HIGHWAY TRAFFIC AMENDMENT ACT, 1991 / LOI DE 1991 MODIFIANT LE CODE DE LA ROUTE
HOSPITAL FOR SICK CHILDREN NURSING GROUP
COALITION FOR HEAD INJURY PREVENTION
CONTENTS
Wednesday 4 December 1991
Highway Traffic Amendment Act, 1991, Bill 124 / Loi de 1991 modifiant le Code de la route, projet de loi 124
Ontario Cycling Association
Hospital for Sick Children Nursing Group
Highland Junior High School
Paul Zehr
Coalition for Head Injury Prevention
Adjournment
STANDING COMMITTEE ON RESOURCES DEVELOPMENT
Chair: Kormos, Peter (Welland-Thorold NDP)
Vice-Chair: Waters, Daniel (Muskoka-Georgian Bay NDP)
Arnott, Ted (Wellington PC)
Cleary, John C. (Cornwall L)
Dadamo, George (Windsor-Sandwich NDP)
Huget, Bob (Sarnia NDP)
Jordan, Leo (Lanark-Renfrew PC)
Klopp, Paul (Huron NDP)
McGuinty, Dalton (Ottawa South L)
Murdock, Sharon (Sudbury NDP)
Ramsay, David (Timiskaming L)
Wood, Len (Cochrane North NDP)
Substitution: Cunningham, Dianne E. (London North PC) for Mr Jordan
Clerk pro tem: Manikel, Tannis
Staff: Luski, Lorraine, Research Officer, Legislative Research Service
The committee met at 1608 in committee room 1.
HIGHWAY TRAFFIC AMENDMENT ACT, 1991 / LOI DE 1991 MODIFIANT LE CODE DE LA ROUTE
Resuming consideration of Bill 124, An Act to amend the Highway Traffic Act / Projet de loi 124, Loi portant modification du Code de la route.
The Chair: It is 4:08 pm. My apologies to people who have had to wait. We were not able to start promptly at 4, as we should have, because not all caucuses were represented.
ONTARIO CYCLING ASSOCIATION
The Chair: The first group making submissions is the Ontario Cycling Association. Welcome. Identify yourselves by name and whatever titles you might have in your organization. Proceed with your comments. Try to keep them to around 10 minutes, if you can, so we have a good chunk of time to ask questions and engage in dialogue.
Mr Keba: I am Shawn Keba, the program co-ordinator for recreation and transportation of Ontario Cycling Association.
Mr Maisonneuve: My name is Jean-Pierre Maisonneuve. I am the chairperson of the advocacy committee of the Ontario Cycling Association. I am also an executive member of the recreation and transportation commission of the Canadian Cycling Association.
Mr Keba: We are very thankful today to have this opportunity to voice the Ontario Cycling Association's concerns regarding Bill 124. The OCA is the governing body for cycling in Ontario. It is a volunteer-run organization affiliated with the Canadian Cycling Association in Ottawa. The OCA's mandate is to develop and promote all forms of cycling in Ontario. For further information on our programs and activities, please refer to our annual handbook.
The issue of bicycle helmets and whether they should be mandatory has been studied on and off by the OCA for the last number of years. When Bill 124 was first introduced a subcommittee studied the issue once again. The OCA supports helmet use and the goals aimed at by Bill 124 but feels the bill will fall so much short of these goals that we must oppose its passing. The issues of safety, injury reduction and risk management are not adequately addressed by this bill, nor have they been discussed in depth by the House. The OCA urges the standing committee to very carefully consider the following issues.
Mr Maisonneuve: There are numerous issues. We will not go into an extensive description but will give you at least an idea of some of them.
First, there is a lack of rational debate concerning helmet usage. In practically all instances where mandatory helmet legislation is being debated, it was caused by either a recent rash of cycling accidents, particularly involving fatalities, and/or the proponents of the legislation have been closely connected with the victims. Because of this public arousal and/or personal trauma, it is often impossible to have rational debate.
A most illustrative example occurred recently in Howard county, Maryland, where three deaths occurred in separate incidents. The public outcry got the debate going -- "Make helmets mandatory." Never mind that in two of the cases the cyclists were riding the wrong way against oncoming traffic and would not have survived in a complete suit of armour.
This knee-jerk reaction, together with a lot of media coverage, is all too common and does not address the promotion of cycling safety or eduction. This suggests legislation by case history and passion, not based on thorough research of risk management with a full cost-benefit analysis.
Another issue is the low level of risk associated with cycling. All road users, whether motorists, cyclists or pedestrians, are constantly exposed to danger. Motorists often do not think about them, surrounded as they are by a steel box, yet thousands die or are seriously injured every year. While all attempts to reduce these numbers must be used, we should not pull things out of perspective when dealing with cycling accidents, even though they may seem dramatic.
The facts quoted earlier clearly show that cycling is not an unduly risky activity. Studies done in a number of places in the United States as well as here -- eg, the University of Waterloo -- amply back this up.
In the case of motorists, even when properly belted in, head injuries still do occur, yet no helmets are required. Society has said seatbelts are enough of a risk-reduction device. There is plenty of evidence that properly trained cyclists, as motorists are trained, even in the pre-helmet-wearing days, are not putting themselves at risk any more than motorists.
Another issue is the design of bicycle helmets. Bicycle helmets are not primarily designed to prevent deaths, merely to reduce the severity of the head injury. 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.
Bicycle helmets do not prevent accidents. This a fact often overlooked by the proponents of a helmet law, yet it is tempting for parliamentarians to pass such a law. In all this, we have not prevented one single accident. In fact, there is good evidence from a study conducted by a gentleman named Gregory Rogers. Mr Rogers produced an article that was published in the Journal of Products Liability. It found that increased helmet use was positively and significantly associated with an increase in the fatality rate of cyclists. That is quite odd, but yes, he found increased helmet use was positively and significantly associated with an increase in cycling fatality rates. The very thing we are trying to achieve is defeated.
People feel safe. They are wearing a helmet, so they may unknowingly expose themselves to greater danger. That is what we call the "lulling" effect. I have experienced that personally. Ever since I have worn a helmet, I have tended to go faster on the streets. It does not mean I do not obey the basic traffic regulations, but I tend to go faster, I tend to feel a little more secure. In certain respects this is an illusion, because this shell can crack. You can drop a helmet and it can crack.
Mr Keba: Another issue the Ontario Cycling Association is concerned with is enforcement of this bill. Enforcement of Bill 124 will not be easy. Currently, police officers are unable to enforce existing bicycle laws effectively. Also, because of the Criminal Code, there will be no way to enforce this law on children under the age of 12, arguably the group that should most be affected by this bill.
To ensure a reasonable rate of compliance, a huge education and enforcement campaign will have to be launched. The OCA believes that if a similar effort were put towards cycling skills training and general cycling education and awareness programs, the results would be more worth while. The current number of cycling infractions would be reduced and there would be many fewer accidents.
Another issue is the environmental concern. The government should be doing all it can to provide for and encourage less energy use. Cycling accomplishes this. Mandatory helmet usage will impede cycling use when the government should be doing all it can to promote cycling.
Another issue is the incorrect wearing of helmets. From OCA observations, it is conservatively estimated that at least 50% of all cyclists who now wear helmets do so incorrectly. Mandatory helmet usage will require a public education program. To date, such a program has not been thought about by the government.
The final issue I would like to talk about that the OCA is concerned with is the belief that helmet usage will help decrease health care costs. It is often argued that since health care is a public expense the public should have the power to regulate apparently dangerous activities. 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. A proper perspective must be used. The incident rate is not out of proportion with the number of participants who cycle.
Mr Maisonneuve: If I may share with members of the committee some views which have been expressed in other jurisdictions regarding mandatory wearing of helmets, one of the objectives of the Ontario Cycling Association is to promote the increased safe use of bicycles. Thus, we should encourage and support actions which increase bicycle use and make bicycling safer.
Encouraging the use of bicycling helmets promotes more and more safer cycling by showing people how to easily prevent serious head injuries. Mandating or requiring the general public or certain segments of it to wear helmets has been regarded with scepticism by various cycling associations in North America and abroad.
According to the Bicycle Federation of America, the introduction of a policy making the use of helmets mandatory would have the following consequences in the United States: Many people would stop riding; many people would disregard the law; the law would not be widely enforced, and, last but not least, the message of the importance of wearing a bicycle helmet would get lost in the rhetoric about freedom of choice.
In Australia, cycling advocates who are less reluctant to have their governments impose requirements and constraints for their general welfare are not yet ready to ask for mandatory helmet use. They believe it is first necessary to make the general public aware of the need for helmets and to achieve a reasonably high level of voluntary use before requiring helmet use.
According to the United Kingdom organization Cycle Touring and Campaigning, the emphasis should be on training children and adults to ride safely. Dansk Cyklist Forbund, a Danish cycling advocacy group, considers that the compulsory use of cycling helmets could reduce the number of fatal accidents but could also lower the propensity to cycle in Denmark. Thus the negative effect on the health of the Danish population -- increased coronary disease induced by physical inactivity -- would override the positive effects gained by the use of cycling helmets.
