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White cycle helmet'Flimsy little helmets' completely pointless, says leading brain surgeon
Cyclists who wear ‘flimsy little helmets’ are wasting their time, a leading neurosurgeon who never wears one has said.
Henry Marsh, who works at St George’s Hospital in Tooting, London, said his patients who have been in bike crashes have not seen any benefit from their helmets.
He told the Hay Festival, where he was in discussion with Ian McEwan about his new novel featuring a brain surgeon: “I ride a bike and I never wear a helmet. In the countries where bike helmets are compulsory there has been no reduction in bike injuries whatsoever.
“I see lots of people in bike accidents and these flimsy little helmets don’t help.”
Instead, he said, he wore a cowboy hat on his bike, which he had been riding for 40 years.
According to the Telegraph, he also cited evidence from the University of Bath that suggests that wearing a helmet may even put cyclists at greater risk.
The research suggests drivers think riders in helmets are more experienced and predicatable and can be passed up to three inches more closely.
Women and the non-helmeted tend to be passed more slowly and widely.
A Department of Transport study has shown that helmets could prevent 10-16 per cent of cyclist fatalities, although this was also an estimate based on a small study.
Angie Lee, Chief Executive of the Bicycle Helmet Initiative Trust said: “I hope he is going to take responsibility for the cyclist who gets injured because they take their helmet off following his comments.
“This may be his opinion but there are a lot more neurosurgeons and surgeons who would counter that argument.
“My advice would be the same as the Department of Transport’s which is that helmets have a place in protecting the head.”
Marsh, who retires in March, also said he jumps red lights to get ahead of the traffic.
“It’s my life at risk,” he said, ‘So I regularly cross over red lights.”
Recently we reported how three of London’s air ambulance doctors called for an overhaul of the capital’s cycle safety measures after three cyclists were killed in three weeks.
In an article for the Evening Standard, entitled How To Ride Safely, by Cyclist Doctors Who Save Lives, Mr Tom Konig, a trauma surgeon, Ali Sanders, an emergency medicine consultant and Mark Wilson, a Neurosurgeon, all defended cycling in London, saying: “Cycling remains a wonderful way to commute and travel cheaply and remain fit and healthy in the process and so should continue to be encouraged.”
But they added that it remained risky, and outlined a number of safety measures, including:
- Avoid sharing roads with buses and HGV’s
- Remember large vehicles are bigger than you and you will definitely come off worse - so give them a wide berth
- Defensive riding
- Wear a helmet
- Use all your senses (don’t wear headphones)
- Make your own decision about how ‘safe’ a cycle route is
And in 2013 we reported the comments of Lynn Myles, a consultant neurosurgeon at the Western General Hospital in Edinburgh.
Ms Myles acknowledged that she is “under no illusion that it [a helmet] will save me in the event of a high speed collision with a car or lorry (nothing will)” – a common criticism aimed at those who insist all cyclists should wear one – but adds that “most cycling accidents aren’t of the high-speed variety.”
Instead, after outlining other things that can be done to improve cycle safety such as addressing traffic speed and improving road layout, she says: “Most of the head injuries I have seen in cyclists are the result of low velocity crashes or simple falls due to ice or wet roads.
“There is no doubt in my mind that a well-fitting cycle helmet will reduce the incidence of scalp laceration and open fracture and will help to reduce the energy transfer to the brain.”
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ICE cars are getting heavier, increasing the particulate pollution from them too....
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She seemed a bit upset about a minor misjudgement that could have killed someone and is going to cause months of stress and inconvenience.
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80 comments
Trouble is, he's only going to see a narrow cross section of accident victims. While he might deal with serious head injuries. he's not going to be seeing the minor scrapes that people walk away from, or dead people is he?
And the line about "his life, his risk" makes him sound like a complete tw@ - how about the person that hits you? I'm sure they just carry on with life as usual?
So, a helmet effectively makes your head significantly *wider*, and adds a modicum of extra weight. If you fall sideways and your helmet bangs the road that DOES NOT necessarily mean your helmet saved your head from a bang. Without the helmet, your head would effectively have been narrower, and slightly lighter, and may not have hit the ground *at all*.
