History Set to Repeat Itself?

Helmet Bill Hearings - 1991/2

On June 27, 1991, MPP Dianne Cunningham's private member's bill to mandate helmet use for Ontario cyclists was given second reading in the Ontario Legislature. The subsequent passage of the bill led to the adult-exempt helmet law that is currently in force. A re-examination of the debate that took place at the time offers an insight into what is likely to occur when new public hearings to extend the law to include adults are conducted.

Fear as a Political Weapon

Like many helmet proponents, Ms. Cunningham belonged the school of politics that adheres to the dictum that you must first create a crisis in order to fix it. The Hansard transcript of the introduction of her bill reveals that she launched the debate by quoting statistics gathered from far beyond the scope of the bill (i.e. head injuries suffered in highway accidents in Ontario); presumably Ms. Cunningham was aware that relevant injury figures just weren't big enough to generate the requisite level of fear to obtain clear passage of her bill.

Cunningham: ... each year in Canada, more than 5,000 children will be seriously injured and more than 60 children will die in bicycle accidents, most from head injuries.

Note that the figures above are for bicycle accidents in Canada. Not head injuries in Ontario. Even the figures for Canada were exaggerated.

Facts: ... each year in Ontario, 1300 cyclists (children and adults) are admitted to hospital; 300 for head injuries. At the time about 80 of the cyclists had injuries defined as major; 30% to 35% (less than 30) of them would have been injuries to the head. (Source: Canadian Institute For Health Information (CIHI).) Each year approximately 30 cyclists in Ontario suffered fatal injuries; 12 or so were children; how many were as a result of head trauma is not known. (Source: Ontario Road Safety Annual Reports)

... each year in Canada, about 33,000 accident victims under 20 years of age are admitted to hospital. Of these, 2,000 are cyclists (not 5,000 as claimed by Ms. Cunningham); about 35% are head injured. That would have been around 700 in 1991. The figure includes off-highway injuries outside of the scope of helmet legislation, but they are not separately identified in hospital data from CIHI.

Cunningham: Bicyclists with helmets have an 85% reduction in the risk of a head injury and an 88% reduction in the risk of a brain injury.

Facts: This claim was repeatedly quoted by Mrs. Cunningham and every health and "safety" group attending the 13 or so public hearings. The claim was taken from a study published in 1989 in the New England Journal of Medicine. (It was the only claim that could be verified by a source.) One uncritical physician even went as far as saying, this is not supposition, this is not possibility; this is proof. Since the 1991 hearings, the claim has never been substantiated among studies of large populations that experienced rapid increases in helmet use; the NEJM study has been roundly criticized for the application of poor analytical methods; and in a later study in which the authors re-analyzed the data, they reduced the percentage to 69%. Despite this and the lack of supporting data during the 15 years since being published, helmet law proponents continue to claim that helmet use reduces head injuries by 85%. See more on the study's shortcomings at: analysis of the helmet lobby's claims.

Public Hearings

Public Hearings were conducted by the Legislature's Resource Development Committee. They ran from November 20, 1991 to June 20, 1992. Full transcripts can be found in Hansard session 1 and Hansard session 2.

(editorial comments in brackets)

What Helmet Law Proponents Said

William Coffman of the Canadian Standards Association Nov 27, 1991: The bicycle helmet, on the other hand, was designed almost strictly for falls from the height of approximately one and a half metres.

(The terminal speed of a head on impact from 1.5 metres is less than 20km/h.)

Cunningham Dec 2, 1991: Basically, we are looking at survivors (i.e. those suffering severe head trauma) as being particularly expensive and having a change in the quality of life.

(This comment suggests that the only injuries under consideration should be those very small number which are potentially permanently disabling.)

.... I have no idea whether this legislation will be a deterrent.

(This showed a lack of understanding of the likely negative impact of reduced cycling levels on long tern public health.)

Dr. Brian Morris, Coalition for Head Injury Prevention Dec 4, 1991: This is the study you have heard quoted so many times: 85% reduction in the risk of head injury, 88% reduction in the risk of brain injury. This is not supposition, this is not possibility; this is proof.

Cunningham Dec 11, 1991 I was hoping, personally, that nobody would talk about their support or otherwise until we had the public hearings, because what we were looking for were ideas on how this whole thing could happen, if indeed it was appropriate at this time in Ontario.

(This was made in reference to a witness's comment that the bill lacked Ministry of Transport support. It became clear that Mrs. Cunningham viewed the public hearings as a vehicle to implement her proposal not to listen to objections to it.)