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We would like to make some recommendations. Introducing compulsory helmet-wearing may seem attractive to members of the Legislative Assembly of Ontario because it enables them to do something decisive about cycling safety. Unfortunately helmet-wearing tends to be equated with bicycle safety. As with many proposed legislative approaches to social problems, effective implementation is the necessary and often missing component.
Generally, traffic laws are not being enforced on cyclists as they are on motorists. So can we expect the police to enforce a helmet law when they do not even ticket wrong-way riders or other important violations accomplished by cyclists?
The Ontario Cycling Association needs to reiterate to members of the Legislative Assembly of Ontario that safe cycling involves more than wearing a helmet. Cyclists need improved roads, better cyclist education and research. It is especially imperative that a comprehensive understanding of behaviours linked to helmet-wearing be developed before any legislation be enacted. As the lifesaving capacity of bicycle helmets is no more than an estimate -- none of the several studies carried out in North America and Australia includes significant numbers of fatally injured cyclists -- serious attention must be given to a scientific assessment of the various levels of risk associated with different cycling activities.
Such an endeavour is now under way in Quebec. The auto insurance board of Quebec, in co-operation with Velo-Québec, the cycling advocacy group there, has developed an outstanding and comprehensive study which will be tabled next September at the international bicycle conference.
The Chair: Thank you. We have 10 minutes.
Mr Dadamo: Thank you for the book, by the way. Is this your annual book?
Mr Maisonneuve: Yes, it is produced with the assistance of the Ministry of Tourism and Recreation.
Mr Dadamo: Very good. I have gone through and noticed that there are several people from my riding who are presidents of associations. So that is very nice.
When I think of -- and the cover seems to show it -- these people whom you represent, who are part of your membership, are they in competition?
Mr Maisonneuve: Our constituency is fairly broad-based. We have on the competitive side people who do what we call road and track. We also have a fairly significant part of our constituency who are what we call mountain bikers, off-road riders. That is one segment. Other segments are what we call the tourers, people who travel by bicycle. We have several of these clubs in the province now. They are what we call randonneur clubs. They do 200, 300 and 400 kilometres on average per ride. The final segment of our constituency is what we call commuters or utilitarian cyclists, people like me who come to Queen's Park every day, who ride their bicycles 45 minutes, half an hour, whatever, basically to promote environmentally friendly transportation. These are the three constituencies of our association.
The Chair: I want to make sure of time for Mr Waters and Mr Klopp.
Mr Dadamo: Actually, I was not finished the question, but thank you for jumping in.
I am thinking they are going extremely fast.
Mr Maisonneuve: Some of them are going extremely fast. Some of them are pretty slow, like me.
Mr Dadamo: Okay. We think of speed. We think of going around the bend. Why would helmets not help these people?
Mr Maisonneuve: For these people, it is a tradition. It is kind of an unwritten law. There is sometimes a gentlemen's agreement among various cycling organizations. These people wear what we call soft shell. This is a hard shell, but racers wear what we call soft shell for aerodynamic purposes.
Mr Dadamo: Okay. That would be a person's agreement, by the way.
Mr Maisonneuve: Yes, yes. I am sorry. Yes, we have to be non-sexist.
Mr Waters: A couple of times during your presentation you talked about the people who died because of helmets. I am concerned about those people, but I am a lot more concerned about those who were unfortunate enough to live. We have had doctors and various other professionals here talking about the situation these people find themselves in for the rest of their lives. I am somewhat more concerned about that. I would like your feelings on those who happen to be unfortunate enough to survive a bicycle accident where they have had a severe head injury.
Mr Keba: Our statistics state that of the 3.5 million cyclists who currently cycle in Ontario, over the last 10 years the average accident rate has only been 4,000 per year. That works out to less than one tenth of 1% of all bicycle users.
Mr Waters: Are you saying that because the rate is so low it really does not matter, they should not have to wear a helmet? If we save one life or stop one child from being brain-damaged for the rest of his or her life and only being a part of the person he could potentially be, then to me the helmet should be worth while. I have trouble understanding why you would say it is not.
Mr Maisonneuve: The point we are trying to put across is the following: The OCA believes in promoting as many devices as possible that can ensure safety, but we must not consider the helmet to be a cure-all. Helmets are fine if they are coupled with other measures such as making not only cyclists but motorists more aware of the relationship they have with each other on the road. Once we get a proper training program compulsory for all people who want to cycle -- because basically the problem is that you can put anyone on the street now. He buys a bike; he is on the street; he does not need a licence. It is what we call a free-for-all situation.
If we provided every adult and every school child who rides a bike with the resources so they could take a Can Bike course, for instance -- We have Can Bike I and Can Bike II, nationally sanctioned training programs, in order to make road users more aware about the requirements for a safe ride on the road. I think we have to see the whole issue of cycling safety as a comprehensive package. One of the elements is convincing people to get a helmet.
I just want to get into a practical aspect. I was talking not too long ago with two board members of the OCA who happen to be store owners. They own bike shops. These people were talking with people from Norco. Norco is one of the key distributors of bicycle parts, including helmets, in Canada. Their own opinion is that if legislation of that nature was introduced, it would take at least two years for the manufacturer just to be able to provide a substantial quantity of helmets so that we would be able to fulfil the obligations of such legislation. If we are talking about phasing in legislation, we have to talk about the practicalities.
Mr Klopp: Do off-road bikers wear helmets?
Mr Maisonneuve: Usually they do.
Mr Klopp: Why do they do that? There are no cars around.
Mr Maisonneuve: If you have ever ridden off-road you will see it is a very dicey type of environment. You never really know --
Mr Klopp: But these people are good drivers; they would not fall accidentally and hit their heads, would they?
Mr Maisonneuve: Listen, I have ridden off-road and I have --
Mr Klopp: Have you ever fallen off a bike accidentally? You are a good driver; have you ever fallen off accidentally?
Mr Maisonneuve: Yes, I have.
Mr Klopp: A lot different than a car, would you not suggest? In a car there is a little bit of frame around you, although we are supposed to wear seatbelts.
Mr Maisonneuve: Yes.
Mr Klopp: That is where I think I agree with you. We need more than just to pass a nice, neat little law that says "helmets," and we are all going to be better off; I think we need to do more education or whatever. But I think you must agree, though, that helmets are necessary off-road and maybe this is what we are trying to do here, promote --
Mr Maisonneuve: That is why I wear a helmet.
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The Chair: Mr Klopp, by the way, notwithstanding that impressive bit of cross-examination, to his credit is not a lawyer, but it was an effective bit. Do not hide your talents or your light under a bushel.
Mr Maisonneuve: I think we have to address other issues. If we are going to get into a compulsory or mandatory helmet program, we also have to think about introducing selective traffic enforcement programs directed at cyclists. We also have to legislate the standards for road construction and design to ensure that cyclists are included.
Mr Arnott: Thank you very much, gentlemen, for coming in this afternoon. I was reading through the mandate of your organization as suggested by the Ministry of Tourism and Recreation. It says that in return you get a bit of funding from them. How much funding do you get from them?
Mr Maisonneuve: We get most of our public funding from the Ministry of Tourism and Recreation.
Mr Arnott: Do you know the dollar figure?
Mr Keba: I do not have a dollar figure, but I think it is about 60-40.
Mr Arnott: So 60% of your funding.
Mr Maisonneuve: We hope the Ministry of Transportation will give us some money at one point.
Mr Arnott: How would you react to a request from the ministry to add a sixth mandate, to promote the interests of bicycle safety in Ontario?
Mr Maisonneuve: We do that implicitly. A lot of our members run, on a volunteer basis, workshops for service clubs and schools about bicycle safety. We do it more or less on an ad hoc basic and we try as much as possible to satisfy the needs, but the needs are immense.
There is a problem. With all due respect to the police force, sometimes it does not understand some of the specifics of cycling. That is why we see with great interest now the fact that more and more police forces are setting up bicycle patrols. That is a very good step.
Mr Arnott: Getting back to the mandate --
The Chair: Mr Arnott, I do not want you to have Mrs Cunningham angry with you.
Mr Arnott: One quick observation: Mandate 5, to increase participating of women in cycling, when was that included in your mandate? I do not know about the priorities. I would think safety should be a very important priority to promote.
Mr Maisonneuve: This stems from some national considerations. The OCA is part of a larger body, which is the Canadian Cycling Association. Because of the directives set forward by Sports Canada and Fitness Canada, which provide the funding for our national organization, one of the requirements when we have to apply for funding at the national level for projects is that we encourage women in sports. So at both the national and the provincial level we have a women's committee. We have a women's committee which is very active which tries to promote specific concerns of women both in sports and also in general transportation issues.
Mrs Cunningham: We chatted briefly before the meeting started and I would just like to say thank you to both of you for coming here today. You have given us some information with regard to concerns you have in your position as representing the Ontario Cycling Association. One of the reasons for these meetings is of course to get the best advice we can and in fact to see if Ontario is ready, so we are listening to everybody who comes before the committee.
I am just wondering how large your cycling association is and if you would describe who these other groups are. For instance, we have bicycling committees from Windsor, London, Toronto, Ottawa, etc. Some will be appearing; some have written us letters. Are they subgroups of your cycling association? How does it work?
