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

death1234567 wrote: »

Almost invariably, in these cases the neurologists involved say that wearing a 20/30 quid helmet would have vastly improved outcomes and allowed the patient involved to carry on with their lives.

Firstly, ICU nurses are some of the greatest people I've ever had the misfortune to need around me. I badly injured my neck playing rugby, and spent some time in the National Rehab Hospital after being released from the ICU, and just have so much appreciation for what you do.

Now, I am sceptical about what these neurologists say.

To put it accurately, these experts at dealing with brain trauma speculate that wearing a piece of compressive foam may have altered the outcome. The efficacy of the foam would be totally outside of his or her realm of knowledge expertise, however, it is reasonable to assume that as they are in the ICU and receiving treatment from a neurologist that the trauma sustained was likely so extreme that the impact resistance provided by a standard bicycle helmet was greatly exceeded, and would probably not have been effective.

Brain trauma in this instance may be caused by deformation of the skull, impact internally with the skull, or a combination. The amount of deceleration a helmet can provide may prevent skull fracture, but likely not internal movement.

Where a helmet can be effective is in low speed accidents, and then successful at preventing concussion. To suggest that a helmet may prevent serious brain trauma is wildly speculative.


EDIT: I have put a line through a word I no longer think is fair, and replaced it with a word that is better.

galwaycyclist wrote: »

Uh no it would still be supposition and a variation on this is part of the junk science that feeds into helmet promotion.

If we take traffic injuries among children as an example.

There is an established correlation between levels of family wealth or social deprivation and risk of being a child pedestrian casualty. So Scottish children from the most deprived backgrounds have been found to be up to 6 times more likely to get knocked down while walking than their peers from the wealthiest sectors of society. A similar pattern is present for child cyclists although the disparity is not as extreme.

There are all kinds of reasons for this the wealthy kids likely experience more supervision and are likely to be protected by their parents from having to use risky environments. So they are more likely do their walking and cycling in parks or traffic calmed leafy suburbs etc.

Among children the wearing of cycle helmets is an indicator of social class.

If a clinician observes that child cyclists who wear helmets tend to experience lower injury severity are they observing the effect of the helmets? Or are they seeing the well established protective effect of membership of the wealthiest socio-economic groups?

Isn't this that study from the states? I think someone showed that wearing a bike helmet also reduces the risk of being stabbed, probably for the same social class reasons.

galwaycyclist wrote: »

Uh no it would still be supposition and a variation on this is part of the junk science that feeds into helmet promotion.

and helmet opposition.....:pac:

It's virtually impossible to derive a scientifically sound answer to this stupid debate without introducing a hefty dose of speculation/supposition/extrapolation of whatever you call it and ruining the whole thing. As soon as you introduce population statistics you introduce a metric sh*tload of potential error and an array of assumptions which may or not be true or applicable.

It's best to deal with the limited facts available and take things back to basics.

We'll assume accidents can happen. I think that's straightforward

There is a spectrum of potential head injuries from superficial bumps to long term brain damage and death.

The energy imparted on the skull in a crash can vary based on all sorts of factors. There is some relationship between the amount of energy involved, where it is applied and the severity of an injury.

Helmets are known to absorb or deflect an unknown amount of this energy.

This reduction in energy may move the injury one or two steps down the severity scale. It may be the difference between 20 stitches and a 20 second memory span...or it may not. It introduces a little more protection or even chance and that can't be a bad thing.

Now can we let people decide for themselves or should the festering of wildly speculative and unproven ideas that helmets are somehow inherently harmful continue?

If there's doubt about any of the above, we can apply the scientific method with a simple experiment involving hard walls or even stationary car bonnets and freshly laid tarmac.

You've lost me there i'm afraid...who's the drunk here?

The debate around the benefits, or not, of helmets all too often gets lost in a shouting match, of which the loudest voices tend to be those arguing that helmets are essential to your health. The most patronising of those arguments usually resort to telling people that the pro-helmet reasoning is based on "common sense" as if anyone holding a differing view is utterly devoid of any common sense whatsoever. It's a very weak position to adopt since you fall on your own sword as soon as someone else comes along and puts the argument that, for example, full face helmets are necessary for safety and that anything less defies common sense. (Incidentally, I witnessed one nasty face plant, and personally know the victim of another, and in both cases a full face helmet might have helped save a few teeth in one case (where the rider was wearing a helmet) and a lacerated cheek in the other (no helmet) - for fans of anecdotes there are potentially grounds for some strong arguments in favour of full face helmets there).

The strongest arguments in favour of helmets tend to just jump straight in at the emotive level, recounting tales of people who've incurred serious head injuries, etc. They skip straight past the crucial question about whether there are good grounds to believe that a modern helmet is really the best, or useful even, device to protect someone in a fall or a collision. The assumption seems to be that this is a question that is already answered, personally I believe it isn't. Issues around helmet design and testing have been referred to several times in this thread but I think it's worth repeating that there remain some real questions in these areas that should subjected to further scrutiny. So, for example:

* Why do the helmet safety standards differ in different parts of the world, are our heads really that different from one side of the world to the other?

