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Some interesting coverage of cyclist injury hospital presentations in Ireland here:

https://www.irishtimes.com/news/health/irish-hospitals-treat-one-cyclist...

Also here:

https://www.breakingnews.ie/ireland/one-cyclist-treated-every-three-days...

and here:

https://www.irishexaminer.com/breakingnews/ireland/30-of-cyclists-admitt...

The reporting includes fairly balanced coverage of the helmet debate, noting the less severe injuries to those who were wearing helmets and also noting the negative impacts of compulsory helmet laws and the possibility that drivers may treat cyclists with less care if they're wearing helmets.

The research only covers patients who made it to hospital, I guess this excludes a number of fatalities and many more less serious incidents. The research indicates that 12 of the patients who made it to hospital died. to put this figure into context as far as I can tell from the Road Safety Authority of Ireland figures on the Central Statistics Office website the number of cyclists killed on Irish roads in this period 2014-2016 was (including provisional figures for 2016) 33 - https://www.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintab.... So my guess is that 21 of these cyclists died before making it to hospital.

I've been unable to find the actual research paper that was presented at the conference.

6 comments

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hawkinspeter [3597 posts] 1 week ago
2 likes

Thanks for posting those - interesting. (Shame we can't 'like' a Forum post).

I find it surprising that 40% (173) were unspecified but that figure would presumably drop if/when they interview the cyclists involved.

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Rich_cb [911 posts] 1 week ago
1 like

More in depth analysis of the 2014 figures here:

https://www.researchgate.net/publication/303921038_Cycling_Injuries_Pres...

Seems the vast majority of the head injuries (in 2014) were concussions. They don't seem to have included cuts/bruises etc in the head injury stats.

If they used same criteria for the presentation above then that's pretty good quality evidence.

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Gubbins [3 posts] 6 days ago
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Good find Rich_cb.

I think the selection criteria is different for the studies. 

The study covering just 2014 for one hospital has 534 cyclists while the study covering 2014-2016 only has 410 cyclists.

One of the news reports I linked to indicates that it covers major trauma, so I think it's much more selective than the other study which covers all emergency department presentations mentioning keywords identifying the patient as a cyclist.

Whilst, as you point out, the vast majority of the head 2014 ED head injuries were concussion, head injuries accounted for about 16% of the cases. The rate of head injuries in the major trauma study 2014-2016 was 27% for helmet wearers and 52% for non-helmet wearers.

The 2014 study doesn't mention rates of head injury for scratches and bruises etc, but it does cover other head injuries like facial fractures. It's worth noting that you can fracture bones in your face without being concussed.

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BehindTheBikesheds [3153 posts] 6 days ago
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Just for starters, "Twelve of the cyclists died, all of whom had head injuries" doesn't in itself say that they died of head injuries as the major or even secondary cause. A head injury could be any trauma of any sort to the head, it need not be the direct cause of death, the statement is dliberately misleading.

 And "Wearing a helmet was associated with a significantly reduced rate of head injury, he said. Some 27 per cent of cyclists wearing helmet had head injuries, against 52 per cent of those not wearing helmets"

No it doesn't, it does no such thing, it takes no account of helmet wearing rates, this is just like Jake 'odds ratio' Olivier . We all know how head injuries are defined, even a small cut or bruise to ANY part of the head is a head injury, so is a cut lip according to Jake Olivier.

However since Ireland has increased its helmet wearing rate over the last few years and were pushing helmets in a big way not long ago when there was a proposal for compulary helmets similar to NI they've seen an increase in cycling injuries outstrip the increase in cyclists,  and also a higher increase than the KSI rate for Irish pedestrians over the same period.

So as helmet wearing rates have gone up, injuries have gone up faster than the increases in cycling numbers and higher than the rate of pedestrian KSIs, not very good is it so far! Oh wait, the same thing happened in Australia and NZ and everywhere in the world including the UK were helmets are made compulsary or have significant increases in wearing.

