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Booze not bikes greater danger to your bonce says US medical journal

A doctor pushing for the City of Austin, Texas to adopt a law making the wearing of cycling helmets compulsory for adults is the lead author of an academic study that found that there was no significant difference in risk of head injury between cyclists wearing helmets and those without.

The study, published last month in The American Journal of Emergency Medicine, and reported on the website The Vehicular Cyclist, was led by Dr Pat Crocker, which analysed 200 cyclists involved in Central Texas, instead found that alcohol use was the leading significant contributory factor to head injuries.

All of the cyclists were treated at UMC Brackenridge's Level II Trauma Center between December 2006 and November 2007, where Dr Crocker previously worked.

Data collected from patients at their bedside included whether or not they had been drinking, helmet use, their level of experience, the type of accident, where it took place and, for road accidents, vehicle speed, and the nature and extent of head injuries.

In an article published in June 2008 on the website of the Seton Family of Hospitals, which includes UMC Brackenbridge, Dr Crocker said that the study found that cyclists who “who had been drinking or using drugs - far away more alcohol than drugs - were four times more likely to have a head injury.”

He suggested that consumption of alcohol made cyclists more prepared to take risks, claiming that “while riding the bike after consuming alcohol, only one out of 40 patients was wearing a helmet, so it appears that one of the first things that happens is that riders don't bother with helmets."

The 2008 article stated that the study had been extended for a year to allow its authors to confirm their suspicions that cyclists without helmets were twice as likely to suffer serious head injury as those with, but the study published last month was unable to reach this conclusion.

Dr Crocker is a longstanding advocate of the reintroduction of an all-ages helmet law for cyclists in the city, which is home to seven-times Tour de France winner Lance Armstrong, in 1996, but the following year it was amended to apply only to cyclists aged 17 and under. In 2006, the city considered reintroducing the all-ages requirement, with Dr Crocker a vocal supporter of such a move, but in the end it decided to leave the law as it was.

Born in Scotland, Simon moved to London aged seven and now lives in the Oxfordshire Cotswolds with his miniature schnauzer, Elodie. He fell in love with cycling one Saturday morning in 1994 while living in Italy when Milan-San Remo went past his front door. A daily cycle commuter in London back before riding to work started to boom, he's been news editor at road.cc since 2009. Handily for work, he speaks French and Italian. He doesn't get to ride his Colnago as often as he'd like, and freely admits he's much more adept at cooking than fettling with bikes.

15 comments

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dave atkinson [6223 posts] 6 years ago
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You're right - the second one should be a 'with', i've amended the article

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Simon E [2721 posts] 6 years ago
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Quote:

The 2008 article stated that the study had been extended for a year to allow its authors to confirm their suspicions that cyclists without helmets were twice as likely to suffer serious head injury as those without, but the study published last month was unable to reach this conclusion.

'Without' is used twice in this sentence but one of them must be wrong as it doesn't make sense.

Isn't research conducted by someone with an obvious bias is likely to be flawed? I don't think I could trust this doctor's findings as I think he's already drawn his conclusions and is looking for data to match his model.

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Peter Howe [1 post] 6 years ago
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Interesting article written by a doctor who is missing from is research a huge amount of data. To look at patients in a hospital only takes into account those who have been injuried. What about the people who have accidents and wear helmets and find it not neccessary to go to seek medical attendation. These people like my son and myself have had incidents where we both where saved from serious injury because we were wearing helmets.
Therefore data produced by this doctor is totally floored and misguided.
However, although I wear a helmet whilst cycling, to make it wear compulsory would stop a huge amount of people from starting cycle and gaining the health benefits which out way any major effect of not wearing a helmet. Peter Howe

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STATO [498 posts] 6 years ago
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Peter Howe wrote:

Interesting article written by a doctor who is missing from is research a huge amount of data. To look at patients in a hospital only takes into account those who have been injuried. What about the people who have accidents and wear helmets and find it not neccessary to go to seek medical attendation.

True, but i think your widening the scope a little too much. If you take into account all people who fall off and dont get a medical consultation then who is to say how injured they were?

The survey took into acount the type of accident, so if they found 2 people who had the same type of accident (one helmeted, one without) and compared injuries to see how much protection the helmet offered, then thats a fair comparison.

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creepymonkey [31 posts] 6 years ago
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Maybe this is over simplyfing it, but why can't we stick a helmet on a crash test dummy and subject it to typical cycle crash impacts and compare the readout to a similar dummy without. We know how much impact, and the sort of impact that can cause brain damage etc to the typical adult or child. Cars are safer now (for the occupants) through this sort of testing.

Or am I missing the point of this topic somehow?

FWIW, on 28th Oct last year, I was hit by a car going across a round about without looking right (where I was coming from). I went over the top of the car and landed upside down. I put out my arm to break the fall (which broke my wrist) before landing on my helmet. Yes, my arm took a chunk of the force away, but I expected landing on my head to be worse (at least to hurt a lot more than it did) but it felt fine afterwards. My bike however, was a write off  2

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dave atkinson [6223 posts] 6 years ago
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Quote:

why can't we stick a helmet on a crash test dummy and subject it to typical cycle crash impacts and compare the readout to a similar dummy without

that would certainly be a lot more useful that what we have now, which is basically low-relevance standards and conjecture. Someone would need to fund it though, and the question would be: whose interests is it in?

We already have some fairly useful large-scale data from countries that have made helmets compulsory. Helmet use shot up, obviously, so you'd expect head injuries to drop considerably over the same time frame. They don't, though: they pretty much stay the same.

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Alankk [135 posts] 6 years ago
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How do you set a "typical cycle crash"? I doubt that such a thing is possible within cost for helmet companies.

