Highway Code revisions: helmet discussion

For all discussions about this "lively" subject. All topics that are substantially about helmet usage will be moved here.
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mjr
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Re: Highway Code revisions: Consultation complete and Government response published

Post by mjr »

Zulu Eleven wrote: 6 Dec 2021, 8:03pm
mjr wrote: 6 Dec 2021, 7:51pm
Zulu Eleven wrote: 6 Dec 2021, 7:30pm Again, the square root of nothing to do with the debate here, which is the veracity of the claim in the Highway Code update
It is something to do with the debate, having arisen naturally during it. It is not the core of the debate, though.

But now I see the source of your confusion and hostility. The debate is not whether that very niche claim is true, but whether it merits being in the Highway Code directed only at cyclists and without warnings. Please refer back to viewtopic.php?p=1656917#p1656917 for a reminder of how the latest debate started.

Not really, the claim there is that the advice “You should wear a cycle helmet that conforms to current regulations, is the correct size and securely fastened. Evidence suggests that a correctly fitted helmet will reduce your risk of sustaining a head injury in certain circumstances” is, and I quote, “questionable”

Nobody has, as yet, managed to provide any evidence in any way refuting that claim.
Indeed. The advice is clearly questionable, so the claim cannot be refuted. So we agree on that much at least?
MJR, mostly pedalling 3-speed roadsters. KL+West Norfolk BUG incl social easy rides http://www.klwnbug.co.uk
All the above is CC-By-SA and no other implied copyright license to Cycle magazine.
Mike Sales
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Re: Highway Code revisions: Consultation complete and Government response published

Post by Mike Sales »

Zulu Eleven wrote: 6 Dec 2021, 8:03pm Nobody has, as yet, managed to provide any evidence in any way refuting that claim.
I think that the burden of proof lies on the other side.
Before making helmet wearing into such a vital and important safety measure, there should be good evidence that helmets cut down casualties.
As has been said above, helmet mandation was tried in Australia, and wearing went from about a third to nearly 100%. The casualty rate hardly changed, but was a little worse, from a rather smaller number of miles ridden. Australia, that sunny, sporty land, has about half our cycling rate, and a much higher rate of casualties.
The Netherlands is much safer than GB per mile cycled, has a much higher rate of cycling. They have tried a different route to making cyclists safer, as is well known. It does not involve polystyrene.
So, you see, I would say that you need good evidence to show that helmets make cyclists safer.
It would be nice if the solution to our vulnerability was to put on a helmet, but it did not work in New Zealand either.
Helmets are a diversion from effective answers, and serve the motorist idea that if only cyclists would wear a helmet they would not need to change their own behaviour, or have road space taken from them to make cyclists safer.
It's the same the whole world over
It's the poor what gets the blame
It's the rich what gets the pleasure
Isn't it a blooming shame?
Zulu Eleven
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Re: Highway Code revisions: Consultation complete and Government response published

Post by Zulu Eleven »

Mike Sales wrote: 6 Dec 2021, 8:23pm
Zulu Eleven wrote: 6 Dec 2021, 8:03pm Nobody has, as yet, managed to provide any evidence in any way refuting that claim.
I think that the burden of proof lies on the other side.
Before making helmet wearing into such a vital and important safety measure, there should be good evidence that helmets cut down casualties.
As has been said above, helmet mandation was tried in Australia, and wearing went from about a third to nearly 100%. The casualty rate hardly changed, but was a little worse, from a rather smaller number of miles ridden. Australia, that sunny, sporty land, has about half our cycling rate, and a much higher rate of casualties.
The Netherlands is much safer than GB per mile cycled, has a much higher rate of cycling. They have tried a different route to making cyclists safer, as is well known. It does not involve polystyrene.
So, you see, I would say that you need good evidence to show that helmets make cyclists safer.
It would be nice if the solution to our vulnerability was to put on a helmet, but it did not work in New Zealand either.
Helmets are a diversion from effective answers, and serve the motorist idea that if only cyclists would wear a helmet they would not need to change their own behaviour, or have road space taken from them to make cyclists safer.
The Highway Code makes no claims at all towards mandatory helmet policy, it says “Evidence suggests that a correctly fitted helmet will reduce your risk of sustaining a head injury in certain circumstances”

You’re literally arguing against something you have entirely imagined, by citing evidence that bears no relation to what was actually claimed.
Pete Owens
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Re: Highway Code revisions: Consultation complete and Government response published

Post by Pete Owens »

Zulu Eleven wrote: 6 Dec 2021, 8:03pm
Not really, the claim there is that the advice “You should wear a cycle helmet that conforms to current regulations, is the correct size and securely fastened. Evidence suggests that a correctly fitted helmet will reduce your risk of sustaining a head injury in certain circumstances” is, and I quote, “questionable”

Nobody has, as yet, managed to provide any evidence in any way refuting that claim.
That is because the statement is so riddled with caveats as to be irrefutable - since it doesn't actually claim any anything at all. It is rather like those statements made on adverts for skin care or dieting products:
"Eating cream cakes may help you to lose weight if taken as part of a calorie controlled diet"

