Highway Code revisions: helmet discussion

For all discussions about this "lively" subject. All topics that are substantially about helmet usage will be moved here.
Jdsk
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Re: Highway Code revisions: helmet discussion

Post by Jdsk »

I should have included another point... don't even start trying to achieve agreement on policy until there's some agreement on knowledge... what's known and what isn't known. And of course what goes into the Highway Code is a matter of policy.

Jonathan
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Re: Highway Code revisions: helmet discussion

Post by Steady rider »

https://www.youtube.com/watch?v=HCIr5V31y1E

I think Goldacre & Spiegelhalter opinion in 2013 was interesting. There could be progress with having another presentation.
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mjr
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Re: Highway Code revisions: helmet discussion

Post by mjr »

Jdsk wrote: 7 Dec 2021, 7:07pm 2 Separate the different questions. For example: do helmets affect injury if an impact occurs? Does wearing a helmet affect behaviour and risk? What are the effects of mandated wearing of helmets?
Why should we only focus on questions that usually benefit the helmet pushers? Why look at impacts and not all use (broader) or only collisions (narrower)? Is there no room for critical questions like "Does helmet use improve outcomes overall?" and "What is the predicted effect on public health of including that rule in the Highway Code?"
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Jdsk
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Re: Highway Code revisions: helmet discussion

Post by Jdsk »

mjr wrote: 7 Dec 2021, 8:47pm
Jdsk wrote: 7 Dec 2021, 7:07pm 2 Separate the different questions. For example: do helmets affect injury if an impact occurs? Does wearing a helmet affect behaviour and risk? What are the effects of mandated wearing of helmets?
Why should we only focus on questions that usually benefit the helmet pushers? Why look at impacts and not all use (broader) or only collisions (narrower)? Is there no room for critical questions like "Does helmet use improve outcomes overall?" and "What is the predicted effect on public health of including that rule in the Highway Code?"
Those were examples to illustrate the importance of separation, there was no suggestion that other well-defined questions shouldn't be asked.

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Thehairs1970
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Re: Highway Code revisions: helmet discussion

Post by Thehairs1970 »

I’ll start this by saying (again) don’t wear a helmet if you don’t want to.

But…

The arguments against possible legislation seem to fall into two main reasons. A) legislation for helmet wear would put some people off cycling. B) the benefits in terms of injury protection are dubious.

A) well if they put them off, how does that affect those of us who already ride? If you would be put off, why?

B) no one has seemed prepared to tell me that would be happier to hit their head without a helmet than with one. That tells me a lot.

Or is this just another fight the system argument? If so, I think you need to find something worth fighting for.
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Re: Highway Code revisions: helmet discussion

Post by drossall »

Thehairs1970 wrote: 7 Dec 2021, 9:51pm I’ll start this by saying (again) don’t wear a helmet if you don’t want to.

But…

The arguments against possible legislation seem to fall into two main reasons. A) legislation for helmet wear would put some people off cycling. B) the benefits in terms of injury protection are dubious.

A) well if they put them off, how does that affect those of us who already ride? If you would be put off, why?

B) no one has seemed prepared to tell me that would be happier to hit their head without a helmet than with one. That tells me a lot.

Or is this just another fight the system argument? If so, I think you need to find something worth fighting for.
With respect, this kind of post confirms my view that the two sides are not engaging. In particular, you have failed to engage with arguments that helmets only prevent minor injuries, and might even do that at the cost of making serious ones worse. You really only have to go one page back in this thread to find the following answer to your point. So that kind of polemic doesn't really help me to review my position.
mattheus wrote: 7 Dec 2021, 4:14pmThis fits my expirences perfectly. I had a nasty looking gash on my forehead when I went to Accident&E after being SMIDSYed. It is pretty hard to dispute that a helmet would have prevented that injury! (Whilst it wouldn't have saved my dental damage, nor the ankle and shoulder injjuries, but anyway ... ) As a kid, I had a few lesser blood-gushing incidents - no trip to hospitla required, luckily.

But statistics don't show an improvement in brain injuries - and these are where the focus of hospital treatment will be. I wasn't even concussed, so they didn't keep me in after initial triage.

