Helmet Safety Poll

[Eldron]

"I think the safety afforded by the helmet outdoes the increase in risk due to wearing it"

 

Based on what do you make this statement? (It's one that I agree with, just interested to know) gut feel, personal experience, info etc?

 

Ps: Data gathering is never flawed, it might not end up supporting the original intention, but conclusions can always be drawn. Even if it is only about people's perceptions. There is alway value if you look for it.

 

Why I wear a helmet (most of the time):

Obvious answer - hitting a pavement with polystyrene is better than hitting it with flesh&bone.

In 30+ years of riding I've had a lot of dings and scratches on my helmet - better the helmet than my skin. I have had a few helmet induced accidents like hitting branches I might have not hit without the extra 3cm of "helmet height" but the consequences were minor.

I have been riding for so long that wearing a helmet is "second nature" so I don't think I suffer from helmet induced risk any more.

Mostly because the potential head inuries in of a big off are real - the studies/stats/investigations are theoretical. Sure there are trends but I don't feel they are concrete enough to make me wear my helmet less.

 

Ultimately we all have brains - we decide on our own risk profile - the studies/stats/investigations are valuable in that they allow us to adjust the profile (if necessary).

 

Data gathering is always flawed when humans are involved. The second you decide to gather data to prove a point you've corrupted the data before you even start. Data gathering has to be absolutely pure. Stats gathered using confusing questions, loaded questions, irrelevant questions, too many questions etc is useless. Gathering useful data from human beings in near on impossible.

[Eldron]

I'm on my way out for the day, so I'll make this quick!

 

Some thoughts on recent comments:

 

1. Quantification of risk and comparison of it's increase and/or decrease is possible. It's commonly done in, at least, 2 ways by comparing 'risky behaviour' eg the speed at which people will ride with/without a helmet,  as an example, where an increase of speed, would be considered an increase in risky behaviour. Likewise the distance that a car will pass you if with/without a helmet. The second means of quantification is determining the consequence of behaviour eg accident rates, fatalities etc.

 

2. Further to 1, various meta-studies (a complex statistical approach) churn out risk factors which inform practioners in the field. See this link for an example of the approach - I'm not pushing the conclusion incidentally. http://www.sciencedirect.com/science/article/pii/S0001457500000488

 

3. This type of field is complex and for most of us, including myself, abstract. The search for, and/or the rebuttal of existence, of understandable and plausible data is akin to a search for the Grail. Scientific consensus, which embraces studies supporting or refuting postulates, would probably better inform and it may exist. Why not ask several specialists in the field?

 

4. If risk homeostatis is applicable with regard to bicycle helmets and aspects of safety, then a simplified approach would suggest that you will be exposed to the same risk factor whether you are helmeted or not. Sure, how is risk factor determined, does it account for unreported accidents which didn't lead to hospitalised injuries etc etc, but doesn't that inform the overall consequence of helmets vs no-helmets? 

 

In some instances it's pretty easy - like measuring how far a car passes riders with helmets and without helmets. Great.

 

Additional risk taking due to wearing a helmet is impossible to measure - as a trend sure but putting numbers to it? Far too many variables to do anythig more than a mild trending.

[Patchelicious]

Why I wear a helmet (most of the time):

Obvious answer - hitting a pavement with polystyrene is better than hitting it with flesh&bone.

In 30+ years of riding I've had a lot of dings and scratches on my helmet - better the helmet than my skin. I have had a few helmet induced accidents like hitting branches I might have not hit without the extra 3cm of "helmet height" but the consequences were minor.

I have been riding for so long that wearing a helmet is "second nature" so I don't think I suffer from helmet induced risk any more.

Mostly because the potential head inuries in of a big off are real - the studies/stats/investigations are theoretical. Sure there are trends but I don't feel they are concrete enough to make me wear my helmet less.

 

Ultimately we all have brains - we decide on our own risk profile - the studies/stats/investigations are valuable in that they allow us to adjust the profile (if necessary).