Mr Maisonneuve: There are two levels of representation: the formal and the informal. On an informal basis, we can say that the OCA represents at least 3.5 million Ontarians who cycle at least occasionally. That is at the informal level. At the formal level we have 2,000 members but we also have a relationship with clubs. There are an awful lot of clubs. I think there are over 50 clubs in the province.
Mr Keba: There are 102.
Mr Maisonneuve: I am sorry, 102 clubs. They are basically racing clubs, but there are also advocacy groups. Under my trusteeship we have also been developing a network of cycling advocacy groups. A lot of cities now have advisory committees. Waterloo, Ottawa, Toronto, Peterborough, etc, all have these advisory groups. These groups also participate within our various committees, basically the advocacy, the recreation and transportation and the women's committees.
Mrs Cunningham: So you would have on a list somewhere at least the chairperson of these 102 clubs?
Mr Maisonneuve: Yes, we do. This is information in the public domain so we would be more than happy to provide you with that information.
Mrs Cunningham: That is fine. Then under each of these 102 clubs you may have, as you have described yourselves, the chairperson of an advocacy committee or a safety committee.
Mr Maisonneuve: Exactly.
Mrs Cunningham: For every one of these 102 clubs you would have at least four or five officers who would be on a list, but maybe not all the members. Is that correct?
Mr Maisonneuve: Yes, but we have the list of the key contact persons for each and every one of these clubs.
Mrs Cunningham: In coming here today and representing all these clubs as the Ontario Cycling Association, I am assuming you probably sent a letter to them and asked them their opinion on this legislation.
Mr Maisonneuve: Yes, and not only that. Three weeks ago we had our annual general meeting in Ottawa. I chaired a special session and we dealt specifically with the bicycle legislation. We had a workshop on that, and during the plenary session we also had a full-fledged debate about it.
Mrs Cunningham: Of the 102 clubs, how many would have been represented, do you think, in Ottawa?
Mr Maisonneuve: I would say at least half the clubs were represented at our annual general meeting.
Mrs Cunningham: Did everybody get one vote or how did it work?
Mr Maisonneuve: Basically, in our organization we try to work by consensus. Obviously we compete against each other in races, so when we debate we try as much as possible to take a non-competitive and more conciliatory approach.
Mrs Cunningham: What about the 50 clubs that were not represented? Did they mail in a ballot or a response?
Mr Maisonneuve: No. We have different instances: We have the annual general meeting, which is one of the decision-making instances, we have the board meetings and we have the committee meetings, but we also have regional committees. We have I think six regions. These six regions meet on a quarterly basis, so the key representatives from the different organizations meet and discuss pressing issues. We have asked that for the coming regional meetings the key issue to be discussed at each and everyone of them be the legislation.
Mrs Cunningham: So right now you do not have all the input you would like to have from your membership.
Mr Maisonneuve: Exactly. But we do, as much as possible, try to provide the committee with the results of our consultation as they develop.
Mrs Cunningham: But you would have had more than 50 people at your meeting in Ottawa.
Mr Maisonneuve: Definitely.
Mrs Cunningham: How many did you have: 50? 60?
Mr Maisonneuve: We had more than 100.
Mrs Cunningham: Basically, you are representing the views in Ottawa here today; you have not had any mailings or anything.
Mr Maisonneuve: Yes.
Mrs Cunningham: I just wanted to get your mandate because we have others coming in giving us other points of view and we clearly want to understand what is happening here.
Mr Maisonneuve: We did not come with that position out of a little meeting. We tried as much as possible to be democratic and try to solicit opinions.
Mrs Cunningham: It might be a good idea, if you have 2,000 members, to allow them to write back. I would be interested to know how many of the active cyclists in Ontario would care enough to let us know. You and I had a discussion about democracy and we want as much input as we can get.
Mr Maisonneuve: Our next newsletter is due to be published within a week or two. We have asked that all members, organizations and clubs write to the clerk of the standing committee on resources development to send in their opinions. We did a little bit of channelling at first, but in the second stage we have asked specifically that all cycling organizations and advocates send in directly, to the care of the Legislative Assembly of Ontario, their opinions on this subject.
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Mrs Cunningham: That is great and we thank you for that.
I noticed in your Cycling Ontario booklet that everybody has a helmet on, even the little one down here. That is great. We are looking for good promotion. But I must say I do not know what study you read about the wearing of helmets being directly related to increased numbers of fatalities, but if these people believe that I do not think they would have a helmet on. That is all I can say. If you can give us that study, I would really be interested in following up on that.
We have a number of studies here. I am not sure whether you have ever read or had reason to read the Seattle study that was published in the New England Journal Of Medicine?
Mr Maisonneuve: I was in Seattle not too long ago, so I met with some cyclist advocates from there.
Mrs Cunningham: Have you read the study that was published in the New England Journal of Medicine? Because if you have not -- the only reason I am raising it -- in the back there are about 28 references to research that has been done on this subject. You are welcome to it. My staff have a package they sent out to people to inform them on both sides of the argument. I wanted to let you know we have a package and I hope you will call our office, and perhaps stay for the rest of the day today because there are a number of other witnesses.
The Chair: I want to say thank you very much.
Mrs Cunningham: Just one --
The Chair: Mrs Cunningham.
Mrs Cunningham: How about 20 seconds? Let me go now and I will do it in 15.
The Chair: Promises, promises.
Mrs Cunningham: On the issue of safety, we have no intention of introducing this legislation without a safety campaign that goes along with it. I want you to know that since 1973 many of us have been involved in home and school associations and school boards across this province, so it is not new. I hope when you leave today you will think we have had a very rational debate.
This is not a bill that has been introduced from any knee-jerk reaction. As you have described, maybe in other jurisdictions; not so here. It has been encouraged by the Ontario Medical Association, people who work with children, parents, cyclists and other cycling clubs. I really want to underline that the debate is only as rational as the people who appear before this committee.
As for enforcement, you are quite right; we agree with you. We do not think the laws of cycling are enforced appropriately. We are looking very carefully at how this can be improved with legislation as it stands now -- for instance, lights in front of bicycles -- and effective implementation. We are counting on you to get ideas about that.
As far as helmets are concerned -- I will close with this, Mr Chairman, because I can see you are very nervous -- Bill Coffman from the Canadian Standards Association came before us and assured us that if this legislation was passed and phased in -- it is not, I do not think, our intent, although we have not discussed it, to have this immediately effective on March 1, 1992. We are looking at probably giving the public 18 months or 2 years of lead time. We will discuss it. This is a non-partisan problem for all of us. He assured us that within months these helmets could be made and be available at a reasonable cost in Ontario by Ontarians. That is what we want. He also said they were American companies. We hope to give Canadian companies enough lead time to get started up and do it.
I wanted to give you that information in response to the concerns I wrote down. We really would appreciate your help if in fact we decide to move ahead with this. We need your help and your support.
The Chair: What I am concerned about, Mrs Cunningham, is that all over Ontario people are going to be saying I am a soft touch as the Chair.
Mrs Cunningham: You are a soft touch, Mr Chair.
The Chair: Gentlemen, I want to thank you very much for taking the time to come here and for preparing the material to talk to us as you did, a valuable contribution. Keep in touch with Mrs Cunningham or the Ministry of Transportation. The parliamentary assistant, George Dadamo, is sitting on the committee. We appreciate your interest. Please keep in touch.
Mr Maisonneuve: Thank you. Can I just make one final remark before I leave?
The Chair: Mrs Cunningham, and now you.
Mr Maisonneuve: I would like to thank the Ontario government, which is my employer, for giving me the opportunity to come and speak before the committee. I would especially like to thank my deputy minister, Mr George Davies, for letting me take 45 minutes time off today from my work to come and address you.
HOSPITAL FOR SICK CHILDREN NURSING GROUP
The Chair: As the people from the Hospital for Sick Children Nursing Group come forward and seat themselves, I want to remind people there are coffee, juices and milk here for you. Please feel free to have something to drink.
The Hospital for Sick Children Nursing Group has distributed its brief. Every member has it, and it has been marked as an exhibit to this committee process now; it will be a permanent part of the record. Can I ask you to identify yourselves and highlight your submissions so that the more valuable process of exchange can occupy most of our time. Please go ahead.
Ms Durnford: Mr Chairman, members of the committee and members of the concerned public, first, before we introduce ourselves as individuals, the group represents the nursing staff at the Hospital for Sick Children who deal with children admitted as a result of injuries, from the trauma room and the emergency room through to the operating room, recovery room, the nursing unit, to discharge, either to home or to a rehabilitation hospital.
My name is Phyllis Durnford. I am the trauma program co-ordinator at the hospital. With me is Irene Elliott. I will let her tell you about herself.
Ms Elliott: I am a clinical nurse specialist and my position is in the neurosciences department, which includes children who are head-injured and the particular group we are discussing. I also have an affiliation with the head-injured children through the intensive care unit coming on to the ward itself.
Ms Bruce: My name is Sheila Bruce. I am a staff nurse at the Hospital for Sick Children. I have been there two and a half years. I am a care giver for children who have suffered a head injury as a result of a bike accident.