* Why is the current EU standard arguably weaker than the SNELL standard (if I remember rightly) that it replaced?

* Is current helmet testing really rigorous enough for a product that so many people put so much faith in?

Not to mention the fact that questions about whether helmets actually increase danger in certain circumstances (rotational injuries, bigger object making for greater risk of collision, etc.) can tend to be dismissed out of hand as if they are not relevant. To my mind such questions are very relevant and no debate about the effectiveness and benefits of helmets can be complete without addressing them.

Thankfully there is a lot of interesting debate in this particular thread, it hasn't been drowned out by the zealots at either end of the opinion range. My own experiences add little to the debate. I rode for years without a helmet, both on-road and off-road, and although I had a number of knocks to the head in that time none of them were serious or anything close (by contrast I left some flesh from one elbow behind after one fall, but who cares enough about elbows to campaign for their safety?). At some point in my early 20's I bought into the "helmets are essential" argument and got myself one, though I only wore it off-road. It was a horrible yoke, like wearing a colander, modern helmets are things of beauty by comparison. It's a very insidious thing though, the helmet, after a while I found that I felt vulnerable without it. My riding style hadn't changed, my low rate of falling off the bike hadn't increased, I simply became paranoid and I started to wear my helmet regularly. That paranoia has stayed with me and I still wear a helmet now even though I've been unconvinced by all of the arguments I've encountered which claim that wearing the helmet makes me a sensible person and that not wearing one would mean certain death. I also still have to stop myself from blessing myself when I pass a church - despite having turned my back on catholicism many years ago the drummed in fear of being struck by lightning for sinning remains hard to shake off.

So I am full of contradictions. ("No I'm not!". "Yes, I am!" - see), just one more reason why I see no sense in my arguing strongly in favour of, or against, wearing a helmet. I will argue strongly in favour of people making up their own minds though, and I'll go further and argue strongly that they should make an *informed* choice hence my questions above. Bicycle helmets represent what I imagine is a lucrative industry, before we give the more of our money we should be asking the manufacturers (and the safety standards authorities) to justify the faith that they encourage us to have in their expensive pieces of polystyrene.

Anyway, yayyy to reasoned debate and booo to emotive rants.

galwaycyclist wrote: »

If you read the legislation they quote, it became mandatory to fit seatbelts to certain classes of vehicle in 1971.

Compulsory wearing didnt come in until 1979.

Even moving it to 1979 , and basing it on the citizen info website being incorrect, there is still a marked decrease from 628 deaths in 1978 to 410 in 1985. What are we attributing that to? Infact moving it to 1979 makes an even stronger argument for it.

Obviously not all are passengers or drivers in cars, but a marked decrease all the same, unless there was a reduction of 200 in pedestrian cyclist etc deaths, certainly no argument against the use of seat belts.

monkeybutter wrote: »

I don't believe that the helmet argument falls on full face helmets being better at protecting the face chin area than say road helmets.

I wasn't claiming that it does, I was saying that the "common sense" claim that is often pinned to the wearing of helmets isn't as common, or as sensible, as those touting that view would like to believe. To some people "common sense" suggests a full face helmet, and they'll quite likely have anecdotes to support that view, to others a full face helmet and body armour is probably the minimum that common sense dictates, and to some others again simply not riding a bike at all is the only "sensible" option. Different people draw the line at different levels of protective gear, and they'll all believe they are right and that the others are either too cautious or too reckless. The "common sense" justification is basically silly.

monkeybutter wrote:

I have witnessed similar myself and it seemed obvious at the time the injury was reduced by the helmet taking the brunt of it.

As you got older, you just got wiser, it happens to us all. :pac:

I have no doubt, from personal experience in some cases, that wearing a helmet has been of some benefit to some people in some crashes. I also have no doubt, again from some personal experience, that not wearing a helmet has not been detrimental to some people in some crashes. From the stuff I've read I believe that wearing a helmet can be detrimental to some people in some cases. Generalising any of those is, I believe, silly.

An individual using anecodotes and their own experiences to inform their own decision to wear or not to wear a helmet I see no issue with at all, the same individual trying to use anecdotes to brow beat others into wearing or not wearing a helmet I find distasteful. The "it's only common sense" argument falls into the latter category.

As for getting getting wiser as I get older, no, if anything I'm shedding brain cells at an alarming rate. I suspect my paranoia is keeping itself fueled by scooping up and eating those brain cells.

The cycling helmet debate seems to cause endless debate when raised here, with the "yays and nays" equally entrenched. It sounds like a debate that will go on as long as cycling is around.

I'm curious if this is common in other sports where head impacts at varying speeds are common? For example snow sports, rock climbing, water skiing, sailing? Is this debate just particular to cycling and maybe reflective of the type of people who cycle?

Surveyor11 wrote: »

The cycling helmet debate seems to cause endless debate when raised here, with the "yays and nays" equally entrenched. It sounds like a debate that will go on as long as cycling is around.

