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End of debate?
https://www.theguardian.com/lifeandstyle/2016/sep/22/bicycle-helmets-red...
**touch paper lit, retires rapidly**
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47 comments
Resorting to abusive name calling when you are made to look a fool nice one SP that's really big and clever.
In relation to the comments made about Curnow and the statistics he came up with, all i can say is the well know phrase:
Lies, damn lies and statistics.
Wear one if you want, dont if you dont want to, its that simple. Dont try and force people to change by spouting so called facts and figures - that goes for both sides.
Speaking from a purely personal perspective, i've seen and dealt with more than enough RTC's over the years and it never ceases to amaze me the mess the ground makes when it comes into contact with a head after someone comes off a bike, but its your choice and i hope it will always remain that way.
As long as you're pretty sure. That makes it science.
Wasn't trying to pass my experience off as science. I was just sharing my experience of what happened in one instance with very specific factors.
In my scenario I believe (note that word believe, not know) that the damage to my ribs and his head was lessened because he was wearing a helmet. I also believe (note that word again) that because of his choice of helmet (with visor/lens) he suffered other injuries that he would otherwise have not.
Here is my experience of wearing a helmet.
I was heading along the canal to where the road goes over it, this involves the path narrowing and going under the bridge. Visibility of the path ahead is greatly reduced due to this and according to strava I was heading towards it at around 15mph. As I entered the underneath of the bridge I encountered another cyclist at the last minute, coming towards me on the same side of the path (my left, his right) and tried to swerve to avoid him but failed.
His helmeted head impacted with my chest at what I assume would be about a 30mph collision if he was travelling at the same speed. I came away with badly bruised ribs and he went to hospital with concussion (he lost consciousness twice before the ambulance took). I am pretty sure that both of our injuries would have been a lot more severe had he not been wearing a helmet.
Though as an aside, his helmet was one that has an attached visor/lens and this shattered on impact badly cutting his face very near to his eyes requiring stitches so might be worth considering good old cycling glasses instead?
Although of course it's possible you may not have been so badly injured if it wasn't a hard helmet hitting you in the chest and he may not have been so badly injured by your own admission, indeed his concussion may have been as a result of wearing a helmet in this instance.
So, you can't really be "pretty sure", can you.
Cycle helmets are useless, says brain surgeon
Leading neurosurgeon tells the Hay Festival cycling helmets are 'too flimsy' to be beneficial.
http://www.telegraph.co.uk/news/health/news/10866273/Cycle-helmets-are-useless-says-brain-surgeon.html
I saw that article, but I think he was speaking from personal experience and obviously he wouldn't encounter those who were uninjured as a result of wearing a helmet. Something he seems to have overlooked.
I had a quick look around for papers in the peer-reviewed literature and found several recent ones investigating the effctiveness of cycling helmets in reducing injury in the case of an accident. Two nice examples are given below. One is a sophisticated computer modelling exercise and the other is a practical experiment based on lab tests. Both come to supportive conclusions.
The practical study is:
"Bicycle helmets are highly effective at preventing head injury duringhead impact: Head-form accelerations and injury criteria forhelmeted and unhelmeted impacts", Cripton, P. A., et al., Accident Analysis and Prevention 70 (2014) 1–7, doi: dx.doi.org/10.1016/j.aap.2014.02.016.
