Canadian research claims cyclists with helmets three times less likely to die from head injury
Researchers analysed coroner's records for fatalities of cyclists in Ontario
White cycle helmet
New research published in the Canadian Medical Association Journal claims that cyclists wearing a helmet are three times less likely to die from head injuries than those who are not.
The researchers say that their study supports calls for the introduction of compulsory helmet laws across Canada for all age groups.
However, concerns have been raised locally regarding the validity of the methodology employed, based on an adjusted odds ratio, which does not take account of relative risk, and which it is said may significantly exaggerate the effect of the claimed findings.
The team studied Ontario Chief Coroner’s records relating to 129 people who died in bicycle-related incidents in the province from 2006 to 2010, three in four of whom had been involved in a collision with a motor vehicle.
The other fatalities resulted from an incident involving another cyclist, a pedestrian or other object and, in 10 per cent of cases, a fall. Males accounted for 86 per cent of the victims, with ages ranging from 10 to 83.
“Helmets save lives,” insists Dr. Nav Persaud of St. Michael’s Hospital in Toronto, who led the research.
“There are about 70 cycling deaths in Canada every year, and based on our study, we estimate we could prevent about 20 of them with helmets.
“We found that 88 per cent of people who died were 18 years of age or older, which is important because the helmet legislation in Ontario currently only applies to those younger than 18 years,” he added.
While Alberta also requires only under-18s to wear a helmet, in the provinces of British Columbia, New Brunswick, Nova Scotia and Prince Edward Island, all cyclists must wear one, irrespective of age.
He acknowledged, however, that making road conditions safer for cyclists in the first place would also lead help reduce casualties.
“Helmets only prevent injuries after a collision takes place,” he explained. “It would be better to prevent the collision from taking place at all. And infrastructure changes like building separated cycle lanes prevent collisions from taking place.
“That being said, even if we had a perfect cycle infrastructure, cyclists would still interact with cars at intersections, for example, so helmets would still be important.”
Opponents of compulsory helmet legislation, including organisations in the UK such as Sustrans and the CTC, believe it should be left to the individual to choose, pointing out that in places where they have been made mandatory, the number of cyclists has reduced, and that the general health benefits of regular cycling mean it is preferable to encourage more people to ride bikes rather than enacting laws that may deter them.
The CTC also cites several research papers published that found no link between the proportion of cyclists wearing helmets and any the safety of cyclists.
In a description of the background to the research in the Canadian article’s abstract, it was claimed: “Cycling fatalities [are] a leading cause of death among young adults worldwide.”
According to a report published earlier this year in partnership with The Lancet, Unicef said that “in middle- and high-income countries, cars are the biggest killers” among young people aged 10-19.
In Great Britain, an average of 10 children under 16 years have been killed while cycling during each of the past five years.
There’s no way of knowing how many of those fatalities involved head injuries, nor how many of the children were wearing a helmet and if they weren't, whether one may have possibly helped prevent the fatality.
During the same period, four times as many child pedestrians – 42 in an average year – were killed in Britain in road traffic collisions, according to Department for Transport figures.
While Unicef cites injury as the leading cause of death for adolescents worldwide, it’s a broad category that includes “road traffic injuries; injuries such as falls, burns, poisoning and drowning; and injuries from violence, including armed violence.”
Look at the incident types. "Collision with motor vehicle" covers 77% of the fatalities, regardless of whether or not they were wearing helmets. Surely there is a better lesson to learn here than "cyclists should wear helmets"? (Regardless of your opinion on that matter - mine is that helmets could help you in certain circumstances, in others there may be better ways to reduce injury risks).
A pet flaw of mine with helmet studies: Didn't consider alcohol intoxication. Not much excuse for this flaw, as it would be recorded in the records they were using (more reliably than helmet usage). From US and NL public accident data, alcohol intoxication is present in a significant number of fatalities (forget exactly how much, I think order 30 to 40% in US case, I remember it being more in NL). My educated guess is that alcohol intoxication correlates strongly with not wearing a helmet (in which case) - which will skew the conclusion a little if not accounted for.
Another flaw: It's not a population study (these are admittedly very expensive to do, and so they're rare). It's only looking at fatalities. Everyone who had an accident, went to hospital but didn't die: excluded. Everyone who had an accident, but didn't go to hospital: excluded. Everyone who cycled but didn't have an accident: excluded. Everyone who lived longer because cycling allowed them to make exercise a normal part of their life: excluded.
Narrow data-sets run the risk of not being representative of the full population. E.g. 86% of the cases in this study were male - why are there are so few women? Are only 14% of cyclists in Toronto female? Perhaps what this study is saying is more about males and/or those who end-up in fatal accidents being bigger risk takers, than anything about helmets?
Narrow data-sets or hypotheses can lead to conclusions that are only narrowly applicable - missing important factors. Also, as the study says "Not wearing a helmet while cycling is associated with an increased risk of sustaining a fatal head injury." - association does not, per se, mean causation.
How do the dutch manage to have such good, population wide cycling safety, while pretty much never wearing helmets? Does the extremely high-rate of cycling the Netherlands have any part to play in the Netherlands having *half* the rate of obesity as the UK?
The key missing relative risk is that cyclists that tend to wear helmets also tend to cycle more, cycle more prudently, use lights & hi-viz at night, and maintain their bikes properly etc.
You can make this observation yourself quite easily; the cyclist that scuttles across the road in front of you, without looking, with no lights on a broken BSO won't be wearing a helmet. (not to say that some helmet wearing cyclists also put themselves in danger just that a lower proportion of them do).
Death isn't the only end point which should be considered when discussing the merits of wearing helmets. I would say non-fatal traumatic brain injury occurs more frequently than death and is more likely to be reduced in severity or even prevented by wearing a helmet.
Of course I'm no expert, I'm just a consultant anaesthetist with nearly 20 years experience of dealing with trauma. I've seen enough to make sure I NEVER cycle without a helmet.
Of course on the roads better separation of cars and bikes would be ideal, but wearing a helmet is one of the few things we can do something about ourselves.
When are we going to see research finding that not driving into cyclists is the key to reducing cyclists' head injuries?
Death isn't the only end point which should be considered when discussing the merits of wearing helmets. I would say non-fatal traumatic brain injury occurs more frequently than death and is more likely to be reduced in severity or even prevented by wearing a helmet.Of course I'm no expert, I'm just a consultant anaesthetist with nearly 20 years experience of dealing with trauma. I've seen enough to make sure I NEVER cycle without a helmet.