Ms Miller: My name is Coleen Miller. I had the privilege of meeting with this committee on Monday. Just to remind you, I am the clinical nurse specialist for the trauma program.
Ms Durnford: I would just like to make one other short point. The colour of my blazer does not represent my political affiliation.
This afternoon the group would like to address the following issues with regard to mandatory helmet usage: first, the size of the bicycle-related-injury problem in this province; second, the impact of the injury or injuries, and the circumstances on the child, the family, the health care providers and the health care system; and third, the strategies which would assist the implementation of this bill.
What is the size of the problem we are facing? Between 1985 and 1989, we had an average of 16 children between the ages of 0 to 16 die as the result of a bicycle-related injury. Cause of death in most instances was a non-surviveable head injury -- in other words, a massive head injury -- and none of these children was wearing a helmet.
The geographical distribution did not and does not favour either rural or urban areas. Bicycle injuries do not know about geography. The other thing the committee should be aware of is that the scene of the injury can be identified as being somewhere within one to two kilometres of home, not five or six miles away. That is important for you to know and to think about, but even more important are those children, literally hundreds of them, who are admitted to hospital, survive the injury and undergo varying lengths of hospitalization in an acute care setting such as ours or a rehabilitative setting such as Chedoke-McMaster Hospital, the Hugh MacMillan Medical Centre and any other rehabilitative setting you can think of.
This is another point: The peak rate for bike-related injuries is estimated as being somewhere about 900 per 100,000 of population for children between the ages of 5 to 14. If you take the population of Ontario and figure that the paediatric population is, let's say a third, multiply that number by 900 and you have some idea of the size of the morbidity problem.
Unfortunately, with all due respect to the male members of this committee, it tends to be more of a male problem than a female problem. I will not get into why that might be.
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Head injuries, again, are a prominent cause of morbidity and disability. We have examined studies from San Diego county, from Pittsburgh, Pennsylvania, and from Calgary which speak to the residual damage associated with these injuries: brain injury figures of 13.5 per 100,000 population. Take that figure of how many kids there are in Ontario and multiply it by 13.5; 83% of children discharged with limited physical activities that can range anywhere from a week to two years; 32% of these kids are going to have either a persistent and/or permanent disability on discharge. If dollar signs are beginning to flash in your head, they should be.
We looked at injury admission data from our hospital from June 1990 to September 1991. The reason we picked that particular period is that it represents two cycling seasons, the cycling season for kids being basically when they get out of school to when they go back to school, so we have got two seasons here.
We found that 80% of the total head injury admissions were due to falls off bicycles. We have all fallen off bicycles. We know how easy it is to do. You hit a rock in the road, you hit a pothole, your baseball mitt catches in your spokes, you put the hand brakes on too hard and you are over the handlebars, you turn too sharply; we all know how it is done. Twenty per cent of them resulted from a collision with a motorized vehicle. It is no surprise the majority of the mortalities are in the latter group.
However, the morbidity crosses both groups. Gentlemen and ladies, the morbidity does not just include the severe head injury; it includes the moderate to minor head injury, the only clue to its existence being that all of a sudden the kid's attention span has decreased and her or his school performance goes down.
The Chair: Distinguish between "morbidity" and "mortality."
Ms Durnford: "Mortality" means you are dead; "morbidity" means you are confined to your bed for three weeks and you have got a headache for two of them.
I have acquainted you with the size of the problem, not that I should intimate you were ever unacquainted with it, but I figured I would put a few numbers in there. Sheila Bruce is going to speak to you about the impact of the injury.
Ms Bruce: The most devastating outcome of these head injuries is the harm that is suffered by these children. Children may die as a result of the injuries they sustain from bike accidents, and if they do not die they may suffer severe injuries from which they may never fully recover.
A normal child may jump out of bed one morning, get ready for school, brush his teeth, have breakfast and off to school he goes. He comes home, jumps on his bike, no helmet, and is off for a ride -- pretty normal so far. This child may have an accident, regardless of whether he falls off on his own or is hit by a car. Unfortunately, he sustains a severe head injury.
Now this child is in hospital. I am the care giver now. I am the one who has to wash this child's face, bathe this child, dress this child and brush his teeth. I have to help this child to eat or feed him if he can eat; sometimes a child requires a tube down his or her nose to the stomach for feeding. Basically, I am the one who has to give this child this care. Unlike you or me, who can fidget in our chairs because we have been sitting too long, this child cannot even tell me if he is uncomfortable.
If the injuries are not this severe, children still may suffer some injuries from which they will have permanent damage, such as decreased attention span, thought process alterations, impaired cognitive abilities or speech impairment, not to mention physical impairment such as paresis or paralysis. Often these children have difficulty integrating back into school, decreased school performance and poor school grades. They have trouble with their peers. Friends at school often do not accept them. Children can be pretty cruel at times.
I would also like to stress at this point that we are not just talking about a child on busy streets in downtown Toronto. Any child who gets on a bike without a helmet is at risk for a head injury.
The next unit is the family. The family is put into a total crisis situation, the life and death of their child, and requires substantial support by the health care professionals. Routines or roles of the family are totally upturned. The family undergoes incredible stress, not only having to deal as individuals with the injured child, but also as a family unit. If this family has had family coping problems before this injury, the injury only aggravates these problems. It often requires additional support from the hospital, such as social work.
The family also lives with total grieving even if this child does not die. No longer are they looking at their teenager; they are looking at a 120-pound baby they have to care for. They are always having an uncertainty and grieving for the loss of the child they knew prior to the injury.
It is also a financial nightmare for parents to have a hospitalized child. Often a parent wishes to be with the child at the hospital. This requires a leave of absence, usually without pay, from their work. It has been estimated that costs for this parent can be upwards of $100 to $120 a day to be with the child in hospital. This includes things such as meals, transportation, parking and accommodation, if they do not live by the hospital. We are talking about hospitalization stays of upwards of five to six months.
The largest unit affected by these injuries is the health care system itself. These children require lengthy hospital stays because of their injuries. The complexity of head injuries often requires many professionals in the hospital to be involved with their care. This is all very expensive and draining on the health care system.
After the critical time of a head injury, rehabilitation and chronic care settings in Ontario are extremely limited. There are not very many places for these children to go. If the parents wish to take the children home, community resources are also extremely limited, often difficult to access or not available at all.
As for the funding and the resources that go into the treatment of these children, if part of this were put into prevention, the cost of treatment would be drastically decreased because there simply would not be the numbers of children requiring treatment.
The last thing I would like to discuss is the impact on me, the health care professional. These children require a lot of physical, hands-on care and a lot of emotional stress and strain, both the child's and the family's. This I can deal with: the emotional and physical part. What I have a very hard time dealing with as a care giver is the frustration of knowing this child has a severe head injury, the prognosis of this child and what the future may hold, knowing that this head injury may have been prevented with a helmet.
Knowing the care these children involve and knowing the outcome -- we have seen some figures -- you, the policymakers, have the ability to start, anyways, protecting these children. I feel it would almost be professional neglect if we did not start taking action and protecting the safety of the public. I feel we can do this by promoting Bill 124.
Ms Durnford: You have heard a summary of what the impact of a bicycle-related injury can be, particularly if it is a head injury. Sheila has stated that one of the prime frustrations for those of us who are care providers, whether we are physicians, nurses, physiotherapists, occupational therapists or whatever, is knowing this could have been prevented.
We appreciate the fact that you people are charged with the responsibility of formulating regulations if this act comes to life. We are very, very interested in helping you with that gargantuan task. We would like to propose several rather broad strategies which encompass concerns of time, cost to the system and the consumer, educational initiatives and enforcement.
In terms of time, we support the need for the public to buy into the necessity of using a bicycle helmet by all age groups. We propose that a two-year time line be established between the enactment of the legislation and its eventual enforcement. During that time, educational initiatives can be undertaken. I will address those initiatives in more detail in a minute.
Manufacturers will discover the growing demand and get ready to meet it. If any other legislation needs to be revised, that revision can be done. I am aware of the fact that there is some discussion about the Provincial Offences Act in one of your deliberations prior to the public hearings starting.
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As this act is an amendment to a current piece of legislation and not a new piece of legislation on its own, the essential mechanisms for enforcement are already in place. Therefore, in our opinion, there needs to be very little additional cost to the system. We do not need more police cars. We do not need more police officers. They are two of the most expensive resources in enforcement.
The cost of bicycle helmets to the consumer is another matter, however. It is our opinion that this can be addressed by coupon campaigns, it can be addressed by rebate programs and it can be addressed by a reduction of the provincial sales tax on bicycle helmets. I did not say a word about the GST, because we all know that is the feds' problem. It can ultimately be addressed through increased consumer awareness to which the manufacturers will have to respond, the law of supply and demand being what it is.
For educational initiatives, we have taken the liberty of suggesting a very round figure of $1 million per year. Let me remind you, gentlemen and ladies, that does not even come to the cost of one severe head injury -- $1 million a year for each year for the two-year time line should be undertaken. It could be based on pre-existing models which have a proven track record in increasing helmet usage. I know for a fact that later -- I think it is the beginning of next week -- you are going to hear about one of those programs, so I will leave it at that.