ABSTRACT - Cycling is a popular form of recreation and method of commuting with clear health benefits. However,cycling is not without risk. In Canada, cycling injuries are more common than in any other summer sport;and according to the US National Highway and Traffic Safety Administration, 52,000 cyclists were injured in the US in 2010. Head injuries account for approximately two-thirds of hospital admissions and three-quarters of fatal injuries among injured cyclists. In many jurisdictions and across all age levels, helmets have been adopted to mitigate risk of serious head injuries among cyclists and the majority of epidemio-logical literature suggests that helmets effectively reduce risk of injury. Critics have raised questions over the actual efficacy of helmets by pointing to weaknesses in existing helmet epidemiology including selection bias and lack of appropriate control for the type of impact sustained by the cyclist and the severity of the head impact. These criticisms demonstrate the difficulty in conducting epidemiology studies that will be regarded as definitive and the need for complementary biomechanical studies where confoundingfactors can be adequately controlled. In the bicycle helmet context, there is a paucity of biomechanical data comparing helmeted to unhelmeted head impacts and, to our knowledge, there is no data of this type available with contemporary helmets. In this research, our objective was to perform biomechanicaltesting of paired helmeted and unhelmeted head impacts using a validated anthropomorphic test head-form and a range of drop heights between 0.5 m and 3.0 m, while measuring headform acceleration andHead Injury Criterion (HIC). In the 2 m (6.3 m/s) drops, the middle of our drop height range, the helmet reduced peak accelerations from 824 g (unhelmeted) to 181 g (helmeted) and HIC was reduced from 9667(unhelmeted) to 1250 (helmeted). At realistic impact speeds of 5.4 m/s (1.5 m drop) and 6.3 m/s (2.0 mdrop), bicycle helmets changed the probability of severe brain injury from extremely likely (99.9% riskat both 5.4 and 6.3 m/s) to unlikely (9.3% and 30.6% risk at 1.5 m and 2.0 m drops respectively). These biomechanical results for acceleration and HIC, and the corresponding results for reduced risk of severe brain injury show that contemporary bicycle helmets are highly effective at reducing head injury metrics and the risk for severe brain injury in head impacts characteristic of bicycle crashes.
From their Conclusions -
"Bicycle helmets are effective at reducing peak translational acceleration and HIC values; parameters that have been correlated with risk of skull fracture and severe brain injury. For a 1.5 m helmeted drop, the risk of severe brain injury was reduced from 99.9%+ to 9.3%. Thus, for realistic impact speeds (Fahlstedt et al., 2012) bicycle helmets changed the probability of severe brain injury from verylikely to highly unlikely. A contemporary helmet can transform ahead impact that would result in severe brain injury (which in somecases could result in lasting disability) into an impact with little potential for skull fracture or severe brain injury."
The modelling study is:
"A computational simulation study of the influence of helmet wearing on head injury risk in adult cyclists". McNally, D. S., and S. Whitehead, Accident Analysis and Prevention 60 (2013) 15– 23, doi: dx.doi.org/10.1016/j.aap.2013.07.011
ABSTRACT - Evidence for the effectiveness of cycle helmets has relied either on simplified experiments or complex statistical analysis of patient cohorts or populations. This study directly assesses the effectiveness of cycle helmets over a range of accident scenarios, from basic loss of control to vehicle impact, using computational modelling. Simulations were performed using dynamics modelling software (MADYMO) and models of a 50% Hybrid III dummy, a hybrid cross bicycle and a car. Loss of control was simulated by a sudden turn of the handlebars and striking a curb, side and rear-on impacts by a car were also simulated. Simulations were run over a representative range of cycle speeds (2.0–14.0 m s−1) and vehicle speeds (4.5–17.9 m s−1). Bicycle helmets were found to be effective in reducing the severity of head injuries sustained in common accidents. They reduced the risk of an AIS > 3 injury, in cases with head impacts, by an average of 40%. In accidents that would cause up to moderate (AIS = 2) injuries to a non-helmeted rider, helmets eliminated the risk of injury. Helmets were also found to be effective in preventing fatal head injuries in some instances. The effectiveness of helmets was demonstrated over the entire range of cycle speeds studied, up to and including 14 m s−1. There was no evidence that helmet wearing increased the risk of neck injury, indeed helmets were found to be protective of neck injuries in many cases. Similarly, helmets were found to offer an increase in protection even when an increase in cycle speed due to risk compensation was taken into consideration.
From their Conclusions -
"There is a commonly held misunderstanding (CTC, 2012) that because helmets are tested at 6.2 m s−1 (13.9 miles per hour) they are ineffective above this speed. Our results demonstrate that cycle helmets are effective at cycle speeds of 14 m s−1. Similarly, it is often believed that, in collisions with vehicles at speeds in excess of 8.9 m s−1, helmets will not offer protection. Our results show that the impact with the vehicle (at speeds up to 17.9 m s−1) does not result in a serious head injury, because of the way the cyclist is thrown over the front of the car. Unlike a pedestrian impact, the cyclist is not accelerated to the speed of the car by the impact. The serious head injuries, in these accidents, result from impact with the ground after a fall from height during the throw phase.
In all cases the risk and severity of neck injury was lower than the head injury. Indeed in the majority of cases helmet wearing was found to be protective in terms of neck injury. There is therefore no evidence that helmet wearing increases the risk of neck injury."
