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

doozerie

Einstein? wrote: »

but preaching that helmets are useless is nonsense

Who is preaching that helmets are useless?

If you actually read this thread you'll find it filled with a lot of debate, most of it constructive, about whether helmets are really as safe as many people claim them to be, whether they could be safer, whether the focus of personal safety should really be on helmets or other things, whether helmets are a victory of marketing over genuine safety, etc.

Are you really so convinced that modern helmets are so effective that no such debate is needed, that protecting cyclists from serious head injury is a solved problem?

Do you not wonder why helmet testing standards differ across the world, with the european standard by one measure seeming to be inferior to the US standard?

Do you not wonder whether an expensive helmet really offers better protection than a cheaper one, particularly as they both have to meet the same testing standard (and no more than that)?

Do you not wonder whether the focus on helmets distracts from other initiatives that might actually provide greater protection to cyclists?

Etc., etc.

If your answer to those questions is no, then this thread is a curious choice of one to post in, you'll just find it endlessly frustrating.

smacl

tomasrojo wrote: »

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.

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

But as is often the case, when you skip past the cyclehelmets.org take on the subject and examine their references in a little more detail, things become less clear cut. For example, they say;

there is very strong evidence that people who cycle regularly live significantly longer, on average, than people who do not

whereas the conclusion in the abstract of All-Cause Mortality Associated With Physical Activity During Leisure Time, Work, Sports, and Cycling to Work reads as follows;

Leisure time physical activity was inversely associated with all-cause mortality in both men and women in all age groups. Benefit was found from moderate leisure time physical activity, with further benefit from sports activity and bicycling as transportation.

So as per my previous post, the primary variable in question is leisure time physical activity, where cycling as transport benefits this.

I also think if you look at the term cycling, it covers a lot of different types of activity for posters on a board such as this, including transport, leisure and strenuous sports, where these activities have varying benefits.

tomasrojo

Mayer Hillman did a similar review using actuarial statistics and came to the same conclusion that habitual cyclists live longer than non-cyclists (on average, obviously). To be honest, he could have done a review of people who are keen tennis players and probably found a similar result. The only reason this result seems problematic to many people (not you, I''m sure) in a way that a survey of habitual tennis players would not is that it flies in the face of the common assumption that many cyclists die in road traffic collisions or falls. In fact, Hillman was asked to do the study by the NHS because the UK authorities were in doubt as to whether it was responsible to promote cycling at all.

This maybe needs a separate thread.

tomasrojo

doozerie wrote: »

Who is preaching that helmets are useless?

"Useless" is too strong, but that editorial in the BMJ by Spiegelhalter and the more famous Ben Goldacre did come to the conclusion that the direct benefit of helmet wearing is too modest to capture: that is, the statistical techniques available can't discern a marked decline in serious head injuries in any jurisdiction, once you benchmark it against the numbers cycling to correct for any change in the numbers cycling during the study. (Other than the general decline that's been going on for years, that is shared by pedestrians.)

Ben Goldacre discusses it here at 1:12:45
http://feeds.soundcloud.com/stream/188278861-britishcomedyguide-richard-herring-lst-podcast-61-ben-goldacre.mp3

He says that wearing or not wearing more or less makes no difference.

The section also discusses why cycling helmets serve as a good introduction to the pitfalls of epidemiology, and what some of the pitfalls of looking at helmet efficacy are.

(Warning: the podcast is rather juvenile in other places and is whatever the audio equivalent of NSFW is.)

smacl

tomasrojo wrote: »

Mayer Hillman did a similar review using actuarial statistics and came to the same conclusion that habitual cyclists live longer than non-cyclists (on average, obviously). To be honest, he could have done a review of people who are keen tennis players and probably found a similar result. The only reason this result seems problematic to many people (not you, I''m sure) in a way that a survey of habitual tennis players would not is that it flies in the face of the common assumption that many cyclists die in road traffic collisions or falls. In fact, Hillman was asked to do the study by the NHS because the UK authorities were in doubt as to whether it was responsible to promote cycling at all.

This maybe needs a separate thread.

Meh, probably allowed a little topic drift this deep into the thread....