The educational initiatives need to be addressed to the adult rider as well as the child, because adults are very powerful role models for children. They could be addressed to the manufacturers to raise their level of awareness with regard to the problem and to the size of the potential market for helmets. Obviously, manufacturers are not in this only to be good-spirited public citizens. They are in it to make money. That is fair.
The last thing is enforcement which, in our opinion, starts at the end of that two-year time line. We would like to propose that it starts with adults, as in the Australian experience, and that it run for a period of six months to a year. That period is based on the somewhat seasonal nature of cycling in Ontario. We have targeted adults first because of their role model capability and because of their economic influence. We propose that children from the age of five upwards be required to wear helmets and that their parents bear the burden of financial penalty until the age of 16, the legal age of consent.
We have chosen five as the cutoff age because it represents the point at which the child enters the school system and is away from direct adult supervision for longer periods of time. It is the age at which the current CSA bicycle helmet standard applies. The amount of the financial penalty should match that applied for failure to use other similar safety equipment like motorcycle helmets and seatbelts.
Once the adult period of enforcement is through, then the child enforcement period starts. We also propose that the first fine have a grace period of about three days during which the person has the opportunity to purchase a helmet or retrieve a current helmet, and by showing this helmet, receive a waiver on the fine. However, a second offence gets a fine regardless.
We also propose that compliance with any of the CSA, the Snell Foundation or the ANSI standard certifications be required of a helmet sold in Ontario, with the preference given to the CSA standard.
In conclusion, members of the committee, we know what the problem is, we know how big it is, we know who is affected by it, we know how much it currently costs us, or we can estimate it, and we know what to do to fix it. It is 5:05 pm and the clock is ticking. The human and material cost of doing nothing continues to grow. Irene?
Ms Elliott: I just want to add one comment. On page 5 we included this, but I want to stress it again as a final sort of thrust when we talk about the size of the problem. The well-known Seattle, Washington, study showed conclusively that bicycle helmets, when worn, can reduce risk of head injury by 85% and serious brain injury by 88%. Children do not die from other injuries in bike accidents; they die from head injuries, and that has been shown at our hospital repeatedly. We do not have children dying from chest injuries, pelvic injuries or abdominal injuries; they die from head injuries. In all cases, I repeat, children who have died have not been wearing helmets.
The Chair: I want to thank you very much. This is the second time this week, as you have already made reference, that nurses and the nursing profession have been here and spoken out at this committee. Once again, a very impressive and thorough commentary, a good analysis, a very useful contribution to the process. We really thank you and look forward to your ongoing participation with this issue whatever course it takes as a result of this committee's dealing with it. Nurses, thank you very much for coming here.
Ms Durnford: If there are questions, we would be prepared to answer or comment at least.
The Chair: We thank you.
Ms Durnford: I get the point.
Ms Miller: Could I have one last word?
The Chair: Sure.
Ms Miller: On behalf of the operating room nurses at the Hospital for Sick Children, we have brought with us at least 50 signatures in support of the proposed amendment to this bill. We would just like to mention their contribution at this point.
The Chair: That will be made an exhibit and part of the record as well.
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HIGHLAND JUNIOR HIGH SCHOOL
The Chair: Bill Crew is here. There are some people accompanying him. All of them, or as many as want to, are welcome to sit with him. Please identify yourselves and commence with your comments.
Mr Crew: Mr Chairman, members of the committee, good afternoon. My name is Bill Crew. I am a teacher at Highland Junior High School in North York, and 50% of my time with the North York Board of Education I work as a program leader or consultant. My area of expertise is design and technology education.
I have here today with me two of our students, Farrah Haniff and Elaine Hsu, who are the president and vice-president respectively of our student council at Highland Junior High School. After I have made my brief comments, these young women I am sure would be most pleased to answer any questions you may have about the two case studies we will bring you today.
I am here today representing the staff and the students of Highland Junior High School and we sincerely thank you for this opportunity to speak in support of Bill 124 and the mandatory use of protective bicycle helmets. The clerk will give out a copy of my brief after I speak.
On June 4 past, Daniel, the 16-year-old son of one of our teachers at Highland, fell from his bicycle and suffered a severe head injury. We believe this accident was probably the result of faulty brakes on his bicycle. Daniel was in a coma for several days and there was some question about his survival. Then, for several weeks there were questions about the possibility of long-term or permanent disability.
Fortunately, this is a happily-ending story because Daniel is now attending school again. He is back to school just this month, in fact, and except for some lingering loss of physical strength and stamina and some short-term memory, he is nearing complete recovery. His recovery is due, in part at least, to his personal determination and the excellent care and rehabilitation he received in our hospitals. You will be pleased to know also that Daniel will later this month begin working as a counselling volunteer in the trauma unit at Sunnybrook Health Sciences Centre. He wants to help those who helped him.
Then, on October 3 just past, our school was thrown into a state of complete shock when we learned that one of our grade 9 students, Shabbir Darbar, had suffered fatal injuries in a bicycle-truck accident that occurred within two blocks of our school near Don Mills and Steeles in North York. Shabbir was 14 years of age. In my 31 years of teaching, I have never experienced such a profound loss by a group of staff and students. Many students and staff wept openly in grief. Some just wanted to be alone. Some students wanted to go home. Some staff and students met with trained counsellors employed by our board of education, while others wrote very profound and moving messages on a huge four-metre-long sympathy card that was placed in the school foyer. It was a tragic situation that I sincerely hope I will never have to experience again during my teaching career.
We of course have no way of knowing for sure what effect the wearing of bicycle helmets may have had in these two situations. In Daniel's case, we are told that a protective helmet probably would have prevented a serious head injury. In Shabbir's accident, a helmet may indeed not have saved his life because of the severe trauma to his bodily organs other than the brain. However, statistics available to all of us about the prevention of such severe head injuries by the wearing of protective helmets so overwhelmingly favours this amendment to the Highway Traffic Act to include mandatory use of bicycle helmets that we must see that this positive step is made. I know from the comments I have heard in the brief time I have been here today, and I know from reading in Hansard about the debate held in the Legislative Assembly on June 27, 1991, that you have heard these overwhelming statistics. I would be pleased to repeat any of the statistics I have if you want to hear that again. I think that is not necessary.
To the credit of the grief-stricken parents of the young student who tragically lost his life, they are adamant that our school do something positive by way of promoting bicycle safety. The students of Highland Junior High School are simply not satisfied with just the usual hanging of a framed photograph in the school hall and placing a memorial page in the school year book, which of course we will do. These students insist that we do something more positive and long-lasting to celebrate Shabbir's life. As a result, plans are being formulated to conduct a series of bicycle safety related activities next spring. We are not sure at this time exactly what format we will employ, but the activities most certainly will include bicycle safety checks, helmet sales at discount prices, assemblies and/or lessons on the topic of safe cycling. The first of our positive steps to promote cycling safety occurs here today as we urge you to support Bill 124.
We are all aware that this bill, like most legislation, will undoubtedly meet with some opposition. We know there are those who will insist that helmets are too expensive, just as they complained about the cost of seatbelts increasing the price of their automobiles. We must find ways to make affordable helmets available to all cyclists through rebate or discount programs and to make helmets available free of charge in truly indigent situations, and we know we have those. I have a hunch those who are most likely to complain the loudest about the cost of helmets are also those who are most likely to ride the very expensive bicycles and who are most likely to complain about the high cost of health care. In Daniel's case, his health care costs were in excess of $1,500 a day.
I quote Mrs Cunningham's comments in the Legislature when she moved second reading of the bill on June 27, 1991: "You cannot afford not to wear a bicycle helmet. The amount of money that goes into rehabilitation and the quality of family life and that child's life or adult's life, no one could ever put a price on."
We know also that there are concerns about enforcement of mandatory bicycle helmet legislation, especially when it comes to enforcement with relatively young children. Although I do not come here today with a lot of particularly innovative or creative solutions to the enforcement problem, this does lead me to my final comment.
The first major step in avoiding the necessity of wholesale enforcement of such legislation is sound education about the benefits of wearing protective helmets at all times when cycling. Such education must naturally begin with very young children. I have no mandate or authority here today to speak for any educational jurisdiction or group of professional educators other than for my own colleagues at Highland Junior High School in North York, but let me assure you that most educators, fortunately, are educators because we love children. Because we love children, we want them to be happy and safe. We know, with or without this legislation, there is a lot of educating to be done, and we will do it. It will certainly be a lot easier and much more effective, however, with this legislation in place.
We urge you to recommend passage of Bill 124. Good luck in your deliberations and thank you for your concern and your time today. Farrah, Elaine and I would be pleased to answer any questions you may have.
Mr McGuinty: I want to take advantage of Farrah's and Elaine's presence here so I can get the student-youth perspective. I want you to think back to the time before Shabbir's tragedy and tell me what students generally thought about safety on bicycles, because most students do not have the experience you have had at your school. Before this happened, what did students think about the idea of wearing a helmet and that kind of thing?
Ms Haniff: It did not cross our minds. It is not something we thought about. You do not think you are going to get hurt by riding a bicycle.
Mr McGuinty: I am probably dating myself, but we spoke in terms of things that were cool and not cool. I do not know what words they use today. Before this happened, how would a helmet be categorized?
