Helmets

Mucco

Irish Times:

Cycling without a helmet
Madam, – Dublin councillor Andrew Montague’s negative views on the efficacy of bicycle helmets (Home News, September 14th) were unfortunate. There is considerable evidence supporting the use of cycle helmets to reduce the incidence and severity of head injury, to the extent that some jurisdictions around the world have made their use compulsory.
Great credit is due to councillor Montague and Dublin City Council for making Dublin city more bike-friendly, but in promoting a healthier way of travel they should go all the way and promote injury prevention through the use of bicycle helmets.
Many of us who look after injured people on a daily basis have treated cyclists with isolated severe and life-threatening head injuries who would not have sustained such injuries had they worn a helmet. This correspondent and occasional cyclist has been reassured sufficiently by the medical evidence to support any move to make the use of bicycle helmets compulsory by law. – Yours, etc.

CONOR V EGLESTON,
FRCSI, FRCSM, FCEM, BSc,
Consultant Emergency
Medicine, Senior Lecturer,
Royal College of Surgeons in Ireland, Dublin 2.

I think the BMA have dropped their claim about the benefits of cycling outweighing the risk - but there's still little (any?) conclusive evidence for compulsory helmet wearing.

CheGuedara

This could be good.

*cancels all hopes of morning productivity and makes sure there's tea and biccies near to hand*

Ok, I'm good.

blorg

Mucco wrote: »

I think the BMA have dropped their claim about the benefits of cycling outweighing the risk - but there's still little (any?) conclusive evidence for compulsory helmet wearing.

I don't think they have dropped that claim at all (20 to 1 was the ratio.)

They have however changed their stance on compulsory helmet wearing (from anti- to pro- compulsion.)

This is not inconsistent if you believe that compulsion does not deter cycle use.

Mucco

blorg wrote: »

I don't think they have dropped that claim at all (20 to 1 was the ratio.)

They have however changed their stance on compulsory helmet wearing (from anti- to pro- compulsion.)

This is not inconsistent if you believe that compulsion does not deter cycle use.

Ahh, OK.
I thought the Australian experience showed pretty conclusively that compulsion does reduce cycling?

RobFowl

Mucco wrote: »

Ahh, OK.
I thought the Australian experience showed pretty conclusively that compulsion does reduce cycling?

That was one study in New South Wales, was clear in its findings but has not been replicated in other area's so there is only so much you can take from it.
(Big fan of helmets, totally oppose compulsion BTW)

Lumen

Mucco wrote: »

CONOR V EGLESTON,
FRCSI, FRCSM, FCEM, BSc,
Consultant Emergency
Medicine, Senior Lecturer,
Royal College of Surgeons in Ireland, Dublin 2.

Yeah, but what would he know?

Raam

CheGuedara wrote: »

*cancels all hopes of morning productivity and makes sure there's tea and biccies near to hand*

I read "bicycles" at first glance, and the statement still made sense to me

tomasrojo

Lumen wrote: »

Yeah, but what would he know?

He knows a great deal about his own area of expertise. He may not know much about statistics.

Gavin

Or physics/engineering

Lumen

I assume based on his undoubted medical expertise that he also thinks fried foods should be made illegal, given the high incidence of heart disease in this country. Actually, better include meat too, and dairy products. And alcohol. And recreational sex, just think of all those STDs and cervical cancer.

By extension we should all be celibate teetotal vegans, drifting around in a cloud of smug with our walking helmets carefully strapped in place.

I care not for this slippery slope. The "correspondent and occasional cyclist" can shove his compulsory helmets up his arse as far as I'm concerned.

Jip

I've no point of view if they should be compulsory or not, each to their own, but coming from speeding town forest tracks without a helmet, quite scary when I think back to it, to wearing one while commuting I've found the transition to wearing a helmet much easier than I expected. I was expecting annoyance and hassle but oddly I got used to to almost immediately and don't even realise I have one on anymore.

tomasrojo

I think there's a divide in the medical community. Paediatricians and surgeons (which is what this doctor is) are usually very much in favour of helmet promotion and even compulsion. GPs far less so, because they see far more of life-style illnesses than traumatic injuries.

The life-style illnesses are many, many times more common anyway and kill or ruin the lives of many more people.

stopped_clock

Is someone who's put off cycling by having to wear a helmet likely to end up cycling enough to derive the lifestyle benefits?

He knows a great deal about his own area of expertise. He may not know much about statistics.

I think Naseem Taleb has a bit in one of his books about how "experts" tend to overestimate their knowledge of fields outside their area. (But I might me wrong .)

Carawaystick

Why do people who are in favour of bike helmets not wear moped helmets? Pushbikes can go far faster than mopeds.

tomasrojo

The head overheats.

JMJR

I believe that the consultant referred to by the OP was replying to this piece of 'journalism' in last saturdays IT, wherein the councillor was let get away with some slick sound bites which conflated safety studies with bike usage surveys.

Irish Times Sat 12 Sept.
FIONA GARTLAND
THERE IS little evidence to prove the benefits of wearing a helmet while cycling, the councillor who initiated the capital’s new bike rental scheme has said.

