Assemblée législative de l'Ontario

HIGHWAY TRAFFIC AMENDMENT ACT, 1991 / LOI DE 1991 MODIFIANT LE CODE DE LA ROUTE

ONTARIO HEAD INJURY ASSOCIATION

ALAN BURKE

MARCIA RYAN

PETER LANE

CONTENTS

Monday 25 November 1991

Highway Traffic Amendment Act, 1991, Bill 124 / Loi de 1991 modifiant le Code de la route, projet de loi 124

Ontario Head Injury Association

Alan Burke

Marcia Ryan

Peter Lane

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)

Murdock, Sharon (Sudbury NDP)

Offer, Steven (Mississauga North L)

Ramsay, David (Timiskaming L)

Wood, Len (Cochrane North NDP)

Substitutions:

Cunningham, Dianne E. (London North PC) for Mr Jordan

Lessard, Wayne (Windsor-Walkerville NDP) for Mr Klopp

McGuinty, Dalton (Ottawa South L) for Mr Ramsay

Phillips, Gerry (Scarborough-Agincourt L) for Mr Cleary

Clerk pro tem: Manikel, Tannis

Staff: Luski, Lorraine, Research Officer, Legislative Research Service

The committee met at 1601 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.

ONTARIO HEAD INJURY ASSOCIATION

The Chair: The first group making a presentation is the Ontario Head Injury Association. We have two people from that group, if they would move forward. They are Jeremy Rempel and Jeff Tiessen, manager, public education. You have a half-hour. We look forward to hearing what you have to say. Please try to give us 15 minutes to engage in some questioning and conversation with you. Which one of you is going to go first?

Mr Tiessen: I am going to start. I am going to talk a little bit more from the technical end of things, what a head injury is and what we do at the Ontario Head Injury Association. Then Jeremy will take over and give you some personal notes from his life.

Telling you that bicycle helmets prevent injuries to the head would certainly be telling you something you already know. Cycling rides very high on the list of favourite summer sports and it is a great example of healthy living, but as we have come to know, it has a grisly side to it. Injuries are common and too often fatal. The number of bicycle-related injuries has risen significantly with the increased popularity of bicycle riding in Canada, and as we have come to learn, the risk of injury and fatality is highest among children.

I would like to offer you a few facts that you may not be familiar with. An Ontario survey found that bike crashes caused 14% of all fatal injuries in children from 1985 to 1987. We do not think that has been reduced at all in the 1990s. There are 5,000 kids injured while bicycling each year in Canada, and 60 of those die. Three out of every four bicycle deaths are due to head injuries. Only 3% of kids are wearing helmets, and probably most important or encouraging, wearing a bike helmet does reduce the risk of injury to the brain by 88%.

The Ontario Head Injury Association is committed to preventing the causes of head injury through awareness and education. We are working to promote the understanding of the importance of prevention of traumatic brain injuries by promoting the use of approved headgear. We have a project called Project Headgear, which is a broad-based prevention campaign designed to reduce bicycle-related head injuries across the province. We work to sensitize elementary school-age kids and their parents to the importance of bike helmets in preventing injuries to the brain.

Brain cells that are damaged are injuries that certainly cannot be repaired. They do not replace themselves. Injuries to the brain cannot be cured like a broken arm can be, which is an example that we use a lot with the kids. Brain injury, more than any other disability, forces its survivors, families and society in general to deal with changes and uncertainties. Brain injury can cause a wide range of physical, cognitive, social, personality and emotional changes.

To understand some of these changes and uncertainties it is important to consider where the brain lies and its physical makeup. It floats in a bath of spinal fluid inside our skulls, and underneath and around are unyielding and lined ridges and projections of the skull itself. We do not know a lot about this organ, but we do know it controls virtually every aspect of our being and we know it is vulnerable to specific types of injury.

There are three types. Injuries occur when the head collides with an inflexible object. This blow to the skull causes the brain tissue at the point of impact to bruise and then drives the brain against the opposite skull wall, bruising more tissue on the other side of the brain. The second type of head injury is concussive injuries and they happen when the brain smashes up against sharp ridges on the inside of the skull, often at the base or the tips and the lobes, and this again results in bruising and some tearing. Then there are the diffuse injuries caused by abrupt deceleration, when the head stops and the brain keeps going. That results in sharp twisting and shifting movements of the brain, and again stretching and tearing and shearing of the delicate nerve fibres throughout the brain occur.

Jeremy will talk a little bit more about some of the functions that are impaired in these kinds of injuries, but just to give you the quick and dirty, executive decision-making, speech, language, motor skills, reasoning, perception, appetite, sleep and emotions are all part of those things that make up who we are and what we do.

Project Headgear is about getting people to understand that head injuries are not always accidents. They are predictable, and preventable when helmets are being worn. Our progress with the project is admittedly very slow. While we are ever so slowly changing attitudes, kids are still dying and being seriously injured on bikes. We feel at the Ontario Head Injury Association that an amendment to the Highway Traffic Act requiring all bicyclists to wear helmets will save lives and save individuals, their families and society from the devastating effects of brain injury, physical, cognitive and the financial costs.

In most cases, it is very fair to say that brain injury does not happen by accident. A bicycle-related head injury does not happen by accident. Not wearing a helmet does not make it an accident. It could have been and should have been prevented. It is our feeling that no one should take to the highway without a seatbelt and no one should be riding a bicycle without a helmet.

At this point, I would like to introduce Project Headgear's official spokesperson, Jeremy Rempel, who sustained a bicycle-related head injury to his brain about 10 years ago. He has a world record in wheelchair sport, and he has encouraged a lot of kids to put helmets on their heads when riding.

Mr Rempel: On behalf of the Ontario Head Injury Association, I would like to thank you for giving me the opportunity to speak to you today.

I am going to do my best to try to convince all of you that wearing a cycling helmet should be made law. In doing so, I am going to have to tell you many personal things about myself, things I do not like to admit about myself and things that I have to live with because of massive brain damage I received in a bike accident 11 years ago. I am willing to put my pride aside in order to save the lives and preserve the quality of lives of anyone who may be susceptible to a head injury.

To tell you the truth, I really should not be here today. It is a miracle that I am alive. On my ninth birthday I and a couple of friends were cycling in and out of the driveway near my house, waiting for the party to begin. My dad was picking up a few friends of mine to come to the party and my mom was busy getting the party ready. I was just cycling out of the driveway when a pickup truck came out of nowhere, his side-view mirror striking me in the forehead. The truck's blow sent me into a nearby ditch and left me unconscious. At the same time, my dad was driving home and saw people gathering around the ditch. Dad thought the neighbour's dog had been hit. When my mom and dad saw me, they realized I was in deep trouble, even though at that point I had no broken bones and no visible marks on my body except for where the truck had hit me.

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I spent four months in total in the hospital. I spent 15 minutes at the Niagara General, then they rushed me to St Catharines General, where I spent three days, then I was airshipped to Hamilton and then to Sick Kids in Toronto. At Sick Kids I had a shunt inserted into my head to drain the excess water off my brain and had my forehead reconstructed.

You see, when you hit your head, the brain bounces around inside the skull, causing cutting, bruising, swelling and irreversible damage. The doctors had to put me into a coma to remove part of my skull to let the brain swell. The skull was reconstructed with five of my ribs, cut and wired together to form a new forehead. A shunt was put into my head to drain off excess water. However, too much water was being drained off, so they had to add another shunt to regulate the water around the brain.

There were many times the doctors, my family and friends felt they were going to lose me, but I pulled through the trauma of the accident and had to start my life all over again. I spent seven months at home with a nurse before I went back to school. I tried to go back to my regular school, but I was not functioning like the other kids. In fact, some of the closest people in my life said they had to relearn to like me because my personality and abilities had changed so much.

Because I could not function at a regular school, I was sent to the Niagara Peninsula Crippled Children's Centre to attend special education classes and receive intensive physiotherapy, occupational and speech therapy. When I first went to the centre, they put me in a power-drive wheelchair. My visual perception was so poor I kept running into the walls. Because I was a danger to myself and the other kids, they put me in a manual wheelchair and I learned to push it myself. When I first started, my dad says it took me at least half an hour to get from the kitchen to my bedroom, which was about 10 feet away.

My physiotherapist at the centre taught me how to walk again, the medical aides toilet-trained me, my teachers worked on my concentration and learning skills and the occupational therapist taught me how to do up buttons, tie my shoes and do all the things I used to be able to do without giving them a thought. I now walk with a limp, live with severe headaches, tire very easily and have no peripheral vision on my left side. I must take seizure medication for the rest of my life.

But let's get away from the physical difficulties. Truthfully, any physically disabled person will tell you it is not so bad; they have learned how to cope and lead full and exciting lives. In fact, two of my co-workers who are physically disabled have no problems holding down active careers and full social lives independently. Fortunately my physical disabilities do not create a big problem in my life either. It is what I call my hidden disabilities that sometimes make my life a ball of confusion and leave me frustrated and make me dependent on others at all times. I call them hidden because if I am with someone who knows the assistance I need, no one around me knows the difficulties I have. But if I am left to fend for myself, my life starts to crumble around me.

For example, my good friend and co-worker Debbie Kerslake and I first met at the crippled children's centre, and I will never forget the day she told me to put my gym bag on top of my head while we were riding home on the bus together. When I got home I said to my parents, "Gee, it was hot on the bus today with my gym bag on top of my head." Debbie knew I would do exactly what I was told without reasoning or asking myself why, but then she started to accept me for who I was. I got a lot wiser, and since then we have become the best of friends.

Now Debbie works with me at the Ontario Head Injury Association. She is my thinker, organizer and planner. She thinks ahead and anticipates for me and teaches me how to do things in a patient, caring and friendly way. Sometimes she gets frustrated and embarrassed and annoyed with the things I may do or say, but day by day things are getting better for both of us.

