Helmets - the definitive thread.. ** Mod Note - Please read Opening Post **

Jawgap

Tenzor07 wrote: »

DFB say always wear a helmet: http://irishcycle.com/2016/08/08/dublin-fire-brigade-recommends-a-helmet-after-tweeting-about-a-leg-injury/

Where can I get my leg helmet?

Roadhawk

Jawgap wrote: »

Where can I get my leg helmet?

you can get one here:

http://www.chainreactioncycles.com/nl/en/body-armour

:):)

2RockMountain

I haven't had time to go digging out the actual paper as yet;

http://metro.co.uk/2016/09/22/wearing-a-bike-helmet-reduces-risk-of-serious-head-injury-by-almost-70-says-study-6144333/

Dermot Illogical

2RockMountain wrote: »

I haven't had time to go digging out the actual paper as yet;

http://metro.co.uk/2016/09/22/wearing-a-bike-helmet-reduces-risk-of-serious-head-injury-by-almost-70-says-study-6144333/

I tried, but you can't without paying. It's a meta-analysis, but the abstract doesn't say which helmet manufacturers were behind the original studies.

alexinkildare

It's a matter of choice but I chose to wear a good helmet. Nothing macho about not wearing a helmet.

NiallBoo

magicbastarder wrote: »

whereas with bicycle helmets, the shell is separated from your head by thin foam cushions whose job is primarily comfort.

The outer shell is there to help the helmet slide along the road.

Earlier helmets without them were found to sometimes grip the road and result in a broken neck.

*different for bmx helmets with a hard shell of course.

shamrock2004

The abus helmet I have is about 18 months old and has developed a small (about 1.5 inch) crack in it, even though it's never been involved in a crash at all and is now compromised. Should I bring it back and ask for a refund? I thought a helmet would last longer than this?

magicbastarder

2RockMountain wrote: »

I haven't had time to go digging out the actual paper as yet;

http://metro.co.uk/2016/09/22/wearing-a-bike-helmet-reduces-risk-of-serious-head-injury-by-almost-70-says-study-6144333/

From what I understand, they analysed crashes to determine if helmet use was or could be helpful - and that is a fatal flaw. The crash had already happened. They didn't look into the effect mandatory helmet law might have on bike use or whether it may be a factor in the causation of the crash.

Dermot Illogical

alexinkildare wrote: »

It's a matter of choice but I chose to wear a good helmet. Nothing macho about not wearing a helmet.

Who said it was macho?

Cee-Jay-Cee

shamrock2004 wrote: »

The abus helmet I have is about 18 months old and has developed a small (about 1.5 inch) crack in it, even though it's never been involved in a crash at all and is now compromised. Should I bring it back and ask for a refund? I thought a helmet would last longer than this?

Somehow I doubt it would be still covered by warranty but you could try.

tomasrojo

2RockMountain wrote: »

I haven't had time to go digging out the actual paper as yet;

http://metro.co.uk/2016/09/22/wearing-a-bike-helmet-reduces-risk-of-serious-head-injury-by-almost-70-says-study-6144333/

When I first heard about this, saw 70%, and saw Olivier was the prinicpal author, I figured this was a resurrection of Thompson, Rivara and Thompson. So it seems to be. Their work figures very heavily. I've never rated TRT's work, for reasons outlined earlier in the thread, I think.

It's discussed here, (this post was quite interesting), and I think there's a link to the paper there.

This seems to be written specifically to counter Rune Elvik's meta-analysis of five years ago, which wasn't all that glowing about helmets' efficacy.

Olivier's use of statistics in general I find bizarre, such as his argument that Ian Walker's study about close passes was burdened by having "too much data". He wrote a paper that simply removed data until the statistical significance disappeared and claimed he'd discredited Walker's paper.

His testimony to the Australian senate hearing into "nanny state" laws was quite odd too, claiming that street counts had no place in determining how many cyclists there were, but that we should hospitalisation data instead.

EDIT:
Link to paper:
http://urbactiv.com/wp-content/uploads/2016/09/IntJEpidemiol.-2016-Olivier-ije_dyw153.pdf

tomasrojo

Also in the news: here comes the folding, recyclable, erm ...



http://bikesnobnyc.blogspot.ie/2016/09/free-your-head-and-your-bike-will-follow.html

Dermot Illogical

http://www.independent.ie/world-news/europe/britain/mother-dies-from-bike-crash-moments-after-taking-this-smiling-selfie-35103791.html
A sad case, with the inevitable call for mandatory helmets. The husband's logic seems to be that because she died riding a bike one-handed and drunk over rough surface at night while taking selfies, everyone else should be forced to wear helmets.

nak

Dermot Illogical wrote: »

http://www.independent.ie/world-news/europe/britain/mother-dies-from-bike-crash-moments-after-taking-this-smiling-selfie-35103791.html
A sad case, with the inevitable call for mandatory helmets. The husband's logic seems to be that because she died riding a bike one-handed and drunk over rough surface at night while taking selfies, everyone else should be forced to wear helmets.