...which I thought was interesting.
(Any formatting errors are mine from copy and paste.)
It's certainly possible to argue that the odds of having a serious cycling accident are so low that it is not worth the bother of wearing a helmet, or that discouraging cycling by mandating helmet use will kill more people through poor health than are saved by wearing helmets. But studies like the two above suggest that it's no longer possible to argue the cycle helmets are ineffective.
When NZ made helmets compulsory the number of riders went down from 250,000 to 150,00, but the injury rate nearly doubled.
Look at this graph and then tell me helmets would save 65% of head injuries.
https://rdrf.org.uk/2013/12/17/the-effects-of-new-zealands-cycle-helmet-law/
When helmets were mandated in Australia wearing rates went up from about a third to nearly 100%. The head injury rate went up slightly.
You can find all the evidence in cyclehelmets.org.
Two scientists whose jobs are assessing statistical evidence for public health interventions and public risks have looked at all the evidence for the efficacy of helmets.
Ben Goldacre, Wellcome research fellow in epidemiology, and David Spiegelhalter, Winton professor for the public understanding of risk, looked for evidence that helmets work. They concluded that it could not be shown that they do. This is what they published in an editorial in the British Medical Journal.
In any case, the current uncertainty about any benefits from helmet promotion or wearing is unlikely to be reduced by further research. Equally, we can be certain that helmets will continue to be debated, and at length. The enduring popularity of helmets as a proposed major intervention for increased road safety may lie not in their direct benefits- which seem too modest to capture compared with other strategies- but more with the cultural, psychological and political aspects of popular debate around risk.
http://www.badscience.net/2013/12/bicycle-helmets-and-the-law-a-perfect-teaching-case-for-epidemiology/
They are saying that there is no evidence that helmets are any benefit.
Rather different to this study, isn't it?
Goldacre and Spiegelhalter are recognised experts in assessing evidence of this sort.
Olivier and his department have form in poor quality work trying to support helmets. Several of the studies that they include in this meta-analysis are notoriously shoddy.
They don't say that, at all. They do say there is a "contradictory mess of evidence," though. And that there is "uncertainty about any benefit from helmet wearing or promotion..." You actually quoted this part!
I don't care who wears a helmet or doesn't. But don't reinterpret evidence simply to justify your point of view. That is poor science.
The enduring popularity of helmets as a proposed major intervention for increased road safety may lie not in their direct benefits- which seem too modest to capture compared with other strategies- but more with the cultural, psychological and political aspects of popular debate around risk.
I quote again the most relevant words from Spiegelhalter's and Goldacre's piece.
They say that the benefits are"too modest to capture". This means that in their reading of all the studies they examined they could find no evidence of helmet efficacy. It is carefully expressed in the way scientists express themselves, but it is clearly saying that in all those studies, including those analysed by Olivier, there is no good evidence that helmets work.
Don't you think that is a very clear rebuttal of Olivier's 65% benefit?
They don't say that, at all. They do say there is a "contradictory mess of evidence," though. And that there is "uncertainty about any benefit from helmet wearing or promotion..." You actually quoted this part!
I don't care who wears a helmet or doesn't. But don't reinterpret evidence simply to justify your point of view. That is poor science.
Exactly. Too modest to capture is very different to no evidence. The evidence is contradictory rather than showing no evidence. They use their language carefully for a reason.
Can we just leave this for now, no more bumps. Start a new thread when something happens, ay?
There are obviously all sorts of arguments that can be run in relation to helmets. I entirely accept that if hit by a lorry, or in a major off, or, indeed, in a minor off, my helmet will make no difference. I also accept that, on current evidence, there is at the very least a risk that mass helmet wearing leads to worse driving behaviour. I also very strongly believe that helmet wearing should not be compulsory, because making it compulsory will have a significant deleterious effect on the number of people who cycle (esp commute/ short journeys etc) and and that would be a very bad thing.
But, for me, it is very simple.
I can very easily see how a moments inattention, or the shock of a close pass, of a spot of ice, or hitting a pothole, or stick or any number of things might cause me to have a fairly low speed tumble off the bike. I can very easily see how as I fall to the ground my head might hit a hard hedge, or corner.
Such an impact would, to my mind, be very similar to that incurred by, say, dropping the edge of a brick onto my head, from a hight of, say, 2 or 3 feet. Of course, if the crash impact is harder, it might be 4 or 5 feet.