I would not be able to hold down a regular job without this kind of assistance. In fact, I tried working independently and I was very unhappy. Although I feel I am a good speaker and I have an outgoing personality, I have great difficulty organizing my thoughts. I have a tendency to say things I regret, and many times people misunderstand the meaning of what I say. But I am one of the lucky few who has sustained a head injury and has been given a great deal of support from family and close friends.

Before my accident I was always very interested and active in many sports. I ran, played hockey and little league baseball. In fact, my ball team won the league championship the summer before my accident. After my accident the best thing I did was sleep. I was very unmotivated and had very few open emotions. However, my dad, being the fighter that he is, was not going to give up on me. He heard about Sports for the Disabled and got me involved, first in wheelchair basketball and then in wheelchair track. He recruited coaches from the local university to work one on one with me.

We went through many volunteer coaches when I first started, as not too many people understand the difficulties of a head-injured person. In a last-ditch effort my dad asked one of the new staff members at the centre where I was going to school to coach me. Being enthusiastic, young and probably pretty stubborn herself, she started coaching me every day after school. We developed a long-lasting relationship and now I have become a world-class athlete with her help. I will be attending the next Para Olympics, which are going to be held in Barcelona, Spain, this summer.

I am very lucky to have the love and understanding of my closest friends and family members. In fact, my coach and I have developed a close personal relationship throughout the years and I am happy to share with you that we have decided to spend our lives together. I think my story may be one in a million for those of us who have sustained a head injury. Not everyone has a father who will not give up, a mother who accepts me and likes me for who I am, an interesting job that is fully supported and a girlfriend who accepts both my physical and hidden cognitive disabilities. In fact, I have not met one head-injured individual who is not struggling in at least one aspect of his or her life.

Even though I have led what may look like a charmed life, I often ask, "Why did this happen to me?" I still have to deal with many difficult situations on a day-to-day basis and I have learned to take the lead from others. I have my days when I get down about my disability and I would never wish it on another person. This is why I have focused my energies on educating others on the importance of wearing a cycling helmet whenever they get on their bikes.

If cycling helmets had been readily available to children when I was nine, my parents may have had me wear one. If wearing a cycling helmet had been law, I would not be in this seat today. Although I do the best I can educating children, parents and teachers on the importance of wearing of a helmet, I can only hope and pray that I make an impact on some other lives. I cannot make kids wear a helmet. Children do not see my hidden disabilities. Not all children and adults are educated on the dangers of a head injury.

Now that you have heard my story I hope that you can understand the importance of making Bill 124 mandatory. If this bill does become law, you will be saving and preserving the quality of lives of thousands of people for years to come.

Mr McGuinty: I want to thank both of you at the outset for some very powerful and compelling testimony before our committee. I am going to ask you, please, if you have any more statistics relating to bicycle injuries. People fall off bikes fairly regularly, I would think. How many of those injuries are more serious than others? How many are likely to result in head injuries and those kinds of things?

Mr Tiessen: I do not have more at my fingertips to help you with right now, but when I mentioned the 5,000 kids in Canada who have sustained injuries by cycling, those are reported hospitalized cases. There is something called the silent epidemic that we talk about in the head injury field, and that relates to the tens of thousands of people who sustain a head injury each year, not necessarily through bike accidents but through other means, that are never diagnosed. They find themselves experiencing headaches more commonly. Math becomes a problem at school. Friendships deteriorate. Those numbers are not included in that 5,000. It is tough to know how many are out there.

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Mr McGuinty: One of the concerns raised here is that if we make it the law that you are going to have to wear helmets, it may be that parents are going to have difficulty keeping the helmets on their kids' heads. Then they will have the possibility, depending on how the law is set up, that the police will be dealing with children without helmets. Do you have any comments on potentially charging kids or charging their parents because the kids disobeyed their parents?

Mr Tiessen: Enforcement is not going to be an easy task. I am sure that is one of the more difficult issues you will have to deal with in this committee. It is our feeling that more difficult tasks have been dealt with by governments on the political level. There are examples out there in other countries of the way those situations are being handled, and I am sure they would offer good examples of what we might do here in Ontario.

Mr McGuinty: Do you think we could accomplish just as much through an extensive education program?

Mr Tiessen: What we do with our prevention campaign is include a lot of education with it. It is probably much easier for a person to understand what happens to your head or your body when you are not wearing a seatbelt and hit the dashboard or the windshield. We find that kids do not understand what can happen when they fall three or four feet off a bicycle, so we feel it is very important to complement all our prevention efforts with education and information about head injury. I think that would be the case here too.

Mr Phillips: This is a technical question you may not be able to answer. If you wear a helmet, does it help you with neck injuries as well? Is there any evidence that helmets would help in more than just head injuries?

Mr Tiessen: I could not answer that.

Mr Phillips: Maybe one of our other witnesses could. My intuition is that it might be the case, but I guess we would need some expert advice. To help me out on the numbers again, the 5,000 injured and 60 dead, you estimate that 45 of those would be through head injury?

Mr Tiessen: That is right, yes. Not so much estimates, but what has been determined by hospital emergency rooms stats.

Mr Phillips: What about any evidence of people who are wearing a helmet in a similar accident? I guess there are not that many wearing helmets now, but is there any good evidence of the impact of wearing a helmet in similar accidents? If you have the helmet on, what does it do to increase your odds of not being badly hurt or fatally hurt?

Mr Tiessen: There have been studies done that show that wearing a bike helmet reduces the risk of head injury by 85% and brain injury by 88%. That has been documented in a study by the Seattle Harborview Hospital.

Mrs Cunningham: I would first of all like to thank you, Jeff and Jeremy, for coming today. I thought it was a most fitting first presentation before the committee. Every time I meet you, Jeremy, something is new, and so congratulations on your future marriage. It is great. And also on that speech you read. It was just great. You have made great gains. For the committee members, Jeremy and I met each other probably about three years ago. We do not see each other often but every time we do, he makes me very proud to know him. I wanted to say that.

I think the technical question that you asked, Mr Phillips, may in fact be answered later on. I notice that Dr Peter Lane, the medical director of the trauma unit at Victoria Hospital in London, will be making a presentation, so perhaps he can help us out. I am not sure of the qualifications of some of the other people coming before the committee but we can certainly continue to ask.

Both of you made a pretty strong presentation today for the legislation. We have not discussed this, but one of the questions I get as a person who has presented this bill to this committee is, are we really ready? Is it necessary that we have legislation? There are still those who feel that we should just pursue the public education-prevention route. I wondered if you could respond to that question. It is one that we get often.

Mr Tiessen: Jeremy has done a lot of work in classrooms and his testimony is very effective. Almost entire classes have purchased helmets after your presentation, if I am correct. Right?

Mr Rempel: Yes. I think we are ready. I think the public is ready for that.

Mr Tiessen: It is tough to take Jeremy's effectiveness into every classroom in the country. As I mentioned, in the province at least, our progress is very slow with an educational and a prevention campaign. We do reach some, but obviously there are some we are not reaching. I think legislation and education can very nicely complement one another.

Mrs Cunningham: You mentioned whole classrooms of students going out and buy these helmets. One of the other criticisms that we do have is the cost of helmets. What can you tell us about the cost of these helmets in your work?

Mr Tiessen: Through Project Headgear, we have aligned ourselves with several helmet manufacturers where we have been able to get helmets at a reduced rate and make them more accessible to kids. It is an issue. We have found help in a number of different areas. Service clubs are willing to help out and provide them to kids who cannot afford them. There are, I think, a lot of examples of how that can be facilitated and we are just tapping into a couple of them, the service clubs and rebates and that sort of thing.

Mrs Cunningham: I guess the third question is, we are not quite certain when we move forward with this legislation. There are precedents around the world but some just legislate for children and others for adults, and I wondered if you would comment on that.

Mr Tiessen: Simply, we think it is important for everyone who is on a bicycle to be wearing a helmet.

The Chair: Mr Lessard and then Mr Dadamo and Mr Waters, if there is sufficient time.

Mr Lessard: I am going to be very brief. I just wanted to thank both of you for making your presentation here this afternoon, especially you, Jeremy, because I think that if this committee accomplishes nothing else, it has given an opportunity for real people to tell real stories about the impact that receiving a head injury from not wearing a helmet has had. We can talk about statistics and numbers and problems with enforcement, but the type of work you could do is probably far more effective than any laws we might be able to pass. You have given a good example about how you were able to influence a whole class to go out and acquire a helmet. I just want to wish you the best of luck and hope that you keep up the good work.

Mr Dadamo: Thank you to Jeremy and to Jeff. I would like to direct a couple of questions to Jeremy. We have been told that the fluctuation in pricing on a helmet can go anywhere from $30 to $200 and maybe up. I want to stress that the federal government has no CSA standards in force at this time for how tough these helmets must be. What do we do when we have kids or parents going out and buying a $30 helmet because they cannot afford the more expensive helmets and that $30 helmet may not be protecting the kid's head?

Mr Rempel: When you look at the helmet, look inside the helmet and make sure it has got either ANSI or Snell or, like you said, CSA-approved. If the kid does not want to wear the helmet when he gets on the bike, just say: "Okay then, you're walking everywhere. The bike doesn't come out of the garage until you put the helmet on." Take the privilege of riding the bike away from the child if the child refuses to wear a helmet and say, "Look, the bike doesn't come out until the helmet goes on the head." Personally, I know people who have done that and they say it works like a charm. The kids will walk everywhere. They will walk to school, they will walk to their friend's house, they just do not ride their bike because they are not wearing their helmet. All you have to do is say, "Look, the bike doesn't come out until you put the helmet on." Right?

That is one way you can do it. Another way is you can say: "Look, you know, helmets are very important and $30 these days is a lot of money. I'm not doing this for my health. I'm doing it for your health." If you don't wear the helmet, what's the point in having it?"

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Mr Dadamo: We also get the impression that kids think that wearing a helmet is not cool. If you could answer, and I am sure you will answer as honestly as you can, if you could go back to being eight or nine years old, do you think that you would have worn one if your mother or father had said to you, "You've got to wear this thing to save yourself"?

