Why Are You Not Wearling a Helmet?

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.
kwackers
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Re: Why Are You Not Wearling a Helmet?

Postby kwackers » 15 Sep 2014, 4:21pm

DaveGos wrote:however there are many safety measures introduced or made compulsory in the last 50 years with significant benefits - namely safety belts in cars

You sure about that?

Seat belts were going to save around 20%(?) of lives lost in accidents. On their introduction the downward trend in accidents which should have shown a drop of 20% simply flatlined for a few years before continuing.
The obvious conclusion is that not only didn't they work but they actually made things worse!
Interestingly at least one report that suggested the safety gain from seatbelts was at best massively overestimated was brushed under the carpet.

In retrospect it looks as though seatbelts improved the lot of those in the car at the expense of those outside, the explanation for this comes under the heading 'risk compensation'. Overall though it would superficially appear that seat belts made things worse...

Loads of stuff about this on the web, interesting reading whether you believe it or not but at the very least to argue that seatbelts save lives you need to be able to explain the lack of improvement when they were introduced.
It would appear that to a large extent seatbelts are simply assumed to work in the same way cycle helmets are assumed to work without any thought given beyond the simplistic concept of "they must be better than nothing".

A link to get you started.
http://www.john-adams.co.uk/2009/11/05/seat-belts-another-look-at-the-data/

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Re: Why Are You Not Wearling a Helmet?

Postby Steady rider » 15 Sep 2014, 7:18pm


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Re: Why Are You Not Wearling a Helmet?

Postby TonyR » 15 Sep 2014, 8:18pm


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Re: Why Are You Not Wearling a Helmet?

Postby snibgo » 15 Sep 2014, 9:13pm

rmurphy195 wrote:If you set a no-helmet example to one of your children/grandchildren, who subsequently had a nasty injury due to following your example, how would you feel?

We could (and should) also ask the converse question:

"If a child followed my example of wearing a helmet, gained a misplaced sense of invulnerability so took greater risks and motorists took less care around him and he suffered a nasty injury, how would I feel?"

I would feel guilty, of course.

I wish life was simple. I wish we could say, "More safety gear = fewer injuries". We can't say it because the evidence doesn't support it. This doesn't stop people assuming that it must be true because, well, it's common sense, innit?

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Re: Why Are You Not Wearling a Helmet?

Postby Tonyf33 » 15 Sep 2014, 9:19pm

I've been shunted from behind twice whilst driving, the first time I had a decent amount of whiplash (which back in the early 90s I didn't even think about claiming for despite having a very sore neck for over a week). Did my seatbelt stop me from being hit..no, did it stop me from receiving an injury..no, did it prevent me from hitting anything else in the car, no (actually I didn't hit anything at all).
Removing seatbelts, airbags and the like would eventually bring about a huge improvement on people's risk taking..the same can be said for helmet wearing within cycling circles

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Re: Why Are You Not Wearling a Helmet?

Postby Vorpal » 15 Sep 2014, 10:16pm

rmurphy195 wrote:If you set a no-helmet example to one of your children/grandchildren, who subsequently had a nasty injury due to following your example, how would you feel?

My children are too young to understand the concept of risk compensation (or maybe I just need to find a simpler way to explain it :wink: ), but my hope is that I will set an example that there is no hard and fast rule about what is best; that my children should educate themselves about their choices, think about and understand the risks they are taking, and behave accordingly.

That may include wearing a helmet, or it may not. But I certainly don't want them to wear a helmet without understanding that wearing one may change their behaviour, just because they 'feel safer' with it on.
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Re: Why Are You Not Wearling a Helmet?

Postby pjclinch » 16 Sep 2014, 10:23am

Vorpal wrote:My children are too young to understand the concept of risk compensation (or maybe I just need to find a simpler way to explain it :wink: ), but my hope is that I will set an example that there is no hard and fast rule about what is best; that my children should educate themselves about their choices, think about and understand the risks they are taking, and behave accordingly.

That may include wearing a helmet, or it may not. But I certainly don't want them to wear a helmet without understanding that wearing one may change their behaviour, just because they 'feel safer' with it on.