 

Data gathering is always flawed when humans are involved. The second you decide to gather data to prove a point you've corrupted the data before you even start. Data gathering has to be absolutely pure. Stats gathered using confusing questions, loaded questions, irrelevant questions, too many questions etc is useless. Gathering useful data from human beings in near on impossible.

Firstly, thank you for a refreshing post.

 

Data should never be gathered to prove a point. It should be gathered to form a point.

 

Good post, makes sense!!

[Patchelicious]

In some instances it's pretty easy - like measuring how far a car passes riders with helmets and without helmets. Great.

 

Additional risk taking due to wearing a helmet is impossible to measure - as a trend sure but putting numbers to it? Far too many variables to do anythig more than a mild trending.

The actual distance to measure is easy.

 

Where the tricky part comes in is when we start looking at difference in societies and laws.

 

In Europe, where those studies were done, if a cyclist gets knocked over there are real consequences. The perception of the driver is to give the non-helmet wearing rider a wider berth, because if they knock them off, there is a greater chance that the rider will suffer a greater injury and therefore have a greater consequence to the driver.

 

But here is SA, I doubt that Mr Taxi driver, or angry Mr Fortuner driver would gives a crap about the possible increase of consequence, because there is not much.

 

So I can absolutely see the merit in that study, I just think we need to take the other party's (drivers) behavioral influences into account too.

[Patchelicious]

A number of studies including:

 

1. Injury rates recorded before an after mandatory laws were implemented in oz. there was no decrease in injuries sustained or deaths. In fact if one considers all stats there was an increase.

2. The extensive work done by Dr John Adams following the Hurt report.

3. Research which show an increase in injuries other than head injuries in oz compared to Netherlands. Simplistic yes, but an avenue which needs to be further understood.

4. Risk homeostatis. I posted a link previously which proves this exists. The extent of which is far larger than yr straw poll indicates. Been rehashed in this thread enough so won't delve into it.

5. A number of cycling injuries are face related an to other parts of the body. The helmet is useless in these but probably increases the risk an severity of these due to our risk perception.

6. In car cyclist accidents helmets are of little use.

7. Our current understanding of how the brain is injured is limited. Much more work needed an in helmet design too.

8. As humans we have a basic misunderstanding of physics. The amount of kinetic energy the body has at relatively low speeds is astounding. When we go down valverde hill at 70 kays plus an hour the physics become frightening. We don't fully understand that.

 

Sure, I will wear a helmet when out training but am well aware of their shortfalls. Hopefully this reduces my risk of an accident.

 

Interesting discussion. We won't convince each other. If you want to put faith in yr helmet then so so. I choose to take all info at hand an have a different view.

I am not trying to convince you of anything, I really am not. Thats not the point of discussions like this. If people set out to specifically to change other peoples minds, its a lost cause.

 

What I am trying to understand is how you arrived at you very explicit conclusion.

 

You go to great lengths to make use aware that the studies are inconclusive, and that its all in  a grey area, yet you arrive at a very explicit conclusion.

 

"What is crystal clear however is that we should not be placing much, if any, faith in helmets" - This is a very powerful statement to be making based on inconclusive evidence?

 

So surely if you think that the data is inclusive, ones hypothesis would be inconclusive too?

[Eldron]

The actual distance to measure is easy.

 

Where the tricky part comes in is when we start looking at difference in societies and laws.

 

In Europe, where those studies were done, if a cyclist gets knocked over there are real consequences. The perception of the driver is to give the non-helmet wearing rider a wider berth, because if they knock them off, there is a greater chance that the rider will suffer a greater injury and therefore have a greater consequence to the driver.

 

But here is SA, I doubt that Mr Taxi driver, or angry Mr Fortuner driver would gives a crap about the possible increase of consequence, because there is not much.

 

So I can absolutely see the merit in that study, I just think we need to take the other party's (drivers) behavioral influences into account too.