I'm curious if this is common in other sports where head impacts at varying speeds are common? For example snow sports, rock climbing, water skiing, sailing? Is this debate just particular to cycling and maybe reflective of the type of people who cycle?

I think the bit in bold is where most of the contention occurs.

My interpretation is that helmets suggest imminent danger. That danger is statistically and, in my experience, empirically tiny. Arguments for their usefulness must address this.

Also, simple arguments are often tainted by extreme examples: the guy who received an ABI while not wearing one, or the girl who walked away from an accident with no more than a broken wrist while wearing a helmet. These detract (or at least distract) from the actual point of the conversation.

Helmets are useful in a number of circumstances. Fortunately, these circumstances are extremely rare. Unfortunately, it's usefulness is surpassed relatively easily.

Well, fair enough. My skull is only 1/8th inches thick (some would say thicker:pac:) and not very good at absorbing impacts. I wear a helmet and hope this will lessen the impact on my skull (I could be wrong of course, and hope I never have to find out).

Agent Smyth wrote: »

why don't you google "people electrocuted on stage"

Why? So I can find links back to this page?

A handful of people die every year due to ungrounded amps. I saw someone get a shock from a live mic once myself. As such, its only common sense that all performers should wear rubber soled shoes, and/or rubber gloves on stage.

This confession may draw a lot of comment I'm sure. For the record I always wear a helmet. My ten cents worth on this is not fact but more personal observations of myself as a cyclist and motorist.

I started cycling my youngest on the bike into a crèche in town from churchtown recently (traffic :mad:). I have noticed that when I have a baby in the carrier, drivers, in general I think, are a lot more cautious when over taking me. When I am on the bike alone, drivers are a little less cautious, in general I think.
This may also be because I'm moving a lot faster on my own and maybe cycle with a little less caution. When I'm out on the road bike I often think I would take fewer risks if I did not have a helmet on. I have also noticed that I would be a more cautious as a driver overtaking a cyclist who i perceive as a vulnerable road user.

Perceptions of safety have a huge impact on our own behaviour and the behaviour of others around us. Safety gear can lead to people taking more risks when undertaking an activity because they perceive the activity to be safer. Helmets are one of those, they will not prevent a potential accident (unlike light or hi viz when cycling in the dark) but may protect us to some extent (in the event of a bump to the head).

I wear a helmet with a cover in days like today, i.e. to keep the rain out. It means in most days. That is its main function.

MediaMan wrote: »

I'm surprised that there hasn't been more discussion in the thread of this paper. It strongly suggests that helmet wearing has a small but definite benefit based on a meta-review of multiple studies.

And this meta-analysis shows little net benefit, becoming no net benefit with later publications:
http://www.cyclehelmets.org/1251.html

(Switching to soft-shell seems to be partly to blame.)

doozerie wrote: »

This thread won't change that, but it provides the opportunity for informed and reasoned debate and that's got to be a good thing. Hopefully the polarised views don't derail it entirely, 'cos I'm finding it informative and interesting.

Definitely the most good-tempered helmet thread I can think of!

By the way (slightly OT), am I right in thinking that hard-shell helmets were (and are?) more compact and have lower coefficients of friction on impact with the ground? Possibly better when it comes to rotational acceleration.

Surveyor11 wrote:

The cycling helmet debate seems to cause endless debate when raised here, with the "yays and nays" equally entrenched. It sounds like a debate that will go on as long as cycling is around.

I'm curious if this is common in other sports where head impacts at varying speeds are common? For example snow sports, rock climbing, water skiing, sailing? Is this debate just particular to cycling and maybe reflective of the type of people who cycle?

I don't participate in those other sports you've named so I don't know how actively debated this topic is within those. My guess though is that it's so prevalent within cycling because of the broad appeal of cycling not just as a sport but as a form of transport, and for that reason it's much more in the public eye than some sports and probably a wider portion of the public have a strongly held view on various things relating to it. Combine that with what seems to be a widespread (mis)conception that the roads are dangerous and you have the ingredients for very heated debate. Chuck in the prospect of kids cycling and the handwringing shoots up the scale.

I'd imagine that within, for example, the base jumping community there are some very strong views on what is safe and what is not, but those kinds of views don't tend to make it into the letters page of a national newspaper, for example, so any debate doesn't tend to get so blown out of proportion. Or maybe the fact that base jumpers usually wear helmets wins over those that rant about non-helmet-wearing cyclists, and they are therefore willing to look past the fact that base jumpers throw themselves off very tall objects whereas a cyclist rolling along a road without a piece of polystyrene has some kind of death wish. I have absolutely nothing against base jumping, incidentally, it's just one example that springs to mind - I just find it odd that of the many widely practiced activities that involve some degree of risk, cycling gets singled out a lot as being extremely dangerous and that cyclists need someone to look after them since they themselves are deemed somehow unwilling or unable to make reasoned decisions for themselves.