Ban pubs and selfies - problem solved.

endagibson

She died back in August. Well done the Indo for bringing us this newsflash.

"...moments after she took a smiling selfie..." - ban selfies?
"...had had a drink before cycling home..." - drunk in charge of a bicycle perhaps?
"...may have had one hand on the handlebars..." - control the bike properly?
"She had been taking some selfies on the main road, she did that regularly and was media savvy," :rolleyes:

"...next second it's a trainwreck." Ah jaysus, now there's a train involved.

Out of nowhere - "He called for legislation to be introduced to require riders to wear a helmet."

No call for high-vis? There is, but not until the comments.

Strange that there's no mention of anyone going to the council about the road condition that caused the fall in the first place.

Seweryn

endagibson wrote: »

"...moments after she took a smiling selfie..." - ban selfies?
"...had had a drink before cycling home..." - drunk in charge of a bicycle perhaps?
"...may have had one hand on the handlebars..." - control the bike properly?
"She had been taking some selfies on the main road, she did that regularly and was media savvy," :rolleyes:

"...next second it's a trainwreck." Ah jaysus, now there's a train involved.

... and she was a mother.

Chips Lovell

What's a factor in more head injuries, alcohol or cycling?

Mandatory drinking helmets all round.

alexinkildare

alexinkildare wrote: »

It's a matter of choice but I chose to wear a good helmet. Nothing macho about not wearing a helmet.

I think the reverse is often true.

Wearing a helmet is - in some circumstances - a statement that the rider is involved in some sort of 'extreme sport'. Not wearing a helmet is a statement that the cyclist is merely going somewhere on a convenient method of transport.

I suspect, based admittedly on zero real evidence, that more men than women wear helmets, often as part of that image.

I don't think the lovely ladies of Copenhagen eschew helmets for 'macho' reasons, and thank god they do not.

CramCycle

Jep Gambardella wrote: »

What's a factor in more head injuries, alcohol or cycling?

Mandatory drinking helmets all round.

I found people who don't like me are a far greater risk to my head, more so than drinking or cycling, although both seem to attract these people.

endagibson

alexinkildare wrote: »

Nothing macho about not wearing a helmet.

Nobody claimed it was.

NiallBoo

endagibson wrote: »

Nobody claimed it was.

Standard stuff.
If people disagree with us we assume that there's some illogical, emotive thing at play rather than because they looked at the same things but reached a different conclusion.

If anything is likely to cause brain damage it's the constant bickering about helmets.

endagibson

NiallBoo wrote: »

If anything is likely to cause brain damage it's the constant bickering about helmets.

Arguing helmets?

Chuchote

TED talk; interesting

BigDickLanger

the coastguard did!

Dermot Illogical

Chuchote wrote: »

TED talk; interesting

Very interesting. How does an industry shill get on to TED Talks with that many logic fails?

He states that helmets are the best at preventing brain injuries. Not falling off your bike is likely to be far more effective, but you don't hear the industry pressing so hard for better infrastructure or more roadcraft training.

He dismisses out of hand the effect of mandatory helmets on bike share schemes. It's almost as if Australia doesn't exist.

He makes a leap from bicycle related brain injuries to talking about how it costs 100b per annum in the US, but neglects to mention that he's no longer talking bicycles with that figure. What he is doing is taking the annual estimate of all injuries, doubling it and then attempting to associate it with bikes. The biggest culprit for those injuries is the simple household fall.

He states that the problem with bike share schemes is low rate of helmet use. That's only likely to be a concern if there is a high rate of head injuries that could be mitigated by helmet use among users of those schemes. If that's not the case he is simply advocating a commercial fix to a non-existent problem.

Dublin Bikes, 16m journeys in the busiest traffic in this country over 7 years. 1 head injury fatality, a student who fell off after a few late-night beers.

Beware those selling a solution for imagined problems, especially when they dress it up as an academic presentation but base it on assumptions and anecdotes. He does say follow the money for bike injuries and it leads to brain injuries. Follow the money for his research and it leads to the Snell foundation, funded by Bell helmets. He's awfully quiet about that in his talk.

CramCycle

He really does nothing for the belief that medics should not try to be scientists and vice versa. If there were anymore holes in his advertorial it could have been marketed as a Swiss cheese.

dub_skav

I stopped watching at his straight faced assertion that helmets prevent 85% of head injuries.
Any modern speaker still taking that as gospel is not worth listening to.

magicbastarder

When you have a hammer...

tomasrojo

dub_skav wrote: »

I stopped watching at his straight faced assertion that helmets prevent 85% of head injuries.
Any modern speaker still taking that as gospel is not worth listening to.