With my Cycling Scotland training hat on I teach primary school kids on-road riding. For helmets, Bikeability Scotland Level 2 doesn't have a helmet requirement beyond respecting the rules of the course provider (in my case P&K or Dundee councils), but the course does require me to, "outline both advantages and disadvantages of helmets and fluorescent/reflective clothing and encourage informed decisions".
In other words, it is recognised that there are downsides as well as upsides, and thus far my experience is I get a lot better class of discussion and debate from the local P6 and P7 kids than I typically get from adults. They are often (certainly not always, but often) more willing to realise they've got something to learn and that what their gut tells them isn't necessarily the right answer.

Not for the first time, I will suggest Tim Gill's excellent review of cycling for the National Children's Bureau as an excellent place to get some perspective. The Annex is as good a discussion of cycle helmet efficacy evidence as you're likely to find at a generally digestible level, but the whole report is a good example of using actual evidence and balance to review issues faced by children and young people. Free download at http://www.ncb.org.uk/media/443203/cyclingreport_2005.pdf. Gill is in the unenviable position of people basing approaches to risks affecting children on what he says, and that he's highly regarded in the field after many years suggests to me he's on the right lines.

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Re: Why Are You Not Wearling a Helmet?

Postby rmurphy195 » 18 Sep 2014, 11:42am

It's a good article but unless I've missed something, the section in the published article reworking backwards from hospital admissions does not or cannot take into account the number of people who've fallen, bumped their head and as a result of wearing a helmet have no need to go to hospital in the first place. i.e. a minor bump does not result in an injury where it would have without a helmet (e.g. helmet scraped instead of scalp). This is an aspect that seems to be missing from many of the discussions I have read, as is the value of a helmet for injury reduction

I have seen the result of a serious collision between a cyclist and a large cast-iron gate as found on many larger properties - in this case she failed to negotiate a sharp bend at the bottom of the hill and went into the gates head first. She had concussion and some bruises and had to go to hospital - but the helmet was completely split. I couldn't help wondering if without the helmet, her head would have been split and after the hospital visit the next stop would have been the morgue, not her home. There is no doubt that the helmet reduced the severity of the injury she would otherwise have had.

Which leads on to another aspect of many of the discussions I see on this and other forums - we see a lot of comments about risk, but when I did risk analysis at various depths as part of my job, there were 2 initial aspects - What is the risk of something happening, and what is the impact if it does. Then we go onto to mitigation or redesign strategies based on a combination of the score (High risk + high impact = 9), or the level of impact ("It's got a low risk of happening but if it does the business fails, so we'd better think of something").

For me the risk of falling and banging my head is small - it hasn't happened yet even though I've gone over the bars a few times in the last 50 years. But the impact of landing on my unprotected head is severe. So the mitigation is - a helmet reduces the level of injury. And the injury might be - at night, the difference between falling, getting up and limping to the side of the road, and lying unconscious/semi conscious until hit by an approaching vehicle whose driver does not see me - maybe 'cos he's avoiding something which is lit (the bike with it's lights) and hits something which is not (Me!). (Mitigation = light clothing, white helmet!)

But also I'm an ex-biker (motorised) of the late 60's and frankly, I wouldn't go near a motorbike, then or now, without a hard hat. Bikers helmets are heavier and give a great level of protection - but then the impacts are likley to be harder and the injury reduction that much greater.

But the cycling hat still sometimes comes off on a hot day on a step hill on a quiet road - risk is - overheating! (Mitigation - remove helmet, cycle to nearest shady bit of road). And I won't wear my son's helmet that he uses for downhilling - it's definitely not for wearing wile pedalling.
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Re: Why Are You Not Wearling a Helmet?

Postby pjclinch » 18 Sep 2014, 1:39pm

rmurphy195 wrote:It's a good article but unless I've missed something, the section in the published article reworking backwards from hospital admissions does not or cannot take into account the number of people who've fallen, bumped their head and as a result of wearing a helmet have no need to go to hospital in the first place. i.e. a minor bump does not result in an injury where it would have without a helmet (e.g. helmet scraped instead of scalp). This is an aspect that seems to be missing from many of the discussions I have read, as is the value of a helmet for injury reduction


The trick with population data is that all the incidents, or indeed non-incidents, are in it. If helmets are removing serious injuries and downgrading them to minor ones then there should be a drop in serious injuries as helmet use goes up. But there isn't.

rmurphy195 wrote:I have seen the result of a serious collision between a cyclist and a large cast-iron gate as found on many larger properties - in this case she failed to negotiate a sharp bend at the bottom of the hill and went into the gates head first. She had concussion and some bruises and had to go to hospital - but the helmet was completely split. I couldn't help wondering if without the helmet, her head would have been split and after the hospital visit the next stop would have been the morgue, not her home. There is no doubt that the helmet reduced the severity of the injury she would otherwise have had.