Ms Haniff: Uncool.
The Chair: Since it happened, has there been a change of perception?
Ms Haniff: Yes.
The Chair: What is the change?
Ms Haniff: Wear a helmet.
Mr Dadamo: I guess we talk about enforcing this all the time. In our preliminary discussions we were talking about not being able to enforce it with 12-year-olds and under. It seems to me that is the category, according to the last presentation, where the bulk of the children are being injured. What are we going to do to enforce it at 12 and below?
Mr Crew: As I said in my comments from my prepared text, I do not have any innovative or creative solutions about enforcement other than enforcement that is in place for similar situations, as the previous group of nurses mentioned. However, I stress that I really believe education is a very important factor. If we make these young people realize the importance of wearing a helmet, I think we have gone a long way to reducing the enforcement problem. It will never go away, of course. It would be a very simple matter for the Ministry of Education to issue a numbered memorandum stating "Thou shalt" and preparing a brief curriculum guideline for schools to use. It would be done in every school in this province.
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Mr Waters: I would like to ask one of the two young ladies if they thought they could educate some of their friends better than we could.
Ms Hsu: Yes.
Mr Waters: What would you do?
Ms Hsu: We would probably get together, have a big assembly and we could have students talk about what they think. I think the kids would probably listen to people around their age.
Ms Haniff: Kids listen to kids more.
Mrs Cunningham: Thank you so much. I think your being here today is going to influence us significantly. That is why we want this legislation, for young people, and I think you are a wonderful teacher and a great role model.
Mr Cleary: We heard the former presenters say we did not need any more police cars or any more officers, but there is one thing they are forgetting about, and that is that many places do not have police officers. They depend on bylaw enforcement officers. So if we are covering Ontario, we have to look at all of Ontario and not just certain parts of it.
The Chair: Mr Crew, Ms Hsu and Ms Haniff, thank you very much on behalf of all the committee. Your comments have been extremely valuable. All of us appreciate your taking the time to prepare this analysis, sharing your insights and coming here today.
It is only 5:23. As you are here, I hope somebody takes you up to the members' gallery in the Legislature, if only for five minutes, so you can see a little bit of what else goes on here. This is your building. People like you should make sure you feel comfortable here, use it and find it accessible, otherwise government will run amok if people in the community do not keep an eye on it and make their presence known. I say that in all sincerity. Thank you and best wishes to Highland Junior High School.
PAUL ZEHR
The Chair: I am sorry we are a little late, but we are trying to make up some lost time. This is Paul Zehr from Kitchener. Tell us what you will.
Mr Zehr: In September my son was killed while riding his motorcycle. I have been thinking about this a long time, because 20 years ago a girl got killed. I knew her and we always rode around a lot on bicycles with my kids. In 1960 a friend of mine was in a car accident and he has been in Freeport Hospital in Kitchener ever since. He was totally unconscious for two years. Then he came out of it, but he is still there; he is really dozy. I could go on and on. Around 1966 a friend of mine went through a stop sign and a sign came through the truck and hit him on the head.
I have known so many people who have been killed on the highways over the years, I have been doing a lot of thinking about this. I always used to say to my wife: "Why don't the bicycles face the traffic? They teach you to walk and face the traffic." My daughter said to me: "Why don't you do something about it after this happened? You always complain."
The problem I have with this is not the helmets. It is what you are doing. Toronto and Kitchener are two different places compared to the rest of the country, and you hear remarks here about the poor people. You know, not everybody has money coming out of their ears. I know that. I would have gladly had $40 this summer to buy a battery so I could have driven down the street beside my kid on his motorcycle one more time.
When you go into this driving business -- my kid always had a problem with his left turns, and I really landed into him. My wife said, "That was on his driver's exam." He took his driver's exam and he passed. He had one bad thing; he looked and turned at the same time. That is what he did on his bicycle; he looked and turned. I am only using this because it is something you really think about an awful lot. He made a left turn in front of two cars and they apparently ran the yellow light. When I saw the skid marks, I knew what had happened. He just really underestimated their speed.
Any time I talk to somebody about driving, I always say, "When you see a bike, move into the left lane." If I see a guy coming behind me, I will block him to save that bicycle. I talked to hundreds of people and they say when they come through this driver training stuff, they are not being taught anything about bicycles. So here you are, you are going to make people wear helmets: five-year-olds, six-year-olds.
We worried about our kid something terrible. He would have been 18 two weeks ago. He had grade 8 honours in the violin, just finished, and he played the piano, and it was just tremendous what he went through. We worried about them when they were kids and we tried to teach them and teach them, and some of these accidents happen. People say it is fate. What happened was that the kid who went into him turned and skidded right in the direction my kid went.
The start of this problem is they do not spend enough time teaching them. They should all have skid training. I have had my pilot's licence since 1970, and there is a difference of day and night in the training. They do not train the kids enough, so make everybody wear helmets. Where is this going to end? Why do you not make everybody in a car wear a helmet? I have a list of all the people I knew who were killed in cars from head injuries, but nobody wants to mess their hair up in a car.
When I phoned the MPP from London, I said to the lady, "This will just cost everybody money." She said, "It won't cost anybody money." I said, "I haven't heard a law yet that doesn't cost money." You buy the helmets, you know. Some poor people have not got the money to go out and buy the helmets. I should say to watch their kids. If I had had more money, my kid would have had a car, not a bike. You are going to end up with more poor kids on the street all the way around.
The helmets are not a bad idea. I am just saying, where are you going to stop with enforcing it if you do not do any of this other stuff? You know what I mean: Nobody should be allowed to drive a car without winter training; the ages could be changed; insurance for a boy -- you know what it is and why it is. My daughter has driven a car now for four or five years and she has never even come close to an accident. There is a difference of day and night, so they should have a split starting age for the kids for driving.
How much time have I got?
The Chair: Go ahead, Mr Zehr. I will let you know when we are coming close to the end.
Mr Zehr: I should have kept going and waited for you to stop me. Anyway, three weeks after my son died a woman told us that his friends saw the driver of the car that hit him him take a cooler out of his trunk and hide it. She did not know it was our son until two or three weeks later when she happened to come into my wife's place of employment and heard her talking about it.
One thing I feel the government should do if it is really serious about saving these kids' lives is that any time there is a fatality they should automatically test them for liquor or drugs, because can you smell everything? I am just saying I know people who were always heavy drinkers, and you would never smell anything on them. I do not think the guy was drinking -- the time of the day and everything. I thought, well, gee, how do you really know, when it gets down to this kind of stuff?
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I have eight pages here, and I really feel I have said as much as I can say about it. There is one other thing I was going to mention about this bicycle business, facing the traffic. I read an article about the old people in Waterloo complaining about wearing helmets. Like I say, this really has nothing to do with the helmet issue. It is the direction of the traffic again. They worry about hitting car doors opening. If you are coming along and you are going towards the traffic and a car door opens, for one thing, the driver is going to see you better. When you get on a bicycle you have an awful time looking around to watch people behind you. This is what really bugs me, because I always told my kid to look twice over his shoulder.
Getting back to these TV spots again, it is the same thing. The government is not very careful about what it does with its ads on TV. It says, "Don't let your father teach you how to drive." Then it better make sure it does a better job of teaching them. Basically, you do not have any support, and it gets back to the poor people again, and the helmets. They do not have enough help when it gets down to what they are doing. You know what I am saying? They try to enforce their kids, and they have not got the energy. So you are going to have one awful problem with a lot of these kids and their helmets, enforcing it.
The Chair: Okay, perhaps we do have some time, because I know these people want to ask you some questions.
Mr Arnott: Mr Zehr, I want to thank you very much for coming in this afternoon and outlining your concerns. If I could summarize what I have heard you say, I think you have given us a number of ideas where you believe that enhanced road safety could be brought into effect. I just want to let you know, for your information, that about a week and a half ago our party -- each party has an opportunity once a year to bring an issue to this committee for 12-hour consideration, and we have brought forward the issue of the graduated driver's licence.
The Chair: There is not enough time for a lecture on the standing orders, Mr Arnott.
Mr Arnott: I hope you will come back again when we consider that issue, because I think you are speaking to that in a lot of your concerns.
Mr Zehr: I wrote this thing out and then I heard about the other, and when I phoned here I told them basically what my concern was. I said, "I don't want to be too much out of place."
Mr Arnott: I am not saying it is.
Mr Zehr: I am just saying I want to start somewhere with this, because there are a lot of things that are really lacking.
Mr Waters: I wish to thank you very much for coming in. It must be difficult enough, but once again, there are a lot of ideas here. I seem to recall that when I was a child, I rode against the traffic, and then they changed the rules --
Mr Zehr: A lot of people do it now.
Mr Waters: -- and I could never understand why. I also believe the whole aspect of bicycling is going to be looked at as well over the next while. That is just to let you know that we are looking at a lot of the problems.
If we enact this, do you feel it is something we would have trouble enforcing?
Mr Zehr: The helmet law? I talked to hundreds of people, always did and will, and everybody says it is a good law. The comment from most of the people will be, "How are they ever going to enforce it?" I think the best way to do it would be like the children who were here before talking. My kid had asthma real bad and he fought it, and we kept his inhaler; his packsack was ripped right in half. My wife and I thought the same thing. She said, "I am going to keep it because you might want to talk to people some time, and I really think that would do more good than anything."
