be left strictly up to the builders, it is
generally recognized that mandatory building codes benefit the homeowner, who
is thus assured that the roof is unlikely to collapse and the furnace probably
won’t blow up.
There are a number of Federal and
state agencies that are concerned with motor vehicle equipment and safety but
cycling is still an orphan. There is
general ignorance of helmet safety issues in the bicycle racing community as
well as a lot of misinformation in the marketplace. Most riders, especially adolescents, are much
more influenced by peer norms and image issues than by safety
considerations. Given the predominance
of “leather hairnets” in bike racing magazines, that is what they buy.
Several people have pointed to the recent reversal of
government regulations requiring that motorcyclists wear helmets. They cite this as evidence that we should not
attempt to legislate bicycle helmet standards.
Indeed, there is a lesson to
be learned from the motorcycle helmet experience, but it is not the one they
think.
Beginning in 1967, the Federal government required the
states to enact motorcycle helmet laws as a condition for obtaining Federal
highway funds. During the next decade,
motorcycle fatalities decreased by 50%.
In 1976, bowing to pressure from a segment of the
motorcycle lobby, Congress revoked the helmet requirement. In the next three years, 27 states followed
suit and the national motorcycle death rate was up 40% by 1983.
A recent study sponsored by the National Highway
Traffic Safety Administration concluded that “the use of a safety helmet is the
single most critical factor in the prevention or reduction of head injury” from
motorcycle accidents.
There is still another sad lesson from the motorcycle
experience. Based on limited studies of
injured motorcyclists who are admitted to hospitals for treatment, about 40% of
them are uninsured [8]. (In practice,
most of them are treated at the expense of the general taxpayer. So the motorcyclists “freedom of choice” not
only inflicts an enormous cost in misery and lost productivity, but the rest of
us get to pick up much of the medical bill.
The medical insurance coverage of bicyclists seems to
be similar to that of motorcyclists, as revealed by the USCF’s
race accident insurance experience. The
losses attributed to USCF riders who have no primary medical insurance have
been grossly larger than their per capita share. This means that the insured riders are
subsidizing the uninsured.
While “freedom of choice” is a fine abstract
principle, other important principles intrude and interact in the real
world. While a strict libertarian would
say “Let them kill themselves if they choose,” I am concerned about the number
who are killing or maiming themselves without quite understanding the issues
and who force others to share in their misfortune.
ANSI Z90.4
unsound?
The primary advocates of the view that the ANSI Z90.4
helmet standard is inadequate are employees of SkidLid
Manufacturing Company. This is not
surprising in view of the fact that their helmets do not meet this
standard. While their arguments should
not be rejected simply because they have a conflict of interest, neither should
they be embraced uncritically.
SkidLid President Kevin Montgomery has presented technical
arguments against the Z90.4 standard to the USCF Technical Commission [9] and
has presented a more general review to the Board of Directors [10]. Mr. Montgomery’s main arguments can be
summarized as follows:
1. He has found a
researcher at
2. The ANSI Z90 committee is
biased somehow.
The first point is neither surprising nor damning to
the Z90.4 standard. If the proposed
modified testing scheme can be shown to be superior for bicycle helmet testing,
it seems likely that its proponent, Dr. Hodgson, will be able to convince the
Z90 Committee that it should be included in an improved Z90 standard.
With respect to the second point, Mr. Montgomery’s
evaluation of the Z90 Committee has an unprofessional aroma of sour grapes,
given that his helmets would likely also flunk any tests based on Hodgson’s
theories.
If a helmet manufacturer whose product meets the
existing standards were to argue for even tighter standards, then careful
consideration should be given to the proposal.
None of the conforming manufacturers appear to be taking that position
at present.
Liability
Some people are worried that if the USCF imposes a
helmet standard and some riders get injured anyway (as they inevitably will),
that there will be an increase in the Federation’s liability. In fact, tighter standards would almost
certainly reduce liability as argued
below.
It is unfortunate that even though there are many
proponents of “freedom of choice,” very few people in this country accept
responsibility for the results of their actions. Riders who are injured in a bike race can usually
find a lawyer who will argue that everyone else was at fault – the promoter,
the promoting club, the sponsor, the city on whose streets it took place, and
the organization that issued the race permit (that’s us). Other riders are seldom found to be at fault
unless they happen to be rich.
