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

MrCreosote

smacl wrote: »

How is a group of people who have a head injuries from cycling crashes an unreasonable indicator of the value of helmets in the event someone incurring a head injury as a result of a cycling crash?

Mainly because it's not clear what they are comparing this group to. It's just the same as all the stories people have of crashing with a helmet on that "saved their life"- I have a few of these myself. But those stories are pointless without a comparison group. Who knows, maybe the crash would have been less likely to happen in the first place if the helmet wasn't on.

dave_o_brien

Surveyor11 wrote: »

The cycling helmet debate seems to cause endless debate when raised here, with the "yays and nays" equally entrenched. It sounds like a debate that will go on as long as cycling is around.

I'm curious if this is common in other sports where head impacts at varying speeds are common? For example snow sports, rock climbing, water skiing, sailing? Is this debate just particular to cycling and maybe reflective of the type of people who cycle?

I think the bit in bold is where most of the contention occurs.

My interpretation is that helmets suggest imminent danger. That danger is statistically and, in my experience, empirically tiny. Arguments for their usefulness must address this.

Also, simple arguments are often tainted by extreme examples: the guy who received an ABI while not wearing one, or the girl who walked away from an accident with no more than a broken wrist while wearing a helmet. These detract (or at least distract) from the actual point of the conversation.

Helmets are useful in a number of circumstances. Fortunately, these circumstances are extremely rare. Unfortunately, it's usefulness is surpassed relatively easily.

petethedrummer

Surveyor11 wrote: »

I'm curious if this is common in other sports where head impacts at varying speeds are common? For example snow sports, rock climbing, water skiing, sailing? Is this debate just particular to cycling and maybe reflective of the type of people who cycle?

Helmets & helmet debates have taken over skiing as well. All the wearers 'feel' safer.

Surveyor11

Well, fair enough. My skull is only 1/8th inches thick (some would say thicker:pac:) and not very good at absorbing impacts. I wear a helmet and hope this will lessen the impact on my skull (I could be wrong of course, and hope I never have to find out).

smacl

@dave & mrcreasote, consider the following;

- Say of a total of N cyclists presenting with ABI, M were not wearing helmets. The percentage of those not wearing helmets, A = 100*M/N.

- Say for the same period of time, the percentage of the active cycling population wearing helmets was P, and that the number and severity of accidents had an even distribution throughout that population.

- If A is significantly greater than P, we can say there is a correlation between not wearing a helmet and ABI in the very limited circumstance of this type of event.

Correlation is only an indication that further investigation is required, and should not be confused with definitive proof, causation, or similar stronger indicators. Correlation of two variables without considering the context of multiple other surrounding variables is also fraught. That said, any of the studies I've read on this subject on either side of the argument don't seem to get beyond this type of weak correlation. There also seems to be a line of argument against the efficacy of helmets in the event of an accident that includes bias on the basis that mandatory helmet usage would be bad for cycling. I agree that it would be, but the bias introduced by the latter has no place in the former.

Edit:

Helmets are useful in a number of circumstances. Fortunately, these circumstances are extremely rare. Unfortunately, it's usefulness is surpassed relatively easily.

Exactly.

droidus

Agent Smyth wrote: »

why don't you google "people electrocuted on stage"

Why? So I can find links back to this page?

A handful of people die every year due to ungrounded amps. I saw someone get a shock from a live mic once myself. As such, its only common sense that all performers should wear rubber soled shoes, and/or rubber gloves on stage.

rollingscone

When climbers wear helmets it's primarily about protection from falling debris, rather than large impacts although helmets are effective in the limited sense of protecting your skull in falls (Mine did).

For kayaking, Helmets are considered essential for river paddlers who paddle under trees and occasionally tip over into rocks or after capsizing travel upside down over the sharp rocks on the river bed (Done this one too).

Sea Kayakers on the other hand tend not to wear helmets and arguably have little or no need for them as they're rarely in closed spaces (caves being an exception).

Konkers

This confession may draw a lot of comment I'm sure. For the record I always wear a helmet. My ten cents worth on this is not fact but more personal observations of myself as a cyclist and motorist.

I started cycling my youngest on the bike into a crèche in town from churchtown recently (traffic :mad:). I have noticed that when I have a baby in the carrier, drivers, in general I think, are a lot more cautious when over taking me. When I am on the bike alone, drivers are a little less cautious, in general I think.
This may also be because I'm moving a lot faster on my own and maybe cycle with a little less caution. When I'm out on the road bike I often think I would take fewer risks if I did not have a helmet on. I have also noticed that I would be a more cautious as a driver overtaking a cyclist who i perceive as a vulnerable road user.

