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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

City wrestles with whether helmet laws make Spokane safer

When the Spokane City Council loosened the city’s helmet laws last week ahead of the return of shared electric scooters, a man in a helmet stood at the podium and warned them of traumatic brain injury.

A few minutes later, a woman told them that studies have shown helmets to be of little use in most situations, and added that requiring them erected barriers to a healthy, active life and made people less safe.

By a 6-1 vote, the council paved the way for the return of shared mobility in Spokane by granting a reprieve from the helmet law — but only for people riding electric scooters rented through smartphone apps. Now, Spokane has two sets of laws: one for those riding electric scooters, and one for those riding bikes, skateboards, roller skates, skate shoes, in-line skates and everything other than a scooter.

Council President Ben Stuckart said from the dais that the city already has two sets of laws, judging by how it was enforced, and those “inequities” convinced him the helmet law should be scrapped.

“Who is the helmet law enforced against?” he said. “Adults that ride BMX bikes. It wasn’t the guy on the South Hill riding his bike without a helmet. … I agree that we should get rid of the helmet law altogether.”

“I rode I think 15 times,” Stuckart said of the Lime electric scooters that were in the city last fall for a trial period. “I didn’t ride (with) a helmet once. The discussion was, if we’re not going to follow the laws ourselves why would we sit up here and put those requirements on it?”

Not every council member was so sure in their vote.

Coucilwoman Candace Mumm, who voted to loosen the law, said she worried about safety.

“I think everyone should wear helmets,” Mumm said. “You look at the CDC recommendations, you look at the medical journals, they all say, wear a helmet. Doesn’t matter what age you are.”

The disagreements and push and pull on display at the meeting show there’s a lot of discussion ahead as the city considers rescinding the helmet law altogether. But there is an unanswered question: Do helmets work?

Helmets do work, not in all cases

John Lemus rode his electric scooter down the center aisle of the City Council chambers, kicked out its stand and kept his helmet on during the three minutes he spoke from the podium.

“People, if they’re going to ride these things, should be bringing their own helmets,” he said. “The No. 1 cause of traumatic brain injury is blunt force trauma without wearing a helmet. I have many friends who have developmental disabilities, who have TBIs from either bicycle accidents or sporting accidents that could’ve been averted if they were just wearing a helmet.”

In a way, Lemus is right. Helmets do reduce the risk of injury, just not as much as people think, and not for the most serious injuries people suffer while riding a bike, skateboard or other type of human-propelled vehicle.

A study from 1987 that said that helmets reduced head injuries by 85 percent is widely cited, but that study was flawed and has been refuted.

More recently, a 2011 analysis of numerous safety studies said that “no overall effect of bicycle helmets could be found when injuries to head, face or neck are considered as a whole.” Helmets protect against head injuries, but increase the likelihood of those to the neck.

A 2018 analysis of 119 cycling deaths in the Czech region between 1995 and 2013, published in the journal Safety Science, found that helmets could have saved the lives of 37 percent of the cycling deaths it examined. However, the deaths that would’ve been prevented were in cases where they “fell off their bicycles or hit obstacles.” The report also noted that the five cyclists who were wearing helmets were all killed in their incidents.

“Helmets would not have helped cyclists in most high-energetic crashes, especially when motor-vehicles or trains were involved,” the study said. “Some rear-end crashes outside urban areas also resulted in injuries when a helmet would not have helped.”

In other words, helmets help in slower-moving situations that don’t involve automobiles.

As for Lemus’ argument about traumatic brain injury being caused primarily when people aren’t wearing a helmet, he’s right. But most of these injuries come from people falling, and no one is making the case that people should wear helmets at all times of the day.

According to the Centers for Disease Control and Prevention, nearly half of traumatic brain injury comes from people falling, particularly older adults and young children. These falls involve ladders, beds, stairs and the bath. Bicycle crashes are not accounted for in this category, but instead under “traffic incidents,” which accounts for 14 percent of traumatic brain injuries and include car-to-car collisions and train incidents.

Still, a 2016 study published in the American Journal of Surgery found that helmets cut the risk of severe traumatic brain injury by half. The study, which used information from the American College of Surgeons’ National Trauma Data Bank, found that cyclists who wore helmets had a 52 percent lower risk of severe brain injury, compared to cyclists without helmets, and a 44 percent lower risk of death.