See also: https://www.youtube.com/watch?v=Lqo4hwnJt6Y ("glad" is dutch for slippy). Note the instinctive reactions people have to lift their heads away from the fall, while sticking out their arms. There are maybe 1 or 2 people who /maybe/ hit their heads. If all those people had been wearing helmets, more would have hit the ground with helmet and have "a helmet saved me!" stories like yours I suspect.
I once, after a sportive, allowed myself and my bike to flop sideways onto a grassy bank, I was so exhausted. I was just expecting to break the fall with my hip and shoulders. I actually ended up with a bang to the head, because the width of my helmet meant it hit the ground and transmitted the shock to my head. Without a helmet, I'd have been fine.
Helmets *do* make a noticeable difference to head injury rates (circa 1.25 to 1.6 times improvement). However, they also slightly increase other types of injury, neck particularly, because of the width and weight issues - and possibly also because of risk compensation issues.
The thing is, the difference helmets make is *piddling* compared to building safe infrastructure for cyclists. The Netherlands has a *many fold* (don't have the figures to hand, something like 5 to 7 times from memory) better death/injury rates than UK.
A 5 to 7 times improvement is *much* better than a 1.2 to 1.6 times improvement. But wait, I hear you say, surely it's not an either/or thing? Wouldn't it be best to have *both* the helmet improvement *and* the safe infrastructure improvement? Well, that's an interesting question. First, if things are much safer, the small improvement may matter much less. Second, it assumes you can have both. However, what if the 1.2 to 1.6 times improvement might actually *decrease* your odds of ever being able to achieve the 5 to 7 times improvement? What if helmets made the safe infrastructure less achievable?
If that sounds ridiculous, consider that countries with helmet pushing cultures or laws, seem to also have low cycling rates, and refuse to invest significantly in proper networks of high-quality cycling infrastructure. Given that helmet pushing seems to discourage cycling (laws definitely do, so it's not unreasonable to think cultural pressure might also), it's actually possible there's a causative process there:
1. In response to increasing perception of danger to cyclists on the roads, various people and orgs push helmets or help reinforce a helmet culture, and so implicate cycling as being unusually dangerous.
2. Some people choose not to cycle (or let their children cycle), because it seems dangerous
3. Fewer people cycling means that:
a) motorists become less aware of how to behave around cyclists, and so the roads become a little more dangerous;
b) politicians have less reason to do anything substantive for cycling safety, so more safe infrastructure just doesn't get built, and any such infrastructure that's there doesn't get maintained. Further, the smaller cyclists become as a group, the more susceptible the politicians become to victim-blaming, cycling-reducing measures from various car and "grieving but unfortunately clueless mother" lobbies. E.g. see helmets laws in AU, NZ, etc., and the daft crack-down on cyclists in New York in the USA.
4. Go back to 1, ad infinitum.
Unfortunately, it's really hard to setup well-controlled experiments involving entire societies. However, comparing the Netherlands and the UK, I feel the above is a very plausible effect.
Helmet cultures may make it *harder* to get safe infrastructure and *real* safe cycling for the masses.
Paul, one word for your verbose post - and that is "yawn".
Now, before deciding if you are going to wear a helmet or not, next time you are doing 30mph in your car, look out of the window and ask yourself if you were going to jump out at that speed, would you rather have a little bit of head protection on or not? A 30mph crash off a bike is going to be similar, the choice is yours.
Got a book to promote, do we?
Look - you can wear a helmet or not - your choice and I'm not in favour of laws. But let's say we each get one smack at the other's head with a cricket bat. I'll have my helmet on, thanks.
Remember the MMR anti-jab 'Doctor" ? How many people's lives has he ruined?
Yes, but it's an awful lot subtler than that though isn't it? If wearing a helmet increases the chances of you getting hit in the first place, and there are studies that suggest that, then it's not as straight forward as saying "I want a helmet on if I bump my head"
For me the most compelling argument is that the countries with the lowest levels of helmet use also see the lowest levels of cyclist head injuries. That's probably largely down to the fact they have proper infrastructure, so that's what we need to concentrate on instead of endless arguements about polystyrene hats.
Wear one or don't wear one it's your choice, but, either way don't prattle on about it. Don't demonise those who don't share your point of view. And, please, save your anecdata and analogies for the pub/café because none of it proves a thing.
I've not seen any "demonising" in this thread, but "prattle" is not not a very respectful word.
