Highway Code revisions: helmet discussion

[Jdsk]

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.?

There is no question from that SR that can answer a question about drivers using airbags because they are not within the scope of the SR.

That's why it's so important to:

1 Have well-defined questions and discuss them separately.

2 Separate questions of knowledge from questions of policy.

That SR can provide knowledge about injuries that are relevant to "Evidence suggests that a correctly fitted helmet will reduce your risk of sustaining a head injury in certain circumstances".

Jonathan

[Vorpal]

There is no question from that SR that can answer a question about drivers using airbags because they are not within the scope of the SR.

That's why it's so important to:

1 Have well-defined questions and discuss them separately.

2 Separate questions of knowledge from questions of policy.

That SR can provide knowledge about injuries that are relevant to "Evidence suggests that a correctly fitted helmet will reduce your risk of sustaining a head injury in certain circumstances".

Jonathan

Actually, I think helmets are a ridiculous red herring. In car-centric countries, both 'safety' organisations and authorities promote helmets in lieu of managing road danger and traffic violence. And we get all distracted with fighting the, 'wear a helmet - it's common sense'

There are no questions to answer with regard to helmets, and attempting to do so is a waste of resources.

It's like advising someone in an abusive relationship to wear a bulletproof vest.

[Vorpal]

Thompson et al was 1999. Eivik was 2011, and was able to include some more studies. Olivier and Creighton was 2017 and has even more.
https://academic.oup.com/ije/article/46/1/278/2617198


Jonathan

Thompson et al eliminated a number of studies from inclusion by using very narrow methodological criteria. It is of course coincidence that their narrow methodological criteria meant that they obtained results which found a large protective benefit from wearing helmets.

[Jdsk]

Another advantage of well-defined and separated questions is that they can be used in building consensus. There are often more areas of agreement than appears to be the case.

Would anyone like to try?

Jonathan

[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.

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 )

Firstly, thanks for the eloquent comment. I needed a pick me up.

In reply to A) the majority of people I see cycling in the uk, do wear a helmet. Therefore I don’t feel legislation is likely to have an effect.

B) The legislation is not suggesting Humber so I don’t get this as an argument.

One last point - I NEVER see a mountain biker without a helmet. Why is this?

[pjclinch]

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.?

There is no question from that SR that can answer a question about drivers using airbags because they are not within the scope of the SR.

That's why it's so important to:

1 Have well-defined questions and discuss them separately.

2 Separate questions of knowledge from questions of policy.

That SR can provide knowledge about injuries that are relevant to "Evidence suggests that a correctly fitted helmet will reduce your risk of sustaining a head injury in certain circumstances".

But it can't answer the question of whether that belongs in the Highway Code.

That wording is a way to hang on to a recommendation the editors are having trouble letting go of by justifying it with something uncontentious, and the wording really is uncontentious as a simple statement of fact: if we define any set of circumstances where "a correctly fitted helmet will reduce your risk of sustaining a head injury" (and it's really not hard to do: the old head-butt the wall rationalisation is perfectly adequate for the job) then we show it to be true.

But just because it's true doesn't make it useful.

What they need to demonstrate is a significant likelihood of public health benefit to recommending cyclists ride in helmets, and no SR yet conducted provides anything like uncontentious evidence that that is the case (and when I say "uncontentious" I don't mean a few desperate hold-outs against reality in the way of climate change, I mean that you can float it past the likes of Goldacre and Spiegelhalter and their peers and they'll say, "yes, pretty much case closed, see X" rather than "dreading questions about cycle helmets")

Pete..

[Jdsk]

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.?

There is no question from that SR that can answer a question about drivers using airbags because they are not within the scope of the SR.

That's why it's so important to:

1 Have well-defined questions and discuss them separately.

2 Separate questions of knowledge from questions of policy.

That SR can provide knowledge about injuries that are relevant to "Evidence suggests that a correctly fitted helmet will reduce your risk of sustaining a head injury in certain circumstances".

But it can't answer the question of whether that belongs in the Highway Code.

I agree, that's a matter of policy.

Jonathan

[pjclinch]

One last point - I NEVER see a mountain biker without a helmet. Why is this?

The BMJ editorial you've been pointed at notes that culture is probably a significant element in what people think. Mountain bike culture is, like most sport cycling culture, one that has adopted helmets. But some MTBers don't bother: I do if I'm doing technical stuff, I don't generally bother for cross country (i.e., when it's about where I'm going than bike handling).

Even if you take the original design goal (in short, a better hairnet) in to account and don't assume they save countless lives it does makes a good deal of sense: MTB is not about comfort and convenience, you are highly likely to fall off (if my efforts are anything to go by), and you are quite likely to fall off somewhere that's remarkably inconvenient to get out of if you've got a blinding headache and quite possibly bonus limb injuries, and also quite likely to be riding where there's plenty of overhanging foliage that the council don't cut back for you.
Thus, MTB is not really comparable to riding for transport in the way that motorsport rally driving doesn't have much in common with "the school run".

Similarly to MTB, the culture in the pro-peloton is very much pro-helmet... because it's been drilled in to them for over 20 years now. When they were initially mandated the pro-peloton threatened to go on strike! They had managed a century or so without them, and back then the culture didn't reinforce their use. It's not clear that rates of serious head injury have changed (the sample base is probably too small), and we still have the likes of Tony Martin citing the peloton is far more dangerous than it used to be as a reason to retire.

In other words, lots of folk doing something isn't always the same as there are great reasons for doing it. SUVs are really popular right now with the car buying public, ask an SUV driver why and they'll almost certainly come up with rationalisations that aren't anything to do with the actual reason of following what everyone else is doing. But if you go to a farming community the SUVs there will probably have a lot more mud on, and they'll have been driving them before they were all the rage.

