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

CramCycle

tomasrojo wrote: »

There probably is some technology that properly ameliorates the outcome of crashes in high-risk activities.

Television and the internet are good examples, whenever I think of doing a high risk activity, the internet and television usually distract me, laziness is a genetic trait that also comes in handy.

NeedMoreGears

tomasrojo wrote: »

Helmet wearers in the Netherlands tend to be sports cyclists (more so than here anyway). Sports cyclists more likely to be injured generally.

Think that might be it.

You've touched on something that was bugging me about his paper and I couldn't quite get a fix on it. He defines his measure of risk to injury/km travelled which, I think, carries with it the implicit assumption that any km travelled is fundamentally equally as risky as any other.

If sports cycling tends to bring more injuries per km travelled (as the non-head injury data suggests), then it may be reasonable to assume that there should be more head injuries per km travelled. If the latter is true and based on the presented data then helmets are quite effective in reducing the incidence of head injury in sports cycling. That, in turn, would suggest they may also be effective in the non-sports cycling case.


Thanks Tomasrojo . No need for me to wear a helmet on the way home as you've broken my brain.

tomasrojo

I'll have to give the paper a proper read. I only read the summary.

Contrary to the original claim of these studies, in two out of three cases the risk of getting a head injury proved not to be lower for helmeted cyclists. Moreover, in all three cases the risk of getting a non-head injury proved to be higher for cyclists with a helmet.

Is this the bit you're referring to, NeedsMoreGears?

I presume the "higher" bit refers to a helmet-wearer having a higher risk of acquiring a bodily injury compared to the risk of a non-helmet wearer acquiring a bodily injury (as opposed to the helmet-wearer being more likely to acquire a bodily injury than acquire a head injury).

The non-HI data is "traditionally" used in case-controls studies of helmet efficacy to establish what proportion of cyclists in the general population wear helmets (the implicit assumption being that this is a pretty good random sample of cyclists). If the proportion of the head-injured cyclists wearing helmets is lower than the proportion of the non-HI cyclists, this is taken as evidence of injury being prevented. The problem is that the non-HI cyclists may not be a good sample of the general cycling population at all.

If you take the famous Thompson, Rivara and Thompson study from 1989 (the source of all claims of 85%/88% reduction in head injuries):

In this study, a comparison was made between 145 children treated in hospitals in Seattle for a head injury (the 'cases'), and a 'community control' group of 480 children who had, in one way or another, simply fallen from their bikes. A comparison of the two groups based mainly on helmet use of children under 15 years (21.1% of ‘control’ vs 2.1% of ‘case’ children) leads to the frequently quoted claim that the reduction in head injury due to helmets is 85%.

However, at the same time as this research was being carried out, there was a much more extensive survey of helmet use in the city of Seattle (DiGuiseppi, Rivara, Koepsell and Polissar, 1989). Of 4,501 child cyclists observed cycling around Seattle, just 3.2% wore helmets. This is not statistically different from the 2.1% of the hospital cases who were wearing helmets.

http://www.cyclehelmets.org/1068.html

tomasrojo

https://twitter.com/Flaminghobo1/status/660411259666436096

In tone, not a million miles away from the real thing.

Qualitymark

Liked this one too:

@RoadSofaAuthority ‏@Flaminghobo1 23h23 hours ago
Sign our petition to the International Criminal Court demanding an investigation into the Dublin City "transport" plan #communistplot

CramCycle

https://www.youtube.com/watch?v=kRed2YNYZoQ

Also the general idea, but taken to the extreme, that children wearing helmets will potentially take risks they would not take without a helmet.

tomasrojo

Fairly good, exaggerated example of moral hazard too!

NeedMoreGears

@tomasrojo ; yeah that's the bit I was referring to.

My only conclusion from all of this is that the data is relatively poor and therefore inadequate for any rigorous conclusions one way or the other.

tomasrojo

I think people have unrealistic expectations of epidemiology sometimes. They expect slam-dunk, stark outcomes (or at least would like such outcomes, provided it matches what they "know" to be the case) and it's usually a lot more nuanced.

