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Old April 18th 09, 08:53 PM posted to uk.rec.cycling
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Default The BMA Promote Safer Cycling



There have recently been some less than honest posts (again) by Guy
Chapman – this time concerning the British Medical Association (BMA)
policy of Promoting Safe Cycling.

In order to provide some balance to his and the BHRF’s biased views
here are some excerpts from the BMA policy paper.

Full details can be found at:
http://www.bma.org.uk/health_promoti...ing.jsp?page=1

(Successive pages are accessed by clicking the links eg Cycle Helmets
on the LHS)



The BMA : Promoting safe cycling
17 March 2008

Introduction

The British Medical Association (BMA) has undertaken substantial work
in relation to transport and health in the past including accident
prevention and reduction, environmental and health impacts of
transport, studies on drink and drug driving and seat belt
legislation. Following previous research by the Board of Science on
cycling, the BMA established specific policy at its 2006 annual
representative meeting that the Association promotes cycling as a
safe, healthy and sustainable alternative to car use.

Doctors have an interest in cycling for two key reasons:

1. The important role cycling has in the promotion of individuals’
and the nation’s health
2. The need for safe cycling in order to prevent cycle related
injury

Health promotion
The BMA believes that cycling has many advantages to the individual in
terms of improved health and mobility, as well as to society; it is a
sustainable form of transport which has a minimal impact upon the
environment. It is the least polluting way of traveling after walking;
cycles do not produce carbon dioxide (CO2) emissions. Cycles also
require fewer resources to manufacture and maintain compared to other
modes of transport.

While a number of studies demonstrate the positive effect of cycling
on lifespan, health and general well being, the majority of this
research is indirect and based on the findings that moderate intensity
physical activity of any kind produces health benefits. It is the fact
that cycling is a form of exercise which confers these positive
effects.


Cycle helmets

In the UK individuals are not currently legally required to wear a
cycle helmet.

There is much controversy on whether cycle helmet wearing should be
compulsory. A great deal of the controversy relates to whether cycle
helmets reduce injuries, if so what type of injuries they reduce and
further whether cycle helmet legislation discourages cycling. The BMA,
as a part of its policy to improve safe cycling supports compulsory
wearing of cycle helmets when cycling for children and adults. The
Association wants to see an increase in voluntary use prior to the
introduction of cycle helmet legislation and supports initiatives that
so increase such use.

There is extensive literature that reviews the case for and against
the wearing of cycle helmets. The most reliable research comes from
Cochrane Reviews which are based on the best available information
about healthcare interventions. They explore the evidence for and
against the effectiveness and appropriateness of treatments
(medications, surgery, education, etc) in specific circumstances.

This briefing contains an overview of the available evidence.

Rationale

Cycle helmets aim to reduce the risk of serious injury caused by
impacts to the head. Injuries to the head generally take two forms;
skull fractures and brain injuries. While skull fractures can heal,
injuries to the brain, unlike those to the rest of the body, generally
do not and may sometimes have long-term consequences. Though not
always visible and sometimes seemingly minor, brain injury is complex.
It can cause physical, cognitive, social and vocational changes that
affect an individual for a variable time period. In many cases
recovery becomes a lifelong process of adjustments and accommodation
for the individual and those caring for them. Depending on the extent
and the location of the injury, impairments caused by a brain injury
can vary widely. Among the most common impairments are difficulties
with memory, mood and concentration. Others include significant
deficits in organisational and reasoning skills, learning, cognitive
and executive functions.

Function

Cycle helmets perform three functions. Firstly they reduce the
deceleration of the skull and hence the brain by managing impacts.
This is achieved by crushing the soft material contained within a
helmet. Secondly a helmet acts by spreading the area of an impact. As
it is impacted, the expanded polystyrene shell of the helmet
dissipates the energy over a rapidly increasing area like a cone. This
prevents forces from being localized to one concentrated small area.
Finally a helmet plays a vital role by preventing direct contact
between the skull and the impacting object.


Conclusion

Best evidence supports the use of cycle helmets. They have been shown
to reduce the risk of head injury and its severity should it occur.
This does not apply to fatal accidents but in such instances the force
of impact is considered to be so significant that most protection
would fail. As has been illustrated by the case studies, the
consequences of traumatic brain injury are significant not only to the
individual involved, but to their families and to society as a whole.
BMA members, in particular accident and emergency staff see at first
hand the devastating impacts cycling injuries can have. Therefore, as
a part of a range of measures to improve cycling safety, the BMA calls
for cycle helmet wearing to be made compulsory. The Association
recognises that voluntary helmet wearing should increase before the
law is enacted.
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