Police advice to wear cycle helmets

This sub-forum all discussions about this "lively" subject. All topics that are substantially about helmets will be moved here, if not placed here correctly in the first place.
De Sisti
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Re: Police advice to wear cycle helmets

Postby De Sisti » 9 Oct 2017, 8:55pm

softlips wrote:I always wear one, working in A&E ive seen at least 15 people die or have major Brian injuries who may have been fine if wearing one. Now the bit that worries me about helmets is they may also allow you to survive injuries you'd rather have killed you outright. That said, I've yet to see anyone personally in this predicament.

Working in A&E I wonder how may people you have seen who have suffered, or died from major brain injuries for motor vehicle accidents?

A colleague of mine regularly visits her mother in a Bristol hospital, where her mother is suffering from a brain related
ailment, which has nothing to do with a motoring incident. My colleague mentioned that she enquired as to what the
other people on her mother's were in for. "Head injuries from motor vehicle accidents" she was told.

Now, no politician or motoring groups are going to advocate for motorists to wear helmets (on the off-chance that they*
may be involved in a serious motoring accident).

(*motorists)

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Cunobelin
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Re: Police advice to wear cycle helmets

Postby Cunobelin » 10 Oct 2017, 6:40am

softlips wrote:I always wear one, working in A&E ive seen at least 15 people die or have major Brian injuries who may have been fine if wearing one. Now the bit that worries me about helmets is they may also allow you to survive injuries you'd rather have killed you outright. That said, I've yet to see anyone personally in this predicament.



It is always a difficult one, because the default position is to save lives

The thought of asking anyone to look at an injury at the site and try to decide whether it is "worth" trying to save that life is never going to be acceptable or desirable. An accident victim will always get the appropriate treatment at the time, because the consequences and outcome cannot be known





(Note: There are criteria in which this can happen, when an individual has chosen not to be resuscitated. However this is a carefully thought out and formalised decision that is unlikely to apply to the average accident or head injury)


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Cunobelin
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Re: Police advice to wear cycle helmets

Postby Cunobelin » 10 Oct 2017, 6:18pm

Steady rider wrote:http://www.bmj.com/content/bmj/320/7250/1631.full.pdf
Thornhill link


The relevant paragraph:

The most common causes of injury were falls (43%) or assaults (34%); alcohol was often involved (61%), and a quarter reported treatment for a previous head injury.


Wot..,,,, no cyclists?

Vorpal
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Re: Police advice to wear cycle helmets

Postby Vorpal » 10 Oct 2017, 7:18pm

rmurphy195 wrote:
Steady rider wrote:Anyone in A&E are probably at a disadvantage in terms of assessing helmets, they see injuries on a regular basis. They cannot assess overall risk/likely gains/likely disadvantages, they are seeing a one sided view of a multi sided problem.


You joke, surely? I must say Its a long time since I read anything so ridiculous.

They - and police and fire officers - also see the upset relatives of victims and quite rightly have a view that is not one sided, it is realistic. I will never, ever forget the face of the ambulance attendant that revisited my cubicle in casualty after i was knocked off my bike, and the sheer relief on her face on finding I was OK. Nor the glances to/from the bruise on my forehead and my damaged helmet, which gave me a damn site more protection than any statistic.

I don't think it is at all joking. He's quite right; someone in A&E can never assess whether the person who landed there took more risks because they were wearing a helmet, or might have been going faster and been injured more badly if they had been wearing a helmet. They can only look at a specific injury and suggest that it might have been prevented or less severe if the victim had been wearing a helmet.

Even high quality research of this nature has been found to be biased. We can never know what *would* have happened.

If helmets worked, why doens't it show up in population statistics? It's easy to say that statistics don't protect a person, but they do show us, in general way, whether someone is protected. Or at least they should. Why do we only find a benefit in studies that look at injured cyclists?

Could it be because those who don't wear helmets are actually less likely to be injured?
“In some ways, it is easier to be a dissident, for then one is without responsibility.”
― Nelson Mandela, Long Walk to Freedom

Steady rider
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Re: Police advice to wear cycle helmets

Postby Steady rider » 10 Oct 2017, 7:54pm

One starting approach
B)
Robinson 1996 also refers to the incidence of hitting their head/helmet in a cycling accident was "significantly higher for helmet wearers (8/40 vs 13/476, i.e. 20% vs 2.7%, p 0.00001)". A bare head width of approximately 150mm may avoid contact compared to a helmeted head at approximately 200mm width. Helmet wearers often report hitting their helmets and the 7 fold increase may have long term effects that may not show up in a meta–analysis.