Smoking being bad for you is a rare-ish case of such a stark outcome, in terms of the certainty of the link and the severity of the effect.

EDIT: comment above not aimed at NeedsMoreGears!

NeedMoreGears

[QUOTE=tomasrojo;97589841

EDIT: comment above not aimed at NeedsMoreGears![/QUOTE]

Not at all!

Yeah I think you're right. Too much expectations based on too little data.

galwaycyclist

New paper in British Medical Journal

Bicycling injury hospitalisation rates in Canadian jurisdictions: analyses examining associations with helmet legislation and mode share
Kay Teschke, Mieke Koehoorn, Hui Shen, Jessica Dennis

http://bmjopen.bmj.com/content/5/11/e008052.full.pdf

They show no effect of helmet laws on the rate of hospitalisation of cyclists although there does appear to be a large difference in wearing rates between helmet-law and non law provinces.

Results:
In Canada, over the study period 2006–2011, there was an average of 3690 hospitalisations per year and an estimated 593 million annual trips by bicycle among people 12 years of age and older, for a cycling hospitalisation rate of 622 per 100 million trips (95% CI 611 to 633). Hospitalisation rates varied substantially across the jurisdiction, age and sex strata, but only two characteristics explained this variability.

For all injury causes, sex was associated with hospitalisation rates; females had rates consistently lower than males. For traffic-related injury causes, higher cycling mode share was consistently associated with lower hospitalisation rates. Helmet legislation was not associated with hospitalisation rates for brain, head, scalp, skull, face or neck injuries.

Conclusions:
These results suggest that transportation and health policymakers who aim to reduce bicycling injury rates in the population should focus on factors related to increased cycling mode share and female cycling choices. Bicycling routes designed to be physically separated from traffic or along quiet streets fit both these criteria and are associated with lower relative risks of injury

mcgratheoin

Conclusions:
These results suggest that transportation and health policymakers who aim to reduce bicycling injury rates in the population should focus on factors related to increased cycling mode share and female cycling choices. Bicycling routes designed to be physically separated from traffic or along quiet streets fit both these criteria and are associated with lower relative risks of injury

Is it just me or is there a fairly major jump from increasing cycling mode share to recommending physical separation - I would have thought that an increased number of cyclists sharing the road would be more desirable than segregation? It would be interesting to see a study on accident statistics and journey numbers in Dublin since the Dublin Bikes were launched.

Qualitymark

mcgratheoin wrote: »

Is it just me or is there a fairly major jump from increasing cycling mode share to recommending physical separation - I would have thought that an increased number of cyclists sharing the road would be more desirable than segregation? It would be interesting to see a study on accident statistics and journey numbers in Dublin since the Dublin Bikes were launched.

I'd just like to be able to cycle where the drivers can't get at me.

CramCycle

mcgratheoin wrote: »

I would have thought that an increased number of cyclists sharing the road would be more desirable than segregation?

reading through, this is exactly the main and most validated point.

The female point was a jump as they admit that this is not always the case, what they were really saying is that people who take less risks are less likely to be in an accident, in the survey they done, this seemed to correlate with female cyclists. They say that females prefer separate infrastructure but not that it was a requirement and seems to be a throwaway comment.

It could also be taken that quieter roads (ie less motorised traffic) would do, therefore encouraging cycling would be applicable here.

The other jump I can make is that it is clear many are raised in a manner that inappropriate driving behaviour is not just the norm but also socially acceptable in many parts of the world, and that instead of insisting on a level of behaviour consistent with improving road safety in one group of road users, we expect all other road users, pedestrians and cyclists alike, to accommodate a problem that really shouldn't exist nor does it need too.

Qualitymark

My strong feeling is that if a network of separated cycle tracks were built that would bring you around the city to the places most of us want to go, the number of cyclists would explode.