Would I rather have a brick dropped from, say, 3 feet, onto my naked head, or my helmeted head.
I'd go for the latter.
What are the odds of ever having a tumble where this happens? Probably vanishingly small.
Am I prepared to run those odds? No. (Unless it is a beautiful day, and I am riding on a cycle path or very quiet rodes at a very sedate pace, and taking in the beauty of the world.)
If someone else is, that is there choice, and I respect it entirely,
Python.
What's your basis for suggesting that helmets 'can't prevent brain injury'?
Clearly they can and do (spread force over a larger area, increase the deceleration zone)
Brain injury:" insult to the brain from an external mechanical force, possibly leading to permanent or temporary impairment of cognitive, physical, and psychosocial functions,"
Ban helmets, ban seatbelts, airbags, soft furnishings in cars too.
What are the bets the accident and death rate go down, for all concerned, a lot?
..actually, having seen madcarews reply i'm off to do some reading myself too.
@SP59 Why don't we start with this study and the studies it was based on. I'm not overly convinced by their ultimate conclusion but you sound way ahead of me with your own analysis of it. After all you've already called them out for their "total bollocks, meta-analysis 'study'" and examined the sub-studies to determine that the majority of them are "also cack and had poor/non existant methodology/set out to prove what they intended to look for using very limited 'facts' to suit an arguement." so I expect that your counter-arguments and proof should be reasonably well formed and detailed. Lets have them on here and we'll have a look at them and the data and see where the evidence points - I don't know exactly where that might be, let's see if you're right.
Oh. Python. Bud!
I have just spent a few hours reading the delightful Curnow, as well as some of the studies he references.
First of all, the onus in any scientific debate or discussion is on the claimant (he who makes the claim) providing the evidence to back it up. This would make it incumbent on you to provide evidence of your various claims, rather than pleading with your reader / adversary to provide the material for you to refute.
Now, I'm not going to reference all of this because it's way too tedious, and you weren't good enough to provide any references for your various claims (Increased head circumference leads to increased head strike; Large numbers of accidents being the result of ambition exceeding ability; The increased heat in the head from helmets etc etc etc). However if you do care to do any reading , do read associated studies referred to by the good Curnow. You will find plenty of the figures and associated evidence you so crave.
I found 7 published works by Curnow on the topic of efficacy of Bike helmets. All of these were analysis of other studies and in particular meta studies. Curnow decried the validity of all the metastudies on the basis that they didn't follow appropriate scientific rigour, that is they didn't provide a hypothesis and test it against the evidence provided (which is not really the purpose of a metastudy). First of all he should do some philosophical reading, starting with the excellent "What is this thing called Science" by Chalmers. He would find that much science doesn't actually follow the observation- hypothesise- test paradigm. And that doesn't reduce the validity of it. I'll leave you to read the book yourself to discover why. It really is worth the read.
The good Curnow then, in his analysis, failed to provide hypotheses and then test them, which makes him simply a commentator, and one providing non-peer reviewed commentary at that (5 out of 7 of his studies / commentaries were posted in Elsevier, which as you know doesn't require peer review before publishing.)
Mr Curnow repeatedly made the claim that ignoring angular acceleration invalidated the test results of the helmet studies. However he provided no evidence whatso ever to show that this was the case (this would be a/ the facts and numbers that you so rigorously insist upon, and b/ the 'hypothesis and test' method he is so insistent on others using.) His arguments relied on the following ideas:
So. I have read your study, and seen much to recommend that you spread your reading a little further than just one study that backs up your preconceived notions, and wider than one biased author who has done little more than criticise the work of others, without actually providing a hypothesis that he dares to test or defend.
Please note, I'm not arguing here whether or not helmets prevent injury / death or are a good or bad idea, I'm simply replying to a couple of the points you raised, and pointing you in the direction of the evidence you are so keen on being provided with.
Do get back to us when you've done a variety and depth of reading, preferably from more than one viewpoint.
I've been similarly dismissive about plastic lids not so much about them as a piece of safety equipment, but as a distraction from the real issue.
They can be debated as a piece of safety equipment. Even in the discipline, it looks to me as though full-face mtb-style helmets are superior. I wouldn't go so far as to say they don't help in certain circumstances, but criticisms on their effectiveness and the deterrent factor - they're not the realm of flat earthers.
