Helmets - the definitive thread.. ** Mod Note - Please read Opening Post **

Traumadoc

very surprised with the 8%/2% figures, of the trauma I see the vast majority is MVC, - mostly hit form behind, certainly high morbidity when you consider whip lash injuries. Cyclist certainly do not make up 8% of injuries from the roads.

tomasrojo

Traumadoc wrote: »

Cyclist certainly do not make up 8% of injuries from the roads.

In 2012 there was a very big increase in minor injuries (as classified by Garda collision reports) and a relatively big increase in serious injuries. In that year and that year only cyclists made up about 8% of all injuries combined. If you look at serious injuries alone, cyclists don't make up 8%, even in 2012.

(In 2012, 30 cyclists were seriously injured, up from 16 the previous year. 600 minor injuries.)

I think you might expect cycling to be somewhat more prone to producing minor injuries than travelling by car or public transport. It's a minor drawback to being active. While that rise in minor injuries in 2012 is unprecedented, and actually kind of puzzling and interesting, it's not really that worrying. Certainly doesn't justify this week's scare-fest.

galwaycyclist

doozerie wrote: »

Wow, I just read that Irish Times article and it's a catalogue of figures, presented as incontrovertible truths, portraying cycling as extremely dangerous. I despair.

I think the technical term is "infomercial" rather than "article". (or whatever the print equivalent of infomercial is)

tomasrojo

Incidentally, that infomerical clarifies what "low-speed, 50km/h" means in the context of the Gilchrist research: it's a car-bike collision, with the speed being the speed of the car, not the bike.

Vincenzo Nibbly

"Some 83 per cent of cycling accidents occur when there is a vehicle such as a car or a lorry involved. This is higher than the international average, a fact Mr Morris suggests may be down to underreporting of falls from bicycles in Ireland."

Come on everyone, fess up properly about your cycle spills. We're making the poor cars and lorries look bad.

tomasrojo

For a bunch of road safety professionals, they throw the word "accident" around a lot. This is no longer regarded as an appropriate term for collisions or falls, for what I hope are obvious reasons.

galwaycyclist

Vincenzo Nibbly wrote: »

"Some 83 per cent of cycling accidents occur when there is a vehicle such as a car or a lorry involved. This is higher than the international average, a fact Mr Morris suggests may be down to underreporting of falls from bicycles in Ireland."

Come on everyone, fess up properly about your cycle spills. We're making the poor cars and lorries look bad.

A statement which suggests that Mr. Morris is blissfully ignorant of general patterns in reporting of cycling accidents. Research in Galway in the 1970s found that about 85% of cycling injuries don't involve other vehicles (and 83% of these were minor injuries). It also found that the Gardai only recorded 9% of serious injury crashes involving cyclists and 4% of minor injury crashes.

The weird thing is this guy is supposed to be a doctor he should have ready access to hospital data.

tomasrojo

For some much-needed positivity, and just out:

The health benefits of cycling are considerably larger than the risks associated with the inhalation of pollutants and increased exposure to road accidents, according to a study published in the Bulletin épidémiologique hebdomadaire (BEH) de l'Institut de veille sanitaire (Invs).

http://www.rtbf.be/info/societe/detail_le-velo-benefique-pour-la-sante-meme-dans-une-ville-polluee?id=9100185&utm_source=rtbfinfo&utm_campaign=social_share&utm_medium=twitter_share

HT @cosaingalway on Twitter

the.red.baron

How are they coming up with those stats?

For every one person killed in a road accident, 400 people are being saved from death by being healthier, per year.

For every 1 person killed in a road accident, 4 are being killed from inhaling fumes during the cycle.

How are they collecting this info?

How are they relating this to actual physical activity? How much cycling are they reckoning to be beneficial? 20 mins a day? Is there a point where it's of no benefit?

What happens if I cycle 20 mins and have an unhealthy diet? If I cycle from ages 20 to 40 and then drive the rest of my life, how does this affect my chances of dementia?

seamus

the.red.baron wrote: »

How are they coming up with those stats?

For every one person killed in a road accident, 400 people are being saved from death by being healthier, per year.

For every 1 person killed in a road accident, 4 are being killed from inhaling fumes during the cycle.

How are they collecting this info?

How are they relating this to actual physical activity? How much cycling are they reckoning to be beneficial? 20 mins a day? Is there a point where it's of no benefit?

What happens if I cycle 20 mins and have an unhealthy diet? If I cycle from ages 20 to 40 and then drive the rest of my life, how does this affect my chances of dementia?

You're overthinking it really. They're looking at high-level stats, e.g.