There are various problems with this. First of all, it's an anecdote and while anecdotes often inform personal decisions they're not really much use at this level, which is why epidemiology isn't interested in them. Next up, while it is often assumed that a broken helmet would have meant a broken skull it's around an order of magnitude harder to break a skull than a plastic hat. Another point is that if you whack a hat hard it tends to undergo brittle fracture which absorbs remarkably little energy. And actually you can't be sure (really, absolutely sure) it must have helped. Aside from various mechanisms for extra leverage from the greater size or similar, part of the issue is whether or not you have an accident in the first place. People using PPE have been observed to (on average) take more risks, which means more accidents.

rmurphy195 wrote:Which leads on to another aspect of many of the discussions I see on this and other forums - we see a lot of comments about risk, but when I did risk analysis at various depths as part of my job, there were 2 initial aspects - What is the risk of something happening, and what is the impact if it does. Then we go onto to mitigation or redesign strategies based on a combination of the score (High risk + high impact = 9), or the level of impact ("It's got a low risk of happening but if it does the business fails, so we'd better think of something").

For me the risk of falling and banging my head is small - it hasn't happened yet even though I've gone over the bars a few times in the last 50 years. But the impact of landing on my unprotected head is severe.


It might be, but actually people have been banging their unprotected heads against hard surfacers for as long as there have been people, and thanks to evolution they have, more often than not, survived. The impact of landing on an unprotected head is typically a headache. And the flipside is that excrement does of course happen and trips and falls are the biggest cause of traumatic brain injury... yet aside from individuals with very unfortunate conditions pretty much nobody uses such a thing when walking, because they know it's safe enough.

rmurphy195 wrote:So the mitigation is - a helmet reduces the level of injury. And the injury might be - at night, the difference between falling, getting up and limping to the side of the road, and lying unconscious/semi conscious until hit by an approaching vehicle whose driver does not see me - maybe 'cos he's avoiding something which is lit (the bike with it's lights) and hits something which is not (Me!). (Mitigation = light clothing, white helmet!)


if there was a significant chance of your helmet making that sort of difference we would see it in a lessening of KSIs as helmet wearing goes up. But even where it's doubled overnight there is no such effect observable. Alternatively your helmet might make the difference between a driver overtaking too close and having you off, and giving you a wider berth because you're "not safe without a helmet". As you mention above, you have to factor in the chances of the accident happening at all.

The bottom line is that while we can reasonably say there are situations where you'll almost certainly be better off in a helmet (say, warding off a gnarly branch while doing a bit of singletrack), as far as setting out on the roads are concerned A Notional Cyclist is no more likely to end their journey in A&E with a serious injury if they set off without a helmet. That may be counter intuitive, but that don't mean it ain't so.

And, as is often the case, we need to look across the North Sea and get a sense of perspective. Despite their much vaunted cycle-friendly infrastructure there is nothing stopping Dutch cyclists falling off their bikes and hitting their heads. They might be less likely to be knocked off by motor vehicles, but then as the original British Standard noted cycle helmets are built for accidents involving low speed falls and no other vehicles. Ride along a crowded fietspad in a major town, perhaps sharing it with lots of kids on their 'phones while giving their mates backies, and you realise that for the sorts of incident helmets are designed for there's no shortage! yet wearing rates are well below 1%, and it's in terms of serious head injuries it'll be as safe as anywhere in the world. If there was a significant safety gain from helmets in simple falls the Dutch would have several million more reasons than most to be enthusiastic advocates, but they by and large don't bother, and the government does not encourage them because they realise it discourages cycling.

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Re: Why Are You Not Wearling a Helmet?

Postby Steady rider » 18 Sep 2014, 6:53pm

Tin Tin at al reported: "The rate of traumatic brain injuries fell from 1988-91 to 1996-99; however, injuries to other body parts increased steadily"
Tin Tin S. Injuries to pedal cyclists on New Zealand roads, 1988-2007. BMC Public Health 2010;10:655. http://www.biomedcentral.com/1471-2458/10/655
see also
Clarke, CF, Evaluation of New Zealand’s bicycle law, NZMJ 10 February 2012, Vol 125 No 1349
http://journal.nzma.org.nz/journal/125-1349/5046/

http://en.wikipedia.org/wiki/Bicycle_he ... hes2007-64
Details the tragic children that have been strangled by the straps.