Mr Rempel: Back when I was nine, they did not have helmets. They thought helmets were just for professionals and people who needed them. The kids these days, their friends call them a sissy or a girl or something like that if they wear a helmet, and they think they are cool if they do not. But what I say is, if you wear a helmet you know what you have to protect and you know how to protect it, but the people who do not, do not. They do not know anything.

What I say to the kids when I go to the schools is, "You can spot the coolest kids in the neighbourhood by looking at the ones who are wearing the helmets, and you can spot the dummies, the people who are not that smart in the neighbourhood, by seeing the ones who do not wear helmets and fall off the bike." You can say: "I had a car crash and I was wearing my seatbelt and I survived it. Another person had a car crash and was not wearing a seatbelt and died." You can look at it like that. That is the kind of stuff I give to the kids when I go to the schools.

Mr Waters: The helmets we have now would probably stand up well to a bump or a fall off a bike, but are they adequate to survive a collision, let's say, with a car doing 20 miles an hour? Do they still protect the head at that speed?

Mr Rempel: Yes, they would. If you wreck the helmet, throw it out, because it is not going to protect you again if it is wrecked. If you have wrecked the helmet in any way, just throw it out and go buy a new one, because it is no good to you any more after that.

Mr Tiessen: The CSA can provide some valuable resources as to how they test the helmets, which are put under a lot of force in the testing they do here in Toronto. Undoubtedly, it would hold up in a collision at 20 miles an hour.

Mr Waters: Okay, because I am assuming that most accidents are on town streets where the people come into collision with vehicles.

Mr Tiessen: Probably mostly. If I could just take a quick second. We have a project we did with the Optimist Club. We gave helmets out to kids over a 30-day period and they were theirs to keep. They could earn the helmets if they logged some of the responses they were getting from friends, family and even strangers about the reactions to them, just so we could get a feeling of what kind of attitudes are out there, the negative attitudes.

One helmet came back with a hole pierced in it. A five-year-old child had just fallen sideways off the bike and the head hit a rock, the rock went through the hard shell cover and into the styrofoam. It undoubtedly saved some sort of brain injury in that case, and that was just toppling over sideways.

The Chair: Mrs Cunningham has a brief response to one of the matters raised by Mr Dadamo.

Mrs Cunningham: It is important that we all understand, because I think it is a bit tricky, the quality of the bicycle helmets that people are wearing.

The federal Department of Consumer and Corporate Affairs did not make a new Canadian standard for bicycle helmets mandatory; it was that simple. The three standards for helmets one buys now in North America are those of the Canadian Standards Association, the Snell Memorial Foundation and the American National Standards Institute. So there are three insignia you can look for that are recognized and sold in Canada that meet these three standards.

We had an opportunity to come down with an even higher standard here in Canada and we did not do it. But it is not that across North America people do not have the opportunity to buy helmets. By the way, they are manufactured in Canada meeting the three existing standards.

The Chair: We are also going to have a chance, when the bicycle helmet standards committee comes here, to talk further about that. I want to thank both of you, Mr Tiessen and Mr Rempel, for coming here this afternoon.

I want to say this as well. The Ontario Head Injury Association has been the leader in education and lobbying for treatment, care and appropriate facilities for persons who have head injuries. Jeremy Rempel and his family, Ray Rempel, have been at the forefront, have been in the leadership, the vanguard, of what has been a real struggle now for a number of years. They were recently given a contract for services by the Ministry of Health which helps relieve some of their financial difficulties. But it remains that they are -- it is no secret -- in the red, not in the black.

They have, among other things, been struggling for the right to raise their own funds by that simple and common process of break-open tickets, Nevada tickets, and have been trying to work with the Ministry of Consumer and Commercial Relations for the right to have volunteers peddle those break-open tickets across Ontario. They recognize that governments are not going to be able to keep on giving money like they have in the past, because governments do not have money. The head injury association really wants the right to raise their own.

I am hoping that all the members of this committee and other members of the Legislature will join with them in the fight to persuade the Minister of Consumer and Commercial Relations. We have to get her and sit on her until she agrees to let us sell those break-opens. The work that Ray Rempel and the head injury association have been doing for so long is too important to let it disappear over some very petty rules and standards which could be quickly rectified.

Please say Merry Christmas to your family, Jeremy. It is good to see you again. Good luck in Barcelona.

Mr Rempel: Thank you.

The Chair: Let me know before you go. There might be an extra seat. These guys would be happy to get me out of here for a while and I would be more than happy to go with you to Barcelona. Take care. Thank you.

ALAN BURKE

The Chair: People of course are welcome to stay and hear what others have to say. We now have Alan Burke. Please give us your comments in five to 10 minutes so we have some time to talk to you.

Mr Burke: I will be fairly brief. I should give you a little bit of my background in cycling. I am currently civic affairs director of the Toronto Bicycling Network. I am involved with the Toronto city cycling committee. I am one of these rare people who actually cycles to and from work 52 weeks a year in downtown Toronto.

I am very much in favour of helmets and currently have personal experience about how they have saved injury just from my own cycling. But I think one of the big issues in this whole area is education and resources being put towards the education of cyclists. Statistics I have read say that 85% of injuries to cyclists usually involve some sort of a head injury, most of which would be greatly lessened if a cyclist was wearing a helmet. I myself have had personal experience where, having had a wipe-out, I am sure I would have been sitting in emergency at the Wellesley Hospital but for having worn a helmet. I basically got up and cycled on my way in a matter of a few minutes.

In the United States, a number of states are currently committing 1% of their transportation budgets, if not more, to education and to resources towards cycling, like road network design and other issues. Currently the Ontario Ministry of Transport has a very minuscule amount of money that is spent in the whole area of road design and in considering aspects of cyclists in road design.

It is great to say, "We will pass a new law and make helmets mandatory," but the reality is that current laws are very irregularly enforced in Ontario. I personally cycle a lot and I know very few cyclists who have ever been charged for violating any rule of the road, for riding at night with no lights, for riding terribly. A lot of this has to do with the attitude of the police and the attitude of the Ministry of Transportation. Somehow a lot of people still do not view bicycles as a viable means of transportation. I strongly urge the committee to look at the education aspect.

I myself, for example, am currently training over the winter with the Toronto city cycling committee to be qualified to give the Canadian Cycling Association's Can-Skills bicycle safety course. I am one of a few hundred cyclists in Ontario who has ever taken the Can-Skills II course. It is a 24-hour course which covers about 16 hours of riding on the road and eight hours of classroom instruction.

I think it is important that the committee look to helmets ultimately. Whether people wear them or not, they will have to be convinced by education that there is a practical aspect to wearing them. Given the lack of enforcement of current laws, ultimately it will come down to people being convinced in their own minds of the benefit of wearing a helmet.

Then you get into the issue of whether, when a helmet is involved in a serious injury, it should be replaced. For the purpose of a police officer enforcing the law, there is no way of telling whether a helmet has been in a serious accident and is still a viable helmet.

One of the committee members asked how much protection a helmet would offer in an actual collision with a vehicle. One of our members on the Toronto Bicycling Network actually went head-first through the windshield of a car wearing a helmet and the chap only sustained minor cuts. I am sure he would have been probably killed or severely brain-injured if he had not been wearing a helmet.

In summation, I would like to say I am personally in favour of a helmet law. But the committee has to look at education and also at the resources being put through the Ministry of Transportation and other agencies, so that it does not become another law on the books which is currently not enforced, which today seems to be the standard for almost every other rule of the road under the Highway Traffic Act relating to cyclists.

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The Chair: Thank you, sir. Mrs Cunningham, try to keep it below four minutes, please.

Mrs Cunningham: Thank you very much for coming down this afternoon to help us, and you really have. I agree with you, although you have said it much more strongly than I ever could, that just because you have a law does not mean to say you do not educate people as to the other things that have to happen. We are making notes of all of these things, Alan.

I wonder if you would answer three questions I think are very important. The necessity of the legislation is one of the questions I get all the time. I am wondering if you would respond to that.

Mr Burke: I think a lot of it would be addressed with education. I myself have been wearing a helmet since 1982 and I cycle thousands of kilometres a year. Also I take my vacations with my bicycle and I cycle to and from work. I think education more than anything will be the most effective long-term solution to the problem.

I really wonder, given that I see very little enforcement of even the current rules under the Highway Traffic Act, whether just passing another law -- I mean, it looks nice; it is on the books; it is now part of the Highway Traffic Act. But the bottom line is that I kind of question that aspect. I know when you hear from the Toronto city cycling committee, it has similar views to mine, that a lot of our resources should be geared towards education, which today does not seem to be a high priority with the Ministry of Transportation.

Mrs Cunningham: Looking at the jurisdictions where there is legislation, the numbers who wear helmets are significantly higher. I would like to say it is 100% because it is law, but we know it is not. But we know we are looking at 95%, so that in itself, I suppose, is one of the reasons I presented the bill.

Have you got anything to offer the committee on the cost of the helmets?

Mr Burke: Yes. You can buy helmets today from $30 up. Typically, the upper range for most helmets would be $30 to $90.

My understanding of the three standards that are currently in the North American market is that the Snell standard is the most rigorous standard. If you look at helmets, not every helmet that is ANSI-approved meets the Snell standard, because it is a more rigorous standard. Personally, when I buy a helmet I always look for a helmet that has the Snell rating versus the ANSI, because typically some of the very cheap helmets, such as are sold by Canadian Tire, may meet ANSI standards but do not meet Snell.

Mrs Cunningham: There is some question within the committee, because the legislation in place now with regard to age groups varies, if you have a preference on that, just from your own experience. We are looking at it for everybody.

