Thanks for that, I certainly see where your argument arises.Here are my concerns: 1. This is lay media reporting on an interpretation of the literature. I would really like to see these studies. 2. Further issues are alluded to and I feel that there is a confusion of multiple variables. One such variable would be why are more accidents occurring? Is it increased traffic? Mobile phones? Cyclists wearing headphones? I certainly think that identifying these key variables is far more important. 3. Of these incidents that occur, where does the blame lie? Is it with the cyclist riding faster or is it the drivers not adhering to road rules? Again, possible (assumed) change in cyclists behaviour may or may not be a factor. Certainly when an incident DOES occur, higher speed = higher force = assumed greater severity of head trauma. There may be more factors in the cyclists speed. 4. Efficacy of bicycle helmets in limiting time in hospital, cost of hospitalisation and mortality is well documented. What the opening paragraph states is helmet use did not decrease hospitalisation rates (no mention of cost or length of stay) in people that already have had a head injury. 5. Cycle helmet design is (and this is my opinion) often structurally suboptimal. I would prefer more occipital and temporal coverage. Thus I can agree with the point raised that perhaps for certain directional forces, protection may be suboptimal. 6. The "New Zealand doctors" anecdotal comments are exactly that, anecdotal. The literature on limiting extent of cerebral injury is well documented in medical literature. Papers are still being published to support this stance, the most recent of which I can find was from Q3 2016. 7. The possibility of increased rotational force to the cranium and neck when subjected to a tangential force is, I believe, of concern especially with helmets with extra "hair room" related to the increased moment of the force. Has it been shown to increase severity of head injury when compared to helmet-less victims? I can not find data to support this. 8. Does lack of exercise contribute to increased cardiovascular mortality? Undoubtedly. Would losing the helmet requirement directly reduce cardiovascular death? I think the problems may be more multifactorial than that. 9. Using your example of the Netherlands, was their accident rate lower or their head injury severity lower? Helmets don't stop accidents, they are there to limit head injury severity if an accident occurs. This brings us back to the multifactorial components of bicycle safety. What do they do differently that is ACTUALLY decreasing their accident rate? I appreciate the discussion. Perhaps I am a little biased having seen my fair share of severe head injuries. Sent from my iPhone using Tapatalk