After the launch of Dublinbikes yesterday morning, Labour councillor Andrew Montague said it was not essential that those hiring bikes in the capital wear safety helmets.

“We don’t have compulsory helmets in Dublin and I would not be overly concerned about cycling without a helmet,” he said.

Blue skies and warm sunshine contributed to what was a perfect day for the launch of the scheme.

Hundreds took advantage of the good weather to try out the 450 bikes now available to rent from 40 stations between the Royal and the Grand canals.

Cyclists can register online for annual membership using a credit card at a cost of €10 or can pay with a credit card at 14 of the stations for a three-day €2 ticket.

Rental is then free for half an hour and costs 50 cent for the first hour, rising to €6.50 for four hours. The bikes are available from 5.30am to 12.30am.

The scheme has been funded by advertising agency JC Decaux in exchange for the use of advertising space in the capital.

Mr Montague, who first proposed the scheme five years ago, said, with the removal of HGVs, Dublin was now a much safer place in which to cycle.

Asked whether helmets should be made available to those hiring the bikes, he said there was little evidence available on their benefits. “In Brisbane they made helmet-wearing compulsory and although the rate of accidents dropped and they thought it was a success, they realised it was because the rate of cycling had dropped by 50 per cent,” he said. “Helmets put people off.”

He said 80 per cent of cyclist deaths involved HGVs, especially those turning right, and “a helmet is not going to save you in that situation”. Mr Montague also said he envisaged the scheme being extended to the suburbs in years to come. “This is just the beginning as far as I’m concerned.”

More than 1,000 bike journeys were made in the first six hours of the scheme, a spokesman for Dublin City Council said last night. He said it now had more than 2,000 subscribers – an increase of 500 since Friday.

Out and about yesterday and wearing helmets were Roddie and Deirdre Aherne. “We’ve been all over the place,” Mr Aherne said. He would recommend the bikes and consider them for business.

Catherine O’Donovan found the bikes “female friendly”: “I don’t cycle, but I feel confident on it.”

She would consider picking up a bike at Pearse Street near where she lives and cycling to the Luas to commute to work. Ger O’Donovan said he would like to use the scheme. “I’m always wary of getting my own bike stolen,” he said.

This article appears in the print edition of the Irish Times


Now if you look at this part:

“In Brisbane they made helmet-wearing compulsory and although the rate of accidents dropped and they thought it was a success, they realised it was because the rate of cycling had dropped by 50 per cent,” he said. “Helmets put people off.”

A quick internet trawl and some reflection will allow you to state that:
The survey in Brisbane (nearly ten years ago) did show that bike usage dropped following the introduction of mandatory helmet laws.
That traffic survey AFAICT was market research carried out by the local council or state government.

Peer reviewed health and safety analysis of accident data, using controlled and accepted statistical analysis showed that head injuries were a consistent element in bike accident injuries and that helmet wearing was a significant factor in reducing or eliminating those injuries*.

I think its something that the journo should have picked up on, it was a shoddy piece or reporting, imo.


* And that is and always will be the case for any activity where the human head can suatain impact. And that is why i always wear a helmet- on a bike, skiing, on a motorbike or scooter.

John

Lumen

JMJR wrote: »

And that is why i always wear a helmet- on a bike, skiing, on a motorbike or scooter.

A skiing helmet? Seriously? Dude, that's just not cool.

tomasrojo

I'm pretty sure Montague was referring to this:

http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=16565131

JMJR wrote: »

* And that is and always will be the case for any activity where the human head can suatain impact. And that is why i always wear a helmet- on a bike, skiing, on a motorbike or scooter.

And playing golf, walking, having a shower, running, descending stairs on a bus ...

JMJR

tomasrojo wrote: »

And playing golf, walking, having a shower, running, descending stairs on a bus ...

I know you know what I mean!

tomasrojo

To save people who are only mildly interested from clicking through, the paper is

No clear evidence from countries that have enforced the wearing of helmets
D L Robinson, senior statistician

and the conclusion relevant to what Montague said was:

Before and after data show enforced helmet laws discourage cycling but produce no obvious response in percentage of head injuries

tomasrojo

JMJR wrote: »

I know you know what I mean!

Actually, I'm only being partly facetious. Cycling isn't unsually productive of head injuries. Golf and walking produce about as many head injuries.

JMJR

As usual the amswer lies somewhere in the middle. This from ROSPA- The Royal Society for the Prevention of Accidents

Cyclist Helmets

RoSPA recommends that all cyclists wear a cycle helmet that meets a recognised safety standard. Cycle helmets, when correctly worn, are effective in reducing the risk of receiving major head or brain injuries in an accident.

It is recognised that helmets do not guarantee protection for the wearer, nor prevent accidents from happening in the first place. The most effective ways of reducing cyclist accidents and casualties are to improve the behaviour of drivers, improve the behaviour of cyclists and to provide safer cycling environments. However, wearing a cycle helmet is a simple, low cost and effective way that individual cyclists can protect themselves.

Surveys in 2000, showed that only 22% of cyclists on major built-up roads wear helmets. Education and publicity measures to promote the use of cycle helmets should continue.

