Evaluating the impact of cycle helmet use...

[Nearholmer]

Apologies on that one - it was just that I’d already given a long reply explaining that point, and didn’t want to type it all again. The nature of forum threads, where people “pop
In and out of the room”.

[Steady rider]

https://www.cyclinguk.org/campaigning/v ... le-helmets

In any case, there are serious doubts about the effectiveness of helmets. They are, and can only be, designed to withstand minor knocks and falls, not serious traffic collisions. Some evidence suggests they may in fact increase the risk of cyclists having falls or collisions in the first place, or suffering neck injuries.

Royal Mail paid compensation to one post man after losing his job due to their helmet requirement.

A problem with helmets is people can design them that seem to make improvements but the other side is knowing all the disadvantages, that designers often cannot take full account of.

[Vorpal]

Have a look at what I said about that.

OK

"The HSE exclude cycle helmets from PPE"

Cycle helmets are excluded from the scope of the PPE Regulations, yes, as are a number of other sorts of PPE that are dealt with in specialist legislation, but that doesn't relieve an employer from the responsibility to control risks to their staff while cycling at work.

Cycle helmets are not PPE. Nothing about the test standards for helmets suggests that they are safety related items at all. The point of the HSE statement is that they do not ask employers to require them, unlike safety footwear, hardhats, protective glasses, welding shields, etc.

Any employer that has staff who cycle in the course of their work should be assessing the risks, and if they conclude that the wearing of helmets is necessary to control those risks to a level ALARP, they should issue helmets, and (this will upset some here) compel the relevant people to wear them, just as they would do in respect of any other PPE for any other risk.

As low as reasonably practicable (ALARP) is achieved through the application of that pyramid I posted previously.

Helmets potentially contribute to this only in limited circumstances, such as professional cyclists racing. The chances of HSE investigating an incident where a helmet could have made a difference are tiny. Even if they were to do so, there are likely to be numerous causes that outweigh the use of a cycle helmet (e.g. the negligence of a driver, road conditions, etc.)

PS: Constables, PCSOs, and paramedics always wear helmets when cycling, do post-persons? I haven't seen a postie on a bike for years, they seem to use trolleys instead nowadays?

Police constables also wear body armour. Should I do so?

as an engineer I'm ever the optimist that a better mousetrap can be invented, especially given advances in mathematical modelling and material science.

As an engineer, I need to keep in mind that the goal is to catch a mouse.

[Nearholmer]

“ As low as reasonably practicable (ALARP) is achieved through the application of that pyramid I posted previously.”

That diagram is often used as a quick way of dealing with some risk-ALARP questions, but it is, as you probably know if you are into the subject as it sounds as if you are, not the whole story.

The fact that cycle helmets, are outwith the scope of the PPE Regs while being used on public roads doesn’t somehow mean that their use can never be called-up as the result of a risk assessment relating to cycling on the road in the course of employment, and if cycling was part of work on an employer’s premises (some chemical refineries issue bikes for on-site use of maintenance staff for instance), a risk assessment identified that cycle helmets were appropriate to mitigate an identified risk, and they were issued accordingly, then they would fall under the PPE Regs. The guidance to the regs is very clear on this, giving motorcycling ‘on road’ and ‘not on road’ examples.

I get that some people don’t like the idea that an employer could ever compel an employee to wear a cycle helmet in the course of their work, but I honestly believe that the way the law stands they could.

As to the likelihood of any of this ever coming to court, I share your view that it is highly improbable, but wouldn’t exclude the possibility altogether.

[pjclinch]

I get that some people don’t like the idea that an employer could ever compel an employee to wear a cycle helmet in the course of their work, but I honestly believe that the way the law stands they could.

Much as I don't like the idea, I acknowledge it happens. Anyone who wants work as a cycle instructor in the UK is pretty much stuck with it in a lot of places, a lot of the time.

Cycle training isn't my day job so I can be choosy... but choosing to not wear a helmet for National Standards training I have trouble giving my time away for free. NHS Tayside Public Health are okay with it but none of the local authorities in Scotland or Sustrans will let me work for them unless I do it in a lid.

Pete.

[Steady rider]

I think it was in about 1992 when a cycling instructor lost his job due to helmet requirements. A calculation can be made regarding helmet promotion, using
A TRL 1997 report detailed, “Eleven Local Authorities had however held a helmet campaign when their activities were focused solely on the promotion of helmets. In these Local Authority areas, a larger increase in helmet wearing was found than in the areas which had not held such a campaign. However, this increase was found to be strongly linked to a decrease in the numbers of cyclists observed: in those areas where a campaign had been held and the numbers of cyclists had increased, helmet wearing fell.” and making an assessment of how much cycling can be discouraged from helmet promotion can be made.

Professor Piet de Jong in 2012 provided a way to evaluate the question whether mandatory bicycle helmet laws deliver a net societal health benefit . A reduction of 1% in cycling would result in an effective loss in health terms, about 2 to 3 times higher than the potential gains.

Cycling UK says,

Given that the risks of cycling are low – they are not greatly different from those of walking or other forms of active recreation – even a very small reduction in cycle use would be counter-productive to health and other public policy objectives, regardless of the effectiveness or otherwise of helmets.

Those insisting on helmet use are setting a very bad and harmful example, but of course they do not see the error in their judgement.

[pjclinch]

My comment was about systematic review not "systematic studies".

Systematic review is merely the current best (or least worst) method of putting together in one place what's known. It doesn't assume anything about there being a clear signal. It will often identify that there is no consistency in the available studies.