Perceptions of safety have a huge impact on our own behaviour and the behaviour of others around us. Safety gear can lead to people taking more risks when undertaking an activity because they perceive the activity to be safer. Helmets are one of those, they will not prevent a potential accident (unlike light or hi viz when cycling in the dark) but may protect us to some extent (in the event of a bump to the head).

galwaycyclist

A policeman sees a drunk man searching for something under a streetlight and asks what the drunk has lost. He says he lost his keys and they both look under the streetlight together. After a few minutes the policeman asks if he is sure he lost them here, and the drunk replies, no, that he lost them in the park. The policeman asks why he is searching here, and the drunk replies, "this is where the light is."

chakattack wrote: »

You've lost me there i'm afraid...who's the drunk here?

With regret you walked yourself straight into that role. The drunk man under the streetlight story is a common illustration of observational bias. You have apparently argued that our observations should be biased. Your apparent argument is that we should isolate our observations to individual collisions without considering the wider evidence such as injury trends among populations where helmets are more common.

To illustrate it another way. Your argument is equivalent to saying that doctors should continue to prescribe thalidomide to pregnant women on the basis that there is laboratory evidence showing it is good for morning sickness. Under your reasoning, we would ignore any evidence of unintended consequences - such as birth defects - because it was being seen at a population level and is difficult to characterise or fully explain.

Is that an ethical or moral approach?

Seweryn

I wear a helmet with a cover in days like today, i.e. to keep the rain out. It means in most days. That is its main function.

Agent Smyth

Konkers wrote: »

Perceptions of safety have a huge impact on our own behaviour and the behaviour of others around us. Safety gear can lead to people taking more risks when undertaking an activity because they perceive the activity to be safer. Helmets are one of those, they will not prevent a potential accident (unlike light or hi viz when cycling in the dark) but may protect us to some extent (in the event of a bump to the head).

I would agree the use of some safety gear/equipment can seem to make an activity seem less risky but in actual fact the gear is only providing an extra layer of protection and I would think most if not all cyclists would view a helmet a an extra layer of protection and not something that will reduce the chances of an accident happening.

tomasrojo

MediaMan wrote: »

I'm surprised that there hasn't been more discussion in the thread of this paper. It strongly suggests that helmet wearing has a small but definite benefit based on a meta-review of multiple studies.

And this meta-analysis shows little net benefit, becoming no net benefit with later publications:
http://www.cyclehelmets.org/1251.html

(Switching to soft-shell seems to be partly to blame.)

doozerie

smacl wrote:

I'd say there are some loud voices on both sides, and wouldn't rush to take either on board at face value. The argument appears very polarised at this point, and IMHO, the actual value of helmets or not lies at some murky point in the middle. YMMV.

As regards the loud voices, I don't interpret any voices in this thread criticising people for wearing helmets, just voices advocating that a choice to not wear a helmet be considered valid. At the other end of the scale though there are voices criticising people for *not* wearing helmets, these are mostly dressed up in language that the poster presumably perceives as being less aggressive but while phrases like "it's only common sense to wear a helmet" rank low on the aggressive scale they are right up there on the patronising scale - such posts contribute nothing to a discussion as they leave no room for debate, they are the debating equivalent of Tourettes.

I agree that the value of helmets lies in a grey area though. This thread won't change that, but it provides the opportunity for informed and reasoned debate and that's got to be a good thing. Hopefully the polarised views don't derail it entirely, 'cos I'm finding it informative and interesting.

tomasrojo

doozerie wrote: »

This thread won't change that, but it provides the opportunity for informed and reasoned debate and that's got to be a good thing. Hopefully the polarised views don't derail it entirely, 'cos I'm finding it informative and interesting.

Definitely the most good-tempered helmet thread I can think of!

galwaycyclist

chakattack wrote: »

You've lost me there i'm afraid...who's the drunk here?

If you would like a broader overview of why your favoured approach to the issue is flawed and can get people hurt or killed there is an article on it here:

Why Scientific Studies Are So Often Wrong: The Streetlight Effect
Researchers tend to look for answers where the looking is good, rather than where the answers are likely to be hiding

http://discovermagazine.com/2010/jul-aug/29-why-scientific-studies-often-wrong-streetlight-effect

tomasrojo

By the way (slightly OT), am I right in thinking that hard-shell helmets were (and are?) more compact and have lower coefficients of friction on impact with the ground? Possibly better when it comes to rotational acceleration.

rollingscone

Argh flashbacks to Kuhn!

doozerie

Surveyor11 wrote:

The cycling helmet debate seems to cause endless debate when raised here, with the "yays and nays" equally entrenched. It sounds like a debate that will go on as long as cycling is around.