I'm not worried about a few bumps, cuts and scrapes.On my head, or my knees, elbows, hips etc etc ... I've had worse driving my car! If I thought a lid would make my brain *significantly* safer, I might well be persuaded to wear one.
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Re: Highway Code revisions: helmet discussion

Post by mjr »

Thehairs1970 wrote: 7 Dec 2021, 9:51pm I’ll start this by saying (again) don’t wear a helmet if you don’t want to.

But…

The arguments against possible legislation seem to fall into two main reasons. A) legislation for helmet wear would put some people off cycling. B) the benefits in terms of injury protection are dubious.

A) well if they put them off, how does that affect those of us who already ride? If you would be put off, why?
I would be put off mainly because I suffered a shoulder/neck injury as a result of using one. A secondary deterrent would be that I crashed far more often in my years using than before or since, which I cannot explain definitively but my strongest suspicions are that insulating my head so thickly impairs my decision-making or that other road users behave differently around helmetted riders.
B) no one has seemed prepared to tell me that would be happier to hit their head without a helmet than with one. That tells me a lot.
I could just as easily point out that no-one is willing to tell me that they would rather crash while using a helmet than not crash without. It is far far better to reduce the number of crashes than to mitigate very slightly a greater number of them.

Once you've crashed, the outcome is almost in the lap of the gods no matter what you wear. If a following truck is going to run over your prone torso, your headgear won't save you.
Or is this just another fight the system argument? If so, I think you need to find something worth fighting for.
Only in so far as the system is malfunctioning in this case. And don't you feel that public health, wealth and happiness through cycling is worth fighting for?
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Re: Highway Code revisions: helmet discussion

Post by Thehairs1970 »

drossall wrote: 7 Dec 2021, 10:02pm
With respect, this kind of post confirms my view that the two sides are not engaging. In particular, you have failed to engage with arguments that helmets only prevent minor injuries, and might even do that at the cost of making serious ones worse. You really only have to go one page back in this thread to find the following answer to your point. So that kind of polemic doesn't really help me to review my position.
mattheus wrote: 7 Dec 2021, 4:14pmThis fits my expirences perfectly. I had a nasty looking gash on my forehead when I went to Accident&E after being SMIDSYed. It is pretty hard to dispute that a helmet would have prevented that injury! (Whilst it wouldn't have saved my dental damage, nor the ankle and shoulder injjuries, but anyway ... ) As a kid, I had a few lesser blood-gushing incidents - no trip to hospitla required, luckily.

But statistics don't show an improvement in brain injuries - and these are where the focus of hospital treatment will be. I wasn't even concussed, so they didn't keep me in after initial triage.

I'm not worried about a few bumps, cuts and scrapes.On my head, or my knees, elbows, hips etc etc ... I've had worse driving my car! If I thought a lid would make my brain *significantly* safer, I might well be persuaded to wear one.
I am not not engaging. The statistics regarding injury are arrived at by a case study basis only. The studies can only really describe the injury. The mechanisms that caused the injury are not controllable and therefore not very comparable. This is the case for both those on the no and yes side. We need a proper testing regime, like NCAP, to do this. Yes, I am sure there will be circumstances where wearing a helmet could cause worse injury. This argument was used against seatbelt legislation. Individual situations should not, however, determine policy. Generalities should. For a long time, there has been an argument that a helmet spreads impact over a larger part of the brain causing more widespread injury. Possibly true. But no one can say whether a deeper, harder impact on one area would have been preferable. Is it also possible that more cyclists who are getting head impacts no longer need to take themselves to hospital as he helmets they wear are preventing them from needing to go?

I only have one axe to grind here. I do not have a problem with people not wanting legislation. What I do have a problem with is being persuaded that wearing one is wrong or makes me less.

All said back with respect.
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Re: Highway Code revisions: helmet discussion

Post by Thehairs1970 »

mjr wrote: 7 Dec 2021, 11:47pm
Thehairs1970 wrote: 7 Dec 2021, 9:51pm
I would be put off mainly because I suffered a shoulder/neck injury as a result of using one. A secondary deterrent would be that I crashed far more often in my years using than before or since, which I cannot explain definitively but my strongest suspicions are that insulating my head so thickly impairs my decision-making or that other road users behave differently around helmetted riders.