Most non-cyclists I talk to say they would cycle if they didn't have to mix with cars, trucks, vans and buses.

mcgratheoin

Qualitymark wrote: »

My strong feeling is that if a network of separated cycle tracks were built that would bring you around the city to the places most of us want to go, the number of cyclists would explode.

Most non-cyclists I talk to say they would cycle if they didn't have to mix with cars, trucks, vans and buses.

Whilst I agree with you in part, the reality is that at some point in this type of infrastructure development you get to where it's no longer viable to create separate facilities. I'm talking about smaller roads, rural areas etc.. (I travel on rural roads for part of my commute each day). My opinion (and it's just an opinion) is that the more we segregate cyclists and motorists, the less considerate all road users become where this segregation is not available. Motorists don't expect cyclists on the road and become frustrated at having to share, while cyclists have no experience of how to cycle in vehicular traffic. When you start creating completely separate facilities you run the risk of some drivers believing that cyclists shouldn't be allowed on the roads at all.

check_six

We were on the school run when we got pulled over by the guards. They had pulled in with blue lights flashing so I was pretty confused to start off with. They pointed out that the kids should be wearing bike helmets, and I just sort of went with the flow for a quiet life.

Then they started talking about fixed charge penalty notices and I had to say something. They said that there were FCPNs in force now and lights and helmets were on the list. I pointed out that helmets were definitely not on the FCPN list and no requirement to wear them was in law. They pointed out that they were a good idea anyway, and this time I countered that they weren't much use. Certainly not better than good road awareness, good brakes, good lights, and a pair of gloves. But what about hurling they said. There's no one swinging hurleys at our heads on the school run I said.

It went on like this for a couple of minutes and eventually the guards gave up and got back in their car. In fairness to them they had been polite and friendly and I made sure to tell them that I appreciated that, and that I appreciated that they were taking bike safety seriously.

Ironically, I've been in the process of ordering a new helmet for my young fella, but I didn't think I should let the guards try and spoof me with the FCPN line. Was I being unreasonable?

CramCycle

Qualitymark wrote: »

Most non-cyclists I talk to say they would cycle if they didn't have to mix with cars, trucks, vans and buses.

And I agree to a point (although many just use the excuse in my opinion). The truth here though is that the tolerance of inappropriate and dangerous behaviour by society in general is why this fear is here.

check_six wrote: »

Was I being unreasonable?

Not at all, you were polite, well mannered and when it got preposterous you engaged in a reasonable manner. My wife insists my young lad wears a helmet, I finally conceded recently. He now holds it in his hands as I cycle home with him. I have no intention of forcing the issue with a disgruntled two year old. If I have to lay down the law, it will be for something a little bit more important.

Qualitymark

mcgratheoin wrote: »

Whilst I agree with you in part, the reality is that at some point in this type of infrastructure development you get to where it's no longer viable to create separate facilities. I'm talking about smaller roads, rural areas etc..

I'm not suggesting that. I'm saying we need a network that'll bring cyclists through the city to major places without having to interact with cars. We're at one here, @mcgratheoin.

mcgratheoin

Qualitymark wrote: »

I'm not suggesting that. I'm saying we need a network that'll bring cyclists through the city to major places without having to interact with cars. We're at one here, @mcgratheoin.

Yeah, I know you're not suggesting that, my point is just that removing cyclists from the road also removes them from the consciousness of motorists and re-inforces the public perception of cycling as dangerous.

I wouldn't be objecting if such a network was built in the city mind you - but I'd be objecting if cyclists were forced to use it.

On another point, I'd be interested to see figures of what an improvement in cycling infrastructure would do for numbers - my experience is that quite a few non-cyclists will have several excuses/reasons for not cycling (weather/roads/shower facilities etc..) but (maybe it's the cynic in me) I'm sceptical about how many of these people would genuinely cycle when these "barriers" are removed.