 

Agreed! It's part of the reason why I half giggle/half face palm when I see statements like "On average drivers pass riders with helmets 30cm closer than riders without"****

 

**** I made this number up.

 

My immediate questions would be:

Which country?

Which part of that country?

What are the partocular laws in that country?

Is there a minimum overtaking berth for cars on cyclists?

Urban or rural?

What time of the day?

Commuter riders or cyclist out training?

What was the weather like?

What type of vehicle?

What time of year?

What time of day?

Which cyclists were wearing flashing safety lights?

Which cyclists were wearing hi viz clothing?

How far were the cyclist riding from the pavement?

What type of road?

 

Like I said before - I think these studies are useful for plotting trends or sparking internal debate (to adjust risk profiles) or raising awareness but anyone who reads that kind of statistic and decides to stop wearing their helmet because cars will give them a wider berth is a nincumpoop.

[IceCreamMan]

"What is crystal clear however is that we should not be placing much, if any, faith in helmets" - This is a very powerful statement to be making based on inconclusive evidence?

Individual studies and research findings are conclusive whether pro or anti helmets and therin lies the rub. With such conflicting views I find it impossible to make an absolute conclusion of the efficacy of helmets...Discretion being the better part of valour and all that.

 

I place more faith in my rear lumen intense flashing taillight in preventing head injurings than I do my helmet as an example. I cycle and run a lot in the early morning in the braodacres/fourways/northriding area and see far too many cyclists wearing helmets but they are not visible to motorists... their risk is huge compared to the guy not wearing helmet but using a tail light. (my estimation only and could of course be completely wrong)

 

Education and a conservative view will prevent far more injuries than a helmet will.

[Patchelicious]

Individual studies and research findings are conclusive whether pro or anti helmets and therin lies the rub. With such conflicting views I find it impossible to make an absolute conclusion of the efficacy of helmets...Discretion being the better part of valour and all that.

 

I place more faith in my rear lumen intense flashing taillight in preventing head injurings than I do my helmet as an example. I cycle and run a lot in the early morning in the braodacres/fourways/northriding area and see far too many cyclists wearing helmets but they are not visible to motorists... their risk is huge compared to the guy not wearing helmet but using a tail light. (my estimation only and could of course be completely wrong)

 

Education and a conservative view will prevent far more injuries than a helmet will.

But you have made an very explicit conclusion..... 

 

"What is crystal clear however is that we should not be placing much, if any, faith in helmets"

 

Anyway, over it now. I am glad some robust discussion took place. People can draw their own conclusions from this thread and poll if they want too. Legally.... wear your helmet!

[IceCreamMan]

But you have made an very explicit conclusion..... 

 

"What is crystal clear however is that we should not be placing much, if any, faith in helmets"

 

Anyway, over it now. I am glad some robust discussion took place. People can draw their own conclusions from this thread and poll if they want too. Legally.... wear your helmet!

A logical deduction really. With the controversy surrounding the efficacy of helmets its clear one should not trust them nor any single research project. The findings are too diverse.

 

Assuming you approached a traffic light and it was shining both red and green simultaneously for all directions of traffic, you would (I would imagine) treat it with extreme caution. This is my view on the ability of helmets.

 

Edit: in hindsight the traffic light example in the ZA context is maybe not apt as here its a free for all anyway irrespective of the light but I trust you get the point.

[Robbie Stewart]

I need a helmet just to read all the posts since my last one...  

Regardless of stats / opinions / factoids et al, I will ride with a helmet because of two main reasons.

1. My last crash left me with 5 days of neurological observation prior to the op to fix all the other broken bits and 8 months of mild to excessive concussion syndrome (this fluctuated from day to day - refer to Pat Lambie - he suffered same type of head injury as me). I have been informed by the neurosurgeon that not having a helmet would have left me possibly permanently incapacitated or worse.