Mr Burke: If you are going to pass a law, I think it should apply to anybody who is a cyclist, regardless of whether it is a kid six years old or an adult. Mind you, you get into the problems of enforcement, particularly with youngsters under 12. Do you charge the parents? How do you enforce it in the case of young children? Currently in our bicycling club, although helmets are not mandatory, basically anyone who shows up at our club and rides without a helmet, we strongly suggest should wear a helmet. Generally over time virtually 99% of the members in our club do wear helmets. A number of them know people who have been in accidents who have easily walked away because they have had a helmet.

Mr Arnott: Thank you, Mr Burke, for coming out today and for your presentation. I am just interested in getting a little more information about the Toronto city cycling committee. I was wondering if the committee directly engages in any educational efforts for the public abroad, if you have the resources to do that or if you have some suggestions as to what the Ministry of Education might be doing to assist you in that respect.

Mr Burke: The Toronto city cycling committee, just to give you a brief description, is a committee formed by the city of Toronto. The group of individuals gets some funding and the committee gets some funding from the city of Toronto and does have at this point, I believe, three permanent staff -- they recently expanded it -- as well as one secretary.

They do provide education through Cyclometre, which is a newsletter which currently has a distribution -- do not quote me on the exact figure, but 4,000 to 5,000 copies are currently being sent out. The names have been gathered during Bike to Work Week promotions the city has and encouraging people to get on the newsletter. I myself even a few years ago appeared before the executive committee of the city of Toronto council when they wanted to disband the city cycling committee because they did not feel it was appropriate but, when they had over 200 people show up, they soon changed their minds.

There is certainly more education being done in the schools through the Ministry of Education, and I have heard of other groups, but there is still a very large growing population of adult cyclists who are not really being addressed by any group directly. In our club a lot of our members are in our thirties as a common age range. The club itself has instructional rides and we do encourage helmet use, but I think the whole area of education for the general population has to be further addressed.

Mr Lessard: Do you not think that passage of legislation would be part of the education as well?

Mr Burke: I will give you a good example. In downtown Toronto I would say probably 90% of cyclists, just from my experience, never have lights at night. I have yet to ever see a cyclist pulled over and given a fine for riding without a light by the Metro Toronto police. The whole attitude of the Ministry of the Attorney General, the police forces and just municipalities has to give more emphasis on cycling.

For example, in some states 1% of the highway traffic budget is geared towards providing cycling. At the University of Colorado all first-year freshmen have to take a bicycle training course because more than half the students cycle to the university. The law probably is something that should be put in force, but you cannot just put it under the Highway Traffic Act and leave the status quo as we have today, which means it will become somewhat of a joke.

Personally I would like to see more enforcement from the point of view of being a responsible cyclist, because most car drivers see 80% or 90% of the cyclists on the road disobeying a lot of the rules of the road, so how can the minority of responsible cyclists get any respect? The answer is we cannot, and I personally would like to see a lot more enforcement of the existing laws under the Highway Traffic Act, but unfortunately that does not seem to be the case today.

Ms S. Murdock: I used to teach school and I was a lawyer who, when I articled, articled in the provincial offences court doing exactly all the charges under the HTA, so I know exactly what you mean in that cyclists do not get charged. Plus, as a driver in this province, every spring I unfortunately -- well no, it is not unfortunate -- I fortunately come from the city of Sudbury. We do not have 52 weeks of bicycling all year, but every spring I dread seeing the bicycles on the road. I was particularly enamoured of the point that you made on 1% of the Ministry of Transportation budget.

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Mr Burke: I believe, for example, the state of Colorado is one of the states that currently commits 1% of the money spent on highway design on design for cycles. There are a lot of things that could be done while building a highway that do not add a lot to the cost but make it a lot safer to cycle. A three-foot shoulder is a common thing. The benefit of that is also that, when the road crumbles, you have some leeway so that the lane is not crumbling as well when the cars are driving in. Some people feel that a shoulder cuts down on the maintenance in the lane. When it is being done, when you are building a new highway or doing a major renovation or reconstruction of an existing highway, it is not that big an issue to add at that time.

Currently before the House of Representatives in the US there is a so-called 3% solution bill which is being proposed, that 3% of all federal moneys in the US that are spent on highways be committed towards allowing design issues to be considered and facilities for cycling as part of that work.

Ms S. Murdock: In terms of enforcement, I know, as you stated, that no one gets charged for not having a light or not having a reflector tape or whatever. I do not know what the situation in Toronto is. When I was an elementary school student we had a sergeant, Archie Stewart, who did nothing but go around teaching elementary school kids bicycle safety. You had to pass a test before you were allowed to get on your bicycle. He is no longer around. Our regional police do not do that any more. In fact, there is no one really designated for that kind of thing. I am wondering if Toronto is in the same situation, although I see that it has got policemen on bicycles now. How does that work down here?

Mr Burke: Currently the Metro Toronto police are expanding. This summer they had approximately 25 police officers on bicyles out of 52 Division and, I believe, out of 14 Division. It has gone over quite successfully. There have been cases where I understand they are starting to enforce some of the rules of the road against cyclists, but still your odds of a cyclist breaking a rule and getting charged are so low that for most people it is not a consideration.

Ms S. Murdock: It is pretty difficult to catch them when you are in a car.

Mr Burke: That is another aspect too, but I guess the Metro Toronto police are starting to realize that, for patrolling the parks and even patrolling certain areas of downtown with congestion, a police officer on a bicycle is a very effective means of enforcement.

The Chair: Thank you. This is this type of question that heightens the concerns we have about the fact that neither the Solicitor General nor the Attorney General, along with Ministry of Health or Comsoc or Tourism and Recreation, have responded to the letters that were sent to them telling them about this committee process. It is just remarkable.

Mr Waters: I represent the area of Muskoka and I have to tell you that, like Ms Murdock, come spring we shudder because we have a lot of two-lane highway and we have a lot of cyclists who seem to think that four abreast is a nice way to tour Muskoka on their bicycles, and you have popped around the corner and there is nowhere to go. I know what you mean. You worry more, I think, as pedestrians in Toronto than you do as cyclists because, when they come to a set of corners, they break the rules.

With the helmets, if we implement the law as it has been where it has been put in in stages, do you think that would be a way to do it, in other words, deal with the adults first? Looking at peer pressure on children, if we legislate the adults, then let's say to age 19 as the young age, and then three months later go to 15 and then down, do you think that would be more effective?

Mr Burke: I think it would be a way of introducing the legislation. In the spring I will be involved in giving education courses, which I am currently qualifying to give over the winter. What I would like to see, if you brought in the law, is that a lot more resources be spent, say, this coming spring, if you decide to bring in the law in a year's time, on the education fact that most people probably do not realize that 85% of injuries to cyclists are head injuries. If you were wearing an adequately approved helmet, you would walk away.

I personally was in an accident on Wellesley near Church because there was on oil slick on the road and my bike just wiped out. It was a spectacular wipe-out and three cars stopped. If I had not been wearing a helmet, I am sure I would have been lying on a stretcher at emergency in the Wellesley Hospital.

I think a lot of the aspect of making it a success is education. Maybe having a massive education campaign and spending some resources and then phasing in the law would give advance notice that you are going to be passing the law. Then start explaining the benefits to the greater adult population of wearing a helmet and the fact that there are enough helmets available today so that one can usually find one that fits and one that is a lot more comfortable. I remember that my first helmet 10 years ago was a Bell Tour Lite. It had very little ventilation and was very uncomfortable. Today your choices of helmets, and they are much better ventilated, are a lot more comfortable than they were 10 years ago.

Mr McGuinty: Mr Burke, I am from Ottawa-Carleton. I thought, when I heard news at the outset of Mrs Cunningham's bill, that this would be received with open arms at my local bicycling clubs, but in fact I took the opportunity to meet with them over this and they are not. The way they presented it to me is that these head injuries are not the problem. They are presenting the symptoms of the larger problem, which is lack of education for cyclists. They are concerned about cyclists who do not respect the rules of the road and about drivers who do not respect cyclists. In fact, some of them have gone so far as to say that if we put helmets on some of these people they are going to think they are invulnerable and they will go even further in terms of abusing their privileges as a cyclist and not following the rules of the road. What do you think about that?

Mr Burke: I certainly think that skills training for being a cyclist is just as important as learning how to drive a car. Currently the Ontario Cycling Association very much spends its resources on racing and has very little time to even look at recreational and transportation areas, which is the majority of cyclists, particularly in bigger cities like Ottawa and Toronto.

There is a valid point to be made that some people may think, "Now I've got a helmet, so I'm safe." I would like to see the Ministry of Transportation fund appropriate agencies so that more cycling education and training courses can be given in the province. I know last summer in Toronto approximately 100 people took the Canskills II bicycle course, of which about 40 were police officers who were going to be going on the bikes.

The number of people who even take a basic eight-hour course, which the Canadian Cycling Association has, is a very small number. I think that should be encouraged. Certainly just the attitude of saying, "It we pass helmets, we will solve all the bicycling problems," is only a symptom, because a lot of accidents are avoidable with learning emergency manoeuvres, emergency braking, which is a skill to be learned just like it is to learn to drive a car.

Mr McGuinty: We had some statistics from an earlier witness, Mr Tiessen, and he talked about 60 children dying each year in Canada as a result of injuries suffered while bicycling. How many of those would have been avoidable? Are you aware of any statistics regarding that?

Mr Burke: I am not aware of statistics. One organization I do not know if the committee has contacted that has done a lot of research is Bikecentennial out of the US, in Missoula, Montana, which is the largest recreational cycling organization in North America, which has about 40,000 members. It has some statistics. I would imagine it would be a good organization to look to for that. There is also potentially the League of American Wheelmen out of the US as well, which has done joint research in that area.

I personally could not give you statistics on that, although from my own experience, because of my skills, I easily avoided one accident just last year because I knew how to make an emergency right-hand turn. If I had not been a trained cyclist, it would have been an accident for sure.

The Chair: Thank you, sir. You know how much we appreciate your joining us this afternoon. Your comments are well made. Please follow this as it develops and, if you have other things to say, just let Mrs Cunningham or Mr Dadamo know. Either of their offices will be pleased to talk to you.