You control it by taking a large cross-section of society - all age ranges, all kinds of dietary habits, all kind of fitness habits.

Take 1,000 people from who do X amount of cycling in a given week, call them "cyclists".
Take 1,000 people who do less than this, call them "non-cyclists".

Of the 1,000 cyclists, you find that in a given year 5 are killed in road collisions, and 20 die in hospital from causes unrelated to collisions.

Of the 1,000 cyclists, 2 die from road collisions, but 40 die from other causes.

So you can say that while your chances of death on the road raise from 0.2% to 0.5% as a cyclist, your chance of death off the road reduces from 4% to 2%.

All figures illustrative, obviously

The google translate of the above article gives;

In particular, according to the "model" chosen for the study, the bicycle system self-service "would have, increasing physical activity for individuals to save 12 lives per year against an increase of 0.03 deaths per year due to traffic accidents and 0.13 deaths per year associated with a higher inhaled pollutants "during these trips.

In other words, you see a reduction in hospital admissions amongst users of the bike-sharing scheme in general, even though you see a small increase for road collisions and pollutant-related diseases. Giving a net 12 people less in a given year who die in hospital.

smacl

Vincenzo Nibbly wrote: »

"Some 83 per cent of cycling accidents occur when there is a vehicle such as a car or a lorry involved. This is higher than the international average, a fact Mr Morris suggests may be down to underreporting of falls from bicycles in Ireland."

Come on everyone, fess up properly about your cycle spills. We're making the poor cars and lorries look bad.

The problem as I see it with all these studies is that by accidents they mean accidents resulting in a hospital visit or Garda being called out. The data on which the studies are based don't include the many lesser spills, and there seems to be no information as to whether or not the helmet in some cases is what keeps the cyclist out of hospital on some of these occasions. There's quite a few posts in this thread where cyclists have felt that the helmet was of benefit, but this is anecdotal evidence at best. Of the three spills I've had in the last five years, two resulted in light road rash, and one in me landing on my back where I was lucky to be wearing a rucksack. Of the two more serious accidents I've seen first hand riding in a group, one was a broken collar bone, and one was a fractured elbow and concussion where a helmet may have saved the concussion if it had been on the guys head rather than hanging off the bars. Of those accidents, only the last one involved a vehicle, which overtook to pull into a drive way on the left.

It would make for an interesting study to poll a significant sample of cyclists that have cycled regularly for the last number of years, whether they typically wear a helmet, how many accidents they've had, the severity of those accidents, whether they were wearing a helmet, and whether it was of benefit or detriment. I don't believe that analysis of accidents involving hospitalization of cyclists provides a reliable indicator on the efficacy of helmets as a safety measure, or says much about the safety of cycling in general. The sampled data excludes too many minor accidents, the long periods of accident free cycling, and the total number of KMs cycled.

Like many here, I feel the safety benefits of cycling helmets are massively exaggerated by the businesses promoting them and the lazy safety authorities looking for a quick fix. That said, without a broader study on cycling safety it is IMO impossible to tell.

smacl

seamus wrote: »

Take 1,000 people from who do X amount of cycling in a given week, call them "cyclists".
Take 1,000 people who do less than this, call them "non-cyclists".

Of the 1,000 cyclists, you find that in a given year 5 are killed in road collisions, and 20 die in hospital from causes unrelated to collisions.

Of the 1,000 cyclists, 2 die from road collisions, but 40 die from other causes.

So you can say that while your chances of death on the road raise from 0.2% to 0.5% as a cyclist, your chance of death off the road reduces from 4% to 2%.

Not really, correlation is not causation. For the last statement to be true you'd need to prove that not cycling was the cause of death in the second group. Only sayin'...

RainyDay

doozerie wrote: »

The RSA are clearly still sticking to their mantra that wearing a helmet and hi-viz clothing are the highest priorities when it comes to road safety for cyclists, with “abiding by the Rules of the Road” (which I’m optimistically assuming they believe to cover the use of lights on a bike) coming in a poor third.

Some of the coverage of yesterday's event had a surgeon from the Mater telling us to wear helmets, hi-vis and not earphones.

The conference had some evidence about helmets, but nothing about hi-vis and earphones. Is it too much to expect that there might be some evidence behind these statements?

tomasrojo

smacl wrote: »

Not really, correlation is not causation. For the last statement to be true you'd need to prove that not cycling was the cause of death in the second group. Only sayin'...

That's why you need a lot of participants, so that you get a big sample of most of the things that kill you. Then you can detect a decline in any of these between your cycling and non-cycling group. The larger your number of participants, the more likely you are to get a clear, albeit maybe small signal in all the noise of causes of premature death.