I could just as easily point out that no-one is willing to tell me that they would rather crash while using a helmet than not crash without. It is far far better to reduce the number of crashes than to mitigate very slightly a greater number of them.

Once you've crashed, the outcome is almost in the lap of the gods no matter what you wear. If a following truck is going to run over your prone torso, your headgear won't save you.
Only in so far as the system is malfunctioning in this case. And don't you feel that public health, wealth and happiness through cycling is worth fighting for?
[/quote]

mjr - firstly I wish I could use he quotes as well as you!

Crashing more when wearing a helmet? Who knows? Possibly, not being rude, your age. It could be riding style has changed, who knows. Again difficult to find evidence/reasons. Your injury may well have been caused by a helmet. MIPS helmets have been shown to be better at preventing secondary injuries. However, what no one knows is what the injury would have been without the helmet.

Head too insulated? This seems very unlikely. Motorcycle riders seems to manage to make very quick decisions whilst wearing full face helmets. Divers have to make live saving calculations etc while wearing tight wetsuits around there heads. Many cyclists wear woolly hats without trouble.

Drivers behave differently around unhelmeted riders. Possibly. However, surely this is about driver education not cyclists. I suspect you will find drivers behaving differently to the elderly or pregnant pedestrian than those who aren’t as well.

Willing to not crash without a helmet?! Well, I think you’ll find better numbers for your study. You are correct though. We do need to have crash reduction full stop. This does not mean you ignore have to ignore protection though.

You are right to a point that crashing puts you in the lap of the gods (wondering if you follow Hinduism or Ancient Greek religion) but it is also science. And yes, the rest of your body can suffer horrible injuries and the helmet won’t do any good, But wouldn’t you wear steel toe cap boots when swinging a sledgehammer even though it might be your fingers you hit? You wear safety goggles when using an angle grinder but might get sharp metal hitting your lips.

Do I think cycling is worth fighting for? Absolutely. But not this. While we focus on a small piece of legislation, cycle paths are still being built that are useless at best and dangerous at worst. Cyclists are killed everyday because of their or drivers poor road behaviour. Facilities for cyclists in towns, cities and workplaces are non existent. Prosecution of drivers who kill cyclists seems to be treated different to those involved in other RTAs. These are the issues worth fighting for I’d say.
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Re: Highway Code revisions: helmet discussion

Post by drossall »

I do think that, looking over the long term, there's been a constant raising of the bar of self-protection. That's where some of Chris Boardman's comparisons with Continental countries come in. So, whilst I'm not telling anyone to avoid helmets, I can see why some would say that this is a measure that doesn't in practice have much effect, and is distracting people from things that would. I've seen that myself, in a situation where accidents were happening when everyone was already wearing helmets, and the first thought was bigger and better (i.e. downhill) helmets, instead of taking measures to stop the crashes.

So yes, there are clear and obvious downsides and, when that kind of thing happens, helmets can make things worse, irrespective of crash mechanics.
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Re: Highway Code revisions: helmet discussion

Post by pjclinch »

drossall wrote: 7 Dec 2021, 6:59pm Can I say that I've tried hard all my life to follow reports of research and to make decisions on my own helmet wearing that are based on evidence? I've got a science degree, so some ability to follow papers, but I'm only a physicist :D But I'm finding it hard to take anything that I can use from this discussion. It's difficult to see a summary view. There are plainly two sides here, but they aren't clearly engaging with each other or going anywhere. So I'm going nowhere.
That fits my view very closely.

Systematic review is a useful tool if there is a clear signal to be found in the noise. We can't say for sure that's the case here: the work on case/control has huge confounders and highly variable results, the population stuff fails to answer anything much useful at an individual level (although it is probably fair game for policy level indication).
The BMJ editorial, from authors who laud the usefulness in the right context of systematic reviews, suggesting it's a tangled mass with few conclusions that can be clearly made, suggests very strongly to me that applying SR techniques to the messy, noisy pile of literature we have is a fool's errand. Using SR on it looks like trying to assess density with a voltmeter.