Of course on the roads better separation of cars and bikes would be ideal, but wearing a helmet is one of the few things we can do something about ourselves.
I am curious if you cycle wearing leg and arm protection, since as someone being involved in the medical profession I'm certain the majority of cycling injuries you'll encounter will be to the limbs. Perhaps all cyclists should adopt the protection used by downhill MTB racers and BMX racers and use body armour, knee/shin guards and a full face motocross type helmet. Those flimsy shell type helmets road cyclists wear are useless anyway.
OldRidgeback
Gasman Jim: No offence, but you are professionally biased. Like a policeman who believes nearly all people are dodgy scum, because their job constantly has them in contact with those kinds of people, and rarely with good people. Your job constantly brings you into contact with victims of trauma - and likely more severe trauma, for those being wheeled into your OR.
Agree though it is also important to look at non-fatal trauma, simply for statistical reasons, if nothing else.
It is also important to include the general cycling population, including the minor and non-accident-having cyclists, for the same statistical reasons. Unfortunately, hospital-record studies (the most common) can not do this.
Why does every study like this seem to bring all the helmet refuseniks out of the woodwork? What is it about the prospect of wearing a lid that they find so odious? It's not like they're even that expensive.
Surely, even if the science is not 100 per cent clear, it's worth hedging one's bets? Surely it doesn't take a rocket scientist to work out that smacking one's head against the road/car bonnet/random object is going to be more painful without a big wedge of styrofoam in between? I'm all for freedom of choice but honestly...
Before I got into cycling, I used to do a bit of rock climbing. Exactly the same fierce debate about helmets happened amongst climbers. And again, those who opposed them were generally the same people who were eventually killed or seriously injured by falling rocks. I guess ultimately you can lead the horse to water...
Death isn't the only end point which should be considered when discussing the merits of wearing helmets. I would say non-fatal traumatic brain injury occurs more frequently than death and is more likely to be reduced in severity or even prevented by wearing a helmet.Of course I'm no expert, I'm just a consultant anaesthetist with nearly 20 years experience of dealing with trauma. I've seen enough to make sure I NEVER cycle without a helmet.
Of course on the roads better separation of cars and bikes would be ideal, but wearing a helmet is one of the few things we can do something about ourselves.
Just curious, like, but does this mean you also wear a helmet when travelling in a car or when you are crossing the road as a pedestrian? Have you also seen injuries which were potentially caused by helmets?
I'm not saying I doubt your expertise, but I'm not sure your reasoning stands up to scrutiny. I'm happy to be convinced otherwise.
In all the helmet debate, I have still, yet, to come across a person who has come off their bike, landed on their spam and who says they were lucky to not have been wearing a helmet... 
Tripod16
What is it about the prospect of wearing a lid that they find so odious?
Why do helmet evangelists always use jokey terms like "lid"? Don't they want adult discussion? But I digress:
Surely, even if the science is not 100 per cent clear, it's worth hedging one's bets?
Apart from the science being considerably less than 100% clear - it is suggested by some that helmet-wearing not only discourages the healthy activity of cycling, but even makes cycling injuries worse in some cases - sure, it may be worth hedging your bets. Just don't make helmet-wearing compulsory, which is what will happen if hordes of cyclists start wearing helmets for no good reason.
Before I got into cycling, I used to do a bit of rock climbing. Exactly the same fierce debate about helmets happened amongst climbers. And again, those who opposed them were generally the same people who were eventually killed or seriously injured by falling rocks. I guess ultimately you can lead the horse to water...
Rock climbing is obviously risky. Cycling isn't.
Why does every study like this seem to bring all the helmet refuseniks out of the woodwork? What is it about the prospect of wearing a lid that they find so odious? It's not like they're even that expensive.Surely, even if the science is not 100 per cent clear, it's worth hedging one's bets? Surely it doesn't take a rocket scientist to work out that smacking one's head against the road/car bonnet/random object is going to be more painful without a big wedge of styrofoam in between? I'm all for freedom of choice but honestly...
Before I got into cycling, I used to do a bit of rock climbing. Exactly the same fierce debate about helmets happened amongst climbers. And again, those who opposed them were generally the same people who were eventually killed or seriously injured by falling rocks. I guess ultimately you can lead the horse to water...
Most shell type cycle helmets are useless flimsy things. You might as well wear a paper plate on your head tied on with a bit of string as the protection offered isn't as different as you might think. Unless you wear a proper competition type full face cycle helmet or at least a skate type lid, then safety is marginal. A shell type helmet is more for decoration than protection.
OldRidgeback
As a medical professional I am sure you know that Cycle helmets are specified by their manufacturers as meeting one or more of the international standards for this equipment. All of the standards test the helmet's protection of only a decapitated headform, (i.e. one with no body attached); and all tests involve only low speed impacts. Impact speeds are less than 6.6 m/s (24 km/h or 15 mph), and in some cases, barely 5 m/s (18 km/h or 11 mph). Unlike seatbelt tests, helmet test standards do not realistically replicate serious crashes.
My injuries for Mountain Biking were a broken wrist, compressed spine and rotator cuff injury. I wore a helmet at all times. I was traveling a lot faster than 11mph and my helmet was not SNELL certified.
As such I can conclude the following. The helmet did not prevent the injuries I sustained.
In all the helmet debate, I have still, yet, to come across a person who has come off their bike, landed on their spam and who says they were lucky to not have been wearing a helmet...
A few years ago, I was riding along a lane in Essex quite fast (about 25mph) when I hit a tree root under the Tarmac which knocked the bars out of my hands.
I parted company from the bike and slid about 50 yards along the road on my head (without helmet) and shoulder.
The only injury was loss of skin, unlike a previous occasion when I'd come off at low speed after hitting a kerb while wearing a helmet. I slid on my helmet a few feet. This resulted in a painfully stiff neck for a week.
Why does every study like this seem to bring all the helmet refuseniks out of the woodwork? What is it about the prospect of wearing a lid that they find so odious? It's not like they're even that expensive.Surely, even if the science is not 100 per cent clear, it's worth hedging one's bets? Surely it doesn't take a rocket scientist to work out that smacking one's head against the road/car bonnet/random object is going to be more painful without a big wedge of styrofoam in between? I'm all for freedom of choice but honestly...