I agree with the notion that cyclists, as a sub-group within the larger group of regular exercisers, live longer than those who don't take regular exercise. Where I have the problem is the comparison to non-cyclists, which is an indeterminate group. As you say, you could divide a population down into two groups based whether or not they do any arbitrary specific form of regular exercise and arrive at the same conclusion. So to labour a point, the variable at play is amount of regular exercise taken, not whether or not you cycle.

While taking up cycling for many can be key to starting to live a healthier lifestyle, it is not exclusive in this regard. Thus saying non-cyclists die younger would appear to be a fallacy, as saying non-tennis players die younger, non-hill walkers die younger, etc.. are all equally true, yet many cyclists don't play tennis, and many tennis players don't go hill walking. Of these groups of people who don't participate in these specific activities, who do you think has the greatest life expectancy?

tomasrojo

Yeah, I see what you mean. The implication that not cycling will cause premature death. Fair enough.

smacl

Einstein? wrote: »

• 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.

Agreed, but to have value the above items have to be quantified as a percentage of total cycle journeys. In the same context you also have the following to consider;

• Being coerced into wearing a helmet is reason enough for some people, e.g. my teenage daughter, not to cycle and can be considered a blocking factor to cycling.
• Cyclist mortality rates decrease as number of people cycling increases, thus at population level, unnecessary blocking factors make cycling more dangerous.
• Some people who don't cycle purely as a result of not wearing a helmet, don't take any other regular exercise either, and their health is at risk as a result.

I honestly don't know how those two lists stack up against each other, and personally don't believe studies based on data from hospitals or morgues tell the whole story by a long shot. I firmly believe more children in particular cycling as a means of independent transport would benefit society hugely, and that the helmet debate is a red herring to some degree. It is worth remembering that wearing helmets for short cycle trips is a recent phenomenon. If the increased perceived risks are down to increased traffic volume or poor driving, there is a strong argument that this is where the problem should be addressed.

liam24

doozerie wrote: »

Who is preaching that helmets are useless?

I would say that they are 'next to useless'. Just like wearing a helmet to walk the dog is 'next to useless'. It might provide protection in exceptional circumstances, but it still seems barmy to wear one.

tomasrojo

Again, not "useless", but Henry Marsh, distinguished (well, he's been interviewed on The Life Scientific anyway!) neurosurgeon doesn't rate them highly:
http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736%2815%2960223-9.pdf

smacl

liam24 wrote: »

I would say that they are 'next to useless'. Just like wearing a helmet to walk the dog is 'next to useless'. It might provide protection in exceptional circumstances, but it still seems barmy to wear one.

Depends entirely on context. Sports cycling and mountain biking for example see more accidents than commuting, and those accidents tend not to involve other vehicles. What safety gear you choose to wear depends on the risks you perceive, how much you consider that gear lessens those risks, and how much of a burden using the gear is. So while I groan inwardly when I see a tot with a helmet pushing a scooter in Marlay park, helmets make more sense on longer faster spins, when riding in a group, or descending through a forest.

tomasrojo

Yeah, it's hard to imagine that skin damage when getting whacked by a low-lying branch when mountain biking is not at the very least ameliorated by having something between your skin and the branch (saving you stitches, for example).

Minor injuries probably don't show up in epidemiological analyses. Not reported all that often. So efficacy there could go unheralded.

smacl

tomasrojo wrote: »

Again, not "useless", but Henry Marsh, distinguished (well, he's been interviewed on The Life Scientific anyway!) neurosurgeon doesn't rate them highly:
http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736%2815%2960223-9.pdf

Although his views seem vehemently disputed here by another neurosurgeon that also treats cycling head injuries regularly; http://road.cc/content/news/121280-cycle-helmets-save-lives-says-neurosurgeon-ongoing-helmet-row

As I see it there seems to be plenty of contradictory expert opinion and information coming from both sides of the argument, to the extent that as an adult, you read the material and make your own choices based on your own conclusions. While helmets are not mandatory, the issue becomes awkward as a parent, where you are expected to mandate helmet usage for your children. I often wonder in that situation is the helmet there more to protect the peace of mind of the parent than the head of their offspring.

tomasrojo

Yeah, that's always the problem with expert opinion. It's still opinion.