The problem then is "confounding": is cycling just an indicator of some other attribute that prevents premature death, such as having a decent income. That might be the case in Ireland, but the effect is seen in China too. Been seen in quite a few countries now, I think.

Sorry if you know all this already and I'm belabouring the obvious. It's just that you never really can "prove" causation in epidemiology. You can just make a very plausible case until there's a consensus that you're right. Actually, you can't really "prove" much in science generally.

tomasrojo

RainyDay wrote: »

Some of the coverage of yesterday's event had a surgeon from the Mater telling us to wear helmets, hi-vis and not earphones.

The conference had some evidence about helmets, but nothing about hi-vis and earphones. Is it too much to expect that there might be some evidence behind these statements?

Even in the case of Gilchrist's work (which I have yet to read), it seems to be based on a model of what happens in a collision.

So we have real-world statistics (the basis of Professor David Spiegelhalter's comment about the direct benefit of helmets being too modest to capture) saying one thing and models and case-control studies saying another.

Which makes me think of a slogan for the RSA: That's all very well in practice, but what about in theory?

Carawaystick

RainyDay wrote: »

Some of the coverage of yesterday's event had a surgeon from the Mater telling us to wear helmets, hi-vis and not earphones.

The conference had some evidence about helmets, but nothing about hi-vis and earphones. Is it too much to expect that there might be some evidence behind these statements?

The IT reported an increase in spinal injuries, but no recommendation about back protectors... maybe fluorescent clothing does the same thing if it has a falsified ce mark by some sweatshop in the far east...

tomasrojo

The consultant who put so much weight on the flimsy 2%/8% mismatch also is a useful reminder that you don't go to consultants to find out about stats.

galwaycyclist

tomasrojo wrote: »

Actually, you can't really "prove" much in science generally.

One school of thought is that you can't prove, you can only fail to falsify using the methods available - but now we are getting into whole different topic.

the.red.baron

seamus wrote: »

You're overthinking it really. They're looking at high-level stats, e.g.

You control it by taking a large cross-section of society - all age ranges, all kinds of dietary habits, all kind of fitness habits.

Take 1,000 people from who do X amount of cycling in a given week, call them "cyclists".
Take 1,000 people who do less than this, call them "non-cyclists".

Of the 1,000 cyclists, you find that in a given year 5 are killed in road collisions, and 20 die in hospital from causes unrelated to collisions.

Of the 1,000 cyclists, 2 die from road collisions, but 40 die from other causes.

So you can say that while your chances of death on the road raise from 0.2% to 0.5% as a cyclist, your chance of death off the road reduces from 4% to 2%.

All figures illustrative, obviously

The google translate of the above article gives;
In other words, you see a reduction in hospital admissions amongst users of the bike-sharing scheme in general, even though you see a small increase for road collisions and pollutant-related diseases. Giving a net 12 people less in a given year who die in hospital.

Thanks for the response.

Do you actually believe such a survey exists and if so do you think it was the basis for the article that was linked, as it's pretty hard to find anything on the existing study other than the conclusions the article comes to.

smacl

tomasrojo wrote: »

That's why you need a lot of participants, so that you get a big sample of most of the things that kill you. Then you can detect a decline in any of these between your cycling and non-cycling group. The larger your number of participants, the more likely you are to get a clear, albeit maybe small signal in all the noise of causes of premature death.

I think by dividing the population into cycling and non-cycling, and considering this a significant variable in cause of premature death, you've created a false dichotomy of sorts. Just because cycling as a healthy physical activity can prolong life, not cycling does not imply a lack of comparable but different healthy physical activity. So the assertion that cyclists live longer than non-cyclists would be considerably harder to support than say physically active people, such as cyclists, will live longer than physically inactive people. The variable affecting longevity here is taking the correct amount of exercise; cycling regularly makes you healthier sure, not cycling regularly says nothing much about you one way or the other.

monument

The two presentations from the RSA event can be found linked within the text on this page:

http://www.rsa.ie/en/Utility/News/2015/Study-Finds-That-Bicycle-Helmets-Most-Effective-in-Low-Speed-Collisions/

tomasrojo

smacl wrote: »

The variable affecting longevity here is taking the correct amount of exercise; cycling regularly makes you healthier sure, not cycling regularly says nothing much about you one way or the other.

I think that it's the nature of cycling that sets it apart from other ways of being active: nearly daily, not too strenuous

For example.