The 8/40 vs 13/476, total survey 516. So you ask say 500 cyclists if they have hit their head or helmet in the past 2 years. x/y for helmeted v a/b for non wearers,( in above, x = 8 impacts to their helmet, 40 = accidents for helmeted) other questions could be added. If x/y was say 20% for helmeted and a/b was say 5%, this would indicate helmeted having a higher ratio of impact to their helmets than for non-wearers hitting their head, for a similar number of accidents. It is a simple research but gives a starting point. The y and b could also be compared.

softlips
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Re: Police advice to wear cycle helmets

Postby softlips » 10 Oct 2017, 8:49pm

Vorpal wrote:
rmurphy195 wrote:
Steady rider wrote:Anyone in A&E are probably at a disadvantage in terms of assessing helmets, they see injuries on a regular basis. They cannot assess overall risk/likely gains/likely disadvantages, they are seeing a one sided view of a multi sided problem.


You joke, surely? I must say Its a long time since I read anything so ridiculous.

They - and police and fire officers - also see the upset relatives of victims and quite rightly have a view that is not one sided, it is realistic. I will never, ever forget the face of the ambulance attendant that revisited my cubicle in casualty after i was knocked off my bike, and the sheer relief on her face on finding I was OK. Nor the glances to/from the bruise on my forehead and my damaged helmet, which gave me a damn site more protection than any statistic.

I don't think it is at all joking. He's quite right; someone in A&E can never assess whether the person who landed there took more risks because they were wearing a helmet, or might have been going faster and been injured more badly if they had been wearing a helmet. They can only look at a specific injury and suggest that it might have been prevented or less severe if the victim had been wearing a helmet.

Even high quality research of this nature has been found to be biased. We can never know what *would* have happened.

If helmets worked, why doens't it show up in population statistics? It's easy to say that statistics don't protect a person, but they do show us, in general way, whether someone is protected. Or at least they should. Why do we only find a benefit in studies that look at injured cyclists?

Could it be because those who don't wear helmets are actually less likely to be injured?


I've not worked in A&E for years, cardiology these days. The last death from head injury I'm aware of was one of my patients who simply didn't clip in correctly and fell sideways before even pedalling.

landsurfer
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Re: Police advice to wear cycle helmets

Postby landsurfer » 10 Oct 2017, 8:59pm

As i have posted previously, in another post ... I am seeing growing numbers of hill walkers wearing cycle helmets in the Cairngorms.
We first saw this in Cuba 3 years ago, our hotel had a large group of German hillwalkers who went out at 0600hrs every morning onto the hill, all with cycle helmets.
So "pedestrians" are wearing helmets...
The Road Goes On Forever

Steady rider
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Re: Police advice to wear cycle helmets

Postby Steady rider » 11 Oct 2017, 8:52am

I've not worked in A&E for years, cardiology these days. The last death from head injury I'm aware of was one of my patients who simply didn't clip in correctly and fell sideways before even pedalling.


Was the cyclist wearing a helmet at the time? What age?

I met a cyclist who told me he knew of three that had died, I asked him if they were wearing helmets, he said they all were.

ps the clip, not toe clips I assume, there is one safety issue we should be discussing. avoiding accidents should always be one main focus.

softlips
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Re: Police advice to wear cycle helmets

Postby softlips » 11 Oct 2017, 9:45am

Steady rider wrote:
I've not worked in A&E for years, cardiology these days. The last death from head injury I'm aware of was one of my patients who simply didn't clip in correctly and fell sideways before even pedalling.


Was the cyclist wearing a helmet at the time? What age?

I met a cyclist who told me he knew of three that had died, I asked him if they were wearing helmets, he said they all were.

ps the clip, not toe clips I assume, there is one safety issue we should be discussing. avoiding accidents should always be one main focus.


No helmet at the time, early 60's, just fell sideways and banged his head sadly.

I have seen cyclists die who were wearing helmets, but none of them due to head injury but it does happen.

As posted above I've seen quite a few hill walkers wearing helmets now and just about everyone I know who skis wears one.

Ruadh495
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Re: Police advice to wear cycle helmets

Postby Ruadh495 » 11 Oct 2017, 9:55am

Not sure emergency services staff have the best perspective on this, because they only see the injured / dead.

So if helmet compulsion were introduced and resulted in a considerable decrease in cycling participation (Australia?) the measure would be perceived as effective in the emergency room (they would see a reduction in cyclists presenting with head injuries). On the street there could be an actual increase in the risk of any individual cyclist being injured, masked by the overall reduction in cyclist numbers.

I have a sneaking suspicion this is the major reason motorcycle helmets are "effective" as an intervention, they deter motorcycling.

