What evidence is there that cycle helmets save lives? [cyclehelmets.org]

There is no direct evidence that the wearing of cycle helmets has led to fewer deaths amongst cyclists. Most research into cycle helmets has not included cyclist fatalities.
The premise that helmets save lives is by extrapolation from research that has suggested that helmets might reduce injuries to the head. As most fatalities involve head injury (this applies to all major external causes of violent death, not especially cycling), the reasoning is that by reducing injuries to the head, cycle helmets can lead to fewer cyclist deaths.

Whole population data

Whole population statistics for cycling fatalities do not support the above hypothesis.
Long-term analyses of fatalities in Canada (Burdett, Can), New Zealand (Burdett, NZ) and USA (Kunich, 2002;Rodgers, 1988) show no helmet benefit; indeed, one study (Rodgers, 1988) suggests helmeted cyclists are more likely to be killed. Although fatality rates have generally declined, cyclists have fared no better than pedestrians. In Great Britain, too, there has been no discernible improvement in fatality trends relative to pedestrians as helmets have become more common (BHRF, 1071Hewson, 2005).
In New South Wales, Australia in the three years following the introduction of its helmet law, 80% of cyclists killed and 80% of those seriously injured wore helmets at the time (Robinson, 1996NSW, 1994). These proportions are almost identical to wearing rates in street surveys (85% and 83% for adults in 1992 and 1993 respectively; 76% and 74% for children - Robinson, 1996Smith and Milthorpe, 1993), suggesting that helmets had little effect on the likelihood of fatal or serious injury.
In Western Australia where bicycle helmets have been mandatory for all ages since July 1992, the annual cyclist death toll from 1987 to 1991 (pre-law) averaged 7.6 fatalities per year. From 1993 to 1997 (post-law) it was 6.4 fatalities per year, representing a 16% reduction (Meuleners, Gavin and Cercarelli, 2003CHC, 1). Government cycling surveys show cycling declined in Western Australia by approximately 30% during the 1990s following mandatory helmet law enforcement (WA, 1). Thus the increase in helmet wearing as a result of the law did not reduce fatalities relative to cycle use and may have led to an increase.

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