Before I got into cycling, I used to do a bit of rock climbing. Exactly the same fierce debate about helmets happened amongst climbers. And again, those who opposed them were generally the same people who were eventually killed or seriously injured by falling rocks. I guess ultimately you can lead the horse to water...
I certainly don't consider myself a refusenik. What does bother me is the lack of evidence, or the dismissal of anyone daring to question the (potential) failings of helmets. Comparison with rock climbing is spurious; clearly a lump of rock landing on your head is going to hurt/damage and it's likely that you'll not be able to react in any way. i.e. you won't know it's coming. If coming off a bike, it's likely that you'll try to compensate and having something which (effectively) makes your head larger can cause problems. If you doubt this, try wearing a hard hat (like builders have to wear) in a confined space and not banging your head.
I think the whole black and white argument is unhelpful. We need to be given the facts (pros and cons) in order to allow us to make an informed choice.
As it happens, I choose to race so I choose to wear a helmet to comply with racing requirements. I could choose not to, but I'd feel happier if proper empirical evidence were provided. This is unlikely as it's impossible to precisely compare/replicate accidents with and without helmets.
If you've not already seen it, here's my kind of reasoning:
http://fiftyyearsandcounting.wordpress.com/2012/08/09/speed-kills/
Rock climbing is obviously risky. Cycling isn't.
Really johnS ? Maybe you should try my 10 mile daily commute. I gladly wear a helmet...
Rock climbing is obviously risky. Cycling isn't.
Really johnS ? Maybe you should try my 10 mile daily commute. I gladly wear a helmet...
So I take it you fall off on a regular basis during your commute? Maybe you are the problem?
If you climb higher than the height of a person sitting on a bicycle a fall is going to do you more danger than a fall from a bike.
If you are hit by a car whilst cycling I am yet to see proof that a helmet prevents, leg, arm, spinal facial or and body injuries.
The core objective should remain to increase cycling as a form of transportation across the board. Helmet laws do not help towards that objective.
Francois.L
Frankly I think people choosing not to wear a helmet is up there with smoking as a brilliant example of Darwinism. You pays your money and you makes your choice, ultimately. Who am I to argue?
Every time someone presents a topic about helmet use it ends up with numerous comments neither proving or disproving the benefit of helmet use, and in the end i dont think there ever will be conclusive proof either way.
Personally if a helmet stops me from hurting my head i will wear one. They dont look cool and some are not cheap if you want the lighter versions. I wear a Giro Atmos cos i do a lot of cycling and the weight is important to me after seperating 3 vertabrae in my neck through rugby
As for people stating the obvious "my helmet didnt stop me from breaking my leg" can i just say (IMHO) you sound very silly, of course it didnt, just like my helmet didnt stop me from cutting my finger when i peeled some spuds.
In the end it should remain as a PERSONAL CHOICE and if you do land on your head without a lid on (i do like the word lid) tough and i hope it bloody hurts.
Stumpy
Frankly I think people choosing not to wear a helmet is up there with smoking as a brilliant example of Darwinism. You pays your money and you makes your choice, ultimately. Who am I to argue?
How so Darwinism? Isn't there irrefutable evidence that smoking is harmful? Where is the irrefutable evidence about wearing a helmet? Isn't this comparing the proverbial apples with pears?
I worked for the Royal Mail for a while. They told me I had to wear a helmet. When I asked about the downsides they were unable to respond. This is my point; there is a default position that helmets will 'save your life' or 'will save you from serious (head) injury'. This is patently not true.
Trust me. I'm genuinely interested and would welcome someone pointing me to the evidence while also pointing me to the evidence of the potential dangers.
Every time someone presents a topic about helmet use it ends up with numerous comments neither proving or disproving the benefit of helmet use, and in the end i dont think there ever will be conclusive proof either way.Personally if a helmet stops me from hurting my head i will wear one. They dont look cool and some are not cheap if you want the lighter versions. I wear a Giro Atmos cos i do a lot of cycling and the weight is important to me after seperating 3 vertabrae in my neck through rugby
As for people stating the obvious "my helmet didnt stop me from breaking my leg" can i just say (IMHO) you sound very silly, of course it didnt, just like my helmet didnt stop me from cutting my finger when i peeled some spuds.
In the end it should remain as a PERSONAL CHOICE and if you do land on your head without a lid on (i do like the word lid) tough and i hope it bloody hurts.
And what if you are wearing a helmet and it causes you to break your neck? I wouldn't wish that on you or anyone and I wouldn't wish you to suffer any pain. i.e. it may save you from injury; it may cause you injury; it will probably make no difference at all.
deleted.
Stumpy
Tripod16 wrote:In all the helmet debate, I have still, yet, to come across a person who has come off their bike, landed on their spam and who says they were lucky to not have been wearing a helmet...A few years ago, I was riding along a lane in Essex quite fast (about 25mph) when I hit a tree root under the Tarmac which knocked the bars out of my hands.
I parted company from the bike and slid about 50 yards along the road on my head (without helmet) and shoulder.
The only injury was loss of skin, unlike a previous occasion when I'd come off at low speed after hitting a kerb while wearing a helmet. I slid on my helmet a few feet. This resulted in a painfully stiff neck for a week.
Whilst its not pleasant to hurt oneself the fact you hurt your neck whilst wearing a helmet may or may not have had anything to do with it. Your neck is very delicate and any sudden movements regardless of speed can aggravate it, hence the whiplash injuries even at low speed. This can be caused by the neck being at an unusual angle causing the muscles / tendons / ligaments to spasm causing the pain and stiffness.
Now i'm not saying the helmet was not responsible just that your injury can be easily caused with or without the wearing of a helmet.
Stumpy
stumps wrote:Every time someone presents a topic about helmet use it ends up with numerous comments neither proving or disproving the benefit of helmet use, and in the end i dont think there ever will be conclusive proof either way.Personally if a helmet stops me from hurting my head i will wear one. They dont look cool and some are not cheap if you want the lighter versions. I wear a Giro Atmos cos i do a lot of cycling and the weight is important to me after seperating 3 vertabrae in my neck through rugby
As for people stating the obvious "my helmet didnt stop me from breaking my leg" can i just say (IMHO) you sound very silly, of course it didnt, just like my helmet didnt stop me from cutting my finger when i peeled some spuds.
In the end it should remain as a PERSONAL CHOICE and if you do land on your head without a lid on (i do like the word lid) tough and i hope it bloody hurts.