Consultant for the city of Toronto health department Dec 18, 1991: We recommend for public education and awareness that there be established a division for cycling within the Ministry of Transportation with the responsibility of addressing cycling issues: updating traffic regulations for example, and to provide sufficient funds for public awareness campaigns and promotion of helmet wearing and safe cycling.
... ensuring funding is available to assist low-income cyclists and to provide funding for helmet loan pools for schools, recreation centres, etc.
... Helmets are not the only answer to reducing trauma. Education in biking responsibility is equally important. Children need this kind of assistance.

(The consultant could have been speaking on behalf of the cycling community!)

MPP Turnbull May 4, 1992: ... perhaps we could apply the same sort of rules that are applied with respect to hunting: confiscation of bicycles if the people are not wearing the helmets.

(Perhaps we could confiscate Mr Turnbull's car when he exceeds a speed limit!)

MPP McGuinty to Dr. Jane Gillett, pediatric neurologist at the Children's Hospital of Western Ontario May 6, 1992: Are there other injuries that -- for instance, if you're hit by a car at 30 miles an hour and you have a bicycle helmet, will that save you?

Dr Jane Gillett: Probably.

(Probably at 50km/h! Physicians should leave the physics to the engineering community.)

... the brain is unable to regenerate. Once you've lost those brain cells, they're gone and there's nothing I can do to bring them back, and the recovery is so much longer than recovery of any other aspect that I think that's one of the reasons.

(This confirms that the only relevant injuries are those that are potentially permanently disabling.)

Cunningham May 11, 1991: Some 15,000 in Ontario are admitted to hospital a year, 1,500 are seriously hurt in Ontario with bicycle injuries and another 15 die. (More non-sequiturs.)

What the Helmet Law Skeptics Said

MPP Remo Mancini June 27, 1991: The police chiefs of this province have commonly told me over the last period of time and I am sure have commonly told members from all sides of this House that they cannot carry out the services that are being required of them by their citizens because of budget restraints. I am going to vote against this piece of legislation.

MPP Dalton McGuinty Nov 20, 1991 ... it would seem to me, given the demand on their (police) resources at the best of times, that if we add this to the slate of items whereby they are going to be called upon to enforce laws, how much time do they have and do police want to be stopping eight-year-olds and nine-year-olds on the street or escorting them to their homes and all those kinds of things?

Marcia RyanToronto cyclist Nov 25, 1991 The legislation will bring about a decrease in the number of cyclists on the roads.... Furthermore, these laws are costly on the enforcement level, costly on the legislative level and costly to our efforts at minimizing the impact we have on the environment. ... you could compare the head injuries with drivers in car accidents. You could say that they should wear helmets while driving.

Mark Buckner, Windsor Bicycle Committee Dec 2, 1991: We could pass this law requiring helmet use, and a year from now studies would be done which show that head injuries and deaths have dropped dramatically, and that could prove the law is working. On the other hand, it could just be proof that there is an equally sizeable drop in the number of bicyclists on the road .... Is there really support among the public for taking those resources away from other things, especially in light of the rising crime rates that we are seeing now and the limits on police budgets? .... I think if we have a helmet law that does not include any of these provisions for education, that does not deal with it, it is like having a seatbelt law without having driver training, .... we have a huge problem with head injuries in car accidents.

Neil Farrow Toronto cyclist Dec 2, 1991: The committee has been presented with a large amount of statistical data from well-organized special interest groups to illustrate the magnitude of the problem. I believe the data you are hearing would be more useful if some context were given to the numbers. In 1988, the number of people below the age of 19 who were killed in bicycle accidents was 48. The total number killed in motor traffic accidents in the same year was 848. Those are the numbers in Canada. For the population as a whole, the number killed on bicycles was 87, whereas the number killed in motor traffic accidents was 4,210.
.... I think this bill is going to marginalize cyclists even further, and in that way it will discourage cycling.

The Ontario Cycling Association, Dec 4, 1991: The facts quoted earlier clearly show that cycling is not an unduly risky activity. ....Quoting fatality figures is thus quite beside the point. In particular, the often-quoted figure that 75% of the deaths of cyclists are caused by head injury is problematic. Aside from the difficulty in establishing such a figure in the first place, even if it were true it would be a serious flaw in logic to conclude that if helmets were worn by everyone there would be 75% less deaths. Deaths will still occur with helmets. ... It has been ably demonstrated by the Danish Cycling Federation that the health benefits of cycling, even in non-helmeted Denmark, outweigh the risks by at least 12 to 1. ... Many people would stop riding; many people would disregard the law; the law would not be widely enforced ...

Dr Michael Schwartz, President of the Trauma Association of Canada Dec 11, 1991: If a cyclist is accelerated by a car, swept up on the hood of the vehicle, to a speed of, say, 40 or 50 kilometres per hour, then the helmet will not work and will not prevent a severe or even fatal head injury. So I think everybody should wear helmets but should have a realistic expectation about what they can or cannot do.
..... The other issue is whether the government is best served by a strategy of education or whether legislation is the best method. To be quite frank, I do not know what the answer to that is.
.... You could make a helmet that would be far more efficient or far more likely to cushion the impact, but it would be bigger and heavier, and if you made it big enough and heavy enough nobody would wear it.

