Do the helmets in accidents involving helmets get investigated?

[Cunobelin]

I’ve done a fair bit of impromptu helmet during accident testing over the years. They’ve certainly stopped me from sustaining serious head injuries. Helmet manufacturers want to sell helmets, and don’t want their profit margins eroded by costly studies, when there are standard tests, which will do, to get the minimum necessary regulatory ‘ticks in boxes’ to enable them to be able to sell at a profit. As far as I know, no one has commissioned any robust scientific studies into the efficacy of cycle helmets. It would be a difficult thing to do, as people involved in accidents where a helmet would have helped, but didn’t wear a helmet, tend to be dead, and dead people don’t talk much.

I am so pleased that you didn't mention cyclists as all of this post would apply to pedestrians, car drivers and passengers

[gaz]

With modern, sophisticated crash test dummies, why can't they standardise a helmet test using one of those for various, real life accident types?

Rig up a bicycle frame, pull it to the side of a car reconstruction that stimulated a driver making a left turn without considering the cyclist. Or a side impact from a motorist coming in from a side road or whatever.

No cycling helmet yet devised has claimed to be of any measureable benefit in a collision involving a motor vehicle.

As stated upthread helmets are engineered down to the minimum standard, there is no incentive for manufacturers to do otherwise.

[Cyril Haearn]

I always wear a seat belt when driving
It has not saved my life
Yet

[pjclinch]

As far as I know, no one has commissioned any robust scientific studies into the efficacy of cycle helmets. It would be a difficult thing to do, as people involved in accidents where a helmet would have helped, but didn’t wear a helmet, tend to be dead, and dead people don’t talk much.

So you can only do a robust study if you can interview the victims?

People in accidents where a helmet would help not be dead would have a better incidence of not-deadness if they were wearing helmets. People in similar accidents without helmets would be more likely dead. You'd be able to see the difference, if there were a clear one. Nobody's been able to manage this, because there isn't a clear difference.

The problems with lack of robust studies come from the way that helmet benefits are, to quote Ben Goldacre and David Spiegelhalter's BMJ editorial where they explain why research isn't helping answer these questions, "too modest to capture". What effect they have is sufficiently small that the confounding noise obscures it completely. It's nothing to do with victims losing the power of speech, and indeed dead people make particularly good study subjects because the mosre serious the accident the less chance of it going unreported.

Pete.

[Tangled Metal]

With the technology used in car testing surely they could devise a good test using crash test dummy technology to measure and model the effect of helmet wear on typical modes of accident? I suspect any benefit found is masked by the error of the test. Benefits are so small you can not be sure you've observed them or observed the experimental error / noise.

Perhaps such a study could design a cycle helmet that could conclusively be proven to benefit the user in an accident. Then helmet companies can market it to cyclists as real safety equipment. I bet the take up of it would be small. I don't want a motorcycle helmet on my head when cycling.

[pjclinch]

With the technology used in car testing surely they could devise a good test using crash test dummy technology to measure and model the effect of helmet wear on typical modes of accident?

For Some Values Of "typical modes of accident". Car testing dummies just sit there and take it, which is pretty much what a driver or passenger will do in a lot of cases and the considerable energies involved meaning that e.g. throwing your hands up in reflex action won't change the bottom line much. Cycling prangs would, I think, involve a far more active victim. For example, a slide on ice, you go down sideways and quite unconsciously hold your head up to stop it hitting the ground and will quite possibly be breaking your collarbone by sricking an arm out to protect your head. A crash-test dummy won't do that.

Pete.

[mjr]

If people are live testing these helmets so much in the real world, then there may be a different problem/solution.
If cyclists are falling off or having collisions frequently then there may be an issue with bike handling skills or traffic awareness.
On 40+ years of riding I seem to recall four 'serious' offs, and in only one of them did I hit my head (and a hat would have made no difference).
So - why are some riders coming off so much?

Oooh, I don't know. Do you think balancing a quarter-pound weight on top of one's head could maybe perhaps affect one's balance? (I'm always reminded of people trying to walk while balancing a book on their head.) Do you think wrapping one's brain in cavity wall insulation might warm it up and impair judgement or reactions? Do you think the increased wind noise might reduce awareness of other road users? There's so many possibilities, plus the oft-suggested risk compensation effects (both of the cyclist and of nearby motorists towards the cyclist).

In 35+ years of riding, I seem to recall many many offs and probably forgot more and the overwhelming majority occurred in my 12ish years of helmet use, even though I rode more before and much more after that period.

[pjclinch]

Oooh, I don't know. Do you think balancing a quarter-pound weight on top of one's head could maybe perhaps affect one's balance? (I'm always reminded of people trying to walk while balancing a book on their head.)