And what if you are wearing a helmet and it causes you to break your neck? I wouldn't wish that on you or anyone and I wouldn't wish you to suffer any pain. i.e. it may save you from injury; it may cause you injury; it will probably make no difference at all.
You see this is what i mean. The "what if" terminollogy should not come into a reasoned discussion. We cant live our lives with the "what if" question.
It should remain as personal choice and not forced onto us without extensive and thorough independant examination of all the facts. I will continue to wear one regardless as i personally believe it will prevent certain injuries.
Stumpy
stevebull-01 wrote:
Rock climbing is obviously risky. Cycling isn't.
Really johnS ? Maybe you should try my 10 mile daily commute. I gladly wear a helmet...
So I take it you fall off on a regular basis during your commute? Maybe you are the problem?
If you climb higher than the height of a person sitting on a bicycle a fall is going to do you more danger than a fall from a bike.
You do realise that rock climbers use ropes and protection (nuts, cams, slings) to limit their chance of falling far? In fact, if seconding you probbaly wouldn;t even fall as far as falling off a bike.
Whereas coming off a bike onto the road at 20 odd mph hurts like hell. I have been more badly injured cycling than climbing.
Having said all that, how much help is an inch of polystyren going to be in a 20 mph crash?
Now i'm not saying the helmet was not responsible just that your injury can be easily caused with or without the wearing of a helmet.
If I hadn't been wearing a helmet, my head would have slid rather than being yanked round. Wearing a helmet made the crash worse.
stevebull-01 wrote:Rock climbing is obviously risky. Cycling isn't.
Really johnS ? Maybe you should try my 10 mile daily commute. I gladly wear a helmet...So I take it you fall off on a regular basis during your commute? Maybe you are the problem?
If you climb higher than the height of a person sitting on a bicycle a fall is going to do you more danger than a fall from a bike.
If you are hit by a car whilst cycling I am yet to see proof that a helmet prevents, leg, arm, spinal facial or and body injuries.
I think we're at cross-purposes. I crashed about four times during 30 years of commuting 35km a day (that's more than 200,000km), never with serious injury, never wearing a helmet. As I said, cycling isn't obviously risky. And is a lot less risky than rock-climbing.
My grey matter, matters! I agree with Gasman Jim - Your brain floats inside a bone skull at the end of the day. Head trauma or Fatality should be enough to make you protect.
I've slung my bike down the road a few times and each time my lid has taken the road rash and [thankfully] what little impact my bonce received.
Ultimately though, you pay your money and take your choice I suppose.
The core objective should remain to increase cycling as a form of transportation across the board. Helmet laws do not help towards that objective.
Spot on. This is just the latest distraction from what really should be being debated/ funded/ implemented.
stumps wrote:Now i'm not saying the helmet was not responsible just that your injury can be easily caused with or without the wearing of a helmet.
If I hadn't been wearing a helmet, my head would have slid rather than being yanked round. Wearing a helmet made the crash worse.
No probs mate i accept what you say. Having bust my neck i know how sore they get 
Stumpy
The advantage of the paper plate protective headgear also is that it is biodegradable, unlike the shell type helmet which requires expanded polystyrene and is not nonly non-biodegrable, but also results in the release of atmosphere damaging gases.
OldRidgeback
Francois wrote:The core objective should remain to increase cycling as a form of transportation across the board. Helmet laws do not help towards that objective.Spot on. This is just the latest distraction from what really should be being debated/ funded/ implemented.
Totally agree there. Unfortunately we, as cyclists, offer very little to the purses of Govt. Until that changes, which i have no doubt the current govt will try, and we have to pay to use the roads we have little say, or should i say, have very little amount people willing to listen to our concerns 
Stumpy
The Canadian Medical Association Journal is currently ranked 11th amongst medical journals. I doubt any other journal would publish this because of it's flawed methodology. Maybe they should have employed a statistician to look at their findings before Dr. Nav Persaud started pontificating, what's referred to in medical terms as, bollocks.
...
Alex: I like their limitations section. The only limitations they consider are those they think might cause the "helmets associated with fewer head deaths" risk to be under-estimated. No consideration at all of any factors that might cause their study to over-state the association - such as their very narrow data-set, focused on the worst accidents, such as other factors that might correlate with fatalities and helmet use (people who are naturally inclined to take more risks, intoxication, etc).
Being very focused and selective with data is a classic way to introduce bias into statistical results (unwittingly or through deliberate manipulation).
Addendum: the authors of the study appear to be medical doctors, a sociologist, and one other person with a BA in something I havn't uncovered - but their professional background doesn't suggest it was in anything math or stats related. The statistical analysis in this study is extremely basic - simple stuff taught in A-levels / undergrad introductory statistics classes. That's not to say it's invalid, but I wonder if part of the reason they didn't do a more sophisticated, multi-variate analysis (e.g. pathology records they used would surely have toxicology details) is simply that none of the authors had the required skills in statistics.
Well put Paul.
Obviously it would be better if we based our scientific knowledge on 'anecdotal evidence', then we could enjoy reading medical journals that started their studies by saying "I met a bloke down the pub and he told me that wearing a wet fish on his head saved his life..."
...
The key missing relative risk is that cyclists that tend to wear helmets also tend to cycle more, cycle more prudently, use lights & hi-viz at night, and maintain their bikes properly etc.
I'm not sure I agree. Plenty of people wear helmets while riding inappropriately or in an unsafe manner. Even some MAMILs with all the gear ride like dicks. Have you not heard of risk compensation?
http://waronthemotorist.wordpress.com/2011/07/25/risk-compensation-and-b...
Of course I'm no expert, I'm just a consultant anaesthetist with nearly 20 years experience of dealing with trauma.
It's OK, I can tell you're no expert on cycle helmets.
How does putting patients to sleep mean you to know more than the rest of us about the effectiveness of cycle helmets? Did you interview the patients and/or police forensic teams about the incident as well? Did you then inspect a significant sample of post-impact helmets? One could argue your conclusion is an emotional one due to what you've encountered rather than it be a decision based on the science. What about all the cyclists etc that have fallen yet not required surgery and quizzed them about whether they were wearing a helmet at the time?
Why does every study like this seem to bring all the helmet refuseniks out of the woodwork?
Because it prompts all the blindly faithful evangelists to cry "You really should wear a helmet!" as if it's some kind of magic answer.