The current liability system is irrational and unfair
but it is the only one around just now so we have to live with it. In effect, the Federation is required to
provide “stupidity insurance” for all riders whether we like it or not. Two recent lawsuits that consumed a lot of
the author’s time will serve to illustrate this point.
In a 1981 district track championships, the rider who
won a certain sprint heat apparently thought that his opponent had fouled him
in the home stretch. (As was later
determined, none of the three referees who watched the sprint from different
vantage points believed that there had been a foul). Just past the finish line, the winner veered
toward his opponent, shouting and waving his fist. They collided and fell heavily.
The rider who initiated the altercation was wearing a
leather helmet and sustained a concussion.
His opponent received a deep thigh wound. Both were given first aid and taken to the
hospital. The rider who was attacked subsequently
filed suit against the aggressor, whose liability insurance carrier settled out
of court. The aggressor then filed suit
against everyone else, including the USCF and a club whose members helped the
district representative stage the championships. His attorney claimed that:
(1) his opponent
should have been disqualified in an earlier round because of foul riding
(though none of the race officials thought that there had been a foul)
(2) his opponent should have been disqualified for foul riding
in the homestretch and the race should have been stopped instantly at that
point by the officials (!), which would have prevented the subsequent
altercation from happening;
(3) the head injury caused him to mishandle the management of
his bike shop, leading to its financial failure;
(4) his mental dysfunction also led to the breakup of his
marriage.
Numerous witnesses had depositions taken over a three
year period. The case went to a trial
that lasted two weeks, requiring these same witnesses to take time off work
without compensation. In the end, the
jury accepted the nonsensical claims (1) and (2) and awarded the aggressor
$29,500 on the grounds that he had suffered a $59,000 loss and he was only half
responsible for the incident! This case
conforms to the general principal that in civil suits involving a personal loss, the party that has money pays, no matter what their
responsibility or lack thereof. This is
not a formal legal principal but is a perverted product of a system that has
been developed to enrich the legal “profession.”
[After this 1985 report was
written, the plaintiff appealed the decision and was awarded a new trial. At
that point, the insurance company settled with him out of court for $55,000! The
lesson that can be drawn from this case seems to be that riders should feel
free to beat up other riders who they think are misbehaving. If they
accidentally injure themselves in the process, they can recover damages from
the Federation.]
The second illustrative case peripherally involved a
criterium for a number of USCF classes.
The promoter also held a citizens race the same day on a slightly
different course, which was conducted by club members, not USCF officials. On the
fifth circuit of the citizen’s race, an eleven-year-old boy drifted to the side
with his head down and ran into a parked truck.
He sustained serious head injuries and went into an apparently permanent
coma.
Even though the Federation had not issued a race
permit for the citizens race and had no control over
it, the conclusion was reached that since it occurred in association with USCF
races that the Federation was responsible.
This case cost the USCF’s liability insurance
carrier $250,000 plus very substantial legal expenses, including flying another
Director and me to
A lesson from this case is that the Federation should
take responsibility for all bicycle
races held in conjunction with USCF events – a position that I have been
arguing unsuccessfully before the Board since 1979 – and should impose adequate
control and safety regulations for citizen’s races. Given that the Federation will be sued in any
case where a serious accident occurs, it will be much better off to take
control of ancillary races and try to ensure that they are run safely. In does no good to proclaim that they are
“not our responsibility.”
The bottom line on liability is that all Federation
policies on safety and enforcement sooner or later get translated through the
give and take of the legal system into liability insurance premiums. The USCF is practically constrained to the
role of donor, so the goal is not to win but to minimize the losses. Liability questions can thus be restated
concretely as “How much will this change increase or decrease the cumulative
cost of liability insurance over time?”
Suppose that tighter helmet standards are adopted and
some rider sneaks into a race with an unsafe helmet, then
gets clobbered. In this case, the USCF will
be sued just as before and may be in a slightly weaker legal position, inasmuch
as the officials should have enforced the helmet standard. However, it seems obvious that any loss
increments experienced from this effect would be more than offset by the
reduction in lawsuits attributable to the general use of safer helmets.