The Chair: Mr Cleary, did you have any comments you wanted to make?
Mr Cleary: Yes. I thank you for coming in. I know it must be very hard for you, and you have all our sympathy. I am of the opinion that you think we should start in the schools.
Mr Zehr: Right. I have been watching the laws and like I said, when I phoned she said, "It won't cost any money." Well, I know it will. It will be a fine. One thing after the other comes in.
There were four of these Portuguese fellows killed in a car on the highway last week and then another one in Kitchener. I happen to know Paul Costa's father, mother, aunt and brother-in-law very well. My daughter's boyfriend's cousin was killed on Highway 6 two weeks ago. He was in the hospital; they operated on his brain, and he would not recover. He died and he killed his 19-year-old friend who was in the car with him. There were five friends. One was killed on a motorcycle earlier in the year and the other one was killed in a car accident last year. Four; there is one left; it goes on and on.
Like I say, people say, "We're really concerned about it," so it is really easy to change Bill 124 and put one word in there. I do not think you are going to change the issue over the long run. Regardless of what anybody says, you are not going to change the facts and the figures, your 85% and all this.
When it is all said and done, if things keep going the way they are, you are still going to have one hell of a mess 10 years from now. I would still feel this way if my kid had died of head injuries. He never had a single head injury. His spleen was split, his liver was split, his lung was split, and I looked at the scene and said to my wife when I got home, "I'll bet you he was going over 60 miles an hour."
I hit a deer once and I know how hard a 120-pound deer hits, and I am really kind of upset that my kid could not judge the speed well enough. I am upset that he did not look twice. I am upset that he did not signal. He used to, you know. He forgot the key to his motorcycle and took the bicycle. We offered him the car, we offered him this and we offered him that and away he went.
Like I said, basically the main reason you could not talk to him -- he was not cocky, he was not smart; he was a very nice kid -- but you keep these things coming on TV that keep saying, "Don't let your dad teach you how to drive," and there are some fathers who know how to drive. I have probably avoided more accidents in my life than anybody sitting in this room -- and I am talking about three since -- because I do not cross an intersection without looking both ways. I never did.
I tried to teach my kid that. He was not too bad. This is the only bad habit he had. If the instructor had cancelled him and said, "That's it," because my wife and I said to each other, "He won't pass" -- I hate to talk like this about my son because my wife would get upset, but it is true. We thought he would fail but he was smart. I have got his thing here. There was one thing wrong and one minor detail, like the seatbelt or something he did not put on in time. He put it on after he went 50 feet. Now what is more important, saving your life or putting on your seatbelt late?
It is the same with the seatbelts. You get on to the fact that seatbelts are good and you put them on, but if you are paranoid about them you have got another problem there. You have got to teach people to look first. I see a lot of it and it is pathetic.
The Chair: Mr Zehr, your comments are staightforward and candid, just about the sort of thing we would expect from folks from Kitchener. I have got little use for the $1,000-a-day consultants governments so often spend your money on. Your appearing here today, along with the nurses and the others, proves that if government listens to the folks out there in communities, it will get some good direction.
I want to thank you for coming here. We appreciate very much your taking the time to come up from Kitchener. Your written material will become part of the record, a permanent part of these proceedings, and will undoubtedly be relied on in the arguments that follow when we have our final arguments about this amendment to the Highway Traffic Act. You wanted to say one more thing before you leave.
Mr Zehr: Somebody typed this for me and left out three things, I think. They got me a little bit upset because I mentioned it, the three tail lights on cars. It was in Germany; here they turn them off. I said, "Don't our politicians ever go on holidays?"
The Chair: You bet they do.
Mr Zehr: Why do they not notice that?
The Chair: As often as not they are junkets.
Mrs Cunningham: Speak for yourself.
The Chair: I have watched too many of them, Mrs Cunningham. Mr Zehr, thank you very much.
1740
COALITION FOR HEAD INJURY PREVENTION
The Chair: The Coalition for Head Injury Prevention. Dr Brian Morris, please.
Dr Morris: Thank you, Mr Chairman. I would like to thank you for allowing me the opportunity to address this committee this afternoon. I was taught about speechifying, that first you tell them what you are going to tell them, then you tell them and then you tell them what you told them; so first I am going to tell you what I am going to tell you.
I am going to discuss this Coalition for Head Injury Prevention up in Barrie, who we are, what we have done and why we have done it. Because I am a medical physician, a family physician and a medical researcher, I am going to address some research issues, some statistical issues and some medical proof issues. Then I am going to make a number of points based on some things I have heard here today and things I read from your preliminary transcript.
First off, as a family physician up in Barrie, a medical teacher -- I teach family practice residents -- and the father of two girls, four years ago, along with a family practice resident, I looked at the issue of bicycle helmets and tried to figure out why kids were not wearing them because we knew then, as you know now, that children are the main target here.
What Dr Nancy Trimble and I did was a piece of medical research, if you like, called a randomized clinical trial. We took three schools in the city of Barrie. At one school we did nothing but observe. At another school we spent a whole lot of time educating. We went into classrooms, there was a poster contest, there were skits, there were plays and there were posters in the halls. We spent a lot of time educating. At the third school we spent just as much time educating, plus we offered subsidized helmets.
The impact of the program: At the school where we did nothing, nothing happened -- good, no children wearing helmets; at the school where we spent a lot of time educating, again there was no impact, nothing; at the school that got education plus subsidy, a whole lot of impact, a significant increase in the number of children wearing helmets. Our conclusion from that -- this paper was recently published and a copy can be entered into the record if you wish -- was that education alone does not work.
Based on that, two years ago Dr Trimble and I formed ago a group called Coalition for Head Injury Prevention in Barrie. This is a community-wide group. We have representation from the Simcoe county health unit, we have representation from the school boards, we have retailers, we have bicycle racers, we have service club representation, we have the local branch of the Ontario Head Injury Association and we have the police safety officer for Barrie.
We have done a lot in the last couple of years. We have organized bicycle rodeos, I have appeared on TV three or four times, we have organized TV ads; we have had park benches with our logo on them; we have gone into schools; we have spoken to principals, we have organized reduced-rate bicycle helmet purchase schemes. We have done lots of stuff and what we have found is a significant increase in bicycle helmet use in Barrie.
In the spring of 1990 our bicycle helmet use rate was 5%. This was measured at various elementary schools, secondary schools and our local community college. That was in the spring of 1990. Five per cent is more or less the rate that was accepted as standard across the province at the time and you have heard that kind of number before.
In the spring of 1991, following just one year of activities, our bicycle helmet use rate was up to 17%. It had more than tripled after one year. I hope and expect that next spring it will be even higher, because we are continuing to do things. My daughters rode in the Santa Claus parade in Barrie on the weekend just past, wearing their helmets and handing out coupons to encourage people in the crowd to buy helmets for each other for Christmas.
This has been an active group that from its very inception has felt strongly that legislation is crucial -- not just important, not just a good thing, but crucial -- because legislation will make everything else work better.
My children's public school principal keeps saying to me: "Brian, as soon as there's legislation, then I can compel kids who ride their bikes to school to wear helmets. Right now I can't. I'd like to encourage my children at my school to wear helmets. Right now I have no power. Please get me that legislation so that I can make that happen."
This is our group, that is, the Coalition for Head Injury Prevention. We are an active group. We are a volunteer group but we are not the only group around. There are similar groups in East York, there are similar groups in Whitby, there are similar groups in Ottawa; there are groups all over the place doing the same kind of thing on a purely volunteer basis. It is working and it is helping.
Let me just correct one point that was in the Wednesday, November 20 preliminary transcript; at least I think I am correcting a point. It was mentioned at 4:55 that a recent Ottawa study funded by the Ministry of Transportation had just released its results -- "I believe they were upwards of the 20% level" -- for bicycle helmet use. With the permission of the author of that study,Dr Rob Cushman from Ottawa -- I believe it is the same study we are talking about -- I have taken a look at his data, which have been submitted to a medical journal, and the bicycle helmet use rate in Ottawa as of 1991 is 32.5%, well above the 25% level that the ministry keeps saying is necessary; 32.5% of people in Ottawa -- these are commuters, adults, children, everyone riding bicycles -- are wearing helmets.This is important; Ottawa is at 32.5%. They have been doing this kind of thing for a few years. We are at 17%; we were only doing it for one year.
Let me go on to the medical proof. Because I am a medical researcher with 20 or 30 published articles under my belt, I know the field of medical literature fairly well. I would give my left arm to publish in this journal, the New England Journal of Medicine. This is the best medical journal in the world. It has the highest prestige and the highest impact. This journal rejects 95% of the manuscripts it receives because it publishes only the highest of high-quality medical research.