Good discussion though - sometimes regular cyclists are a bit at odds with the experience as it exists for someone who is new to the roads or maybe not that confident amongst traffic.

Seaswimmer

mcgratheoin wrote: »

On another point, I'd be interested to see figures of what an improvement in cycling infrastructure would do for numbers

Slightly off topic but the new cycle counter on the Rock Road was turned on again a couple of weeks ago. Its been out of action for the best part of a year or more.

As I leave the house everyday at the same time I was interested to see if there was an increase in the numbers cycling since the counter last worked.

I was always between number 120 - 150 on any given day in reasonable weather on the old counter.

On the new one I am consistently up around 230 - 260 every morning.

Not very scientific but shows how cycling numbers have increased on that corridor..

CramCycle

mcgratheoin wrote: »

I wouldn't be objecting if such a network was built in the city mind you - but I'd be objecting if cyclists were forced to use it.

I think it would lead to unnecessary hostility to those who don't use it, as well as remove cyclists more from motorists, making them less likely to expect those who do use the roads. Studies and common sense have shown that greater enforcement of the law and safe road using on all road users, would be far more beneficial to cyclists safety.

On another point, I'd be interested to see figures of what an improvement in cycling infrastructure would do for numbers - my experience is that quite a few non-cyclists will have several excuses/reasons for not cycling (weather/roads/shower facilities etc..) but (maybe it's the cynic in me) I'm sceptical about how many of these people would genuinely cycle when these "barriers" are removed.

Same here, some would but I know deep down many won't, at least not until it becomes a more normalised activity in their eyes.

Good discussion though - sometimes regular cyclists are a bit at odds with the experience as it exists for someone who is new to the roads or maybe not that confident amongst traffic.

I think experience is good but there are times when it leads to complacency as well.

Gadetra and myself have parents who are / were HGV drivers, my father in London for years. Most drivers of HGVs are super cautious but there are always cases where no matter how cautious you are, someone will do something incredibly stupid. I have seen cyclists and pedestrians run under the windscreen of a HGV mid turn, its just insanity. These people, due to experience, accept this as OK as they have yet to be killed. I agree with other posters about the need to bring in more safety features and retrofit HGVs with as many as is practical, but these can all fail and it is a risk that complacency develops among younger HGV drivers who to me are far more dangerous than the older ones, just opinion though.

My Dad finally packed it in last year, the times and turnarounds he was getting from operators were unbelievable, and he wouldn't be the most H&S savvy but he knows common sense, and the trips, distance, times are insane.

The industry as a whole needs a far higher set of operating procedures and inspection rates. But then, no one wants this apparently, when they realise there bag of Tayto may go up by 20c or their load of stone up by 10euro a load. Its time people realise that if they want the improvements, they have to pay the price as well.

Qualitymark

CramCycle wrote: »

The industry as a whole needs a far higher set of operating procedures and inspection rates. But then, no one wants this apparently, when they realise there bag of Tayto may go up by 20c or their load of stone up by 10euro a load. Its time people realise that if they want the improvements, they have to pay the price as well.

Not only the price of Taytos; it's also that people drive rings around the tachometer (sp?) because the ferries are at times that make it impossible to catch them. Like, after leaving the Roscoff ferry, you have to drive without sleep to get across the Péripherique in the early hours of the morning before the nose-to-tail hours-long traffic jam traps you. Or at least it used to be so many years ago when i was hitching on artics.

CramCycle

Qualitymark wrote: »

Not only the price of Taytos; it's also that people drive rings around the tachometer (sp?) because the ferries are at times that make it impossible to catch them. Like, after leaving the Roscoff ferry, you have to drive without sleep to get across the Péripherique in the early hours of the morning before the nose-to-tail hours-long traffic jam traps you. Or at least it used to be so many years ago when i was hitching on artics.

Years ago the Police over in the UK couldn't read the Tachs because they weren't trained so they judged your reaction to see whether or not they should proceed further.