Before I got into cycling, I used to do a bit of rock climbing. Exactly the same fierce debate about helmets happened amongst climbers. And again, those who opposed them were generally the same people who were eventually killed or seriously injured by falling rocks.
Are you really suggesting that every bare-headed cyclist will inevitably die from a blow to the head while out riding? There are weirdo religious groups desperate for idiots like you to help them spread their message.
Most of us arguing against you are not refuseniks. I wear one most of the time now, even in bed (you can't be too careful, you know). Lots of people have cycled for many years without one so don't see it as an essential survival aid. More important is the risk of creeping compulsion. Helmet compulsion has shown to be counterproductive and damaging to the health of the population as a whole. You don't have to be a brain surgeon, anaesthetist, lawyer or rock climber to work that one out.
After reading some of the comments placed on the forum on this discussion and other helmet discussions i think i might change my stance towards the wearing of a helmet. I've said, even on this current discussion, it's the individuals choice.
However i now think it should be made law. Not because there is all of a sudden some magical evidence to say its right, just so that all the plonkers who come on here and belittle those who do think its a good idea without offering any other form of discussion, will have to wear one. God that would be a good sight 
Mind you there are those on the site who give very good and well thought out arguements against wearing them and i do not mean to say you are a plonker, far from it, but i guess everyone knows who i mean 
Stumpy
The issue here is not whether helmets make you safer but one of being compelled to wear one. I should have the right to choose to take the risk not to wear one, in the same way I can choose to take the risk of crossing a road at a non-designated crossing point. It is highly unlikely that I will damage anyone other than myself by not wearing a helmet, there is the issue of potentially costing more to fix/look after me in terms of medical costs if I suffer a head injury whilst cycling without one but that argument can be endlessly extended to include people who drink too much, eat too much, drive to fast etc. By all means lets have more studies into the risks so that we can all make more informed decisions about when we choose to wear or not wear a helmet but if the study recommends compulsory helmet wearing it should be clear who they think needs protecting or what money they are trying to save for whom.
Trackal: Do you believe that you should also have the right not to wear a helmet whilst riding a motorbike or a seatbelt whilst driving or riding in a car?
Trackal: Do you believe that you should also have the right not to wear a helmet whilst riding a motorbike or a seatbelt whilst driving or riding in a car?
I'm all for wearing a helmet but even i have to admit its nothing compared to the wearing of a lid for a motorbike or a seat belt in a car.
Stumpy
In the UK, smoking kills literally thousands of people a year, obesity and lack of exercise again probably thousands and alcohol again thousands. Last year cycling deaths were 116. We don't know the injuries or helmet situation in these fatalities so lets pretend that none of the cyclists were wearing helmets. According to the Canadian study, about 30% would be saved by wearing a hat. So that's 30 - 35 people a year. Sorry guys, any government that fails to address smoking, drinking and obesity but concentrates on a few (albeit tragic) cycling fatalities is deliberately missing the big picture. Cyclists are an easy target for well meaning do gooders who think victim blaming is the way to promote a healthy activity.
Interesting comment above "rock climbing is dangerous, cycling isn't". When you are riding uphill in the Pyrenees you will discover that they are eroding and that large chunks regularly fall onto the road. Personally I wouldn't be a pedestrian high up there without a helmet. Something to think about during your next Etape or Marmotte when you feel like taking your helmet off on the hills. It may indeed be a rare occurence for a rock to hit you, but in the words of Dirty Harry "do you feel lucky, punk?"
(the rate of erosion of the Pyrenees flies in the face of a theory of an old earth - but that's a story for another time).
If cycling is indeed a sport of self-abuse why aren't more cyclists sectioned under the mental health act?
Trackal: Do you believe that you should also have the right not to wear a helmet whilst riding a motorbike or a seatbelt whilst driving or riding in a car?
Yes. There is a junction on my regular commute where it is dangerous to wear a seatbelt because it prevents my leaning forward and craning to see round/over a wall and tell if someone is coming before I pull out. (The belt always locks solid as I brake before the Give Way sign.) So I take the belt off. By doing so I am endangering no-one other than myself; if I fail to, I potentially put others at greater risk too.
Being permitted to drive half a ton of potentially lethal metal around in public places carries with it an awesome responsibility, which I always take seriously. As the 'captain' of my vessel, the safety of others rests in my hands, not the government's, I and resent that I might be fined for putting others before myself. (Though in this case, mine and others' interests coincide because it is better to avoid a collision in the first place.) But I wear a belt at other times and refasten it as soon as it is safe to.
I don't ride a motorbike so am not really qualified to answer, but I would wear a helmet if I did.
- The risks are greater because of the bike's speed compared to a cycle
- Motorbike helmets are more effective than cycle ones
- We do have a responsibility, all things being equal, to avoid making ourselves a burden on society unnecessarily
- You don't get all hot and sweaty from pedalling like you do on a cycle.
Whether that lot adds up to an argument for compulsion is another matter.
Interesting comment above "rock climbing is dangerous, cycling isn't". When you are riding uphill in the Pyrenees you will discover that they are eroding and that large chunks regularly fall onto the road.
Do tell me you're joking. And by the way, the valleys into the Vercors are more prone to rockfalls than those in the Pyrenees, to the extent that my favourite routes are closed for road works every summer in alternate years; and I don't wear a helmet when riding uphill in heat.
I have only banged my head once in over 200,000 miles - on a jay-walking pedestrian in Battersea High Street. I bought a helmet recently though (Giro Savant, very comfy) just because of the ignorant pronouncements of coroners. I want maximum compensation for my children when I'm killed.
The Helmet Debate enters it's 5th year... I'm not getting involved this time.
MercuryOne
The Helmet Debate enters it's 5th year... I'm not getting involved this time.
I thought the same then bingo a dozen entries later
Stumpy
Phew, I'm glad I read this. Now I know how dangerous it is to wear my helmet. Thanks, guys.
Strange lot ! Ok my experience ? I got taken out at 30 mph (it was down a slight hill) basically they went to overtake me and then pulled in trapping me between a park car and theirs. Result straight over the bars and down the road for about 50 m or so. Helmet split in half. Got whiplash left to right as I hit the road on my side. Lost a large amount of skin from ankle, knee and hip. Jacket protected up half. After 3 days could not walk - ribs at the back had been pushed of the spine 3 months before I could cycle .