As for the Highway Code wording, the whole reference to helmets (and hi-viz) should go. Or if it's to stay then add the same advice and rationalisation about e.g. airbags and ABS brakes to the driving sections. They won't do the latter as it's clearly outside the scope of the document, and so they shouldn't pull the same nonsense for cycle helmets either.

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Re: Highway Code revisions: helmet discussion

Post by Jdsk »

pjclinch wrote: 8 Dec 2021, 9:08amSystematic review is a useful tool if there is a clear signal to be found in the noise. We can't say for sure that's the case here: the work on case/control has huge confounders and highly variable results, the population stuff fails to answer anything much useful at an individual level (although it is probably fair game for policy level indication).
The BMJ editorial, from authors who laud the usefulness in the right context of systematic reviews, suggesting it's a tangled mass with few conclusions that can be clearly made, suggests very strongly to me that applying SR techniques to the messy, noisy pile of literature we have is a fool's errand. Using SR on it looks like trying to assess density with a voltmeter.
It depends on what question you're trying to answer.

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Re: Highway Code revisions: helmet discussion

Post by mattheus »

Thehairs1970 wrote: 7 Dec 2021, 9:51pm I’ll start this by saying (again) don’t wear a helmet if you don’t want to.

But…

The arguments against possible legislation seem to fall into two main reasons. A) legislation for helmet wear would put some people off cycling. B) the benefits in terms of injury protection are dubious.

A) well if they put them off, how does that affect those of us who already ride? If you would be put off, why?

B) no one has seemed prepared to tell me that would be happier to hit their head without a helmet than with one. That tells me a lot.

Or is this just another fight the system argument? If so, I think you need to find something worth fighting for.
There are simple responses to both of these - I hope you will engage with them:
A) You don't need to ask us (let alone believe us); look at the numbers. MHLs reduce cycling numbers. They DO put people off - it's happened.
B) If I crash, I'd rather be in a HumVee. But I still choose not to travel by HumVee - do you?

(I don't want to fight the system - I just want the system to leave things that work, working. Fix the stuff that needs fixing - you've written about that stuff eloquently in your post about infrastructure and law enforcement :) )
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Re: Highway Code revisions: helmet discussion

Post by mattheus »

pjclinch wrote: 8 Dec 2021, 9:08am
drossall wrote: 7 Dec 2021, 6:59pm Can I say that I've tried hard all my life to follow reports of research and to make decisions on my own helmet wearing that are based on evidence? I've got a science degree, so some ability to follow papers, but I'm only a physicist :D But I'm finding it hard to take anything that I can use from this discussion. It's difficult to see a summary view. There are plainly two sides here, but they aren't clearly engaging with each other or going anywhere. So I'm going nowhere.
That fits my view very closely.

Systematic review is a useful tool if there is a clear signal to be found in the noise.
I've cut off the rest of Pete's great post because I think it helps provide a REALLY SIMPLE answer to the [bold] query above.
There IS a simple summary view:

If there is a benefit from helmet-wearing, it is far too small to be measurable.

That's it. If some people want to wear them, that's fine. Let's move on please!
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Re: Highway Code revisions: helmet discussion

Post by pjclinch »

Jdsk wrote: 8 Dec 2021, 9:10am
pjclinch wrote: 8 Dec 2021, 9:08amSystematic review is a useful tool if there is a clear signal to be found in the noise. We can't say for sure that's the case here: the work on case/control has huge confounders and highly variable results, the population stuff fails to answer anything much useful at an individual level (although it is probably fair game for policy level indication).
The BMJ editorial, from authors who laud the usefulness in the right context of systematic reviews, suggesting it's a tangled mass with few conclusions that can be clearly made, suggests very strongly to me that applying SR techniques to the messy, noisy pile of literature we have is a fool's errand. Using SR on it looks like trying to assess density with a voltmeter.
It depends on what question you're trying to answer.
Yes...

So what question can we get a clear answer to from the SR to date on helmets that supports a special bit of advice in the Highway Code that's rationalised in a clearly different way for cyclists than e.g. drivers using airbags/ABS etc.?

The only reason I can see for the 'Code's continued preoccupation with helmets and hi-viz is it's a cultural Given that they're good benefit-of-the-doubt interventions and the DfT just can't bring themselves to let go of that.

Pete.
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