Helmets for kids: I imagine that it's partly to do with wanting to be on the safe side, and partly to avoid being lectured by other people (who usually have their kids' helmets on backwards or with the straps dangling down, or using an adult helmet, or some other negating factor).

Funny you mention the scooter issue. In fact, it's more common to see a kid wearing a helmet on a bike than a scooter, but bikes actually seem to be more stable with proper brakes and wheels less likely to catch. Chances of you being flung forward seem lower on a bike. But bikes seem to have a danger halo around them. (You can of course go faster on a bike, but again, we're talking about supervised kids riding on the grass in the park wearing helmets.)

check_six

In their favour, kids helmets are a handy spot for a light. Smaller kids bikes tend to have limited options for mounting a rear light so a light built into the helmet is quite useful.

tomasrojo

Never thought of that. Pretty decent height off the ground for a light too.

Traumadoc

HivemindXX wrote: »

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.

Actually there why don't they give the percentage of Irish cyclists killed who were wearing helmets? What percentage of the spinal injuries were wearing helmets?
If the RSA was serious about cyclist mortality and morbidity, they would be concentrating on minimum passing distance rather than forcing cyclists to wear a helmet?

Shep_Dog

check_six wrote: »

In their favour, kids helmets are a handy spot for a light. Smaller kids bikes tend to have limited options for mounting a rear light so a light built into the helmet is quite useful.

Mounting lights on helmets is a really bad idea. The whole idea of helmet construction is that in an impact, the helmet's material crumples with the impact. The last thing you want is having batteries and electronics driven into your skull.

enas

Shep_Dog wrote: »

Mounting lights on helmets is a really bad idea. The whole idea of helmet construction is that in an impact, the helmet's material crumples with the impact. The last thing you want is having batteries and electronics driven into your skull.

But does that actually happen? Do we know it? Do we have studies measuring this? Do we need a new helmet-like debate?

Traumadoc

Shep_Dog wrote: »

Mounting lights on helmets is a really bad idea. The whole idea of helmet construction is that in an impact, the helmet's material crumples with the impact. The last thing you want is having batteries and electronics driven into your skull.

Most lights are so small , that it would be unlikely to make a difference, on the balance of things, in terms of collision prevention, lights on helmets make sense.

check_six

Shep_Dog wrote: »

Mounting lights on helmets is a really bad idea. The whole idea of helmet construction is that in an impact, the helmet's material crumples with the impact. The last thing you want is having batteries and electronics driven into your skull.

The lights are built into the straps/fitting-dial of the helmet, they're not "mounted" on the super structure of the helmet.

These are quite common. Surely you've seen them before?

tomasrojo

Yeah, the inbuilt lights are pretty common, rather small, and usually not built into the polystyrene bit. They have a tendency when riding drop bar bikes to disappear behind backpacks, but other than that, they don't seem an objectionable development at all.

tomasrojo

Traumadoc wrote: »

If the RSA was serious about cyclist mortality and morbidity, they would be concentrating on minimum passing distance rather than forcing cyclists to wear a helmet?

They've shown no interest in 30km/h zones either.

Lower speed limits of 30km/h was only been mentioned once in the last 10 years in correspondence from the Department of Transport to the Road Safety Authority

http://irishcycle.com/2015/04/16/it-took-my-baby-to-die-for-them-to-start-discussing-the-30kmh-limit/

Whatever the situation on the road, for the RSA it points towards more helmets and hi-viz. KSIs up? People are not wearing "their" helmets and hiviz, more promotion urgently needed. KSIs down? Helmets and hiviz are starting to do their job, more promotion urgently needed.

Macy0161

I'm not convinced on the 30km/h thing, however, every announcement that has a reference to cycling, even when the focus is supposed to be driver behaviour, has to throw in at least one bit of victim blaming by bringing up helmets and hi-viz.

Macy0161

Shep_Dog wrote: »

Mounting lights on helmets is a really bad idea. The whole idea of helmet construction is that in an impact, the helmet's material crumples with the impact. The last thing you want is having batteries and electronics driven into your skull.

Really? I fit those silicone yokes through the vents on occasions...

tomasrojo

Macy0161 wrote: »

I'm not convinced on the 30km/h thing, however, every announcement that has a reference to cycling, even when the focus is supposed to be driver behaviour, has to throw in at least one bit of victim blaming by bringing up helmets and hi-viz.