RoSPA does not believe that it is practical to make the use of cycle helmets mandatory because voluntary wearing rates are too low. Should compulsory cycle helmet legislation be considered in the future, it should be based on evidence that cycle helmets are effective in reducing cyclist casualties, and on evidence that voluntary use is sufficiently high for enforcement of the law to be practical. There may be stronger arguments for limiting mandatory cycle helmet use to child (rather than all) cyclists. As cycling provides health and environmental benefits, the likely effect of such legislation on cycle use should also be assessed .

tomasrojo

It doesn't really lie in the middle though. There are two source of evidence: case-control studies and time-trend analyses. The first suggest that helmets are very effective (hence what the RoSPA says), the second suggests that they do very little, perhaps nothing.

I don't see how they can both be right. In fact, they can't. One of the two must be flawed. My money's on the case-control studies. I can't think of any other scientific area where people would give case-control studies credence over large-scale time-trend studies.

p

There's 2 things at play which needs to be considered.

1 is whether in any given accident how effective a cycling helmet is at reducing injury.
The 2nd is whether promoting cycling helmets actually reduces the number of people who cycle in general, thereby making drivers less aware of cyclists and making it more dangerous for those who continue to cycle.


There's a big difference to what should be decided by individuals and what should be promoted to an entire community. The benefits to a community of cycling (better health, lower traffic and better for the environment) may mean that the overall way to encouage people to cycle is by making cycling safer through separated bike lanes and other measures, rather than promoting cycling safety equipment that puts people off.

humbert

Personal safety personal choice. Why can it not be this simple

starbelgrade

humbert wrote: »

Personal safety personal choice. Why can it not be this simple

Good call - it's not like wearing a seatbelt, which can reduce risk to others, besides saving your own skin, but how many people have been saved from injury / death from a cyclist wearing a helmet.

Plus they make you look like a div.

Mucco

My reply didn't get published, but one along similar lines did:
http://www.irishtimes.com/letters/index.html#1224254643250

Nietzschean

Lumen wrote: »

A skiing helmet? Seriously? Dude, that's just not cool.

i must admit to wearing one snowboarding...but then i tend to collide with objects frequently...mostly the ground. And my headphones for snowboarding are part of the helmet.....

Crippens

I have to admit I don't know the research done in this area but I would suspect that definitive conclusions are difficult because the reduction in the absolute risk of head injury achieved by wearing a helmet (i.e., in a crash, there will be some % reduction in head injuries for cyclists with helmets compared to those without) does not lead to a significant/appreciable reduction in the relative risk of cycling accidents resulting in head injuries (i.e, so many head injuries per time or distance travelled).
If I had the time I'd look it all up. My personal opinion (poorly informed as admitted above) is that wearing a helmet should be a personal choice as I suspect my risk of head injury from a crash is relatively low whether wearing a helmet or not.
I've also often wondered what the risk is for head injuries in car accidents; if the relative risk is greater than for cycling (which I suspect it is) then there is a more compelling argument for wearing helmets in cars.

I really should google the research or has anyone done this before; does anyone have links to the key/critical research?

tomasrojo

Crippens wrote: »

I really should google the research or has anyone done this before; does anyone have links to the key/critical research?

http://en.wikipedia.org/wiki/Bicycle_helmet

It has links to most of the major research in the area, as well as summaries.

blorg

Remind me, why are we having this thread AGAIN?

Raam

blorg wrote: »

Remind me, why are we having this thread AGAIN?

Cos no one is interested in the Vuelta.

Doctor Bob

Crippens wrote: »

I've also often wondered what the risk is for head injuries in car accidents; if the relative risk is greater than for cycling (which I suspect it is) then there is a more compelling argument for wearing helmets in cars.

http://www.copenhagenize.com/2009/05/motoring-helmets-for-real-high-risk.html


Also, I believe you are correct- higher incidents of head injuries in cars.

tomasrojo

Because, like the giant Antaeus, being thrown to the ground merely makes Helmet Thread stronger.

RedPlanet

Doctor Bob wrote: »

http://www.copenhagenize.com/2009/05/motoring-helmets-for-real-high-risk.html


Also, I believe you are correct- higher incidents of head injuries in cars.

But, does anyone have hard statistics of that?

stopped_clock

I think it's worthwhile every once in a while.

The first helmet thread I read educated me, and I doubt that was the first one ever.

I suppose the alternative is a mod locking a thread in the early days and linking to the wiki.

Jawgap

Helmets are a matter of personal choice (for me anyway!)

As for the IT article - I like this quote - "......with the removal of HGVs"...... so they were ice cream vans thundering by me this morning on Gardiner Street before they swung left around Beresford Place and headed off down the quays.

I think the initial positive impact of the port tunnel has worn off to a large extent - it now seems there as many HGVs around the city centre as there ever were.

Crippens

The Centre for Automotive Safety Research in ADelaide is developing this for car occupants:

CheGuedara

You can see the guy in the third picture thinking 'crap, now there's a dorky photo of me with this on my head on the internet'

Lumen

Helmet threads are cathartic.