BTW I imagine the hill walkers are wearing helmets for the same reason climbers do; risk of falling objects. A climbing helmet wouldn't make much difference to a climber who fell on his/her head from a height, but it can make a massive difference when the climber above you dislodges a stone, or drops a piton...

Steady rider
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Re: Police advice to wear cycle helmets

Postby Steady rider » 11 Oct 2017, 10:09am

Typically older people are more at risk from falls, so 60+ is near by. A sideward impact to a helmet, is hitting the lowest area of protection in strength terms, also with a low area of coverage, profile higher than the ears. Normally falling sideward is a slow event, sufficient time to get one hand out. The problem stems from the clips and there design - the problem of not getting the feet out when needed. In the 1960 with cleats I fell over a few times, easy done. Later in the 1980s I generally used shoes suitable for walking and cycling in, no cleats. Pedal were modified, with small attachments, allowing for more support to the shoe and easy sliding out when required. They made little difference to hill climbing overall, made walking and cycling more convenient, and safer in my experience.

ps
from page 1,
Cost of accidents for helmet wearers v non-wearers
One report provided hospital costs associated with bicyclists and motorcyclists, who had incurred head injuries and been admitted. On average for bicyclists the medium costs for helmeted were $6500 v $5600 for non-helmeted.
For motorcyclists the medium costs for helmeted were $7700 v $11400 for non-helmeted.
Bicyclists not wearing helmets had a lower cost than those helmeted.

Refer to; https://www.researchgate.net/publicatio ... ntre_study

irc
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Re: Police advice to wear cycle helmets

Postby irc » 11 Oct 2017, 10:28am

Ruadh495 wrote:Not sure emergency services staff have the best perspective on this, because they only see the injured / dead.

So if helmet compulsion were introduced and resulted in a considerable decrease in cycling participation (Australia?) the measure would be perceived as effective in the emergency room (they would see a reduction in cyclists presenting with head injuries). On the street there could be an actual increase in the risk of any individual cyclist being injured, masked by the overall reduction in cyclist numbers.

I have a sneaking suspicion this is the major reason motorcycle helmets are "effective" as an intervention, they deter motorcycling.

BTW I imagine the hill walkers are wearing helmets for the same reason climbers do; risk of falling objects. A climbing helmet wouldn't make much difference to a climber who fell on his/her head from a height, but it can make a massive difference when the climber above you dislodges a stone, or drops a piton...


I was formerly a mountain rescue team member. I recall two incidents where hillwalkers died and might have been saved by helmets. One, a elderly hillwalker was reported missing. After a search we found him dead with a head injury after a fall on relatively easy ground.

The second was on a day in the Cairngorms when the wind was so strong that we had decided to train in the Northern Corries rather than going onto the tops. I was blown off my feet walking round to the corries. I ended up crawling on my hands and knees for 100 yards to make progress. A party of hillwalkers were walking up a ridge heading for the tops. One was blown off, slid a few hundred feet on snow then hit rocks. Still talking when loaded into the helicopter but dead on arrival at Inverness with a head injury. But allowing for the vast numbers of hillwalking person/days in Scotland the risk is still minimal. Just like for cycling for me the disadvantages of helmets are bigger than the protection they give.

As for emergency services perception. In 30 years in the police attending road accidents regularly I dealt with one cyclist with a serious head injury. He was wearing a helmet. The crash was probably preventable if he hadn't been riding a bike with a known brake problem. I dealt with more car occupants with head injuries. By far the most were falls and assaults though.

Steady rider
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Re: Police advice to wear cycle helmets

Postby Steady rider » 11 Oct 2017, 10:50am

http://pure-oai.bham.ac.uk/ws/files/165 ... g_2014.pdf

It reports;
The results showed that the wind induced force is a function of the crosswind angle. The actual aerodynamic loads arising from such winds can be up to about 2.5 times the aerodynamic drag


So for hill walkers, the advantages could be in protection from small stones falling or in a fall perhaps. One disadvantage could occur in high winds, where they may be more likely to loose balance due to the extra forces. They could always take the helmets off in very high wind situations but may lose any benefit if they did fall. It could take 25 years with of lots of people wearing helmets when walking to have sufficient data to evaluate their use. Each time a helmet wearers fell or got hit by a rock, they could say the helmet had saved their life.

LollyKat
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Re: Police advice to wear cycle helmets

Postby LollyKat » 11 Oct 2017, 10:53am

softlips wrote:I have seen cyclists die who were wearing helmets, but none of them due to head injury but it does happen.


Presumably you've also seen fatal head injuries caused by falls in the home, or outside while walking? Some of the elderly folk in my church tell me off for not wearing a helmet, but are bemused when I suggest that they should wear one themselves. And they do fall and damage themselves, though fortunately no fatalities so far.