Given that a large fraction of all riders who are
seriously injured in bike races will sue in any case, the key to reducing
liability is to reduce the number of serious injuries. Adopting and enforcing better helmet
standards should reduce the incidence of serious head injuries and this will
yield lower insurance premiums in the long run.
Because of recent large liability losses, mostly
attributed to head injuries incurred by riders wearing inadequate helmets [12],
the Federation’s former liability insurance carrier has refused to renew its
policy in 1985. It has been necessary to
pay substantially more for narrower coverage.
The $3.00 increase in Senior riders’ racing
licenses in 1985 was specifically earmarked to cover the estimated increase in
liability insurance costs.
If the Board would like to see some really large
insurance bills in the future, it should continue the present policy of
imposing no helmet standards.
ANSI helmets uncomfortable?
It has been asserted that helmets meeting the ANSI
standard are too hot, too heavy, or obstruct vision. While it is possible to construct a helmet
that meets the ANSI standard and that also exhibits one or more of these
problems, none of these problems is an intrinsic byproduct of meeting the
standard. Indeed, there are helmets
available in the market that meet the Z90.4 standard, offer excellent vision,
and are quite comfortable.
The Washington Area Bicyclist Association has been testing
and reviewing helmets for a number of years in cooperation with the Snell
Foundation [13]. Their tests have
included the hot and muggy Summer conditions of the
My personal experience confirms the WABA
findings. I switched to an ANSI standard
helmet two years ago and have used it for daily commuting and occasional
racing. Although I am annoyed by the
sponge pads that fall out and must be re-glued once in awhile, this helmet has
been just as comfortable as my old leather helmet.
[Scientific studies that have
since been conducted show no increase in rider temperature when wearing ANSI helmets
over riding helmetless, (e.g., see C.V. Gisolfi et al., “Effects of wearing a helmet on thermal
balance while cycling in the heat,” The Physician and Sportsmedicine,
16(1), January 1988)].
While those who claim that all ANSI Standard helmets
are hotter than nonconforming helmets are clearly misinformed, let me point out
that if they were right, it would be
another argument in favor of adopting the ANSI standard. If safe helmets were hotter, then in the
interest of safety and fairness, it would be essential to require that all riders wear the safe helmets, since
otherwise there would be a competitive advantage in wearing unsafe helmets.
Only novice riders need safe
helmets?
Some have argued that only the young or inexperienced
riders need to wear ANSI helmets because they crash more frequently. While it is true that some novice riders crash
more frequently than experts, it is also true that everyone who races crashes periodically. All available evidence indicates that the
skulls of Category 1 riders are made of the same material as those of novices.
Aside from the fact that a class distinction of this
sort makes no sense on safety grounds, it would also present an unfortunate
image to the novice riders. If elite
riders were permitted to ignore safety requirements, then that would become
part of the aspirations of those on the way up, with unfortunate consequences.
Those who would argue that elite athletes are less
susceptible to cycling accident injuries might benefit from discussions with
some former leading riders like National Team Member Alan Kingsbery,
who was lucky to live through an altercation with a cement truck during the
1978 USCF National Championships and now can barely walk. Or Bill Harrison, winner of
the Nevada City Classic and other major events, who is still pretty fast on his
wheelchair. Or
former world-class rider Jocelyn Lovell of
Not even old bureaucrats have been smart enough to
beat the odds. At least two former USCF
Directors and District Representatives have been killed in cycling accidents in
the last five years.
Needs more study?
A number of people have argued that there should be
more study of the helmet safety issues before standards are enacted. While it is important not to make serious
legislative mistakes, it is sometimes better to take a series of steps in the
right direction, rather than trying to get it exactly right the first
time. I believe that helmet standards
are such a case.
Errors can be costly, but so can inaction. It would be nice to be able to stop the world
while we think this one over but that is rather hard to do. Another 1,000 or so Americans will die in
cycling accidents in 1985,a large portion of them from
preventable head injuries.
I am unsympathetic to the claim that there has been
insufficient time to examine the issues.