(My bad on "study" rather than review, effectively a typo)
But it effectively does assume a clear signal: that is why systematic review will have a quality threshold to sort out the wheat from the chaff.

(- Edit, addition, "signal" perhaps a bad choice of word, what I'm meaning by "signal" is "the reality of the situation", which may be present as "about zero".)

You've suggested before that an SR would only contain "well designed" studies, and while that should be the case it will come down to a degree of subjective judgement in how the quality threshold is set.
In these fields, where we have considerable variation in opinion of what constitutes "good", the selection of a quality threshold (be it too permissive or too restrictive) can enormously affect the result. For example, if you think hospital case/control without very tough confounder control is fine that will let through a lot of stuff that will almost certainly skew the conclusion high, but if you think it's mince that's a lot of the literature straight in the bin. Too restrictive is cherry picking but too permissive is at least as bad, a sort of reverse cherry picking where we go out of our way to get all the rotten ones.
We have to trust the authors are doing a good job here, and personally I don't trust anything with Jake Olivier's name on it in that regard. That's a subjective judgement, of course, but whether or not it's fair I'd hope you can see the potential for a poorly set quality threshold to systematically distort the conclusions where you have a rather contentious literature base, especially where you tend to go from slight negative to enormously positive.
The requirement for quality thresholding and how it is achieved means that SR isn't necessarily the clean objective process we'd like it to be.

I think this problem of using a system that can amplify the outcomes of dubious methodologies where poor papers are included (even if in entirely good faith) is why Goldacre & Spiegelhalter effectively give up on the literature base rather than saying systematically reviewing it will make everything surer.

In other words, I don't think in this case, with a highly contentious and polarised literature base where there is considerable disagreement on what constitutes "good work", that you can assume an SR is at least as good as anything else out there. I would agree with your assertion that a lot of what goes on is cherry picking and is bad... But dismissing it in favour of what amounts to an elaborate way of amplifying potentially dubious results is not objectively better in this rather strange evidential cul-de-sac.

Pete

[Stevek76]

As an engineer, I need to keep in mind that the goal is to catch a mouse.

Which surely is preceded by the question of whether there's actually a mouse problem in the first place.

I'd suggest anyone doing a risk assessment that results in safety equipment required for cycling but not for walking in general transport circumstances isn't doing their assessments properly. It's both or neither depending on where you draw the alarp line. Only one is not a rational outcome.

[pjclinch]

I'd suggest anyone doing a risk assessment that results in safety equipment required for cycling but not for walking in general transport circumstances isn't doing their assessments properly. It's both or neither depending on where you draw the alarp line. Only one is not a rational outcome.

Indeed.

As a cycle trainer I will be presented with an RA I must work with, and for a typical Level 1 session in a playground that will typically have something like:
Risk: riders may fall or collide
Control: riders will wear helmets

And if I point out that the same kids, in the same playground, engaged in free play are far more likely to fall or collide, that the consequences will be at least as bad but there is less immediate supervision, first aid cover and activity structure designed to stop falls and collisions to start with, and that the control for such falls is they can make their way to the office with a pal for some TLC and a sticker and a form letter home, then "that's different" and I'm "being difficult"...

Pete.

[Vorpal]

As an engineer, I need to keep in mind that the goal is to catch a mouse.

Which surely is preceded by the question of whether there's actually a mouse problem in the first place.

I'd suggest anyone doing a risk assessment that results in safety equipment required for cycling but not for walking in general transport circumstances isn't doing their assessments properly. It's both or neither depending on where you draw the alarp line. Only one is not a rational outcome.

I did many risk assessments when I was teaching Bikeability. Not one included helmets. They included hazards at junctions, crossing places, traffic volumes, children's behaviour, information about infrastructure, if we needed any special measures, etc.

[Vorpal]

Indeed.

As a cycle trainer I will be presented with an RA I must work with, and for a typical Level 1 session in a playground that will typically have something like:
Risk: riders may fall or collide
Control: riders will wear helmets

And if I point out that the same kids, in the same playground, engaged in free play are far more likely to fall or collide, that the consequences will be at least as bad but there is less immediate supervision, first aid cover and activity structure designed to stop falls and collisions to start with, and that the control for such falls is they can make their way to the office with a pal for some TLC and a sticker and a form letter home, then "that's different" and I'm "being difficult"...

Pete.

We did our own risk assessments, specific to the locations that we used for training. We got 1,5 hours paid for each location to do them. It wasn't really enough time, especially if the area was completely new to us, but it was a good excuse for a bike ride & exploring the area.

I don't know if our risk assessments were subsequently used by others. We sent them into the the county training coordinator. Occasionally the school asked for them.

[pjclinch]

We did our own risk assessments, specific to the locations that we used for training. We got 1,5 hours paid for each location to do them. It wasn't really enough time, especially if the area was completely new to us, but it was a good excuse for a bike ride & exploring the area.

I did RAs for areas I was doing teaching for, but those were location specific on top of a general document for all areas from the LA.
So mine never mentioned lids, but they were pre-ordained in the general RA. I did raise issues with the general RA, and while I did persuade them we didn't need hi-viz in the playground and I wasn't going to lose my feet if I didn't wear "proper cycling footwear" they weren't going to budge on lids. At first I was (grudgingly) allowed to teach kids in lids while I didn't have one, but after "anonymous parental complaints" that I was setting a bad example I gave up. So that obviously made everyone safer...

Pete.