I'm curious if this is common in other sports where head impacts at varying speeds are common? For example snow sports, rock climbing, water skiing, sailing? Is this debate just particular to cycling and maybe reflective of the type of people who cycle?

I don't participate in those other sports you've named so I don't know how actively debated this topic is within those. My guess though is that it's so prevalent within cycling because of the broad appeal of cycling not just as a sport but as a form of transport, and for that reason it's much more in the public eye than some sports and probably a wider portion of the public have a strongly held view on various things relating to it. Combine that with what seems to be a widespread (mis)conception that the roads are dangerous and you have the ingredients for very heated debate. Chuck in the prospect of kids cycling and the handwringing shoots up the scale.

I'd imagine that within, for example, the base jumping community there are some very strong views on what is safe and what is not, but those kinds of views don't tend to make it into the letters page of a national newspaper, for example, so any debate doesn't tend to get so blown out of proportion. Or maybe the fact that base jumpers usually wear helmets wins over those that rant about non-helmet-wearing cyclists, and they are therefore willing to look past the fact that base jumpers throw themselves off very tall objects whereas a cyclist rolling along a road without a piece of polystyrene has some kind of death wish. I have absolutely nothing against base jumping, incidentally, it's just one example that springs to mind - I just find it odd that of the many widely practiced activities that involve some degree of risk, cycling gets singled out a lot as being extremely dangerous and that cyclists need someone to look after them since they themselves are deemed somehow unwilling or unable to make reasoned decisions for themselves.

doozerie

tomasrojo wrote:

By the way (slightly OT), am I right in thinking that hard-shell helmets were (and are?) more compact and have lower coefficients of friction on impact with the ground? Possibly better when it comes to rotational acceleration.

I'm not sure that hard-shell helmets are more compact in themselves. The old sausage-style cycling helmets were more compact again, and my first hard-shell helmet was huge (I was looking through old photos recently and with the benefit of hindsight I can now say with certainly that that thing was a monstrosity!). I expect hard-shells do slide more readily though.

While watching one of the pro races on Eurosport recently I noticed that some teams are now wearing hard-shell helmets which are much more rounded than what I've come to recognise as the modern bike helmet. They have far less bulk at the back of the helmet. I've no idea what motivated this significant change in design, whether it's a safety thing or something else, but it's an interesting change.

Another change in design is the use of a solid outer shell, with little or no venting, but from what I understand that design was based entirely on improved aerodynamics rather than being anything to do with improved effectiveness of the helmet in a collision (though the two might not be mutually exclusive).

Edit: Here is one of the newer helmet designs, more rounded and "smooth" at the back. It looks not unlike some of the newer TT helmets, which are very rounded, but this was worn by Gilbert for Milan-SanRemo so not a TT event:

smacl

doozerie wrote: »

I don't interpret any voices in this thread criticising people for wearing helmets, just voices advocating that a choice to not wear a helmet be considered valid.

What I'm seeing is are many posts saying the following; you probably won't be in a bike accident. If you are you probably wont hit your head. If you do hit your head the helmet probably wont help you much. And anyway, wearing helmets is bad for the cycling community. I'm also seeing numerous regular posts both in this thread and on a regular basis in this forum saying I was in a bike accident. I hit my head. The helmet was of great benefit in avoiding serious injury.

I then see further posts suggesting any first hand anecdotal accounts should be dismissed as invalid, and links to various studies of varying veracity attempting to correlate variables to support arguments as to why helmets should or should not be worn should be considered in their place.

It's all very confusing, Joe, I don't really know what to make of it. I like the cycling community as much as the next man, but if I arrived home one day with a fractured skull, my missus would kill me.

bedirect

we listened to all these debates when wearing seat belts became mandatory, i know people who have crashed & definitely the helmet saved them. It is very easy to fracture your skull

tomasrojo

smacl wrote: »

I then see further posts suggesting any first hand anecdotal accounts should be dismissed as invalid

I don't think that was the point. Another point was made, along the lines of: "Look at all these stories of people hitting their heads and being sure the helmet saved their life", together with the claim (made by only one poster) that such a body of claims was as good as real-world evidence could get.