While there’s no debate that helmets prevent skull fractures and other potentially lethal brain injuries, a 2013 report by the Institute of Medicine and the National Research Council found helmets don’t protect against the most common injuries that can lead to long-term neurological problems. While the study focused on headgear worn by child athletes playing team sports, its findings applied to bicycle helmets.

Heleen Dewey, a health program specialist with the Spokane Regional Health District, said there is no question.

“Helmets save lives,” Dewey said. “Helmets are a safety accessory that should always be used when folks are using active forms of transportation, like biking and skateboarding.”

While Health District spokeswoman Kim Papich would not comment on the city’s helmet law in particular, she said “mandates and rules and laws are beneficial” in encouraging good behavior, like wearing a helmet, as well as discouraging bad behavior.

Safety in numbers

At the podium, Jessica Engelman said there is a better way to increase safety without mandating helmet use.

She pointed to a law requiring bicycle helmets for riders in New Zealand, which led to a 51 percent reduction in cycling rates between its introduction in 1994 and 2005. The decline in riders was important to note, she said, because it’s the presence of cyclists that makes the roads safer for everyone.

“The presence of having more bicycles and cyclists on the road actually made things safer for everyone,” she said. “The more people walking and cycling, the less likely you are going to be hit while walking and cycling.”

Rhonda Kae Young, a professor of civil engineering at Gonzaga University, agreed. She said she began her career wholeheartedly believing that helmets should be required by law, like seat belts. As she learned and studied more, she “migrated to another point.”

“I absolutely think that helmets should be encouraged, readily available and low cost,” Young said. “But I don’t believe anymore that it’s something we should mandate.”

Young said Spokane, like many cities, has the equation upside-down. It’s not the presence of people on the streets without helmets that’s the problem. It’s the lack of people on the street.

“A lot of the reaction to bicycles or pedestrians or anything that’s not cars is, we should arm them to protect them,” she said. Instead of requiring helmets and other safety gear, Young said we should remove barriers to cycling, which in turn would encourage more people to ride.

“Safety comes from higher use. The more people out there, the safer we all are,” she said.

Rather than requiring helmets, Young said the city should build better facilities for pedestrians, cyclists and scooter riders alike.

“It’s less about helmets and more about infrastructure,” she said.

Nation’s most stringent helmet laws

Brandon Blankenagel, a city engineer who manages Spokane’s shared mobility program, said he and other city staffers didn’t dig into the complex, and sometimes contradictory, information around helmet usage. They left that up to the city’s policymakers on the council.

He did note, however, the singular role Washington state plays in the helmet discussion.

“Washington state is fairly unique. We might have the most stringent helmet laws out there,” he said. “By and large, Washington has the most helmet laws.”

He’s right. According to the Bicycle Helmet Safety Institute, the state does have the most laws requiring people of all ages to wear helmets. Most of the other laws in the nation’s states, counties and cities apply to people under the ages of 12 to 19. There is no federal law requiring bicycle helmet use.

With the reprieve from the helmet law, the council also voted to strengthen rules prohibiting people from riding on the sidewalk.

While the move was done to appease most people who were annoyed — or frightened — by sidewalk riders, it has thrown those same scooter riders into a potentially dangerous situation: riding, without a helmet, in traffic with automobiles.

Blankenagel recognized this, and said the city was putting together a program to educate all users of the street: motorists, cyclists and scooter riders.

“The interaction between drivers and bikes and scooters, we’re going to be putting out an education campaign about being respectful to everybody,” he said. “It takes everybody.”

Young, the professor, said the move may have the benefit of convincing the city to put more money toward better on-street facilities.

“Pushing people into the street will highlight pretty quickly the lack of infrastructure we have,” she said.

But Lemus said the law will only change, and the council will see the error in its ways, when tragedy strikes.

“Drivers do not care about cyclists or pedestrians in this city. You can’t cross the street in the downtown core without somebody’s car inching at you while you’re tying to cross the street. So now we’re going to say the only place where these can be ridden is in the street,” Lemus said. “I think you’ll need to re-look at this once a couple people get hit in the street by cars whose drivers aren’t paying attention or drivers who are road-raging because they don’t think we should be there.”

Editor’s note: This story was changed on April 2, 2019. Health District spokeswoman Kim Papich would not comment on the city’s helmet law in particular, and she said “mandates and rules and laws are beneficial” in encouraging good behavior, like wearing a helmet, as well as discouraging bad behavior. The information was incorrectly attributed in an earlier version of this report.