After this you learned to pull out the fuse and it just stopped the Tach, when they linked them to the engine start, you then seen some fairly simple workarounds. Considering this was done at a time when enforcement was minimal and the hours are not as bad as they are now, I can't imagine it has gotten better.

eeeee

It used to be my job to take out fuse no 19 which disabled the tachograph and the limiter

Hoever, it's not the 80's of the 90's anymore, there's a hell of a lot more traffic on the road. Now tachographs are on the lorry drovers license and digital. The first generation of non-paper tacho's could be cheated with a bearing…now you can't.

However a problem remains because there is no regulation of rates int eh haulage industry - so operators are all undercutting each other and promising ever more unrealistic turnaround times. Also employment law is largely absent - in almost 40 years of driving 80-90 hours per week my father never earned minimum wage per hour. So if you're paid by the load you're gonna be under pressure. However, that notwithstanding, they are still the most regulated and watched driver on the road. We got pulled over regularly, I have only ever been in a car pulled over twice. They also have to do cpc's every 6 months or so, which goes onto their license (it's a european driving license, like a credit card). All the guards have to do to read hours or qualifications is scan the card.

It's a different industry now than it was then. The father doesn't do ti anymore. H&S is catching up with it from a driver and passenger even, point of view (I never wore a seatbelt in a lorry for example, ever! :eek:), lorries are A LOT more traffic friendly than they were, with mirrors and sensors and the like. I would now.

Qualitymark

mcgratheoin wrote: »

I'd be interested to see figures of what an improvement in cycling infrastructure would do for numbers - my experience is that quite a few non-cyclists will have several excuses/reasons for not cycling (weather/roads/shower facilities etc..) but (maybe it's the cynic in me) I'm sceptical about how many of these people would genuinely cycle when these "barriers" are removed.

This is possible, but looking at places where the cycling infrastructure is mostly separated from cars - Amsterdam, Copenhagen (Milton Keynes?) - the result seems to have been that cycling gradually becomes the norm.

And a separated network never means that cyclists are always separated from cars, it means that they mostly are.

gadetra wrote: »

Also employment law is largely absent - in almost 40 years of driving 80-90 hours per week my father never earned minimum wage per hour. So if you're paid by the load you're gonna be under pressure.

And truckers, being self-employed, have never used the sense God gave them and got together to form a union or association to co-operate and set minimum prices and standards of safety.

That's the way it works: if the bosses can get the workers to go for each other's throats and undercut each other, guess who profits, guess who loses?

Back in the 1980s, when I was working casual for around three-four different employers regularly, the law was stringent (for casual rather than self-employed like truckers): the first employer you worked for in a particular week paid your insurance stamp; you were entitled to - and the Department ensured that this was enforced - sick pay and holiday pay pro rata with the staff in each place.

This was not enforced was in catering, and perhaps in other jobs perceived as working-class, but it was stringently enforced in the area I was working in then. It encouraged the bosses to staff people.

Then as the Thatcher ethos took over, little farts in blue serge suits who thought they were part of the boss class started screaming that we should 'break the unions and break them hard'. It was their own rights they destroyed. /RANT /GURN /SNARRRLLL

galwaycyclist

Qualitymark wrote: »

This is possible, but looking at places where the cycling infrastructure is mostly separated from cars - Amsterdam, Copenhagen (Milton Keynes?) - the result seems to have been that cycling gradually becomes the norm.

And a separated network never means that cyclists are always separated from cars, it means that they mostly are.



And truckers, being self-employed, have never used the sense God gave them and got together to form a union or association to co-operate and set minimum prices and standards of safety.

That's the way it works: if the bosses can get the workers to go for each other's throats and undercut each other, guess who profits, guess who loses?

Back in the 1980s, when I was working casual for around three-four different employers regularly, the law was stringent (for casual rather than self-employed like truckers): the first employer you worked for in a particular week paid your insurance stamp; you were entitled to - and the Department ensured that this was enforced - sick pay and holiday pay pro rata with the staff in each place.