I first pointed out to the Board of Directors the need for tighter
helmet standards in a 1981 Board of Control Report [1]. I brought this problem to the attention of
the Board continually in the last two years [1] [2], calling for consideration
of the ANSI Z90.4 standard.
At the May 1984 meeting of the Board, I expressed
interest in adopting the ANSI standard and asked the Board to assign
responsibility for careful study of this possibility to a committee. The Board of Directors assigned it to the
Board of Control. I also offered to
provide copies of the proposed standard and other documentation to any
directors who were interested. I
received exactly one request, from a Director who later resigned.
To those who would like to think about it a while
longer, I recommend keeping a count of the number of racers who have been
killed while they have been reflecting on this issue. They might also interview some of those who
have been permanently maimed by head injuries in this time. For myself, I have seen and heard quite
enough.
Conclusions
As shown above, none of the arguments against adopting
the ANSI Z90.4 helmet standard stands up under scrutiny. My impression from talking with a number of
people is that the key issue is “freedom of choice.” While I sympathize with that position from a
philosophical standpoint, I believe that the cost of that ideal is far too
high.
Aside from the humanitarian argument that we should be
trying to minimize injuries to participants in the sport of cycling, it appears
that the Federation is experiencing substantial economic losses as a result of
its failure to adopt helmet standards.
The major portion of USCF liability losses are the result of preventable
head injuries, which are reflected in increased liability insurance rates.
In addition to liability losses, USCF medical
insurance rates are being driven up by the same process. For example, in 1983 and 1984, all claims
over $3,000 were the result of head injuries and ran as high as $30,000 each
[14]. This loss experience is driving up
medical insurance premiums.
The Federation should be willing to spend a significant
segment of its income to reduce rider injuries.
Instead, it is paying ever-increasing amounts to subsidize unnecessary
deaths and maiming. It is time to stop
underwriting the expenses of those who have a death wish or who are too
irrational or uninformed to choose safe equipment.
I hope that in September the Board recognizes its
responsibilities and places the ANSI Z90.4 helmet standard in the Racing Rules
effective
Suggested additional reading
An excellent article by Ed Burke on head injuries and
helmet safety will appear in the next two issues of Cycling USA [15]. It
includes the comprehensive helmet review compiled by WABA [13].
A thoughtful paper by Randy Swart gives substantial
background on helmet comfort and safety standards issues [16].
Next part: The big decision Cyclops USA home page
References
[1]
L. Earnest, “Board of Control Report,” USCF BoD
minutes, April 1981, January & October 1984.
[2]
L. Earnest, “Technical Commission Report,” USCF BoD minutes, January & April 1985.
[3]
Thomas Balderston, “Bicycle Helmets:
Which one?,” Bicycling, March 1983.
[4]
“Bicycles – Buy Right, Drive Right,” pamphlet by U.S. Product
Safety Commission.
[5] Neil Gillies, “Helmets for Use by Bicycle Riders,” Traffic
Accident Research Unit, Dept. of Motor Transport, New
[6] “1984 Standard for
Protective Headgear,” Snell Memorial Foundation,
[7]
“ANSI Standard Z90.4,” American National Standards Institute,
March 1984.
[8] Donald Trunkey, “Trauma”
Scientific American, August 1984.
[9] . Kevin Montgomery,
letter to L. Earnest,
[10] Kevin Montgomery, letter to USCF directors,
[11]
R. Hodgson, “Improving Head Crash Protection,” technical note,
[12] J. Scott (St. Paul
Insurance), letter to A. Gambucci (Tolley-Weidman Insurance Agency) Re: USOC and Miscellaneous
Sports Liability Policies,
[13] “A Consumer’s Guide
to Bicycle Helmets,” pamphlet by Washington Area Bicyclist Association,
December 1984 (updated about every six months.)
[14]
E. Seubert (Campbell Brokerage), letter
to L. Earnest,
[15]
Ed Burke, “Head Injury, Helmets, and the Cyclist,” Cycling USA, August 1985 (to appear).
[16]
R. Swart, “Bicycle Helmet Workshop,” paper given at ProBike 84, December 1984.