Conclusion ? I always wear a helmet ! But I firmly believe that you should be allowed to decide for your self
And before you ask the driver ? That stoped and waited for the police / ambulance etc .
BUT they did not take any further actions ! Despite over 10 witness validating my story
Maybe crying and saying sorry lots of time works!
After reading some of the comments placed on the forum on this discussion and other helmet discussions i think i might change my stance towards the wearing of a helmet. I've said, even on this current discussion, it's the individuals choice.However i now think it should be made law. Not because there is all of a sudden some magical evidence to say its right, just so that all the plonkers who come on here and belittle those who do think its a good idea without offering any other form of discussion, will have to wear one. God that would be a good sight
Mind you there are those on the site who give very good and well thought out arguements against wearing them and i do not mean to say you are a plonker, far from it, but i guess everyone knows who i mean
Ok, here's a good reasoned argument against compulsory wearing of helmets by cyclists. The vast majority of cycle helmets offer so little impact protection as to be next to useless. They offer such low levels of protection and are tested to such laughably low standards as to be an utter waste of time. That's why I made the sarcastic comment about the paper plate. Many people seem to think they're protecting themselves with a cycle helmet when they're riding, but they're not because it doesn't.
Yes, we've seen a few stories about how people fell off their bikes, slid down the road and the cycle helmets prevented head injury. But to be really scientific, each person would have to repeat the incident exactly as before but without a helmet.
I wear a motorbike helmet when I'm riding my motorbike because it's the law. But it also makes sense as the motorbike helmet does offer impact protection and as my motorbike travels faster than a bicycle. Car seatbelts are required by law and also offer protection.
The health benefits of cycling outweight the risks by a factor of 20:1. And as another post made quite clear, the government would do a lot better if it addressed the completely preventable damage caused by smoking and obesity on which the country wastes fantastically large amounts of money every year.
And in any case, it would be far far more effective to reduce the danger at source and tackle what causes most cycle accidents, bad driving on behalf of other road users. I've cycled in London and Amsterdam a lot over the years and I know which is safer and where very few people bother with helmets.
OldRidgeback
if you don't wear a helmet you are a moron ... fact
stumps wrote:After reading some of the comments placed on the forum on this discussion and other helmet discussions i think i might change my stance towards the wearing of a helmet. I've said, even on this current discussion, it's the individuals choice.However i now think it should be made law. Not because there is all of a sudden some magical evidence to say its right, just so that all the plonkers who come on here and belittle those who do think its a good idea without offering any other form of discussion, will have to wear one. God that would be a good sight
Mind you there are those on the site who give very good and well thought out arguements against wearing them and i do not mean to say you are a plonker, far from it, but i guess everyone knows who i mean
Ok, here's a good reasoned argument against compulsory wearing of helmets by cyclists. The vast majority of cycle helmets offer so little impact protection as to be next to useless. They offer such low levels of protection and are tested to such laughably low standards as to be an utter waste of time. That's why I made the sarcastic comment about the paper plate. Many people seem to think they're protecting themselves with a cycle helmet when they're riding, but they're not because it doesn't.
Yes, we've seen a few stories about how people fell off their bikes, slid down the road and the cycle helmets prevented head injury. But to be really scientific, each person would have to repeat the incident exactly as before but without a helmet.
I wear a motorbike helmet when I'm riding my motorbike because it's the law. But it also makes sense as the motorbike helmet does offer impact protection and as my motorbike travels faster than a bicycle. Car seatbelts are required by law and also offer protection.
The health benefits of cycling outweight the risks by a factor of 20:1. And as another post made quite clear, the government would do a lot better if it addressed the completely preventable damage caused by smoking and obesity on which the country wastes fantastically large amounts of money every year.
And in any case, it would be far far more effective to reduce the danger at source and tackle what causes most cycle accidents, bad driving on behalf of other road users. I've cycled in London and Amsterdam a lot over the years and I know which is safer and where very few people bother with helmets.
Mate, i wasn't having a pop at you, far from it, you always put reasoned points over whatever subject we talk about. Its the ones who make snide comments but cant offer anything in reply that annoy me
Stumpy
One of our club members was squeezed/hit by a car in the last fortnight. Apart from being "officially" critically injured including badly broken ribs and punctured lungs, his helmet saved his life. When paramedics undid the straps it split into 2. He and his wife are most grateful he had it on. The other injuries will heal eventually. If it wasn't for helmet then they probably wouldn't have mattered....
I crashed on the Ballbuster Duathlon in March hitting my head on the road so hard my helmet cracked and was caved in when I examined it at the end of the race. I'd never ride without a helmet ever again.
The core objective should remain to increase cycling as a form of transportation across the board. Helmet laws do not help towards that objective.
If we believe the 'Wiggo effect' then most people who have taken up cycling recently will have done so after seeing riders in the TdF and Olympics all of whom wore helmets.
People copy the leading figures in their sport, so it's unlikely that wearing a helmet will be a deterrent.
“That being said, even if we had a perfect cycle infrastructure, cyclists would still interact with cars at intersections, for example, so helmets would still be important.” Dr. Nav Persaud, one of the authors of this report.
This quote demonstrates quite clearly that the researchers know absolutely nothing about cycle helmets, road safety or anything really. Cycle helmets are pretty ineffective even in single vehicle accidents, where the cyclist just falls off, but they are utterly, utterly useless in collisions with motor vehicles, and the manufacturers always warn that they are not effective in those circumstances. Anyone who says that they are useful in collisions with motor vehicles is clearly misinformed to the point of ignorance, and demonstrates a very considerable degree of bias. Given that this is exactly what the good doctor did, I wouldn't trust his research farther than I could see in a pitch black cellar.
As others have pointed out, the methods used to produce this result are suspect, and any conclusions drawn are not robust. All long term, large scale, reliable research shows at best no benefit from helmet wearing, and at worst an increase in risk. Check out cyclehelmets.org for research a little more reliable than this hashed up nonsense. Who trained these researchers? Thompson, Rivara and Thompson?
burtthebike
burtthebike
if you don't wear a helmet you are a moron ... fact
Were you wearing a helmet when you wrote that?
burtthebike
burtthebike - you are asking for trouble mate when you make a sweeping statement like "they are utterly utterly useless in collisions with motor vehicles".
There will be numerous people on the site who can recount instances when it has helped them in a collision. I for one attended an RTC when the helmet did prevent quite a nasty injury to a colleague but thats irrelevant at the mo.