From a scientific point of view, these are essentially anecdotes, and not regarded as especially good evidence. Expert testimony without reference to studies isn't that high up the list of highly compelling scientific evidence either. What is well-regarded is large bodies of quantitative data measured as objectively as possible. Not that anecdotes and expert testimony are wrong, as such, just that they need to be backed up with solid, objective data.

Archie Cochrane's long campaign to stop consultants in the UK justifying practices by saying things like "Of course, I'm right. I'm the head of surgery at Saint Bartholomew's!" is an interesting story.

bad2dabone

doozerie wrote: »

, more rounded and "smooth" at the back. It looks not unlike some of the newer TT helmets, which are very rounded, but this was worn by Gilbert for Milan-SanRemo so not a TT event:

QUOTE]

That's the Giro Air Attack helmet, I think it's a very nice looking helmet and I'll be picking one up as soon as i see one for sale. Giro say it's to be used for both TT and Road events. Tejay van Garderen wore it on the Col D'eze TT in Paris-Nice too.

dave_o_brien

bedirect wrote: »

we listened to all these debates when wearing seat belts became mandatory, i know people who have crashed & definitely the helmet saved them. It is very easy to fracture your skull

Nobody is arguing with that. What people are saying is that an impact that can fracture a skull normally far exceeds the reasonable performance expectations of helmets currently on the market.

smacl

Surveyor11 wrote: »

I'm curious if this is common in other sports where head impacts at varying speeds are common? For example snow sports, rock climbing, water skiing, sailing? Is this debate just particular to cycling and maybe reflective of the type of people who cycle?

I'm involved in full contact martial arts and also wrestle. Full contact amateur comps tend to include head guards, but we'd often not bother wearing them while sparring. No safety gear other than the mats while wrestling, and though you do get thrown about a fair bit, the concern is more spinal injuries than head trauma. In terms of head injuries, first hand I've witnessed a broken cheekbone, numerous lost teeth, knock outs, and concussions, but the consensus of opinion is they're part and parcel of the sport. As a result of this (and old age) I'd wrestle much more than box these days.

I think the big difference between cycling and other sports is the visibility of the participants. Other sports happen out of sight, and hence out of mind. Cycling tends to be more in public view, leading to the inevitable the hand wringing. There's also a tendency to conflate the risks associate with the likes of racing with utility cycling, which to my mind is a mistake.

doozerie

smacl wrote:

What I'm seeing is are many posts saying the following; you probably won't be in a bike accident. If you are you probably wont hit your head. If you do hit your head the helmet probably wont help you much. And anyway, wearing helmets is bad for the cycling community.

I don't see those various statements (which I agree have each been made in one form or another) being tied together in this thread to support an argument against wearing a helmet. Where references to the likelihood of an accident occurring, and the cyclist hitting their head, are made I think they've been in response to the suggestion that cycling is inherently dangerous, which is a suggestion strongly implied by those that consider a helmet to be essential. It's a matter of opinion, but I don't see the individual statements as being at the opposite end of the scale to the "helmets are essential" views, I see them as being a lot more moderate and trying to drag the debate back to a reasoned middle ground and away from the very emotive "you'll die without a helmet" arguments. Linking the statements together as if each implied the next though, would certainly form an argument that's heading to the far end of the scale, in my view, but I don't think that has actually happened.

As regards the dismissal of anecdotes, I agree with tomasrojo's post on that, anecdotes are interesting but when things get emotive they can get casually elevated to the level of fact, which hinders the debate rather than helps it. The core of the debate can end up being lost as supposed facts are challenged and counter-challenged.

galwaycyclist

smacl wrote: »

I'm involved in full contact martial arts and also wrestle. Full contact amateur comps tend to include head guards, but we'd often not bother wearing them while sparring. No safety gear other than the mats while wrestling, and though you do get thrown about a fair bit, the concern is more spinal injuries than head trauma. In terms of head injuries, first hand I've witnessed a broken cheekbone, numerous lost teeth, knock outs, and concussions, but the consensus of opinion is they're part and parcel of the sport. As a result of this (and old age) I'd wrestle much more than box these days.

I think the big difference between cycling and other sports is the visibility of the participants. Other sports happen out of sight, and hence out of mind. Cycling tends to be more in public view, leading to the inevitable the hand wringing. There's also a tendency to conflate the risks associate with the likes of racing with utility cycling, which to my mind is a mistake.