I touched wheels and came off, banging my head, but luckily I was wearing a cotton cap. This anecdote is as valid as the ones above, but you can find real data at http://www.cyclehelmets.org/. if you are interested.
We use data to decide on many important questions. Drug efficacy for instance.
I hope that wearing a helmet does remain my choice, but in the countries where the rate of cyclist casualties are the highest helmets are compulsory, whereas the safest countries are those where helmets are rare.
Here is an article on the failure of voluntary helmet wearing to reduce casualties.
"Millions of parents take it as an article of faith that putting a bicycle helmet on their children, or themselves, will help keep them out of harm's way.
But new data on bicycle accidents raises questions about that. The number of head injuries has increased 10 percent since 1991, even as bicycle helmet use has risen sharply, according to figures compiled by the Consumer Product Safety Commission. But given that ridership has declined over the same period, the rate of head injuries per active cyclist has increased 51 percent just as bicycle helmets have become widespread."
http://www.nytimes.com/2001/07/29/business/a-bicycling-mystery-head-inju...
No this again...Wear or don't wear, it's a choice.
I don't really care what other people do.
Of course it is.
I don't accept this argument when one of the choices has a social cost. You get hurt or killed and society bears the cost.
FFS...Not again!
I will only day the following... If you bang your head in a helmet and walk away unscathed, the chances are that it didn't save your life.
If you spend three days in a coma and have a serious concussion, then yeah, maybe your helmet made a life and death difference.
It bugs the hell out of me when folk was lyrical about the magical life saving properties of helmets.... It's an inch of polystyrene, that's all. Yes they add protection, and that protection van make all the difference, but for lives to be at stake, you'd still be walking away with a mighty headache.
I was riding on black ice once and fell heavily on my left arm. I wasn't wearing a helmet, but I'd wrapped my entire body in several layers of bubble wrap as a precaution and this made the bruising on my arm less severe than it could have been.
Im with Ms Myles on this one so I will carry on wearing a helmet.....I fell on ice at slow speed a while ago... the helmet saved my head from hitting the road directly, so I avoided concussion at least,I think.
For me its more worrying when an emminant brain surgeon jumps a red light surely he must of seen the result of those kinds of accidents .. for me its a kind of percentage game, eventually I could get hit,(and it doesn't get car drivers so wound up, I hope)
Agreed, it sounds as if he is referring to the tiny padded leather helmets worn by the pros in the 50's and 60's. 'Eminent neuro surgeons' tend to think they are experts on everything, and he will only see the most severely injured people transferred from lesser hospitals. Views of experienced road cyclists equally valid, and the jury is still out.
Ah ha ha ha ha.... that's going to cause a ruckus. Though, next time someone tells me about how the bored nurse they once talked to said helmets save lives...
This isn't about HGVs etc...I came off my bike on black ice last winter. Bike shot right, I got whiplashed left and cracked my head on the ground. According to the neuro doc who saw me, the point of impact could have been fatal if I had not had a helmet on. Cheap little £30 helmet saved my life probably, and I was only doing 5mph! Agree the choice is yours, but for a few 100g, I will always wear one.
I'm with you on this one - I had a similar experience and while the helmet doesn't help with concussion from the impact, it does stop your skull from cracking open on the tarmac or pavement and little splinters of bone going into your brain. I think until people who are anti-helmet have an experience like this they will keep their views. Does it discourage people from cycling? Yes, some. Do I care about helmet hair? No.
There is nobody who is anti-helmet. There are people who choose not to wear one and there are people opposed to any law which might make them wear one but I have never seen anyone argue they should be banned. The only people trying to force their views on others are those arguing for them to be compulsory.
Here we go again!!
Do or Don't the choice is yours?
When I was younger, I didn't wear a helmet. I had several crashes including being run off the road into a ditch but somehow never smacked my head.
My wife eventually persuaded me to wear a helmet about 15 years ago and since then I have smacked my head off tarmac twice.
By this measure it is surely a result of me wearing a helmet that has led to these incidents?
Seriously though, while a helmet won't do much in a head on collision or prevent injury when a truck rolls over the top of you, it will help when you come off otherwise.
Recently, I crashed at just under 30mph and was unconscious for nearly 15 minutes, I had and still have have memory issues, mild aphasia, and issues with irritability and mood swings... Nearly three months later.
Had I not been wearing one...?
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