I didn't watch the talk. I have a limited download allowance, so I tend not to watch longish videos.

I presume though that he is this Rivara. So he's responsible for the 85% figure in the first place.

Fascinatingly, he is still pushing the 85% figure, even though he co-authored a paper that corrected that figure downwards, based on exactly the same dataset from the late 80s.

tomasrojo

Based on what Dermot Illogical said, it also lends support to my suspicion that bike-share schemes pose a problem for people who push helmets heavily, in that they represent a very large dataset of largely helmetless cyclists who are overwhelmingly having safe journeys.

Dermot Illogical

http://crag.asn.au/misguided-doctors-or-marketing-agents/

PokeHerKing

So are people advocating not wearing helmets?

CramCycle

PokeHerKing wrote: »

So are people advocating not wearing helmets?

I advocate making your own mind up, if you want to wear one, wear one. If you don't, then don't. Do not criticise those who do not, and do not chastise those who do.

magicbastarder

PokeHerKing wrote: »

So are people advocating not wearing helmets?

i'm not wearing one.

WindomEarle

PokeHerKing wrote: »

So are people advocating not wearing helmets?

For what? Driving? Walking?

PokeHerKing

WindomEarle wrote:

For what? Driving? Walking?

For cycling of course. Sorry if that wasn't clear. I wear one, I'm fairly new to the cycling gig. I commute to and from work.

I was more interested to know why people who would be avid cyclists would be arguing against wearing one?

I sense some tension, I'm not looking to throw stones. Just genuinely interested in people's reasoning for not wearing one.

Chips Lovell

PokeHerKing wrote: »

I was more interested to know why people who would be avid cyclists would be arguing against wearing one?

The level of risk doesn't call for wearing of one at all times.

Chuchote

PokeHerKing wrote: »

For cycling of course. Sorry if that wasn't clear. I wear one, I'm fairly new to the cycling gig. I commute to and from work.

I was more interested to know why people who would be avid cyclists would be arguing against wearing one?

I sense some tension, I'm not looking to throw stones. Just genuinely interested in people's reasoning for not wearing one.

Because the figures suggest that they're not needed. As Dermot Illogical writes above:

Dublin Bikes, 16m journeys in the busiest traffic in this country over 7 years. 1 head injury fatality, a student who fell off after a few late-night beers.

Mind you, that one fatality might have been avoided if he'd had a helmet on.

In places where there are wide, well-paved, clearly-signalled cycle lanes separated from motor traffic, people seldom wear helmets and the rate of head injuries is low. However, even in those places brain surgeons often call for use of helmets, since they're the ones who see the effect of head injuries when they do happen.

In countries where helmets are compulsory, there is often a low take-up of cycling; there's a theory that this is because helmets make it seem like a dangerous activity.

My own feeling is that it's like seat belt use - when both cycling and helmet wearing become the norm, this will be less important to people, it'll just be part of cycling.

It's up to yourself; you make your own decision.

dub_skav

tomasrojo wrote: »

I presume though that he is this Rivara. So he's responsible for the 85% figure in the first place.

.

D'oh, the name should have clicked.

Makes more sense then, but as you say it is odd that he still hasn't changed the figure, must just be too lazy to update his slides

Lumen

Chuchote wrote: »

Mind you, that one fatality might have been avoided if he'd had a helmet on.

Your implied suggestion is to always wear a helmet when cycling drunk.

My brain is itching for an alternative solution but I just can't quite put my finger on it.

Chuchote

Lumen wrote: »

Your implied suggestion is to always wear a helmet when cycling drunk.

My brain is itching for an alternative solution but I just can't quite put my finger on it.

Heh… a few more glasses of Black Bush or Jemmy's may make you think straighter…

buffalo

Chuchote wrote: »

Dermot Illogical wrote: »

Dublin Bikes, 16m journeys in the busiest traffic in this country over 7 years. 1 head injury fatality, a student who fell off after a few late-night beers.

Mind you, that one fatality might have been avoided if he'd had a helmet on.

It's true, we'd avoid a lot of fatalities and traumatic head injuries if helmet use was promoted and encouraged more among people consuming alcohol.

I support you entirely in this Churchote. Drinking helmets for everyone!


edit: DYNF Lumen!

tomasrojo

Chuchote wrote: »

even in those places brain surgeons often call for use of helmets, since they're the ones who see the effect of head injuries when they do happen.

You do get prominent surgeons who completely disagree though, such as Henry Marsh. He says they're just too flimsy to make a difference. (I should really say "I have heard of one prominent surgeon who disagrees; there may be others")

Mayer Hillman, who wrote some thoughtful commentary on the issue, said that in any case it doesn't do to put too much emphasis on catastrophic outcomes when they're pretty unlikely. He compared putting the opinions of surgeons over other experts to seeking advice on whether to buy lottery tickets and only asking lottery winners.