I did a traverse of the Crib Goch last Saturday in snow.

http://www.youtube.com/watch?v=OuDdScxt2oo

On this occasion we wore helmets but previously we haven't. I have no illusions regarding the likely benefit in a serious bang. Very few people would dream of going from this to arguing that you should wear a helmet walking to the shop. However it seems routine to use similar arguments for cycle helmets.

smacl

tomasrojo wrote: »

From a scientific point of view, these are essentially anecdotes, and not regarded as especially good evidence. Expert testimony without reference to studies isn't that high up the list of highly compelling scientific evidence either. What is well-regarded is large bodies of quantitative data measured as objectively as possible. Not that anecdotes and expert testimony are wrong, as such, just that they need to be backed up with solid, objective data.

Absolutely, but what this says to me is the array of anecdotal material demands some further investigation. At a guess, we'd see a couple of such anecdotes relating to a crash with a knock to the head and a "praise be to the helmet, it saved my life" line each month. Say we ignore whether or not the helmet helped them as we simply don't know, but accept that they came off their bike and had some degree of an impact to their head. Say we see 20 such posts per annum, out of a population of say 1000 contributing boardsie cyclists. (Picking numbers out of the air, for sure, but roughly the right order of magnitude). That gives us a 2% probability of such an event happening to any given cyclist, in any given year. Small, but significant. In my case, we've four cyclists in the family, so if we all cycle regularly for about five years, the balance of probability is that one of our heads may be visiting the tarmac at some point. We then consider whether the claims made by our medical friends warrant attention, perhaps not, but I wouldn't be in a hurry to dismiss them. We also look at the studies suggesting that helmets are a waste of time at a population level, and decide whether this also holds true at a personal level.

I honestly don't know, but don't find the arguments for or against particularly clear cut.

doozerie

smacl wrote:

I'm involved in full contact martial arts and also wrestle. Full contact amateur comps tend to include head guards, but we'd often not bother wearing them while sparring. No safety gear other than the mats while wrestling, and though you do get thrown about a fair bit, the concern is more spinal injuries than head trauma. In terms of head injuries, first hand I've witnessed a broken cheekbone, numerous lost teeth, knock outs, and concussions, but the consensus of opinion is they're part and parcel of the sport.

Only slightly related to the topic at hand this but I heard boxing being discussed on RTE Radio earlier this week, on the John Murray show. I think it arose from some story they discussed last week of someone taking up boxing for the first time, or something. Basically it led to people ringing in and writing in to the show to argue that boxing should be banned because of the dangers of brain damage it posed.

I only heard some of the debate but the contributions I did hear were the stereotypical ones. The people who opposed boxing had adopted the view that it is dangerous and dismissed out of hand any mention of the likes of head guards used in amateur boxing to reduce risk, or the low incidence of recorded serious injuries. What's more, when the risks of rugby were mentioned, they were played down as being insignificant since the aim in boxing is to "harm the other person" and apparently this isn't the case in rugby.

It was interesting, if a little depressing, to hear the same rigid attitude ("boxing kills!") and the same reluctance to actually debate the topic that you tend to encounter when cycling safety is mentioned. It made me think that if compulsory helmet use, and compulsory hi-viz, and compulsory cycle lane use, etc., were all introduced, then public attention would turn to "fixing" other activities in order to save even more people from themselves. As a species we seem to worry a lot, maybe we need more hobbies!

chakattack

tomasrojo wrote: »

I don't think that was the point. Another point was made, along the lines of: "Look at all these stories of people hitting their heads and being sure the helmet saved their life", together with the claim (made by only one poster) that such a body of claims was as good as real-world evidence could get.

From a scientific point of view, these are essentially anecdotes, and not regarded as especially good evidence. Expert testimony without reference to studies isn't that high up the list of highly compelling scientific evidence either. What is well-regarded is large bodies of quantitative data measured as objectively as possible. Not that anecdotes and expert testimony are wrong, as such, just that they need to be backed up with solid, objective data.

Archie Cochrane's long campaign to stop consultants in the UK justifying practices by saying things like "Of course, I'm right. I'm the head of surgery at Saint Bartholomew's!" is an interesting story.

You're embellishing what i said a little. I said injury reduction and not life-saving.

There is a distinct lack of the objective data needed that is very true.

I'm with you on the consultants thing...partially why I disagree with a lot of the info referred to earlier on cyclinghelmet.org...it's biased opinion with an academic sheen.