Mr Burke: Thank you very much.

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MARCIA RYAN

The Chair: We now have Marcia Ryan. Come up and be seated. Proceed with your presentation, and then of course we are all going to want to ask questions and engage in some dialogue.

Ms Ryan: I am Marcia Ryan. I cycle every day in Toronto throughout the year and I am involved in encouraging others to do the same. I am concerned about this bill.

I do not support mandatory helmet wearing for cyclists in Ontario. It is a regressive measure that does not address the issue of safety for cyclists. Wearing a helmet in Toronto does not decrease my chances of an accident at all. To shift the responsibility of safety away from motorists, from urban planning and from the general non-cyclist mentality does not advance the cause of cycling. The bill overlooks major contributions brought to our society by all cyclists. As a Canadian, I feel we lack maturity vis-à-vis our cyclists.

There are two kinds of cyclists: those who wear helmets and those who do not. This amendment discriminates against a certain kind of cyclist and singles out cyclists from motorists. Motorists do not wear helmets while driving, a far more dangerous activity and perhaps one that subjects many to head injuries. Furthermore, the legislation singles out those with very modest incomes from the main population who indulge in the privilege of driving, cycling being the equalizer in an unequal society. Is this another example of social injustice?

Many of us have chosen the bicycle over the car or public transit as the solution to protect the environment. This is a conscious effort that now faces a setback if this bill were to be passed. The setback will be triggered by the extra cost of helmets and by tension increased between the cycling community and the law. This is demoralizing for those who do not wear helmets and who are responsible. Not wearing a helmet will be breaking the law. There will be fines, perhaps confiscation, or are these details not yet addressed? After all, these must be only details to those who do not live by their bicycles.

As a result, the legislation will bring about a decrease in the number of cyclists on the roads. How does this answer the city of Toronto's commitment to the 20% reduction of carbon dioxide emissions in the transportation sector by the year 2005, global warming being the worst threat to this planet? The environmental issue is not just a theory. It is real and with us for ever. We are living in times of crises.

Cyclists have taken the initiative to change the habits of Canadians in their mode of transportation. As Canadians, we are so addicted to our cars we cannot see the pioneering of our cyclists. Yet we decide what is good for them. Let them decide for themselves. We need all the cyclists we can get on the roads. They must be allowed to be, without infringing on their efforts.

As a responsible society we must come to grips with the real issues, and the real issues are not addressed by padding our cyclists. Time is running out. We need to stand by our cyclists very strongly and not look upon them as a problem, but as a solution to heavily motorized urban communities such as Toronto.

I will never campaign against helmets. I will never undermine the confidence of helmet wearers. I respect them. Therefore, I ask the same from them towards me. I resent being taken for an idiot. I resent losing my right to ride my bicycle as I see fit. I have never endangered anyone by riding my bike. I respect the Highway Traffic Act and I respect my sense of wellbeing.

Why is there such harshness? Why such meanness? I see this amendment as a licence to harass cyclists. What happens to the grandmother in Kensington Market going to fetch her bread at the bakery? Is she irresponsible? No. I see her as being beautiful. In winter will the helmets have earflaps or will you try to legislate not riding while it is snowing? When do laws become useful and when do they become a hindrance to a way of life? This is a situation where the law would definitely be a hindrance.

I resent being forced to ride in a certain way by someone who does not ride to work every day throughout the year. Does my life as I live it not mean anything to you? Why is my life yours to change? Why is my sense of poetry subject to your mockery? We need poetry. We are impoverished as a society that has little imagination.

I envision a place with more bicycles and fewer cars. I see a less aggressive and simple way to be. There is beauty in the simplicity of cycling. Perhaps it is the last vestige of freedom which attracts many of us, freedom that allows imagination. We are losing a sense of wellbeing with laws of this nature. There is safety in wellbeing.

Furthermore, these laws are costly on the enforcement level, costly on the legislative level and costly to our efforts at minimizing the impact we have on the environment. The key to safety is education. There should be a lobby for cheaper helmets. This does not require a law.

I do not believe that mandatory helmet wearing will increase awareness of one's safety; education will. Support groups within the community are beneficial to safety, but I see nothing of this nature in the bill. The issue is to maintain the confidence of the cyclist, not undermine it. I feel confident on my bike and I feel responsible. However, I feel unaccounted for in your bill.

This morning, on a bicycle trip between Bathurst Street and Sherbourne Street, there were 30 cyclists to be seen. Six wore helmets and 24 were riding without helmets. A few minutes later, on another bicycle trip between Bloor Street and Queen Street, out of the 15 cyclists seen, one wore a helmet and 14 did not wear a helmet. Out of 45 cyclists only seven wore helmets. This is significant, as we are observing here the more committed cyclists in the community who feel confident about their daily habits. They should not be undermined; they should be respected, yet they are unaccounted for in Bill 124.

Please consider cyclists who do not wear helmets as vital and responsible members of our society. Stop the discrimination and spend your energies on the real safety of cyclists. That concludes my presentation.

Mr Waters: In your presentation, when you were talking about accidents, I noticed you focused on people having accidents with vehicles. I am wondering why the focus on that. Granted they are head-injured then with accidents with vehicles, but they are also head-injured when they just slip on a patch of oil, as the previous gentleman said, and their head strikes a curb, or when they get hung up in a streetcar track in Toronto and they strike their head. I think that is part of what it was for. I wonder about your comments on that.

Ms Ryan: Indeed it is very dangerous to ride in Toronto. You hardly address safety when you put on a helmet. I mean, the streetcar tracks will always be there. The oil patch will always be there. In fact, if we opened the curb to be able to dismount at intersections, that would help safety more than a helmet. It is indeed very dangerous. The fewer cars on the road the better, and the fewer oil patches, but you cannot get around it; it is dangerous to ride your bike.

I think we have to promote a cycling mentality. We have to promote allowing cyclists to take the road. If you do not feel confident, that is also a very dangerous thing. If people want to wear helmets, then they ought to wear helmets because if they feel safer then they should. I think there should be a lot of education and a lot of support for that to make people feel safe and confident. But I think that is a different issue to the whole picture.

Mr Waters: What about, let's say, the two-year-old who is strapped in a little seat behind mom or dad and they are going along the street and they wipe out? They get away clear from the bike. How do you feel about that particular instance? Should those children who are strapped into the bikes have helmets on? Unlike the actual rider who can step free or roll free or whatever if he falls, in most cases these children cannot. Do you feel there should be helmets there or no helmets in any way?

Ms Ryan: I feel that to be the parent's responsibility. I feel that a lot of parents do not want to take their children out on their bikes. It is far too dangerous. There is just no cycling mentality yet in this city. We are just at the beginning. I think parents are responsible and that they would be more so with education and greater awareness that is brought about within the community, within the structure.

Mr Dadamo: You said that out of 45 cyclists, you counted seven wearing helmets on the excursions you were making that day. Do you think we should be spending money on education? Do you think that education should be the operative, that we should be spending money to educate people, parents and kids in the schools that they should be wearing helmets and that wearing helmets will save them traumatic injuries?

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Ms Ryan: I think they should be educated to wear helmets and they should also feel that this is where it is at for them. If helmets make them feel safe then so be it, but I would not impose it upon them if they feel safe without the helmets. I think those are two different things, to educate and to impose.

Mr Dadamo: What about enforcement? Do you think police officers will want to stop people who are not wearing helmets? The way I look at it is that we give them something added to do.

Ms Ryan: Yes, we give them something added to do. Are you asking me to guess whether they are going to stop?

Mr Dadamo: I am talking about the whole thing of enforcement.

Ms Ryan: I have never been harassed by the police as a cyclist, but then again, I obey the law and I do have lights. I do not know if it is a requirement. I see a lot of people who wear helmets but do not have lights so I am not quite sure what goes on in their minds as to safety.

Education has to be greater than helmets. There has to be a sense of wellbeing, but I think education has to extend to the drivers. The drivers should be told to drive as little as possible, to be taught at the driving stage and before they get their licence to be aware of cyclists, to allow and give priorities to cyclists, to look over their shoulder before they open the door. Maybe test them with cyclists on the road so they realize they are a vital part of our community.

Ms S. Murdock: The inability to enforce is a concern to me here. Having said that, the last part of your presentation reminded me of all the arguments we got on the seatbelt law when it came out. People said, "I know how to do it. I'm not going to get hurt. I have been driving this way all my life and I don't need to wear a seatbelt," when it has been proven statistically that it has been a safety factor and reduces accidents.

It reminds of my mother when she used to tell me that just because everybody else jumped off the cliff did not mean you had to do it. Just because everyone else is not wearing a helmet, does that mean it is okay for you not to wear a helmet? Do you know what I am saying? I am concerned that it is an argument that just because seven out of 45 were wearing helmets does not mean that makes it okay.

Ms Ryan: We are not.

Ms S. Murdock: I am just saying that the reverse side of your argument is that it does not make it right because they are not wearing them, although what you are talking about I think is a personal freedom.

Ms Ryan: Yes. I am talking about a personal freedom and about safety issues that are not addressed with this bill. It is dangerous to ride out there. There is a lot of work to be done to make cycling safe.

To take cyclists this morning as being irresponsible is not right. They are responsible cyclists. They cycle every day, and in this weather it is obviously people who are committed to cycling to work every day. They chose to wear hats instead of helmets. It is a reality we have to face that these people, me included, want to ride their bicycles with a hat instead of a helmet.

The seatbelt is to do with a very dangerous way of transportation. Cars are a very dangerous way to go. But if you want to compare helmets to helmets, heads to heads, as I presented, you could compare the head injuries with drivers in car accidents. You could say that they should wear helmets while driving. Then I think the comparison is legitimate.

Ms S. Murdock: You do not see a comparison at all between seatbelts and wearing helmets? Making it mandatory, I mean.