The lead article in May 1989 was a case control study on the effectiveness of bicycle safety helmets. In the hierarchy of medical research, case control studies are strong. They are counted as strong evidence. There are methodological reasons why this is so and there are statistical reasons why this is so. I would ask you to believe that this is strong evidence. 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. This is the same quality of proof that would make me as a physician prescribe a new drug or say that this treatment is better than that treatment. This is proof. This article has stood the test of time. It has not been refuted because it cannot be refuted. The conclusions have been accepted. There were other studies before that had said indirectly, "Yes, bicycle helmets save lives." This is the major study that has proven this. When I hear people either directly or indirectly saying there really is not proof, sorry, they are wrong. From a medical point of view, from a scientific point of view, there is proof that bicycle helmets save lives. Let there be no doubt about that, please. Again, there are lots of other studies around that have looked at it. This is by far the strongest.
I have my eye on the clock, Mr Chairman.
The Chair: So do I, Doctor.
Dr Morris: I am sure you do, sir. Let me move now to a few other points in no particular order.
First, you were speaking to the young ladies from the high school here about peer pressure and how uncool it is to wear helmets. In many places, including in Barrie now and at my children's school, there is a thing called positive peer pressure. My kids have worn helmets since they rode bikes and they do not travel two feet on the bike without a helmet on. When they get their bikes down in March or April, they say, "Daddy, don't forget to get our helmets too." My kids do this.
Another kid on the street fell down a couple of years ago and bumped her head; it was not serious. Mom looked at my kids standing there with their bike helmets on and said, "Brian, where do we get bike helmets?" There are 10 kids now who wear helmets. Because the Morris kids and the Ruttan kids wear helmets, the Green kids said to their dad last year, "Daddy, where can we get helmets just like those neat helmets the other kids wear?" At our kids' school the helmet use rate is well over 50% because we have pushed them at this school and it is the accepted thing to do.
Within a year, within two years, it can very quickly become the accepted thing to do in any small group, in any city, in any population. We are very close to the break point, with Ottawa at 32.5%, with Barrie at 17%, with East York climbing rapidly, with the various schemes that are under way across the province. This is taking off and this is why legislation is mandatory now, because legislation will be additive to everything else. Because a good proportion of the population is now wearing helmets, they are accepted. Nobody any longer looks and says, "What's that thing on your head?" For legislation to be added now, with a phase-in period, if you like, of a year or two -- I think it is an excellent idea -- would make the whole thing work much more effectively. Education will work better if there is legislation. Subsidies will work better if there is legislation. Legislation works better if there are subsidies. The whole thing works together, but we need legislation.
There is an army across Ontario is working to do this already, free of charge. We are volunteers. We are not entirely Dianne's army but at times it feels like it and that is good with me. There is an army of people working out there right now to encourage bicycle helmet use. You have heard from a lot of them and you will hear from a lot more. This army needs legislation to make it really happen. We are counting on this legislation and your help to make it happen.
1750
Briefly, with regard to cost, there are lots of ways around the cost of helmets. Every major chain has offered bicycle helmets for less than $25 in the last year. A bicycle costs whatever. There have been innovative schemes elsewhere. In one American state a $50 fine for not wearing a helmet is rolled into a special fund which is used solely for education and buying helmets for low-income families. It is a beautiful scheme. The fines pay for helmets for people who cannot afford them. It all works together.
The Canadian Medical Association scheme, of which I am very proud, offered excellent, CSA-approved helmets for $20. The response was overwhelming: 20,000 helmets went out during the first couple of months of the program across Canada. This scheme is available next year. If legislation is enacted soon you can take advantage of this scheme and get a drug company to subsidize the helmets for you, for us, for our children. If this legislation is enacted with a phase-in period there is no excuse for cost. You can get a CSA-approved, high-quality helmet for $20 without a problem. As the volume of sales goes up, the price will come down.
I feel legislation must apply to all ages. There has been excellent research I was proud to take part in through the Hospital for Sick Children. It showed that children most likely to wear helmets were riding with adults who were wearing helmets, presumably their parents. You have to get parents wearing helmets to set the role models for the kids. So it has to be for all ages.
I do not feel enforcement is a bugbear, because our police are looking forward to positive enforcement. They have already started to talk to McDonald's to get french fries coupons so that if they spot a child wearing a bicycle helmet the kid gets a coupon, runs home and tells the other kids: "Why? Because I was wearing a helmet, this is what happens." There are lots of positive reinforcement schemes that can be done.
This is Ontario's chance to lead. No other Canadian province has done this yet. From a medical point of view, there are lots of ways in which Ontario does not lead; this is a chance for us to lead. This is a chance for Ontario, not to be the first in North America and certainly not the first in the world, but to be the first province in Canada to take a very positive, useful step towards better health for all our citizens. Thank you, folks. I would entertain any questions if we have time, sir.
Mr Dadamo: I guess you said we have to educate the grown-ups before we get to the kids.
Dr Morris: Yes.
Mr Dadamo: I think we need to get the awareness factor up to that 25%. What I do not understand is why it would be 32.5% in Ottawa, why it is lower here and why --
Dr Morris: It entirely depends on how long that particular community has been working towards this and how hard they have been working. Our group has been working very hard and we have only done it for one year. We had only done it for one cycling season by the time we collected those statistics. That is a short time, but in that short time we tripled bicycle helmet use. Dr Cushman and his group have been doing this in Ottawa for four years and that is why the difference.
Mr Dadamo: Yes, I think the key component is to phase in a program where we can do the education, and kids finally realize that maybe it is cool to wear a helmet, and maybe get a role model for the kids.
Dr Morris: Again, I feel strongly that education without legislation -- I do not care if it is 1993 legislation; the fact that the legislation is on the books and is going to be coming in will give the education punch.
Mr Waters: Could you elaborate on the fine? I found that quite interesting. You were saying in one area they levied a fine if you were caught without your helmet and it went to purchasing --
Dr Morris: Yes. It was rolled into a special fund.
Mr Waters: Do we know where that is?
Dr Morris: I believe it is New Jersey. Mrs Cunningham, do you know?
Mrs Cunningham: About the fine; you mean the $20?
Dr Morris: The one American state where it is rolled --
Mrs Cunningham: The state of Maryland did that.
Mr Waters: The key thing we keep hearing here is the cost. With adults spending $3,000 for a bicycle, I cannot see where a $20 helmet is going to bankrupt them. There are a lot of children out there at the lower end and that is a very interesting thing. I would like us to maybe look at that when we are making our recommendations.
Dr Morris: Again, numerous retailers who belong to CHIP have said to me: "Brian, if a school wants 100 helmets or 200 helmets, we'll get you $15 helmets. If we're going to move 100 helmets this afternoon we'll give them to you for $15." Any group that wants to make this happen can make it happen.
Mr Waters: One quick one: winter riding of bicycles. I come from just north of you. I have some concern and I would not mind your comments on people riding bicycles in the winter, especially with the conditions you face in your community, and without helmets.
Dr Morris: Without helmets it is ludicrous. Even with helmets I think it is difficult, but our group, Mrs Cunningham and most of the groups you have heard have taken a one-issue stand. I do not feel I want to talk about brakes, horns and riding on this side or that side, riding in winter versus summer, lights and other bicycle-safety issues. I am not denying they are important, but there is no other single issue with regard to bicycles that has shown this kind of impact. Our group has never talked about anything else but helmets because this is the one thing we can make happen that has the biggest impact. I do not ride my bike in the winter, but I am sure it can be done safely in the proper circumstances and with a helmet.
Mr Cleary: I would like to thank you for how far you have come in a short time. As I mentioned earlier, we talk about a number of issues -- education. I speak to a lot of students and I think the place to start is in the schools. In our part of Ontario we start on the environment in the schools and it is really rubbing off. They are the ones who go home and get after their parents, so I think that is a good place to start. Whether it is a period of a year or two to start it, I do not know. Thank you for your presentation again.
Mrs Cunningham: Dr Morris, I cannot thank you enough. My colleagues on this committee have witnessed the enthusiasm of somebody who has shown wonderful leadership in his own community and in the whole community of Ontario. From my point of view, when I first got involved in this, never thinking it would come this far and realizing now that it is a reality, with the help of people like you and the nurses who came today with, by the way, very specific recommendations that we will look at -- that is the first brief we have had with every issue dealt with in a specific way and I am sure it took them a long time to come to a conclusion around every point they made.
From my own staff's point of view, we have had hundreds of phone calls and letters over the last two or three years and we are convinced Ontario is ready for this. This committee has been extremely non-partisan and open and we know we are going to have to take a look at the issues of enforcement of bicycle helmets. We have all been convinced, I think, on bicycle helmets and we were not when we first came. With the experts who have come here so far, I do not think one of us would have said you could not get one that people could afford, that they can be manufactured here in Ontario -- hopefully by Canadian companies if we give them a couple of years' lead time -- and that we are absolutely convinced education has not worked, because everybody who has been involved said they have been involved for a very long time.
It is up to us to take the political bullet here and move forward, but you have been a great source of support to my staff and me and I want to thank you here in front of everybody.
The Chair: Thank you, Mrs Cunningham. Dr Morris, the committee thanks you for coming down from Barrie, for the time you spent this afternoon, as well as the time preparing your submission. Accept our gratitude and please keep in touch.
We will meet again on Monday at 3:30 and, subject to anybody saying otherwise now, we are going to start at 3:30 regardless of who is here, because people have to wait and that is not fair to the people who have to wait.
The committee adjourned at 1800.