Robinson DL; Head injuries and bicycle helmet laws; Accid Anal Prev, 28, 4: p 463-475, 1996 http://www.cycle-helmets.com/robinson-head-injuries.pdf

Avoiding helmets may help avoid accidents and head impacts but helmets may help to avoid head injuries in some impacts, a mixed bag. Helmet laws are bad news for cycling.

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Re: Why Are You Not Wearling a Helmet?

Postby snibgo » 18 Sep 2014, 7:24pm

rmurphy195 wrote:... but the helmet was completely split. ... There is no doubt that the helmet reduced the severity of the injury she would otherwise have had.

Did you examine the helmet? Did the polystyrene crush? If it didn't then it absorbed no energy and did not reduce the severity of the injury.

A broken helmet is not evidence that it absorbed energy. It takes no significant energy to break a cycling helmet.

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Re: Why Are You Not Wearling a Helmet?

Postby TonyR » 19 Sep 2014, 8:05am

rmurphy195 wrote:Which leads on to another aspect of many of the discussions I see on this and other forums - we see a lot of comments about risk, but when I did risk analysis at various depths as part of my job, there were 2 initial aspects - What is the risk of something happening, and what is the impact if it does. Then we go onto to mitigation or redesign strategies based on a combination of the score (High risk + high impact = 9), or the level of impact ("It's got a low risk of happening but if it does the business fails, so we'd better think of something").


So lets do a comparative risk analysis for walking and cycling.

Risk of falling off a cycle: 1
Risk of tripping or falling on foot: 5


Risk of head injury falling off a cycle: 3
Risk of head injury tripping or falling on foot: 4


Impact of head injury cycling: 2 - 9
Impact of head injury tripping or falling: 2 - 9

All risk figures sourced back to official statistics.

So having done the risk analysis the risk is much higher on foot and the impact is the same yet you choose only to wear a helmet for the lower risk activity? Do you really believe your risk analysis argument and wear a helmet on foot?

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Re: Why Are You Not Wearling a Helmet?

Postby Vorpal » 19 Sep 2014, 9:49am

rmurphy195 wrote:Which leads on to another aspect of many of the discussions I see on this and other forums - we see a lot of comments about risk, but when I did risk analysis at various depths as part of my job, there were 2 initial aspects - What is the risk of something happening, and what is the impact if it does. Then we go onto to mitigation or redesign strategies based on a combination of the score (High risk + high impact = 9), or the level of impact ("It's got a low risk of happening but if it does the business fails, so we'd better think of something").

'We'd better think of something' could be a knee-jerk reaction that includes all sorts of things that don't actually work.

IMO, a risk assessment system that doesn't include verification of the mitigating actions is an inadequate system.

In other words, do you have any evidence that the mitigation will be effective?

If not, you'd better think of something else

Also, according to the heirarchy of controls, personal protective equipment is the very last thing that should be implemented.
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Re: Why Are You Not Wearling a Helmet?

Postby horizon » 19 Sep 2014, 10:17am

One passing thought I had when reading this thread is that helmets are a reflection of a non-cycling population. Proponents of helmets for others (e.g. adults for children) don't, it seems. cycle themselves. Those who wear cycle helmets seem to be new riders (as witnessed by lots of photographs of organised rides). My understanding is that the risks and mitigation are sorted out at a very young age, while you are learning to cycle, growing up and developing confidence. A helmet reflects IMV uncertainty about one's skills and the possibility of a fall and the likely consequences. I don't think I would now cycle if I thought that a helmet was necessary. That doesn't mean that I will never have an accident, just that the risks are mitigated by and subsumed into a whole set of other practices and perceptions.
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Re: Why Are You Not Wearling a Helmet?

Postby Lance Dopestrong » 19 Sep 2014, 10:25am

I wear a lid and I've been cycling for 41 years (not continuously, I've had the odd break to eat and sleep) so I'm hardly a new cyclist. I'm very happy with my skills, ABC level 1, Mountain Bike Leader Level 5 - I just prefer to wear lids for my own reasons, and there's no other conclusion can be drawn from that.

That said, what others do with their heads is their business and whether they wear a helmet is not is no more important to me than the bike the ride or the brand of clothing they wear. I never preach to others what they should do, and I never draw unfounded conclusions about their skills, knowledge or experience from that. That's entirely their business, just as me wearing a bonce potty is entirely mine.
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