Ms Ryan: No, not at all. You are going 60 miles an hour in a car. It is very slow on a bicycle compared to a car. The safe thing is not to have cyclists, which is what I heard in your comment.

Ms S. Murdock: No, I was not saying that at all.

The Chair: Ms Murdock, let her finish, because time is fleeting.

Ms S. Murdock: I was not saying not to have cyclists at all.

Ms Ryan: But, you know, you cringe in your seat.

Ms S. Murdock: Having said that, though, your argument holds water as long as you are working on the supposition that all bicyclists are safe bicyclists. Unfortunately, that is not the case in this province. It is not so much the adults. I have been driving in Toronto here and I find a lot of them hazardous; not all of them, but a lot. It is the young kids I have the problems with, particularly in my own home town. They do not know the rules of the road.

Ms Ryan: That is education. A helmet on their head is not going to give them the rules of the road either.

Mr McGuinty: I am glad you raised the aspect of the environmental benefits of cycling. There are so few things today, it seems, we can label good without reservations, and I am glad you brought forward the health aspects and the environmental aspects. You went on to say, however, "The legislation will bring about a decrease in the number of cyclists on the roads." Why are you so sure about that?

Ms Ryan: A lot of presentations were saying that if you do not have your helmet, you are not going to ride your bicycle. Personally, if I am stopped and I am fined because I am not wearing a helmet, I can either really be aggressive and say, "I'll ride again and then I'll get fined again" -- who knows? My bike will get confiscated. That makes me less a rider on the road.

Nobody wants to be hassled. People want to be good citizens and harmonious, and it is going to bring down the number of cyclists unless you are going to turn a blind eye, at which point why have a law and waste everybody's time and not address the issue of safety at all?

Mr McGuinty: What if we were to bring about a comprehensive safety education program in concert with mandatory helmets? What if we were to educate everybody to your satisfaction and in addition require that they wear helmets? I understand a lot of your argument to be that the helmet is not addressing the safety concern, but what if we do that and helmets?

Ms Ryan: What do you say to somebody who does not want to wear a helmet? Are they irresponsible?

Mr McGuinty: I will tell you what some people might say. They might say, "Our right to cycle, like any other right we exercise in a democracy, is bounded by certain limits."

There is always the economic argument. People might say, "Listen, if somebody suffers a head injury as a result of failing to wear a bicycle helmet and society at large is paying for medical treatment, it would have been cheaper to put in place a mandatory helmet program rather than to treat these people, and I as a taxpayer insist that we go ahead with the mandatory helmet program." What would you respond to that taxpayer?

Ms Ryan: There are a lot of things that weigh on taxpayers, a lot of things that could be addressed. I do not see those arguments being valid, because you just say, "Take the cyclists off the road and that will save a lot of tax money." It really is a hindrance to legislate a law that has nothing to do with the people who ride bicycles responsibly. I cannot see it being effective in the safety aspect.

I would never say to people, "Don't wear a helmet." It is extremely important, if it makes you feel safe, to wear a helmet. But I do not wear a helmet and I feel kind of vulnerable having to justify it.

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Mr McGuinty: You do not wear a helmet and you do not want to wear one.

Ms Ryan: That is right. If I were mountain biking, I probably would wear one, because it is a lot more dangerous. But yes, I feel quite safe the way I ride. It is not as dangerous.

Mr McGuinty: If my premise was correct, that it is cheaper to implement a mandatory helmet program rather than it is to treat you, I gather your right to choose not to wear a helmet is superior to society's right, for instance, to minimize health care costs.

Ms Ryan: Society is a group of us anyway. We have a number of us who do not wear helmets, and surely we count for something. Surely that is society too.

Mrs Cunningham: Thank you, Marcia, for coming down today. I know that you have been in touch with our office before and that you have some strong feelings. I just wanted to reassure you, and I think you probably heard it earlier today, that it certainly is not our intent to take away from the issues of good urban planning or from public education, and certainly not from the issue of motorists having the responsibility for safety. I share your views, certainly as a cyclist, that we would like to see more bicycles out there.

I did want to ask you a question with regard to costs, because you raise that as an issue. I am sort of going along the line Mr McGuinty had there. I wonder if you heard the two previous presenters, especially young Jeremy Rempel. The cost of his not wearing a helmet has been significant to his family, and certainly to society. One of the arguments we get from people in favour is that $50 or $20 or $90 for a helmet is not a high price to have to pay, but it is a high price if one is head-injured and has to go through what that young man has gone through.

Ms Ryan: There is no argument there. It is obviously a sad situation, but I think it is a cost for a lot of us who do not have an income. That is a reality too. If the man who presented earlier had worn a helmet, I am not sure what would have happened either. Everything is theoretical, and if there was a law, would he have worn a helmet at that particular time?

Mrs Cunningham: I suppose I would take a very strong argument on theoretical, because I think for many years it was theoretical in this province, but for myself, if I had not been not presented with very strong statistics, I would not ever have presented this bill, and I have to tell you that.

This was not a new suggestion. Some seven or eight years ago in London, Ontario, there was a group that wanted to see this kind of legislation. At that time I did not feel, even though they did, we had strong enough facts and research in many areas, not just accidents but helmets. There were all kinds of aspects, as you yourself have pointed out to us, and I want you to know that I would not be presenting this bill if it did not have very strong backing with regard to statistics and the fact that as a cyclist you would be much more protected with a helmet. You choose not to wear one, but as a person who came here and said, and I believe you, the key to safety is education, I cannot believe you ride as much, if you are educated, and do not wear a helmet, given the facts.

Ms Ryan: So you are saying I am stupid.

Mrs Cunningham: No, I am not. I am saying that in spite of facts, if you are educated -- and you say you are, because I certainly would not call anybody stupid -- you have chosen for other reasons not to wear one, and I respect that.

That was one of the problems in presenting this legislation. I do believe in individual rights and freedoms, and every once in a while people like ourselves are entrusted with I think a very significant responsibility when we are even looking at this legislation. My first viewpoint of course would have been yours, for many years, but I just wanted to say that, when you say it is hearsay or whatever, for me it is not hearsay. I do not believe people who choose not to wear their seatbelt or not to wear a helmet are stupid. I believe they have made some kind of a personal choice, and that is up to them. In the case of seatbelts, they have also chosen to break the law, which draws me into the next one.

You mentioned something about lights on bicycles and you were not certain about what the rules were.

Ms Ryan: That is right. I sense that you are supposed to have a bell, but whether you have a light or not in the front is not law.

Mrs Cunningham: It is the law to have a bicycle light, an amber or yellow light on the front of your bicycle. You must have that bicycle light on half an hour before sunset and half an hour after sunrise, and the fine for not doing that, for breaking the law, is $20. That is in the statutes of the same act we are trying to amend. That is part of this act now.

Ms Ryan: Does the back have to have a light?

Mrs Cunningham: The back has to have a reflector, and there are a certain number of inches of reflecting material you have to have at different parts of your bicycle. The legislation is quite extensive. It is amazing that it has been in place for so long. Those of us who were educated in the 1950s had it memorized, because we had to have a licence. When I was a child growing up in this city and all the way through high school, I was a cyclist. I had to get a licence by the first of April every year to ride my bike. This dates me significantly, I understand.

My own children, as part of the Cubs and Scouts and Girl Guides, would have a police officer in. This is recently; I have to tell you that. They would have a safety officer from the police force or someone else -- we had a presenter before -- come to educate the children around the rules of bicycle safety. We had to upgrade our bicycles quite frequently, especially with regard to lights, which became quite expensive, and the bell did too actually. They would be kids and it would break and they would not do anything about it.

But with us, in Toronto, on April 1 you did something about it or your principal would not let you bring your bike to school if you did not have your little licence. That was quite embarrassing, because if you broke the rule with your principal, then you did not get your school letter, right? I am just telling you that it is important to be educated around safety. One hopes that the laws are there to protect us in some way. But I do appreciate your coming down, because I think you do hold the views of many people, and I do respect them.

The Chair: Mr McGuinty, real fast.

Mr McGuinty: A real quickie. Ms Ryan, if you had children, would you require that they wear helmets?

Ms Ryan: Yes. Riding in the city, yes.

The Chair: Ms Ryan, I want to thank you for taking the time to prepare the submission and come here and engage in this dialogue. Your point is well made. It is an interesting perspective. I am confident it will be repeated in future days, and I think I speak for all the committee when I say we are particularly gratified to see individuals responding to legislation like this and participating in the committee process and showing an interest. It is horribly important and we look forward to your coming back on another issue in the near future, whichever issue that might be. We are not sure what it is yet.

Mrs Cunningham: We will phone you first.

The Chair: But thank you, Ms Ryan, very much. We appreciate your time.

Ms Ryan: Thank you.

1730

PETER LANE

The Chair: Dr Lane, if you would please commence with your presentation, sir, I think it can be done in less than 15 minutes and that will give us plenty of time for questions and dialogue.

Dr Lane: First I will read my presentation, but I sense there may well be a number of questions, so I will try to be brief as you suggest.

When I first learned of the proposed legislation you are considering today, I was excited and impressed: excited at the potential impact of the bill and impressed with its simplicity. Rarely in health care does such an opportunity exist to so positively and significantly affect the wellness of our communities with so little expenditure of public resources, and rarely in health care is a preventive answer to an identifiable health problem so clear and irrefutable. Rarely in health care is the need for such a measure so great.

By way of introduction, I should perhaps outline my background a bit so that you can appreciate my perspective. I am an emergency physician and have been involved in the field of injury control and trauma medicine for more than 10 years, initially here at Sunnybrook and now in London at Victoria Hospital. I have served as president of the Canadian Association of Emergency Physicians and the Trauma Association of Canada. Currently I serve on the board of directors of the Association for the Advancement of Automotive Medicine. That is the principal organization internationally involved in the field of injury control and automotive medicine. Since April of this year I have served as the medical director for trauma services at Victoria Hospital in London. Victoria was designated in February as the lead hospital for most of southwestern Ontario.