I could make a equally irrefutable statement:
"Evidence suggests that riding on the right hand side of the road will reduce your risk of collision in certain circumstances”
That would most certainly reduce the incidence of the run-over-from-behind type collisions - but it would not be a basis for the highway code to instruct cyclists that they should ride on the right.
Pete Owens
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Re: Highway Code revisions: Consultation complete and Government response published

Post by Pete Owens »

Zulu Eleven wrote: 6 Dec 2021, 9:55pm
The Highway Code makes no claims at all towards mandatory helmet policy, it says “Evidence suggests that a correctly fitted helmet will reduce your risk of sustaining a head injury in certain circumstances”
I note in this case you have clipped off the preceding sentence which starts:
“You should wear a cycle helmet "

Now where the HC says you SHOULD do something, while that doesn't mean it is part of legislation, it is still something the courts take into account when deciding on cases. If road users are doing things which the highway code says they shouldn't or not doing things it says they should then that is taken as evidence of negligence. We will not be prosecuted for not wearing helmets, but whenever a bareheaded cyclist is mown down by a motorist in a collision the insurance company uses non helmet wearing as an excuse to reduce any damages payment due to contributory negligence.

So those words do cause serious negative consequences for cyclists in the real world.
Mike Sales
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Re: Highway Code revisions: Consultation complete and Government response published

Post by Mike Sales »

Zulu Eleven wrote: 6 Dec 2021, 9:55pm
The Highway Code makes no claims at all towards mandatory helmet policy, it says “Evidence suggests that a correctly fitted helmet will reduce your risk of sustaining a head injury in certain circumstances”

You’re literally arguing against something you have entirely imagined, by citing evidence that bears no relation to what was actually claimed.
You mistake my argument.
I mention Australia to show the futility of trying to improve cyclist safety by getting us all to wear a helmet, whether by compulsion or propaganda and persuasion.
Likewise I mention the Netherlands as an example of what works.
Which example do you think we should put our effort into following?
All this stuff about helmets diverts us from what is really needed.

Perhaps you can quote my literal argument that The H.C. is mandating helmets?
It's the same the whole world over
It's the poor what gets the blame
It's the rich what gets the pleasure
Isn't it a blooming shame?
mattheus
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Joined: 29 Dec 2008, 12:57pm
Location: Western Europe

Re: Highway Code revisions: Consultation complete and Government response published

Post by mattheus »

A small cushion will reduce injuries in certain circumstances.

You can put it on your head, your bum, or the front of your bike, depending on the circumstances you want to be ready for!
Steady rider
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Re: Highway Code revisions: Consultation complete and Government response published

Post by Steady rider »

Probably the best evidence come from risk per hour cycled and very few articles cover this aspect. Most research compares the proportion of injuries and this can change depending on the type of accident. Research suggests being helmeted results in a higher fall rate, that would entail a lower proportion of serious head injuries. Several reports show other differences in helmeted to non-helmeted in general terms, such as alcohol use.
The government provided a review of the evidence in 2018 (including cycle helmets) prior to the consultation, that had several flaws. In 2021 more evidence is now available and should be considered.

Dennis et al. (2013) conducted an interrupted time series study examining the impact of introducing mandatory helmet legislation aimed at under-18 year-olds in six provinces of Canada. The study did not detect an effect for legislation on the rate of hospital admissions for cycling related head injuries.
The 'evidence' part of the Code relates only to cycle helmets, is that correct? Could that a signification stepping stone on a path to legislation?
Last edited by Steady rider on 7 Dec 2021, 10:45am, edited 1 time in total.
Jdsk
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Re: Highway Code revisions: Consultation complete and Government response published

Post by Jdsk »

Steady rider wrote: 7 Dec 2021, 10:31amDennis et al. (2013) conducted an interrupted time series study examining the impact of introducing mandatory helmet legislation aimed at under-18 year-olds in six provinces of Canada. The study did not detect an effect for legislation on the rate of hospital admissions for cycling related head injuries.
https://www.bmj.com/content/346/bmj.f2674

That's the study which triggered the comments from G and S. And is about the effects of mandation. As above there are several different questions milling around here, and it's important to be precise about which one is being discussed.

But they did include a comment about helmets and injuries:

While helmets reduce the risk of head injuries and we encourage their use...

That appears to be consistent with the revised wording in the Highway Code.

Jonathan
mattheus
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Location: Western Europe

Re: Highway Code revisions: Consultation complete and Government response published

Post by mattheus »

Jdsk wrote: 7 Dec 2021, 10:44am
Steady rider wrote: 7 Dec 2021, 10:31amDennis et al. (2013) conducted an interrupted time series study examining the impact of introducing mandatory helmet legislation aimed at under-18 year-olds in six provinces of Canada. The study did not detect an effect for legislation on the rate of hospital admissions for cycling related head injuries.
https://www.bmj.com/content/346/bmj.f2674

That's the study which triggered the comments from G and S. And is about the effects of mandation. As above there are several different questions milling around here, and it's important to be precise about which one is being discussed.