These are related but different issues to should the Highway Code be bothering itself with them. As Vorpal has suggested, they're a red herring, so I'd say "no". But, if you want to wear one nobody here wants to stop you.

Pete.

[thirdcrank]

But, if you want to wear one nobody here wants to stop you.

I don't think this bit is right. In the last couple of days in helmet discussions on here I've seen the words zealot and evangelist, both in relation to helmet advocacy rather than wearing, but I think at the very least, helmet wearing is seen by some as letting the side down. In stronger terms heresy or even apostasy.

[pjclinch]

But, if you want to wear one nobody here wants to stop you.

I don't think this bit is right. In the last couple of days in helmet discussions on here I've seen the words zealot and evangelist, both in relation to helmet advocacy rather than wearing, but I think at the very least, helmet wearing is seen by some as letting the side down. In stronger terms heresy or even apostasy.

I must admit I didn't go through the whole lot due to loss of will to live.

A bit like the genuinely "anti-helmet" POV, I'd at least hope that's not a typical case. That one may simply want to wear a lid is all the reason needed to wear one.

[thirdcrank]

To correct some ambiguity in my last post, by "on here" I meant "on this forum" rather than "on this thread."

[Steady rider]

Looking at some numbers,
see link below,

Table 2 shows that the 0-17 age group had 132 ‘head’ claimants (7.8%), whereas the 18+ age group had 40 claimants (4.9%). The younger age group had a 59% higher proportion of head injuries (7.8/4.9 = 1.59). The meta-analysis appears not to fully take account of the different types of accident and age grouping and the proportion of head injuries that occurs from different types of accidents.

(2) (PDF) Weaknesses with a meta-analysis approach to assessing cycle helmets. Available from: https://www.researchgate.net/publicatio ... le_helmets [accessed Dec 08 2021].
Considering this in more detail, wearing rates in 1987-1989, were roughly 40% for the 5-12 age group, 10% for the 13-18 age group, 25% for those older than 18 years. Assuming 500, 1100 and 800 accidents to roughly match the data in table 2. The younger age group, generally cycling slower and more falls, could have 40% helmeted, the 12-17 age group riding more in traffic and more serious injuries could have 10% wearing helmets, the older group could have 25% wearing helmets. In total for helmeted, it could be 200 + 110 + 200 = 510 including 200 subject to assumed lower speeds (about 39%). For none helmeted, 300 +990 + 600 = 1890 including 300 subject to assumed lower speeds (16%). Therefore, helmet use could show up as a benefit due to the age grouping and assumed lower speeds.
With legislation, cycling levels reduced, assuming say 10% for 5-11 age group, 45% for 12-17, 20% for 18+. Helmeted use may have been 80%, 50% and 80%. Total by age group could be 450, 610 and 640. The first and last group would total 1090 (41% from the younger slower group).
added.
For non-helmeted, 90+305+128, total 523 including 90 subject to lower speeds (about 17%).
Helmeted, 360 +305 +512, total 1177, including 360 subject lower speeds (30.5%).

It appears that the circumstances may help to show up a benefit for helmets, by having a higher proportion in the younger age group and cycling at lower speeds.

[mjr]

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.

It could be my riding style, but if it was, that would mean that my style changed several times coinciding closely with the start and end of each period of helmet use, which would suggest that the helmet may be causing the change somehow.

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.

I can tell you with absolute certainty that that injury would have been zero 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.

Motorcycle riders are not exerting themselves, divers are water-cooled and I actually wear a woolly hat while cycling in winter. A beanie regulates my temperature far better than helmets ever did: no sweat/freeze pattern in winter... and I don't wear it in summer, switching to a cooler patrol cap, casquette or bandana.

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.

We should push for better driver education for many reasons, but how do we best deal with it for now?

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.

I'm not ignoring it, but we should consider that helmets might not only be protection and could be causing an increased crash rate somehow. That would explain why real-world injury rates do not seem to vary in step with helmet usage rates.

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?

Here we go again: no, I'd wear composite toecaps when doing stuff like swinging a sledgehammer. Steel toecaps have more risk of breaking toes if used for that task.

So it's not only about protecting the right parts of your body, but using the appropriate protection for the task. A cycle helmet is appropriate protection for the head in a standing fall but that's a pretty rare way to die or get seriously injured and, like steel toecaps where heavy stuff is falling, it's inappropriate for the general task of cycling because the drawbacks at least negate the protection.

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.

So why are you fighting so strongly for helmets instead of those other things?

[Bonefishblues]

There is no question from that SR that can answer a question about drivers using airbags because they are not within the scope of the SR.

That's why it's so important to:

1 Have well-defined questions and discuss them separately.

2 Separate questions of knowledge from questions of policy.

That SR can provide knowledge about injuries that are relevant to "Evidence suggests that a correctly fitted helmet will reduce your risk of sustaining a head injury in certain circumstances".

Jonathan

Actually, I think helmets are a ridiculous red herring. In car-centric countries, both 'safety' organisations and authorities promote helmets in lieu of managing road danger and traffic violence. And we get all distracted with fighting the, 'wear a helmet - it's common sense'

There are no questions to answer with regard to helmets, and attempting to do so is a waste of resources.

It's like advising someone in an abusive relationship to wear a bulletproof vest.

You mean it's cycling's very own 'look squirrel' VP?

[pjclinch]

You mean it's cycling's very own 'look squirrel' VP?

Drawing a blank on that one tbh...