Those who used the bicycle as transportation to work (20% to 28% of the sample, according to educational status) experienced a much lower mortality rate even after adjustment for leisure time physical activity and sports participation

http://www.cyclehelmets.org/1185.html

Traumadoc

monument wrote: »

The two presentations from the RSA event can be found linked within the text on this page:

http://www.rsa.ie/en/Utility/News/2015/Study-Finds-That-Bicycle-Helmets-Most-Effective-in-Low-Speed-Collisions/

It does not say how many cyclists would have been saved if they wore a helmet?

It is a very spun report.

Any fatal cycling injuries I have been involved, with a cycle helmet would not have saved them.( in fact they were all wearing helmets).

HivemindXX

Traumadoc wrote: »

It does not say how many cyclists would have been saved if they wore a helmet?

It is a very spun report.

Any fatal cycling injuries I have been involved, with a cycle helmet would not have saved them.( in fact they were all wearing helmets).

They don't say because they can't possibly know.

This is the nature of the pro-helmet argument. They focus on two cases. Firstly ones where a cyclist without a helmet dies, which are cited as cases where a helmet may have saved them (with no real account taken of the severity of the injuries). There is no way to tell if a helmet would have save a person in this situation but the assumption is that it would have. Then ones where a helmet wearing cyclist hits their head but doesn't die which are cited as cases where a helmet may have saved a life (I say may, but the common phrasing is "I certainly would have died if I hadn't been wearing my helmet"). There is of course no way to know if the person who hit their helmet would have died if they hadn't been wearing it.

Cases where a cyclist does not receive serious injuries are ignored, as are ones where a cyclist is wearing a helmet and dies anyway.

If you question how much benefit a helmet gives you are faced with "if it saves even one life surely it is worth it?". An argument which is deemed ridiculous when it is turned around and applied to car helmets, walking helmets and shower helmets.

ODEON123

Personally I think its personal preference and what kind of cycling do you do, if you cycle through heavy traffic or high traffic areas where the cycle track is on the road definitely wear a helmet because you are most likely going to get hit by a car, bus, lorry etc more then your going to crash into a wall or something

Me personally I dont wear a helmet but i dont really ever cycle on the road or through an area where there is a high risk of getting knocked off, I mainly use my bike for going to the gym or just going around my area so never too far away from my house...:p

Einstein?

I know a few people who live to tell the tale only because of their helmet. I don't know anyone dead who lived to tell theirs though. Granted, they might have had a helmet - but there is that one family out there who's son/daughter/sister/brother/dad/mum isn't with them anymore whilst they could be had they been wearing a helmet. Those who argue that a helmet is useless need to go and present their arguments to that family, look them in eye and tell it with a straight face ... maybe then I'll find some credibility in all that camp.


They're designed to protect your head - certain parts of it mostly; so yeah you can get hurt pretty bad and your helmet will be useless to you in that instant... but say that to the lad on the bike who checks his rear mechs or looks over the shoulder when the car or bus in front of him suddenly jams on the breaks.

Personally, I don't wear a helmet cycling to work through the city, only when I go out 'to cycle' - long spins, with group, friends, new places, etc. I'm all for using a helmet to protect you, but I think it should be kept optional.

galwaycyclist

Einstein? wrote: »

I know a few people who live to tell the tale only because of their helmet. I don't know anyone dead who lived to tell theirs though. Granted, they might have had a helmet - but there is that one family out there who's son/daughter/sister/brother/dad/mum isn't with them anymore whilst they could be had they been wearing a helmet. Those who argue that a helmet is useless need to go and present their arguments to that family, look them in eye and tell it with a straight face ... maybe then I'll find some credibility in all that camp.

Actually this is exactly what needs to happen. Bereaved families need to be given honest and open information regarding the limitations of helmets. In many cases a helmet would have made no difference - why should the family have their sense of loss deepened by being told a piece of polystyrene packing foam has "life saving" properties?

I should point out that there are plenty of people out there who are quite happy to exploit the grief and credulity of bereaved relatives. Who are happy to go to them and tell them that a piece of polystyrene has "life saving" properties. People who are happy to exploit grieving families and use them to push a political agenda that seems to as much about victim-blaming and pushing car-culture as it is about head injuries.

And many of us who are sceptical of helmets would have no problem explaining the limitations to families - but we are honourable people - we have enough sense of personal embarrassment not to go out of our way to intrude on peoples grief. Is that supposed to be a failing?

doozerie

Einstein? wrote: »

I know a few people who live to tell the tale only because of their helmet. I don't know anyone dead who lived to tell theirs though. Granted, they might have had a helmet - but there is that one family out there who's son/daughter/sister/brother/dad/mum isn't with them anymore whilst they could be had they been wearing a helmet. Those who argue that a helmet is useless need to go and present their arguments to that family, look them in eye and tell it with a straight face ... maybe then I'll find some credibility in all that camp.