This was not enforced was in catering, and perhaps in other jobs perceived as working-class, but it was stringently enforced in the area I was working in then. It encouraged the bosses to staff people.

Then as the Thatcher ethos took over, little farts in blue serge suits who thought they were part of the boss class started screaming that we should 'break the unions and break them hard'. It was their own rights they destroyed. /RANT /GURN /SNARRRLLL

As far as I am aware Milton Keynes has one of the lowest cycling levels in the UK. The segregation issue can be a distraction. I think it is more accurate to say that cities with high cycling levels are prepared to restrict cars. That policy may then help to create conditions in which segregation is used to help cycling. But it does not follow that segregation by itself will grow cycling.

Qualitymark

galwaycyclist wrote: »

As far as I am aware Milton Keynes has one of the lowest cycling levels in the UK. The segregation issue can be a distraction. I think it is more accurate to say that cities with high cycling levels are prepared to restrict cars. That policy may then help to create conditions in which segregation is used to help cycling. But it does not follow that segregation by itself will grow cycling.

You're right. Blog about it here https://aseasyasridingabike.wordpress.com/2012/04/26/they-built-it-and-they-didnt-come-the-lesson-of-milton-keynes/

(Milton Keynes') cycle paths, in the main, run alongside dual carriageways, often those with 70 mph speed limits.

I asked about Milton Keynes purely because I'd read that the town was built deliberately on a human scale - built as a place where people could walk to work. Never been there, though. And it seems that their cycling infrastructure isn't well designed.

Also:

http://www.copenhagenize.com/2007/11/debunking-flat-countrybike-country-myth.html

Seville… went from 0.2% on bike to 7% in under five years because of their implementation of an infrastructure network

galwaycyclist

Qualitymark wrote: »

Quote:Seville… went from 0.2% on bike to 7% in under five years because of their implementation of an infrastructure network

We are getting off topic for this thread. But I am sceptical of the way the Seville issue gets framed by some commentators. My Spanish skills are not great but I have the feeling that there was more going on than simply building segregated cycle facilities. Much of the city was already low-traffic streets suitable for cycling (so cars had been restricted) the new cycling facilities then connected these streets up. So it created a network based mainly on restricting cars. Also I have impression that there was significant rearrangements of car-parking in the city along with building the cycle facilities. Rearranging car parking implies a willingness to manage or "restrict" cars for a greater purpose.

eeeee

Qualitymark wrote: »

And truckers, being self-employed, have never used the sense God gave them and got together to form a union or association to co-operate and set minimum prices and standards of safety.

That's the way it works: if the bosses can get the workers to go for each other's throats and undercut each other, guess who profits, guess who loses?

Back in the 1980s, when I was working casual for around three-four different employers regularly, the law was stringent (for casual rather than self-employed like truckers): the first employer you worked for in a particular week paid your insurance stamp; you were entitled to - and the Department ensured that this was enforced - sick pay and holiday pay pro rata with the staff in each place.

This was not enforced was in catering, and perhaps in other jobs perceived as working-class, but it was stringently enforced in the area I was working in then. It encouraged the bosses to staff people.

Then as the Thatcher ethos took over, little farts in blue serge suits who thought they were part of the boss class started screaming that we should 'break the unions and break them hard'. It was their own rights they destroyed. /RANT /GURN /SNARRRLLL

Most truckers are not self employed, the vast and overwhelming majority work for other people. In my father industry, one guy decided to try and get the timber hauliers together to agree a set price, when it came down to it he was blacklisted from the sawmills and everyone undercut him. It's dog-eat-dog, and a long march to the lowest of bottom lines. So it's not a question of sense or stupidity, or rather it is, but there is so little money in it now no one can rock the boat.

I agree with you it should be done, as soon as posisble. I hope some day soon it will be!