But the main reason I disparage them is because they don't stop what kills cyclists, which is being driven into. Pushing a helmet agenda right now is like standing in 1939's Poland and being offended by the invading Nazis' uniforms (there's the Godwin, if anyone wants it
).
So you've said there is a problem, and you have told us what doesn't work. Are you going to enlighten us, or is this just a random "we must do something" without defining something?
Python, somehow I don't think anyone will be providing you with 'evidence.' Why would they waste their time finding research to present to you so you can nitpick and deny it? When you call helmets "hats" you show you are not an unbiased judge. You are not the Arbiter. I have seen the same rhetorical techniques from Flat Earthers, antivaxers, chemtrailers, Global Warming deniers all over the net. You clearly have an overinflated sense of your own abilities. Good luck, you will need it.
The danger differs, depending on the type, so is difficult to quantify, isn't it?
But the bulk of the risk faced by cyclists comes from being driven into by vehicles. A helmet doesn't prevent that - I'd like to see much more effort and resources spent effectively on stuff that does.
Yep. Risk is different in each case, which is precisely why people need to accept it and quantify it. I thought I'd answered your other question but here goes: Drivers and cyclists both need to be educated to the fact there is risk, and how to minimise it. Pussy footing around telling people there is no danger in cycling when we have regular incidents which prove otherwise does nobody any good.
What 'regular incidents which prove otherwise'? Are you referring to the ones involving, and mostly caused by, motorised vehicles? They show the danger in driving, not in cycling. I think that's where your reasoning falls down, as you are shifting those numbers into the wrong column.
And again there's that mantra about 'education', which has never worked, never will work, and ends up just being a means of avoiding doing anything. Not to mention the inaccurate implication the situation is symmetrical with drivers and cyclists having 'equal' responsibility.
Yes, those same cases, but to say that the danger is in driving not in cycling is ludicrous. There is no danger whatsoever to a driver in running me down on my bike, he will walk away unscathed, probably without so much as a triggered airbag. The "equal responsibility" argument is of no comfort to me when I am lying in A&E.
The helmet debate is a distraction, at best.
Cyclists die in the uk. If that's a problem worth adressing, why does it happen?
The majority of cyclist KSIs are caused by motor vehicle collisions. We know this (see rospa and uk gov stats). Why?
1. they share the same space, and 2. driver error (see rospa and uk gov stats). We know this.
So what should the energy, resource, government, web pages be set on resolving? What do you do to resolve a problem or fix a process? Treat the cause of the problem (prior to the collision occurring) or give yourself very debatable protection from a post-collision symptom?
I know it's not binary; it is possible that we can chat about helmets and that helmet wearers might be happy that they've been saved from serious injury - and they (we, I do wear one) could well be right. I know accidents will happen and cyclists will still die away from cars and vehicles.
But let's have proportion. For each of these debates, dodgy 'meta research' reports, and articles referencing them, let's have 10 times the effort put into what is actually the cause of the risks that cyclists face, and not the sideshow of a debate on a topic that ultimately can only make a relatively small difference in the numbers of cyclists killed or seriously injured.
Davel, your second sentence here says much. If people are dying, does that not suggest that there is danger? Yet some, and indeed yourself in your later post, suggest that we should not put newcomers off by suggesting cycling is dangerous. Don't you see the ambiguity?
I have noticed a tendency here for people to say cycling is different to everything else, therefore the experience gained in other sports is irrelevant, however I have been involved in a number of other "hazardous" activities where they do exactly the opposite of what people here are doing. In one sport I was very active in we talked about the importance of having a "mature sense of risk". In other words, the safe guys were the ones who understood, assessed, and managed, the risks, which sometimes mean't packing up and going home for the day. The brave ones who said there is no risk, were the ones who got hurt. Back to my previous example, I would happily cycle without helmet on the B roads round my area, but they are sadly, linked by A roads. Anybody who says it is not dangerous cycling on an A road being overtaken by 30ft trailers at 60mph, which first disrupt your airflow, and then close the gap as they return to the left hand side due to oncoming traffic, is not cycling the same roads as me.
But back to my question. You say yourself thay cyclists are dying (not to mention being disabled). How then can we justify saying to newcomers :"don't worry about about a helmet, cycling is not dangerous"?
And that's why your reasoning is flawed. Who said anything about 'sports'? What does sport have to do with it?
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