They're designed to protect your head - certain parts of it mostly; so yeah you can get hurt pretty bad and your helmet will be useless to you in that instant... but say that to the lad on the bike who checks his rear mechs or looks over the shoulder when the car or bus in front of him suddenly jams on the breaks.

Personally, I don't wear a helmet cycling to work through the city, only when I go out 'to cycle' - long spins, with group, friends, new places, etc. I'm all for using a helmet to protect you, but I think it should be kept optional.

Can't we have a rational debate without all the emotive hyperbolic crap? Is that too much to ask? Really?

And you do realise that cyclists die while wearing helmets too right? And not because their other injuries were so severe, but simply because the helmet did not protect them in what would generally be considered to be an otherwise "minor" collision. Helmets are not magic, sometimes they help and sometimes they don't. Those deaths are also tragedies, and using them to argue that *no-one* should wear a helmet is as distasteful as the emotional blackmail your post is filled with.

Einstein?

Both of ye lads must have misread my post.

I know this from my mates who have been involved in serious cycling accidents. This is my personal opinion.. if you think it's crap then don't get your knickers in a twist.

Go on have your discussion or more like get accused of blackmail because I shared my own personal view??? ... I was only throwing my 2 cents in the hat, and I do stand by my views which I think are only logical in my opinion.

• People have fatal accidents cycling with AND without helmets.
• People survive accidents with AND without helmets.
• People (some) have lived on BECAUSE THEY WORE A HELMET (like my mate did).
• People (some) who have had fatal accidents COULD have survived had they been wearing a helmet.

Based on this and this alone.... helmets are NOT useless. That's all I was saying.



All this technical stuff is all well and good and I see nothing against it, although I do think making any sort of experiments to assess the effectiveness of a helmet are extremely difficult to control due to the many variables involved, and setting for each variable. This large degree of variability is to some extent the cause of this debate... which again is all well and good... but helmets are not useless.


And what :eek: are helmet ''skeptics'' ... lads this isn't is God real or did we land on the moon ... this is a cycling helmet we're talking about, it saves people, not all of them, just like seatbelts don't save everyone (I know, bad comparison but it's too late to think straight) . And on my last post about coming face to face... again I challenge you, because it's all well and good writing on this thread about it and coming back at me with internet farts (blackmail? seriously dude?!) but preaching that helmets are useless is nonsense and SOME (not all) families know it best. My mate who survived and his family sure do, they bought him a really expensive helmet after his old one took the fractures he would have sustained to his skull, cracking the helmet into several pieces. It didn't stop the glass from scarring his nose & chin, but it saved him from much further injury and possibly brain damage/death.

galwaycyclist

Einstein? wrote: »

Both of ye lads must have misread my post.

I know this from my mates who have been involved in serious cycling accidents. This is my personal opinion.. if you think it's crap then don't get your knickers in a twist.

Go on have your discussion or more like get accused of blackmail because I shared my own personal view??? ... I was only throwing my 2 cents in the hat, and I do stand by my views which I think are only logical in my opinion.

• People have fatal accidents cycling with AND without helmets.
• People survive accidents with AND without helmets.
• People (some) have lived on BECAUSE THEY WORE A HELMET (like my mate did).
• People (some) who have had fatal accidents COULD have survived had they been wearing a helmet.

Based on this and this alone.... helmets are NOT useless. That's all I was saying.



All this technical stuff is all well and good and I see nothing against it, although I do think making any sort of experiments to assess the effectiveness of a helmet are extremely difficult to control due to the many variables involved, and setting for each variable. This large degree of variability is to some extent the cause of this debate... which again is all well and good... but helmets are not useless.


And what :eek: are helmet ''skeptics'' ... lads this isn't is God real or did we land on the moon ... this is a cycling helmet we're talking about, it saves people, not all of them, just like seatbelts don't save everyone (I know, bad comparison but it's too late to think straight) . And on my last post about coming face to face... again I challenge you, because it's all well and good writing on this thread about it and coming back at me with internet farts (blackmail? seriously dude?!) but preaching that helmets are useless is nonsense and SOME (not all) families know it best. My mate who survived and his family sure do, they bought him a really expensive helmet after his old one took the fractures he would have sustained to his skull, cracking the helmet into several pieces. It didn't stop the glass from scarring his nose & chin, but it saved him from much further injury and possibly brain damage/death.

Challenge accepted. Pm sent with contact details.