Ms. de Fort Menares Ottawa cyclist Dec 11, 1991: Now, if you have this helmet legislation, I think what will probably happen is that they will either not wear the helmet, because they will not get one, or they will not go out.

Citizens for Safe Cycling Dec 11, 1991: It is an unfortunate reality that police officers do not see the enforcement of legislation against cyclists as being a major priority
.... It would therefore appear that additional funding will be required to enforce this legislation.
... In summary, we are extremely concerned that the helmet bill is taking a very narrow approach to the serious problem of bicycle accidents and injuries by seeking to prevent the injuries without addressing any of the causes of cycling accidents.

Ontario Provincial Police Sergeant Bob Scott Dec 16, 1991: Forcing everybody point-blank to start wearing helmets may go against encouraging people to use bicycles over other means of transportation.

Solicitor General Dec 16, 1991: Having something in a piece of legislation which says "helmets must be worn," is very difficult to enforce.

Audrey Voice Ottawa cyclist Dec 18, 1991: We are told 17,000 to 19,000 people will suffer a head injury this year in Ontario. Half will be in motor vehicle accidents, 21% in falls, 12% in assaults and violence and 10% in sports and recreation. Assuming cyclists are included in the latter category, 90% of head injuries occur in activities unrelated to cycling or sports. With motor vehicles causing fully half the head injuries, I wonder if making helmets mandatory for drivers and passengers would be more appropriate

(CIHI figures indicate 25% of recreational injuries are suffered by cyclists so about 97.5% are unrelated to cycling.)

... if you look at a few children in a population of millions, there are probably a lot of things by which you have a one-in-a-million or even a one-in-500,000 chance of being killed.

MPP Grandmaitre Dec 16, 1991: Do you think that by introducing this mandatory equipment on a cyclist people would become more reckless and take more chances?

(the "risk compensation" phenomenon)

Brampton Cycling Club Dec 16, 1991: The bill will only promote the current public misconception that wearing a helmet is the only way of preventing cycling injuries -- again, the cause and not the symptoms.
...Cycling is only dangerous when undertaken without a proper understanding of traffic rules and principles

Ministry of Transportation May 4, 1992: The approximate cost to deliver the items I've mentioned is about $3.5 million for the first year, not including developmental costs. A helmet subsidy program could add considerably to this cost.
McGuinty in follow-up: A thorough and effective program, as you've described it, is $3.5 million. I'm wondering what it would have cost us to treat those injuries through health care facilities this year.

Solicitor General (Hutton) May 11, 1992: While the ministry supports the intent of the legislation, the imposition of mandatory helmet use at this time may be premature
... There would be increased costs in enforcement, litigation, and to the cyclist to purchase helmets
... it is preferable to encourage voluntary helmet use

Ministry of Tourism and Recreation May 13, 1992: ... legislation must be appropriate to all aspects of safety in cycling, not merely compulsory use of helmets, in order to have the desired impact.
... To introduce legislation which deals only with the aspect of safety in collisions and does not deal with accident prevention or safe cycling opportunities is at best incomplete.
... using the amendment of the Highway Traffic Act creates considerable shortcomings for recreational cycling which does not take place on public roadways.
...the legislation also raises some concerns about potential negative effects on tourism and recreational activities.
... but you can take a bicycle on a roadway without training. So to introduce legislation that wouldn't require that seems to me to be incomplete

Ministry of Transportation May 25, 1992: The definition of highway in the HTA generally contemplates well-defined travelling areas. The words "for the passage of vehicles" contemplate movement of vehicles between or across the area from points within to points outside the area.
MoT (Chyz): It's a pathway but it's not designated as a highway.

(This exchange occurred in a longer discussion about the definition of the word "highway". It demosntrated that child cyclists cycling away from roadways would not be within the scope of the Highway Traffic Act.)

McGuinty May 27, 1992: I think we've got to look at the impact it would have on tourism.

Commentary 2004

Bill 124 was passed by the legislature with an implementation date of October 1995. Just prior to that date, the Harris government used the regulatory powers in the bill to exempt adults. The objections and concerns of the cycling community and the advice offered by senior bureauctrats from various ministries were ignored and, to this date, successive governments have done nothing in respect of improving the safety of cyclists. They failed to consult with organized cycling. Likewise, the multitude of health and "safety" groups which showed up to urge passage of the first bill, and which are showing up again behind the sponsor of the current proposal, in the intervening years have not tapped user group expertise to learn what it takes to reduce cycling accidents.

It looks as though history is preparing to repeat itself.