 

2. When I arrive at the trail head, there is usually a posted sign that starts with NO HELMET, NO RIDE! I wanna ride!

 

Also, ask any Redbull Rampage rider to forgo a helmet to prevent risky behaviour. See how far that gets you.

[geoffois]

I think one of the major confusion points is how and why research is done. There are seldom absolutes in any research outcomes. Variables get identified as important, but can almost never be studied in isolation, and even then studies of variables in isolation may not have any real world relevance.

My thoughts on some of the issues raised.

 

1. Risk compensation. Does it exist? Yes. Can it be studied and quantified? Yes. Does wearing a helmet modify behaviour? Yes. Does this directly and statistically significantly increase accident rates? I can find no data to support this. Empirically it seems logical that it should, but we need to look at all aspects objectively. There is no data to show helmet use in itself increases accident rate.

 

2. Does wearing a helmet increase the rate of injuries in other areas of the body. There is no data to support this. The data comparing severity of head injuries between the Netherlands and Australia did show in the Australian cohort that thoracic injuries were reported statistically more frequently WHEN COMPARED TO HEAD INJURIES. This can mean the head injury rate was lower and thus the other injuries were more frequent when compared to the whole. We cannot in anyway extrapolate from this data that non-cranial trauma rates increased with helmet use. Furthermore we can not compare directly societally and geographically distinct populations directly without some reserve. Traffic patterns may differ, bicycle types may (on average) differ, even terrain, weather and clothing type may vary and could conceivably alter the nature of an accident.

 

3. The claim that cycling helmets do not protect against facial injuries is false. There is clear data in both trauma and maxillofacial texts that have shown a reduction in facial trauma with hard shell cycling helmets. This was not only for full face helmets.

 

4. The claim that cycling helmets do not protect you in car related cycling accidents is false. I have listed the data to support a reduction in head injury severity scores for all modes of injury when comparing helmeted to non-helmeted.

 

5. The introduction of helmets did not reduce the incidence or severity of head injuries claim is (potentially) false. This is where comparison of data across time frames becomes difficult. A very nice study in 2007 looking at head injury and mortality rates in Arkansas before and after the compulsory helmet laws were withdrawn shows a sudden and sustained increase in both mortality and severity of head injury after legislation was reversed regarding compulsory use of helmets on motorcycles.

 

6. The assumption that someone else's head injury as a result of their decision to not wear a helmet not being societies problem is ludicrous. Let's take an example. Rich business person, full medical aid in place has a severe head injury. He lays a claim with the road accident fund and claims 60 million in compensation and ongoing medical support as a result of his injuries. Who pays for this? Society.

A commuter, minimal income, no medical aid has a severe head injury. Goes to a state hospital, total cost of initial ambulance, trauma stabilisation, ICU, neurosurgery, medication and rehab comes to 1-1.5 million. Who pays for this? Society does.

 

7. The expectation that research and small scale data collection report studies will ever give a conclusive outcome is imbecilic. What ones needs to look at is data that is geographically and societally applicable and applies to similar real world situations replicable in our society. Do we have much data is RSA? No. what we do have is unequivocal in the recommendation that helmets be worn and in fact be compulsory particularly in the paediatric population. Good old (controversial) Tim Noakes had a review article to this effect some years ago.

 

Perhaps what needs to be considered is what is the argument about? Is it about the restriction of the individual in a nanny state? Is it regarding the interpretation of risk compensation studies? Is it about modifying force patterns in an impact? Or (perhaps more importantly) is it about whether a helmet WILL modify injury severity in the event of an accident? We can not look at all these lumped together, they are not the same and they cannot be studied concurrently.

 

 

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[Patchelicious]

Great post Geoff.

 

You truly seem like the kind of fella that I could share a few beers with while discussing these topics.

 

To answer your question, I think the core argument was if we should place faith, if any in wearing helmets

 

My question is very simple. Does the increased accident rate created by risk compensation out weigh the increased injury prevention afforded by helmets.

[geoffois]

Great post Geoff.