Chuchote wrote: »

My own feeling is that it's like seat belt use - when both cycling and helmet wearing become the norm, this will be less important to people, it'll just be part of cycling.

To some extent, helmets have been normalised. People don't laugh at people wearing them anymore; not the way they used to. However, they're substantially different from seat belts, in that they look at least somewhat "goofy", to use bikesnobnyc's word, they don't conveniently and automatically store themselves inside the bike when you're finished cycling, and their efficacy against serious head injury in a collision can reasonably be argued to be zero, with error bars. At least that's essentially what David Spiegelhalter and Ben Goldacre argued in the BMJ, and they're both distinguished, in the field of statistics and epidemiology, respectively.

There is of course the possibility that a much better helmet could be developed, but if you have people iike Rivara saying that the current design prevents 85% of head injuries, that takes the pressure off coming up with a design that really does work well.

Chuchote

Seriously, though, I was in Holland a few years ago and was chatting to friends, and (secondhand…) one had a friend who was a young brain surgeon and who was pressing him to wear a helmet because of the head injuries he'd seen; he said that the feeling among brain specialists over there is that helmet use would be a good thing.
It would probably be a more useful TED talk to get some of them talking about the injuries they'd seen and whether helmets would have prevented them rather than the one I quoted above.
So… back to trying to fix the dishwasher…

PokeHerKing

Chuchote wrote:

Mind you, that one fatality might have been avoided if he'd had a helmet on.

Chuchote wrote:

Because the figures suggest that they're not needed. As Dermot Illogical writes above:

Do we have figures of how many brain injuries were avoided in that same period due to helmet use?

CramCycle

I have found since I stopped wearing my helmet that my hair is more volumised and softer in work. It also hides my increasingly large bald spot from anyone under the height of 5'10.

This reduces my stress levels, makes me feel more confident, leading to greater productivity at work.

All in all, the benefits of not wearing a helmet are stacking up. I imagine the net gain to the irish economy is more than the VAT on a typical helmet (which if they were really safety equipment should be zero rated regardless).

Chuchote

PokeHerKing wrote: »

Do we have figures of how many brain injuries were avoided in that same period due to helmet use?

I think it would be hard to make up such figures; after all, if you're knocked to the ground and your helmet saves your head, you're not so likely to be in the hospital.

I don't really have a dog in this fight; I've taken to wearing a (MIPS) helmet; if others don't want to, I'm fine with that.

It seems to me that we're not getting good figures from people with no initial prejudice but with sound knowledge. If we could get figures from brain surgeons and rehab, and A&E (or whatever they've changed the name to now in the craze for renaming rather than improving), and racing cyclists, who have the most crashes and the most dangerous crashes - then we might be better able to judge.

tomasrojo

PokeHerKing wrote: »

Do we have figures of how many brain injuries were avoided in that same period due to helmet use?

That's a very hard trend to disentangle. If you look at hospital data (case-control studies) comparing helmeted cyclists with unhelmeted cyclists who've have been hospitalised, you can see a lower incidence in serious head injury among the helmeted. However, you can also see a lower incidence in lower body injury as well. Essentially, higher-income people tend to have fewer collisions with motorised vehicles (they live in safer neighbourhoods for a start) and also are more likely to wear helmets, so the helmet is probably not the main thing making the difference in those studies, but the income level of the patients. This is "confounding", and income confounding is really common in case-control studies. You could, to be trivial, find an association between lower head injuries and eating five a day as well.

If you look at trends for serious head injury per million cyclists, on the other hand, as helmet-wearing rates rise, you usually see serious head injury rates go up (though not stratospherically).

So there's no clear way to calculate how many lives have been saved, if any. As Spiegelhalter and Goldacre put it, the direct benefit is too modest to capture.

Chuchote

tomasrojo wrote: »

So there's no clear way to calculate how many lives have been saved, if any. As Spiegelhalter and Goldacre put it, the direct benefit is too modest to capture.

Or we're not calculating the right way, maybe.

I mean, while racing cyclists are obviously the group that have the most crashes and the most dangerous ones, they're also the fittest, and the most likely to know how to recover from a small crash. They universally (I think?) wear helmets, but they are presumably at greater risk of crashing and of head injuries than people cycling in urban traffic. Or are they?

tomasrojo

Incidentally, it's been linked before, but Ben Goldacre discusses this statistical tangle in this podcast at 1:12:45
http://feeds.soundcloud.com/stream/188278861-britishcomedyguide-richard-herring-lst-podcast-61-ben-goldacre.mp3

He says it's a very good example of the pitfalls of epidemiology in general.

(The podcast, as with all Richard Herring's podcasts, has sections that are junvenile, and NSFW, even if you have a workplace that lets you play podcasts out loud.)