Personally, I'm in favour, but even if they're not a good idea, you'd think they'd have really looked into it over the last ten years, even if they ultimately decided they weren't the right approach. But they already have the perfect solution, so no need to discuss.

smacl

check_six wrote: »

The lights are built into the straps/fitting-dial of the helmet, they're not "mounted" on the super structure of the helmet.

These are quite common. Surely you've seen them before?

The only issue is they also put out very little light and IMHO aren't really an alternative to a proper back light, but people are tempted to use them that way.

tomasrojo

smacl wrote: »

The only issue is they also put out very little light and IMHO aren't really an alternative to a proper back light, but people are tempted to use them that way.

"Secondary" lights are like cable locks. They're sort-of not a bad idea, except that people start to think they're an adequate substitute for "primary" lights/U-locks.

doozerie

Shep_Dog wrote: »

Mounting lights on helmets is a really bad idea. The whole idea of helmet construction is that in an impact, the helmet's material crumples with the impact. The last thing you want is having batteries and electronics driven into your skull.

(Disclaimer: this may read like an attack of your post because of the language I use, it’s not, it’s meant as a reasoned response on my part and I hope it comes across as such.)

What circumstances are you picturing where a a light might be embedded in the skull, through a helmet, and where this could prove to be a worse outcome than had the light not been there? Personally I reckon that an external object being caused to pierce the helmet suggests that the force of impact involved so far exceeds the capabilities of any helmet (check what impact force the safety standards test for) that the presence of anything at all in between head and impact source is irrelevant.

Your point highlights the problem with discussion of safety devices though, helmets or otherwise. On the face of it your point is a good one, you are suggesting that people not introduce extra risk. I agree with the sentiment, my instinctive reaction is even to agree that adding a light to a helmet is a bad thing. But when I stop and think about why that’s a bad thing, which involves having to wade through my own layers of personal safety paranoia (and that paranoia does exist, even though I have a dim view of helmets), I conclude that the risk you identify is simply not relevant.

My use of the word “irrelevant” may shock some people, and I believe the reason for that is that we are now in the realm of well-meaning hysteria when discussing the risk posed by a light on a helmet. Many people will focus on the “well-meaning” aspect of the risk, selectively, and perhaps subconsciously, ignoring the “hysteria” aspect of it. That seems to be representative of a lot of the discussion about safety gear, and certainly bicycle helmets - group A can’t fathom why their clearly (from their perspective) “well-meaning” concerns are rejected by group B, group B can’t fathom why group A seem so “hysterical”, lines are drawn, opinions get entrenched, and it gets (mis-)labelled as a “helmet versus no-helmet” argument, rationality goes out the window and any useful discussion ends.

There is one reason not to wear a light on a helmet that I do consider valid, incidentally, and that is that it’s one more thing to snag should the helmet come into contact with something, potentially leading to more stress on the neck or increased risk of damage to the brain. During winter months though I do attach a light to my helmet, when I wear a helmet, as per a previous post I consider the added (in addition to a powerful light on my handlebars) visibility it provides (particularly on a dark and wet winter evening when every other car’s windscreen is fogged up or their windscreen wipers are not doing a good job of clearing a layer of water off) offers far greater safety benefits than the risk it poses should a collision occur.

tomasrojo

tomasrojo wrote: »

Whatever the situation on the road, for the RSA it points towards more helmets and hi-viz.

Speaking of which ... one of these EU transport delegates is doing his own thing! Flying the flag.



HT @cosaingalway on Twitter

Shep_Dog

check_six wrote: »

The lights are built into the straps/fitting-dial of the helmet, they're not "mounted" on the super structure of the helmet.
These are quite common. Surely you've seen them before?

Even if they are built into the straps, I'd be wary of the damage such devices could cause in an accident as you'd never know what way the helmet, straps and anything attached would be yanked and in what direction.

There are many places to attach lights on a bike and to clothing. I'd avoid embedding or attaching devices to helmets. A bright coloured finish and some effective reflective material would be the best approach. If you feel the need to wear a helmet, then you should be cautious too about creating additional risks.

Are such devices tested/approved by the RSA?