Stumpy
One of our club members was squeezed/hit by a car in the last fortnight. Apart from being "officially" critically injured including badly broken ribs and punctured lungs, his helmet saved his life. When paramedics undid the straps it split into 2. He and his wife are most grateful he had it on. The other injuries will heal eventually. If it wasn't for helmet then they probably wouldn't have mattered....
And:
"I crashed on the Ballbuster Duathlon in March hitting my head on the road so hard my helmet cracked and was caved in when I examined it at the end of the race. I'd never ride without a helmet ever again."
This is not proof that helmets are effective, it is opinion, unverified and unverifiable. It is anecdote and is as scientifically valid as claiming that smoking doesn't harm anyone because your grandad lived to 98 and he smoked twenty fags a day. All reliable evidence shows that cycle helmets are not effective at improving the safety of cyclists, and that smoking kills people. There are thousands of "helmet saved my life" stories and if even ten percent of them were true, there would be a marked effect at a population level, but there is no such effect. So either the stories are not correct, or just as many people are killed by their helmets as are saved by them, but the people killed by them don't tell the rest of us that that was what killed them, unlike the people who think they were saved.
It is a very common misconception that a helmet has been effective at preventing death or injury when actually it has failed catastrophically and has provided little if any protection. This is especially true if they have split or cracked, which takes little energy and demonstrates complete failure to work as intended.
burtthebike
I don't wear a helmet when riding uphill in heat.
YOU WILL SURELY DIE!!!
@hairyairey - do people driving open-top cars in the Pyrenees wear a helmet? And what about the vast majority of us who aren't in the Pyrenees? Should we fear rockfalls too?
if you don't wear a helmet you are a moron ... fact
So the Dutch Prime Minister is a moron then? http://www.telegraph.co.uk/finance/debt-crisis-live/9220235/Debt-crisis-...
All politicians are morons, even the ones I vote for.
JohnS wrote:I don't wear a helmet when riding uphill in heat.YOU WILL SURELY DIE!!!
if you don't wear a helmet you are a moron ... fact
Since the main purpose of a cycle helmet is to assuage the guilt of the motorist who runs you down, I think you may be wrong.
I always wear a helmet since coming off without one and gashing my head open. I think it was Chris Boardman though who suggested the best way to improve road safety was to ban seatbelts and have a large sharp spike protruding from the steering wheel of all cars to within a couple of inches of the drivers heart, would focus the mind on driving carefully I suppose !
High vis is more important than helmets (maybe). I don't think some people realise just how much difference it can make, I was out early in the car on Sunday and didn't see the guy dressed all in black (really ?) on a slightly foggy morning with low winter sun casting long shadows. Fortunately I drive slowly and look out for such things, but the fact is this guy was asking for a SMIDSY episode
This is not proof that helmets are effective, it is opinion, unverified and unverifiable. It is anecdote and is as scientifically valid as claiming that smoking doesn't harm anyone because your grandad lived to 98 and he smoked twenty fags a day. All reliable evidence shows that cycle helmets are not effective at improving the safety of cyclists, and that smoking kills people. There are thousands of "helmet saved my life" stories and if even ten percent of them were true, there would be a marked effect at a population level, but there is no such effect. So either the stories are not correct, or just as many people are killed by their helmets as are saved by them, but the people killed by them don't tell the rest of us that that was what killed them, unlike the people who think they were saved.It is a very common misconception that a helmet has been effective at preventing death or injury when actually it has failed catastrophically and has provided little if any protection. This is especially true if they have split or cracked, which takes little energy and demonstrates complete failure to work as intended.
Precisely the point I have been trying to make. Why is it so difficult for people to grasp this aspect of the debate?
Anyway, my concern is primarily road safety and the (re)education of drivers. If just 10% of the energy spent on the helmet debate amongst cyclists was directed towards getting drivers to give us all more room and respect, maybe we'd start to see some progress.
Actually, angelfishsolo, I've never fell off my bike. The point I was making is that cycling is risky. Of course wearing a helmet isn't going to necessarily stop serious or fatal injury, but as part of being safe on the bike surely it helps
if you don't wear a helmet you are a moron ... fact
I am a great admirer of brevity. A concisely, clearly made argument is something to aspire to.
However, you have simply exposed yourself as an ignorant jerk. You'll be telling me next that Armstrong raced clean, is a lovely guy and it's all a conspiracy.
Expert opinion, anecdotal evidence and common sense all suggest I'm safer with a helmet. But if some of you want to put your heads on the line to prove me wrong, I'm grateful.
Maybe a few martyrs will persuade Governments to invest in better cycling infrastructure rather than spoiling our fun. And those lard-asses for whom a helmet is the only barrier to a healthy life style will thank you too.
Please stop this nonsense and look at the Netherlands and Denmark
Thank you
@ontheroad - what a gloriously self-righteously smug person you are. Martyrdom, whatever the cause, would be too exalted an end for you.
My Dad cycled for 30 years or so to and from work not wearing a helmet and never once suffered a serious head injury. I, on the other hand never ride without my helmet on. I guess I'm trying to say it's personal choice, there seem to be arguments both for and against helmets. We're all cyclists here though and all on the same side, I hope, so maybe the it's time to stop with the insults....
I'm neutral in this debate, but I'm struggling to understand what harm can be caused by wearing a helmet.
I'm old enough to remember the fuss when wearing seat belts was made compulsory, lots of stories about people being trapped in burning cars and unable to unfasten their belts etc. Some of the arguments on here seem similar.
I also don't understand why anecdotes from people who have fallen on their heads and report serious damage to their helmets are dismissed. Is it that the helmetless head would not have been damaged and a bare head absorbs shock better than a helmet?
Wear helmet => less sexy => less sex => fewer children => less DNA passed on => Darwinian loser
Sadly this study has not put the issue to bed. The point still stands that wearing a helmet may result in more relative risk (likelihood of being involved in an accident in the first place) [1].
There are a few forms of study which would (potentially) put the issue to rest:
1 - A population study: take a large population, of those who cycle compare the mortality rates and collision rates of the group which mostly wears helmets with the group which mostly does not wear helmets. Problems: age and sex matching are difficult, ignores effects of helmet wearing on cycling uptake.
2 - A randomised controlled trial: take a group of cyclists, divide into three groups: 1 group do not wear helmets (control), 1 group wear "placebo" helmets (placebo), 1 group wears real helmets (treatment). Compare the mortality rates and collision rates.