I hope, in the context of this presentation, to bring you some understanding of the costs of acquired brain injury, both human and financial, to review some of our experience in southwestern Ontario and to remind you, in addition, of some of the evidence supporting the efficacy of helmets and helmet legislation. I thought, to begin with, I would put a bit of a human face to it, although I obviously cannot compare to the presentation that was made earlier by the Ontario Head Injury Association. But I would like to talk about a real person, a child who sustained a head injury riding her bicycle. Surely the goal of any such preventive measure is to positively affect the lives of real people in a real way.

I would like to speak of Emily. Emily is not her real name, but Emily is a 10-year-old child who sustained a devastating injury recently. She had been a happy child, doing quite well in school. She was going into grade 6 and had been an excellent student to that point. On the day of her injury she was riding her bicycle and she was following her brother. Her brother did not see her at the time, but he remembers that she wobbled a bit and then lost control, fell off her bike and struck her head on the pavement.

She did not lose consciousness and she was taken to the local emergency department where she seemed fine and had a minor laceration repaired. As she went home, she was a bit drowsy. Her mother let her nap and returned only one half hour later to find Emily unresponsive. She was taken back to the hospital where she was resuscitated and transferred to the Children's Hospital of Western Ontario, which is the paediatric division of Victoria Hospital. There she was further resuscitated, investigated and underwent surgery for a massive epidural haematoma. An epidural haematoma is a collection of blood from a haemorrhage of one of the blood vessels around the brain. In Emily's case, the bleeding was so severe that it compressed the entire brain over the left-hand side. That caused irreversible damage by blocking off the blood supply to most of her brain.

Emily spent the next three weeks in our paediatric critical care unit undergoing intensive therapy to combat brain swelling and other consequences of her injury. The head injury, by the way, was her only injury. She spent another eight months undergoing intensive neuro-rehabilitation and eventually was transferred to another centre for further therapy. At the time of discharge from our centre she could not sit unsupported. She could not stand or walk independently. She had double vision, little sensation of any sort on the right side of her body, could not speak and had a major learning disability. Our hope is that Emily will be rehabilitated to the point that she can operate a wheelchair. We hope she can learn an alternative form of communication and, with full-time assistance, perhaps benefit to some degree from school.

This child, I will repeat, had been an excellent student in grade 6. Her injury in all likelihood was entirely preventable had she been wearing a bicycle helmet. Emily's life would have been dramatically affected by the legislation that you are considering here today.

I thought it would be helpful to take that case and look a little bit at case costs as a means of estimating the economic impact. This was alluded to a few moments ago, and I think it is an important part of the consideration. Case costs are difficult to estimate in Ontario for any condition, but perhaps they are better understood in the field of injury than in most others. If we look simply at the hospital costs of the course of care that I have outlined to you so far -- 10 months in an acute care hospital -- Emily's care cost was approximately $230,000. But if we further add in the costs of subsequent neuro-rehabilitation, the cost of physicians' services, special education, attendant care, assistive devices and other ongoing care costs for the rest of her life, this figure amounts to well over $1.5 million.

The American Trauma Society, which this past year has mounted a public education campaign on bicycle helmets, estimates that the lifetime cost for a severely injured pedal cyclist in that country averages -- and that is an average -- more than $4.5 million in US funds. That could buy a lot of bicycle helmets. Preventing the costs generated by a few cases like Emily's could go a long way to solving some of the problems that I hear Mr Laughren has these days.

Many pedal cyclist injuries occur at low speeds or even while stopped, particularly among children. This is an important point to bring out in light of some of the discussions about collisions with automobiles. Bicycle riders are in a precarious position perched atop the seat with their centre of gravity much higher than normal, with their feet off the ground. For the young rider just learning, sometimes the injury may simply occur as a result of a loss of balance while stopped in the driveway or on the sidewalk. However, the deceleration that the brain undergoes inside the rigid, bony box of the skull when this child hits the pavement can be just as severe as if he or she were hit by a truck.

Trauma medicine has advanced to the degree where we can effectively treat many if not most of the other injuries a cyclist may suffer. But the treatment options with severe head injuries are much more limited and the results much more frustrating. Plainly stated, we would rather not have to treat them at all.

Thankfully, few pedal cyclist injuries are as devastating as Emily's. I have outlined in the table in your document our recent experience at Victoria Hospital. I should say, though, that daily, particularly in the summertime, hundreds if not thousands of patients with minor injuries are seen across this province in emergency departments, and they never get admitted to hospitals so they do not factor into these numbers. As we learn more about acquired brain injury, it is becoming quite clear that these minor injuries do in fact have long-term consequences. Many of these children go on to develop mood disorders, sleep disturbances, headaches, significant cognitive defects, as evidenced by reduced school performance or workplace performance, and in the adult population, marital breakups and sexual dysfunction.

You can see there some of the statistics with respect to the cases we are seeing. Perhaps I will save time by not going through those numbers but leave those with you for reference. I should mention that those come from one of 11 lead hospitals for trauma in the province. We see many but certainly not all of the significant injuries within our region. To try to compute a provincial figure, you would need to multiply that factor by probably at least 15. We are hoping in this province to get a trauma registry in place some day in the near future. It does not exist at the moment so I cannot give you provincial numbers that have any sort of accuracy.

Looking at helmets now as a preventive measure, epidemiologists speak of three levels of prevention. They occur at three different phases in the course of an illness. Primary prevention involves the introduction of measures to reduce or eliminate the chance of an illness occurring at all. The eradication of smallpox through universal immunization programs is a good example of that. The total elimination of bicycles in our province would achieve that, but it is neither feasible nor desirable.

A secondary prevention, however, involves identifying the population at risk and introducing specific measures for that population to reduce or eliminate the illness. Breast cancer screening programs and pap smear programs are examples here. The screening programs to identify those risks are expensive but the payoff is felt to be worth while. With pedal cyclists, however, we have an easily identifiable population. There is no need for a screening program. The only screening you could say is involved is simply in the area of enforcement. Tertiary prevention refers to measures taken once an illness has been identified to reduce the severity and incidence of complications and to improve outcomes.

The requirement to wear bicycle helmets would serve principally as a secondary preventive measure, the at-risk population is clearly identified,and the measure is effective in reducing the incidence of illness. As an added bonus, we know that helmets also serve to reduce the severity of those injuries that do occur. I am sure your staff has provided you with the article from Seattle, published in the New England Journal of Medicine in 1989, in which the authors conclude helmets were "highly effective in preventing head injury." They reduced head injury by some 85% and reduced the risk of brain injury by 88%.

It should be noted that very few preventive measures already legislated or regulated can come anywhere close to that sort of efficacy. This includes, I must admit, a number in the field of injury control. Motorcycle helmets are rather ineffective at high speeds. Seatbelts are of limited use in side-impact crashes and at higher velocity frontal-impact crashes. Driver's licence suspension would appear to matter little to the many drunk drivers involved in crashes while under suspension. But the projected efficacy of bicycle helmets is by comparison quite remarkable. The fact that they could be introduced with minimal public expense verges on the spectacular in terms of cost-effectiveness in public health measures.

I want to thank you for the opportunity to address you on the legislation. I have tried to give you a bit of the perspective of some of us involved in caring for these patients. I understand that Dr Michael Schwartz later in your hearings will be making a presentation on behalf of the Trauma Association of Canada and he will reflect some of these issues as well. The problem of brain injury among cyclists is a tragic one and the solution seems unusually effective and inexpensive. I urge you to help us prevent these injuries by supporting the legislation.

1740

The Chair: Thank you, doctor. We have six minutes for each caucus, beginning with Mr McGuinty.

Mr McGuinty: Dr Lane, thanks very much for coming around and sharing your experience with us. I wonder if you are familiar with statistics on a broader basis as to the incidence of injuries in terms of the age groupings. Do we see more kids injured on bicycles than we do adults?

Dr Lane: Yes, we do, and if you look briefly at our table, our table is pretty reflective of what you will find in most of the articles published in the literature. A little more than half of the injuries in Canada are in children. The difference in children is that, because of the relative size of their head with respect to their body, they are much more likely to sustain a head injury, and in more than half of the cases of injured children their head injury is the only injury, whereas in the adult population significantly less than half of them will have a head injury. They will have other injuries because they are at higher speeds and they more often involve motor vehicles. Well over half of the injuries in children involve no other vehicle.

Mr McGuinty: I see. So we are talking about children toppling over, essentially, at very slow speeds.

Dr Lane: Yes, toppling over. Sometimes slow, sometimes faster speeds. They may even be stopped. But again, as I say, if you can picture the child perched atop the bike, his centre of gravity is a lot higher than his little balance mechanisms are used to figuring out. When he topples over, his feet are off the ground, his hands are on the handlebar. He does not have the same sort of protective instincts that an adult does; he does not know how to roll. So yes, they are in a precarious position and they are usually toppling at low or no speeds.

Mr McGuinty: Have you ever had any experience dealing with the kinds of helmets that are available on the market today? Have you ever been asked for any input?

Dr Lane: No, but I certainly wear them, as does my family, so I am familiar with them from that perspective.

Mr McGuinty: Are they satisfactory?

Dr Lane: Yes. I am familiar with the ANSI and Snell standards and essentially CSA has the same level, I believe, as the ANSI standards, with a few amendments. From everything I understand, the Seattle study in fact was looking at helmets that met the ANSI and the Snell standards. They are a little bit different. I would not say that one is necessarily better than another, because they conduct their crash impact worthiness in a different fashion. The ones in Seattle had to meet both standards as they do in most state legislation.

Mr McGuinty: One of the earlier witnesses I think indicated he felt that Snell was better. What do you say about that?

Dr Lane: As I say, they are different standards. They conduct their impact crash worthiness testing differently. It is just a different model. One involves crashes into a fixed barrier; another involves striking it with a more penetrating object, and there are different loading factors. You would need a physicist to thoroughly explain the different standards to you, but they are both reasonable standards.