But they did include a comment about helmets and injuries:

While helmets reduce the risk of head injuries and we encourage their use...

That appears to be consistent with the revised wording in the Highway Code.

Jonathan
Do you think such editorial comment makes good science? Or good health policy?
[I do generally hold the BMJ in high regard BTW! But no-one should be above criticism and question.]
Jdsk
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Joined: 5 Mar 2019, 5:42pm

Re: Highway Code revisions: Consultation complete and Government response published

Post by Jdsk »

mattheus wrote: 7 Dec 2021, 10:52am
Jdsk wrote: 7 Dec 2021, 10:44am
Steady rider wrote: 7 Dec 2021, 10:31amDennis et al. (2013) conducted an interrupted time series study examining the impact of introducing mandatory helmet legislation aimed at under-18 year-olds in six provinces of Canada. The study did not detect an effect for legislation on the rate of hospital admissions for cycling related head injuries.
https://www.bmj.com/content/346/bmj.f2674

That's the study which triggered the comments from G and S. And is about the effects of mandation. As above there are several different questions milling around here, and it's important to be precise about which one is being discussed.

But they did include a comment about helmets and injuries:

While helmets reduce the risk of head injuries and we encourage their use...

That appears to be consistent with the revised wording in the Highway Code.
Do you think such editorial comment makes good science? Or good health policy?
[I do generally hold the BMJ in high regard BTW! But no-one should be above criticism and question.]
That isn't an editorial comment. It was made by the authors of the study.

Jonathan

PS: But as it's the BMJ responses are welcome and published:
https://www.bmj.com/content/346/bmj.f26 ... -responses
Steady rider
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Joined: 4 Jan 2009, 4:31pm

Re: Highway Code revisions: Consultation complete and Government response published

Post by Steady rider »

Helmet legislation was not associated with reduced
hospitalisation rates for brain, head, scalp, skull or
face injuries, indicating that factors other than
helmet laws have more influence on injury rates.
https://bmjopen.bmj.com/content/bmjopen ... 2.full.pdf
Conclusions: These results suggest that
transportation and health policymakers who aim to
reduce bicycling injury rates in the population should
focus on factors related to increased cycling mode
share and female cycling choices. Bicycling routes
designed to be physically separated from traffic or
along quiet streets fit both these criteria and are
associated with lower relative risks of injury
The focus should be on improving conditions for cycling.
Jdsk
Posts: 24640
Joined: 5 Mar 2019, 5:42pm

Re: Highway Code revisions: Consultation complete and Government response published

Post by Jdsk »

Mike Sales wrote: 6 Dec 2021, 8:09pmYes, behaviour is affected by whether the actor feels safer or more endangered. The amount of change in behaviour necessary to use up the minimal protection afforded by a cycle helmet is not large. If a helmet is felt needed to ride, say, a busy A road, this is risk compensation, in action. The helmet has not made you safe, but may have led you into more danger!
Risk compensation theory is fascinating. IMO it should always be considered. But the difference of opinion in this subject is whether risk compensation is a dogma that can be accepted without evidence or whether it should be sought and studied in the domain of interest.

"Bicycle helmets and risky behaviour: A systematic review": 2019
https://www.sciencedirect.com/science/a ... 7818305941

"Is risk compensation threatening public health in the covid-19 pandemic?": 2020
https://www.bmj.com/content/370/bmj.m2913
... despite the title this discusses helmets in two settings.

Jonathan
Jdsk
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Joined: 5 Mar 2019, 5:42pm

Re: Highway Code revisions: Consultation complete and Government response published

Post by Jdsk »

Steady rider wrote: 7 Dec 2021, 10:59am
Helmet legislation was not associated with reduced
hospitalisation rates for brain, head, scalp, skull or
face injuries, indicating that factors other than
helmet laws have more influence on injury rates.
https://bmjopen.bmj.com/content/bmjopen ... 2.full.pdf
Conclusions: These results suggest that
transportation and health policymakers who aim to
reduce bicycling injury rates in the population should
focus on factors related to increased cycling mode
share and female cycling choices. Bicycling routes
designed to be physically separated from traffic or
along quiet streets fit both these criteria and are
associated with lower relative risks of injury
The focus should be on improving conditions for cycling.
This is about a different question: helmet legislation. This debate won't make any progress if the question keeps being shifted.

And for any well-defined question systematic review is far superior to cherrypicking individual papers.

Jonathan

PS: But the authors do make a comment about helmet and injuries:

Bicycling injury research is dominated by helmet research; it shows that helmet use is associated with reduced odds of head injuries among those injured in a crash.

That seems to be consistent with the revised wording in the Highway Code.
Last edited by Jdsk on 7 Dec 2021, 11:37am, edited 2 times in total.
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