Problems: at least 1 group (placebo + 1 other group) have been placed in (relative increased) danger, randomising where individuals have very strong personal opinions is nigh impossible (dropouts).
3 - Intervention study: take a group of cyclists. Require all to wear helmets. Compare mortality rates and collision rates to overall cycling population normalising for distances travelled.
Problems: ignores effects of helmet wearing on cycling uptake, group will be self selecting for those who normally wear helmets (dropouts), the act of intervention may change the behaviour of the group (e.g. reduce risk taking).
Anyone else have any ideas / proposals?
Sorry guys accept it as the motorcyclists had to. One day helmets will be compulsory nuff said
Just get everyone in the whole country to wear helmets at all times. Surely it's only common sense that this will decrease the chance of death and injury?
How ridiculous you steadfast refusniks are! It's just plain obvious that if you hit your head & it's not protected you risk injury - the same goes for many professions where a helmet is expected to be worn. How many builders refuse to go on site or leave the trade because a helmet is mandatory?
Make it law - if some people stop cycling then fine, they can sulk for a bit then go buy a damn helmet once they've got over it & put weight on.
How ridiculous you steadfast refusniks are! It's just plain obvious that if you hit your head & it's not protected you risk injury - the same goes for many professions where a helmet is expected to be worn. How many builders refuse to go on site or leave the trade because a helmet is mandatory?Make it law - if some people stop cycling then fine, they can sulk for a bit then go buy a damn helmet once they've got over it & put weight on.
Since the helmet standards are so incredibly low, the level of protection offered by a cycle helmet is so minimal as to make wearing one commpletely and utterly pointless.
Try this test. Pick up a motorcycle helmet. Now pick up a cycle helmet in the other hand. Feel the difference in the weight. Examine the structure of the motorcycle helmet. Now do the same with the cycle helmet. You will notice that the motorcycle helmet is rather more substantial. It works. The cycle helmet on the other hand, is insubstantial and the protecion it offers is almost non-existent.
Denmark and Holland have the highest percentages of people cycling in Europe, and also the best safety record for cyclists. Go there and see how many wear helmets while riding. If you wait long enough, you might see one.
OldRidgeback
beelzebomb wrote:How ridiculous you steadfast refusniks are! It's just plain obvious that if you hit your head & it's not protected you risk injury - the same goes for many professions where a helmet is expected to be worn. How many builders refuse to go on site or leave the trade because a helmet is mandatory?Make it law - if some people stop cycling then fine, they can sulk for a bit then go buy a damn helmet once they've got over it & put weight on.
Since the helmet standards are so incredibly low, the level of protection offered by a cycle helmet is so minimal as to make wearing one commpletely and utterly pointless.
Try this test. Pick up a motorcycle helmet. Now pick up a cycle helmet in the other hand. Feel the difference in the weight. Examine the structure of the motorcycle helmet. Now do the same with the cycle helmet. You will notice that the motorcycle helmet is rather more substantial. It works. The cycle helmet on the other hand, is insubstantial and the protecion it offers is almost non-existent.
Denmark and Holland have the highest percentages of people cycling in Europe, and also the best safety record for cyclists. Go there and see how many wear helmets while riding. If you wait long enough, you might see one.
Way to go Ridgeback, couldn't agree more.
antonio
Yep, I second that one. Should also add that builders wear safety hats to prevent their noggin being penetrated by falling masonry etc. Those forces are totally different to the sudden acceleration and deceleration that occurs in a collision with a vehicle.
By all means make helmets and hiviz compulsory BUT make the sentence for 'death by driving' a minimum of 5 years with a life long driving ban. Make all motorists and passengers wear full face helmets and neck braces after all more drivers suffer head and neck trauma than cyclists.
I've been cycling for near enough 40 years and the worst injuries I've had are a twisted shoulder and road rash. I've learnt to hold a good road position, give clear signals and read the road. The issue that needs to be addressed is the aggressive driving that exists and the fact that the majority of our towns and cities are not designed for motorised traffic
Yep, anyone who really believes in wearing a helmet whilst riding for protection should wear a motorcycle helmet, or at the very least a full-face race helmet for downhill MTB racing or BMX racing. Downhill MTB racing/BMX racing body armour incorporating arm protection and knee/shin guards are of course even more important as anyone should be aware limb injuries are prevalent amongst cyclists. A kneck brace is of course necessary for protection too.
Those shell type things some people call cycle helmets are a waste of space, other than for decoration if you ask me.
And no, I haven't plucked those beliefs from opinion derived from reading comments online. I've a bit of paper at home somewhere that reminds me I qualified as a mechanical engineer, with expertise in materials technology and structural design.
Ride safe, claim the road.
OldRidgeback
How ridiculous you steadfast refusniks are! It's just plain obvious that if you hit your head & it's not protected you risk injury - the same goes for many professions where a helmet is expected to be worn. How many builders refuse to go on site or leave the trade because a helmet is mandatory?Make it law - if some people stop cycling then fine, they can sulk for a bit then go buy a damn helmet once they've got over it & put weight on.
so people dying of obesity is okay but people dying from hitting their heads is not? not sure i follow. and you should check how much the NHS spends on those two things.
the health benefits of cycling outweigh the risks by an order of magnitude and more. since cycling actively decreases your chance of dying overall, why put obstacles in people's way? what we should be doing is making it easier and cheaper, not harder and more expensive. to take head injuries and look at them in isolation completely misses the point.
Death isn't the only end point which should be considered when discussing the merits of wearing helmets. I would say non-fatal traumatic brain injury occurs more frequently than death and is more likely to be reduced in severity or even prevented by wearing a helmet.Of course I'm no expert, I'm just a consultant anaesthetist with nearly 20 years experience of dealing with trauma. I've seen enough to make sure I NEVER cycle without a helmet.
Of course on the roads better separation of cars and bikes would be ideal, but wearing a helmet is one of the few things we can do something about ourselves.
You're right - you are no expert. You can cite your personal experience but it is just that - personal. It is not scientifically compiled or statistically validated. You have no control group. You are apparently looking at head injury without considering limb and torso injuries, which are more prevalent in incidents with vehicles, especially HGVs, in urban situations.
You are not taken account of what non-trauma doctors such as cardiovascular, obesity, diabetes and other specialists might have to say.
It is better than the old " a helmet saved my life" canard, but only just.
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