I'm afraid the Bad Analogy Police have you bang to rights on this one. if the book was concave, head shaped and strapped on you might have a point, but the difficulty isn't keeping one's balance, but that of the book. No shortage of people with heavier hats or hairdos who've never raised balance issues before now, so I think this one is a non-starter. It certainly doesn't seem to trouble Danny MacAskill's ability to do daft stuff.

Pete.

[mjr]

Oooh, I don't know. Do you think balancing a quarter-pound weight on top of one's head could maybe perhaps affect one's balance? (I'm always reminded of people trying to walk while balancing a book on their head.)

I'm afraid the Bad Analogy Police have you bang to rights on this one. if the book was concave, head shaped and strapped on you might have a point, but the difficulty isn't keeping one's balance, but that of the book.

If all users actually strapped the helmet on tightly enough for it not to move around, you might have a point, but many of them really do seem to have difficulty keeping the helmet steady on top of their head...

Part of the difficulty in walking with a book on your head is keeping one's balance. Have you tried it? If you start to lose the book, there comes a point where you have to choose whether to save the book or yourself. I can't find it but I was sure there were videos on youtube of people (some possibly drunk) actually making the wrong choice there!

Anyway, I only said it reminds me of it, not that it was exactly the same.

No shortage of people with heavier hats or hairdos who've never raised balance issues before now, so I think this one is a non-starter. It certainly doesn't seem to trouble Danny MacAskill's ability to do daft stuff.

Professional stunt people can learn to ride with all sorts of encumbrances.

[The utility cyclist]

I'm surprised that Rospa, headway and other groups whom seemingly highlight head injuries of people on bikes massively more than any other and push for helmets of same haven't grasped the opportunity of studying the benefits helmets would seemingly give to those groups who present the biggest number/% of serious head injuries, that being everyone else who isn't cycling.

Serious head injuries presented by people on bikes is estimated at 26% of all serious injuries suffered by those on bikes (of which a massive % will be at fault motorists), currently that makes around 816 serious head injuries a year, compared to all the other groups whose admissions alone due to a serious head injury (not all serious head injuries are admissions) number circa 159,184, or 99.5% of all the head injuries.

I'm sure studying the effects of helmet use by those groups who have circa 1.3 million reported head injuries would be really useful ... oh wait it's only people on bikes that are forced/pushed to wear them despite the facts as to risk - which has being shown to only get worse when they do wear helmets at all levels from the potterer to the pro

[pjclinch]

I'm surprised that Rospa... <snip>

I'm surprised they haven't looked at their name, and joined the dots that helmets don't prevent accidents. <sigh>

[horizon]

Has this ever been done or is it done?

Can I take it as a "no" then and presume that basically there is no reliable evidence that helmets protect at all?

In which case it's humble pie on the menu for lots of cyclists, other people and organisations?

[pjclinch]

If all users actually strapped the helmet on tightly enough for it not to move around, you might have a point, but many of them really do seem to have difficulty keeping the helmet steady on top of their head...

I've never seen anyone have difficulty keeping a lid on their head, and that's in the context of a Bikeability instructor where there's been years of hilariously mis-fitted examples.

Part of the difficulty in walking with a book on your head is keeping one's balance. Have you tried it? If you start to lose the book, there comes a point where you have to choose whether to save the book or yourself. I can't find it but I was sure there were videos on youtube of people (some possibly drunk) actually making the wrong choice there!

Of course I've tried it, I've got 18 years of childhood behind me. And all of the problems are caused by needing to keep the book in place, which requires considerable input to keep up because it's designed to sit still on a flat surface. Without that input there's nothing much to affect your normal balance, so it isn't difficult.

I'm no fan of helmets but demonising them with obvious non-sequiturs really doesn't help anybody.

Pete.

[Vorpal]

Do you think balancing a quarter-pound weight on top of one's head could maybe perhaps affect one's balance?

Damn. I guess I'd better get a haircut.

[pjclinch]

Has this ever been done or is it done?

Can I take it as a "no" then and presume that basically there is no reliable evidence that helmets protect at all?

In which case it's humble pie on the menu for lots of cyclists, other people and organisations?

You might take it as a "no", but that's not the same thing as "no reliable evidence that helmets protect at all".

To protect at all is a very low hurdle. To prove an EN1078 helmet can protect at all have someone drop a cricket ball on your head from a couple of meters up with and without a helmet. If the helmet example is less uncomfortable it has protected you to some degree. It hasn't saved your life, but it's quite possibly saved you a bit of a headache, and that is some measure of useful protection.

This is not, of course, anything to do with protection from serious or fatal injury in any number of modes of cycle crashes, but that is (a) not what you asked and (b) not what they're designed for, which is more mitigation of minor injury. There is no reliable evidence that if two notionally identical "average" cyclists start the same notionally "normal" journey, one with and one without a helmet, that either one will clearly be in less chance of ending up in A&E than the other. But that's not the same thing as no reliable evidence a helmet can be of any use.

Pete.