Mr McGuinty: You are dealing with people, parents, children and adult cyclists, who have become acquainted intimately with the problems that arise when you do not have a helmet. What about the general public? Do you feel the level of support is out there now that we would need in order to put in place some kind of legislation, which is going to require tremendous support? We just cannot enforce it, realistically speaking. What do you think that level of support out there like?

Dr Lane: I should turn the question back to you. You are a much better gauge of what the public opinion is on different issues than I am. I can tell you a depressing fact, and that is that probably over half -- it varies; I think there are about three studies in the literature -- the people who have been involved in bicycle crashes not wearing a helmet who sustain a head injury actually wear a helmet the next time they go out on their bike. No matter how intimately you become acquainted with the risk of riding a bike without a helmet it does not seem to have the impact it ought to. So I am not sure. I hold out hope for education, probably more so in the field that has been referred to earlier: traffic safety standards and adhering to the rules of the road.

A good example to look at is what happened with motorcyclists. We tried for many years in the injury control field to try to educate the motorcycle population through motorcycle safety associations and through public advertising campaigns on the utility of motorcycle helmets. I think the most optimistic usage rates were in the range of 40% to 45% among motorcyclists. Since legislation was passed, you virtually have 95% to 98% usage rates on the public roadways. People wear them even if they do not believe they are going to help them. They realize they are so visible as a sign that they are violating the law if they are not wearing a helmet that they accept it and they all wear it.

I do not know whether the public is generally in support of the measure right now. I think the public that thinks about it is. I would suspect that once introduced it would not be as much of a problem to enforce, certainly in the adult population, as you suspect.

Mrs Cunningham: First, thanks for coming in from London. It was not great this morning. I doubt whether it was great this afternoon.

Dr Lane: A lot worse.

Mrs Cunningham: Is that right? Everybody is in a snowbelt today.

I want to ask the same three questions, but before I do I want to thank you. I think members of this committee from time to time feel particularly privileged at the kind of input we get. Today I would like to thank you, Peter, for coming, from that point of view, because so often people are too busy to come to speak even when they have the expertise. We really do appreciate it.

I think my first two questions you have already spoken to: Obviously you think the legislation is necessary, and the cost-effectiveness you presented in a way I could not have done. I am wondering if we are under some pressure to stage this. The previous two people I did ask the question of said that we should not stage it and that it ought to be for everybody if we are going to do it. I wonder if you have any strong feelings on that, given your work with all age groups.

Dr Lane: I would think it should be for everybody. I do not think we are going to be able to convince children to wear helmets unless they see adults wearing them. I do not think you could stage it in terms of having children wear them first. I do not see any rationale to staging it for adults first before children because children are, if anything, the higher-risk population and there is more more of a moral argument than anything else to get children to wear them, since they are not at an age usually where they can make that decision for themselves.

I had difficulty, to tell you the truth, with the way seatbelt legislation was introduced in this province in 1976 when we went for adults before we went for children. A lot of American jurisdictions, although they dragged their heels on the adult side, felt there was more of a moral argument to introduce it for children first, and I would think so. I do not see any reason to stage it at all. I think we should recognize it is important for all ages.

Mrs Cunningham: With regard to the head-injured as you see them, one of the questions we get asked is with regard to rehabilitation programs close to home. I wonder if you could talk about the availability in Ontario, and in your experience, what kind of costs we are looking at for the rehabilitation programs.

Dr Lane: I chose this case because to some degree it illustrates that. There are some real problems in the area of brain injury rehabilitation in Ontario. There has been within the past couple of years a joint initiative from the Ministry of Community and Social Services and the Ministry of Health to address this to some degree, but there are still tremendous service gaps throughout our communities.

This case highlights some of those points. This child is from a region to the north of London. She spent approximately eight months in London and is now in Toronto. That gives you an idea of the sort of rehabilitation facilities there are close to home. You can just imagine the costs to that family in terms of spending almost a year in London and now having to go back and forth from Toronto: tremendous dislocation for the family and dislocation for the child from the emotional supports she needs at a very vulnerable stage. We have some real problems.

We had hoped, in the context of the regional trauma network initiative through the Ministry of Health, to start moving out into the communities and training hospital staff in the different communities throughout southwestern Ontario in rehabilitation and particularly brain injury rehabilitation, but that unfortunately has not been funded. There is a real need throughout all areas of the province, but certainly in the southwest, for care closer to home, care in the community and in secondary hospitals in the province as well as in the teaching centres.

1750

Mr Arnott: Dr Lane, thank you very much for coming in. Very briefly, do you feel kids on skateboards should be wearing helmets? Should that become mandatory as well? Do you see many patients who are involved in that sort of accident?

Dr Lane: We see some. We see very few with major head injuries, though. Having said that, my son wears a helmet when he skateboards. There are extremity injuries from skateboarding in terms of wrist and leg injuries that can be significant, but we can do something about those. The head injuries are not as severe, to tell you the truth, from skateboarding. It is usually larger children skateboarding whose centre of gravity is lower and usually something hits the ground before their head does: hips or shoulders or something else that takes a fair bit of the decelerative force.

Mr Arnott: Can you project this beyond bicycling and suggest any other activities that should require helmet usage by kids?

Dr Lane: I think we have looked at that in the area of organized sports, and hockey is the obvious example there. I would encourage that sort of thing to occur. But in a recreational activity as unregulated and as unorganized as bicycling, I think we have to do it this way. I cannot think off the top of my head of any other category that comes anywhere close in terms of the incidence of head injuries as cycling.

Mr Waters: I do not know why this puzzles me: If you were to take an adult and a child who had the same accident with the same blow to the head, would the adult's skull and brain take the blow better than the child's?

Dr Lane: Let me understand your hypothetical situation a little bit better. Do you mean an adult and a child falling from the same height or do you mean involved in the same bike accident or do you mean a single blow, decelerative force, to the skull equivalent in both?

Mr Waters: I guess all three, but let's say off an average bicycle and the same fall they strike their head on the asphalt.

Dr Lane: Because of the relative proportions of body weight and size to head, the adult is much less likely to strike with his or her head first, whereas the child is most likely to strike with the head first because it is heavier and bigger and as they go over the head strikes first. That takes a lot of the impact, whereas with the adult it is usually the leg or the hip or the shoulder that strikes first, so there is less impact taken.

On the other hand, we must not forget that the adult is more likely to be involved in a collision with another moving vehicle, and in that case head injuries are certainly sustained. That is a different situation. In the situation where the two are falling from the same height, the adult is much more likely to hit something else before the head and the child will suffer more of a head injury.

Mr Waters: I am trying to get an idea of the history. When you are spending up to $3,500 on the new bicycles that are out, obviously they must do something more than just go down the road at the same old speed as the old ones. I am assuming there is an increase in speed.

Dr Lane: Yes.

Mr Waters: Are we finding there are more head injuries because of that increase than what there were 10 years ago with the same numbers in population? When you spend that kind of money, you have to be doing something; it has to be speed.

Dr Lane: I do not know of any evidence to suggest there has been a dramatic increase in head injuries in the adult population from cycling. I think there is an unacceptably high rate right now that is preventable even at the speeds these bikes go. I think when somebody is spending that much money on a bike they are pretty serious about their cycling and they are going to be pretty serious about where they cycle. They are not going to want to be bothered with the traffic. They are going to go on a road that is safe and where they can stay away from traffic.

In many ways they are less likely to get involved in a crash, whereas the person who is using an inexpensive bike as the primary mode of transportation, if you are talking about the adult population, is more likely to be on the same roadway that is not designed for bikes and more likely to get into trouble. I would think there are probably very few major injuries among serious cyclists. There are a few high-profile ones we probably all know about, but I do not think there is any increase in them because of the increased expense and speed of the bikes.

Mr Waters: The other thing I would like to get back to is the child who is captive behind the parent because, once again, you are looking at a child who is exceptionally high up for that age because he is on an adult bike, not a child's bike, he is strapped in and he would not have the ability, even if he had the strength, to protect his head. Do you have any idea how many of those children are injured because of this?

Dr Lane: When we looked at our numbers while preparing this, there were only two children below bicycle riding age. One was about a year and one was about 18 months. They would have been in these sort of seats. If you do a run on provincial data that exist you probably will find a low incidence. I suspect it is because the mother or whoever is driving is pretty concerned about the little one on the back and any sort of minor fall they have they will hold the bike to prevent. Where you get into trouble is when they are in collision with a motor vehicle. Then they have no way of protecting themselves, but the bike rider probably does not either.

Ms S. Murdock: I have one question. In your experience in the emergency room, I presume you have met up with a lot of police officers who reported the accident or who had to take down the information. What kinds of comments do they make in terms of their thoughts? I know this is hearsay but I do not have a police officer in front of me to ask what he or she thinks about mandatory legislation.

Dr Lane: I have not quizzed any of them on mandatory legislation. I would be surprised if there are a lot of them opposed to it. I know in London we have, as Toronto does, a bicycle component of our police force. Those officers enthusiastically embrace helmets and they certainly do what they can to educate other bike riders on the utility of helmets. I do not think there would be any great opposition to it; they probably are pretty much in favour of it.

The Chair: Thank you, Dr Lane. On your own initiative you prepared this material and contacted the clerk so as to be permitted to appear before the committee. Once again, as with others this afternoon who have done similarly, we are extremely grateful for your interest, your comments and your input. We appreciate your coming. We trust you will be following the progress of this committee. Obviously Mrs Cunningham, who initiated the bill, or Mr Dadamo, who is the parliamentary assistant to the Minister of Transportation, would be pleased to hear from you if you have further comments or questions. Have a safe trip back to London.

Dr Lane: Thanks for hearing me.

The Chair: We will now recess until Wednesday, November 27, at 3:30 pm. We will have a subcommittee meeting right now to which Mr Edgar and Mr Dadamo are invited because they may well find the subject matter of interest.

The committee adjourned at 1800.