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Felix [111 posts] 6 years ago
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I fell off yesterday, nearly saved it but went over in the end. Bruised hip, slight graze, sore shoulder and gave my head a bit of a thump. Helmet now has some nasty gouges in it but my head is fine!
Now I don't know about the rest of you but I would rather have the gouges in the helmet than in my head!
Simple test would be put a helmet on and nut the road then take the helmet off and try it?
Simples  26

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DaSy [688 posts] 6 years ago
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I tripped over the other day carrying some boxes that obscured my view of an obstruction in front of me, I fell and caught the side of my head on the floor. It wasn't anything very much, but a helmet would have protected me, why do I not wear one for walking or at least when carrying stuff?

I don't doubt that a helmet would protect from bumps and scuffs in all falls, so why just wear it on the bike?

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Shiny Flu [84 posts] 6 years ago
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This is how I figure it: I don't have kids yet but I do have a partner that supports my love of riding but also wants me to stay safe, fit, healthy and able. My Family also wants me to stay safe and healthy. I don't want to end up in a wheelchair and I don't want to have to re-learn how to feed myself. I want to be able to keep riding till I'm at least in my 50's or 60's. If wearing a 250-300gramm thing on my head reduces the risk of serious brain injury- why not wear it.

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Recumbenteer [166 posts] 6 years ago
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Helmets are only of limited use!

The biggest danger to cyclists arises from large vehicles.

I knew that HGVs / LGVs were dangerous, but I had failed to appreciate the full extent of the danger that they present to cyclists and pedestrians.

Some time ago I discovered by sheer chance, just how ignorant I was of their great dangers, principally due to their large blind-spots. There is a video titled '44 tonne articulated trucks and towns don't mix'. From the road casualty figures, it is clear that I was not alone in my ignorance, but luckily I found out the easy way. It seems that too many, if not most find-out the hard way and with an HGV there is no second chance.

This film was made by Robin Webb because his daughter was killed in just this way!
http://starturl.com/crras

Please note, these lorries aren't necessarily 44 tonners. But they are more than capable of killing a cyclist.

A quote from an experienced Traffic Police Officer in the film [paraphrased]:
Quote:
Accidents between lorries and cyclists are always very similar. They almost invariably involve a lorry turning left, that hasn't seen a cyclist on their near-side. The lorry will have moved-out to allow himself room to make the turn, which creates an inviting lane for the cyclist – the advice to cyclists is don't go there... There are several mirrors but the area near the cab is very hard if not impossible to see into.., There will be a gentle impact at first with the side of the lorry, just enough to knock the cyclist onto the ground. Once on the ground, the cyclist will be too close to the ground to be caught by the side protection bars...,

Article
http://starturl.com/esvgn

Film
Part 1
http://starturl.com/plimw
Part 2
http://starturl.com/ztrff

For those who are unaware of the article or the film, please read the article and watch the the film - NOW! It just might save your life!

Please tell every cyclist you know about this! You might save theirs!

Safe cycling!

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cat1commuter [1421 posts] 6 years ago
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Helmets don't offer much protection against serious head injury. They're designed for impacts up to about 12 mph. So, yes, they are useful at protecting from bumps and grazes in the kind of accidents reported above. They will be less useful in the kind of impacts which would leave you relearning to feed yourself.

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Shaun Audane [137 posts] 6 years ago
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The helmet debate will rage on regardless of whether or not we have compulsion in the same fashion as motorcyclists the UK have since 1973.

I discovered a few years back underlined in bold on my medical notes is "Motor-cyclist". One consultant who I can only assume had a very clear dislike of this insisted that during one accident some years previously, I must've incurred scarring on the brain (despite all the evidence to the contrary-fortunately I have always been conscious and never taken a blow to the head.)

To this day, I can only assume his agenda was to remove my licences and their entitlements.

Data, despite claims to the contrary is never impartial and open to various interpretations depending on the viewpoint and focus of the individuals or groups concerned. Do the advances in car passenger safety make the roads safer or the actions of drivers more caviller?

The motor manufacturers and public alike would probably promote/agree with the initial statement, many of us will lean toward the latter. As a cyclist, motorcylist and regular driver of small cars I've noticed an increasingly disturbing "Might is right" philosophy of the road.

Driving my little Ka at the legal motorway limits, larger cars will often bear down aggressively. The same does not happen when I command a big derv estate at slower speeds along the same roads.

I have mixed feelings about HGVs. They are a real problem due to sheer size, variable driver competence and the fact successive governments have favoured road over rail transportation.By the same token, I am alive today because of the quick thought and remarkable skill of a trucker.

I personally loathe the thought of compulsion and am heartened by the findings-even if the author was arguably looking to confirm their prejudices.

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OldRidgeback [2620 posts] 6 years ago
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Skip lorries have a bad reputation, borne out by the accident statistics.

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neilwheel [130 posts] 6 years ago
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I once had my path across a junction cut off by a housewife off her teeth on valium and sherry. She didn't see me, and what she did see was probably all a bit of a '60's acid-trip-flashback to her.
I hit the cars' front wheel arch at about 15mph and went flying over the bonnet. My head broke the fall. The helmet I was wearing collapsed like a soft-boiled egg. My head didn't.
I'm in no doubt the lid saved my life that time.

That said, I love the freedom of riding without a helmet. I love the comfort of riding sans casque in the summer and the ability to regulate heat loss in the winter.

Youth tells you you're invincible and will live forever; experience tells you you've no control over the actions of others. Your best intentions cannot and will not correct the recklessness of inconsiderate drivers. So, I suppose when riding in traffic, I'll steer on the side of caution and wear a helmet, no matter how much it pees me off.

Above all, be safe.