 

You truly seem like the kind of fella that I could share a few beers with while discussing these topics.

 

To answer your question, I think the core argument was if we should place faith, if any in wearing helmets

 

My question is very simple. Does the increased accident rate created by risk compensation out weigh the increased injury prevention afforded by helmets.

Thanks. I do enjoy beer!

 

This brings me back to my point, is there an increased accident rate? I don't see any data to suggest this. If there is an increased accident rate and reported accidents remains the same, surely this would imply an increase in minor (non reported) accidents only?

 

 

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[IceCreamMan]

Thanks. I do enjoy beer!

 

This brings me back to my point, is there an increased accident rate? I don't see any data to suggest this. If there is an increased accident rate and reported accidents remains the same, surely this would imply an increase in minor (non reported) accidents only?

 

 

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Great post. Very articulate thank you.

 

I re read yr research posted on the other thread an disagree with yr interpretation. There a large difference between non head related injuries between oz an Netherlands. I believe yr interpretation is incorrect unless you have additional findings.

 

You guys are talking bout accident rate. Most cycle related accidents are unreported thus not measurable. My point has never been around accident rates BUT injury rates.

 

On another note, today early morning was perfect cycling conditions an I cycled a nice loop down to Hendrix potgieter an into cradle. Nice an overcast an lil drizzle now an again. Most cyclists wore helmets an most cyclists had no lights of any kind. To my mind this is bloody stupid.

 

Nice day out.

 

Just one thing ous, only one beer each at the pro helmet meeting hey. Pint each

[SwissVan]

I place more faith in my rear lumen intense flashing taillight in preventing head injurings than I do my helmet as an example.

 

I cycle and run a lot in the early morning in the braodacres/fourways/northriding area and see far too many cyclists wearing helmets but they are not visible to motorists... their risk is huge compared to the guy not wearing helmet but using a tail light. (my estimation only and could of course be completely wrong)Education and a conservative view will prevent far more injuries than a helmet will.

 

 

How will the rear light prevent your head from slamming into the pavement should you fall off your bike due to an incident not involving a vechile approaching you, for example slipping on gravel, hitting a pothole, group riding related incident, etc.....

 

I fully understand the importance of lights and being visible.... but accidents due to lack of visibility are not the only cause of head injuries.

 

In my personal experience I don't recall ever falling off or being injured due to lack of lights.... in fact I recall one incident at night were we were a group of about 6 all with front and rear lights riding at pace and we hit a pedestrian who did not see us and crossed the road causing 5 of the riders to collide with him and hit the road hard.... luckily we were all wearing helmets and dressed for cool weather (Joburg winter evening) so the loss of skin and red stuff was minimal.

 

In the above situation, would you willingly forfeit your helmet or red light .... considering the rest of the group would all have their lights?

[eccc whippet]

How will the rear light prevent your head from slamming into the pavement should you fall off your bike due to an incident not involving a vechile approaching you, for example slipping on gravel, hitting a pothole, group riding related incident, etc.....

 

I fully understand the importance of lights and being visible.... but accidents due to lack of visibility are not the only cause of head injuries.

 

In my personal experience I don't recall ever falling off or being injured due to lack of lights.... in fact I recall one incident at night were we were a group of about 6 all with front and rear lights riding at pace and we hit a pedestrian who did not see us and crossed the road causing 5 of the riders to collide with him and hit the road hard.... luckily we were all wearing helmets and dressed for cool weather (Joburg winter evening) so the loss of skin and red stuff was minimal.

 

In the above situation, would you willingly forfeit your helmet or red light .... considering the rest of the group would all have their lights?

 

No light and car hits you from the back...helmets isn't gona do much to save you.

 

no research required for this statement...i have just been going through pics of the accident on the M4 were Jared and Richard where killed...both were wearing helmets. 

 

the only catch is they both had lights on the back of their bikes...in fact Jared had new lights fitted to his wheels which lit up the entire wheel...the ships passing along the coast could see him.