In fact the 2014 study said this 
"This is a retrospective study, and while data collection was rigorous, certain
variables such as helmet documentation, location of the injury, exact time and date of the injury
or mechanism of injury in particular were not documented in detail. Therefore, the impact of
helmet use on the incidence and outcomes of head injury could not be assessed."

So the latest data is basically the same old incomplete bollocks that tells half a story, implies certain aspects without any actual full facts but makes a over simplified statement saying helmets improve injury rates in hospitals which is not just inaccurate but dangerous and yet more flawed data/reasoning!

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Rich_cb [911 posts] 6 days ago
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BehindTheBikesheds wrote:

Just for starters, "Twelve of the cyclists died, all of whom had head injuries" doesn't in itself say that they died of head injuries as the major or even secondary cause. A head injury could be any trauma of any sort to the head, it need not be the direct cause of death, the statement is dliberately misleading.

 And "Wearing a helmet was associated with a significantly reduced rate of head injury, he said. Some 27 per cent of cyclists wearing helmet had head injuries, against 52 per cent of those not wearing helmets"

No it doesn't, it does no such thing, it takes no account of helmet wearing rates, this is just like Jake 'odds ratio' Olivier . We all know how head injuries are defined, even a small cut or bruise to ANY part of the head is a head injury, so is a cut lip according to Jake Olivier.

However since Ireland has increased its helmet wearing rate over the last few years and were pushing helmets in a big way not long ago when there was a proposal for compulary helmets similar to NI they've seen an increase in cycling injuries outstrip the increase in cyclists,  and also a higher increase than the KSI rate for Irish pedestrians over the same period.

So as helmet wearing rates have gone up, injuries have gone up faster than the increases in cycling numbers and higher than the rate of pedestrian KSIs, not very good is it so far! Oh wait, the same thing happened in Australia and NZ and everywhere in the world including the UK were helmets are made compulsary or have significant increases in wearing.

In fact the 2014 study said this 
"This is a retrospective study, and while data collection was rigorous, certain
variables such as helmet documentation, location of the injury, exact time and date of the injury
or mechanism of injury in particular were not documented in detail. Therefore, the impact of
helmet use on the incidence and outcomes of head injury could not be assessed."

So the latest data is basically the same old incomplete bollocks that tells half a story, implies certain aspects without any actual full facts but makes a over simplified statement saying helmets improve injury rates in hospitals which is not just inaccurate but dangerous and yet more flawed data/reasoning!

I think your bias is precluding you from assessing the evidence properly.

The articles linked to originally don't mention how head injury is defined so you can't jump to conclusions there.

The article I linked to does define head injuries (cuts and bruises are not included) but makes no claim for helmet efficacy.

Helmet wearing rates are irrelevant if you are looking at the rates of head injury in each group individually.

In fact if helmets increased the risk of injury, as you often claim, then the approach taken in the original article would be exactly the approach you would need to identify the increased risk.

Your claim that KSI rates have gone up in the UK as helmet wearing has increased is simply a lie.

If you wish to challenge that claim then please post links to your data for both KSI rates AND helmet wearing rates.

Avatar
Rich_cb [911 posts] 6 days ago
0 likes
Gubbins wrote:

Good find Rich_cb.

I think the selection criteria is different for the studies. 

The study covering just 2014 for one hospital has 534 cyclists while the study covering 2014-2016 only has 410 cyclists.

One of the news reports I linked to indicates that it covers major trauma, so I think it's much more selective than the other study which covers all emergency department presentations mentioning keywords identifying the patient as a cyclist.

Whilst, as you point out, the vast majority of the head 2014 ED head injuries were concussion, head injuries accounted for about 16% of the cases. The rate of head injuries in the major trauma study 2014-2016 was 27% for helmet wearers and 52% for non-helmet wearers.

The 2014 study doesn't mention rates of head injury for scratches and bruises etc, but it does cover other head injuries like facial fractures. It's worth noting that you can fracture bones in your face without being concussed.

Thanks.

I think the study I found looked at all cycling related injuries while the original you linked to just looked at major trauma.

They are based at the same hospital though and share an author so hopefully they will be otherwise quite similar in methodology.

We'll have to wait for more detail but if the head injury classification is consistent between the studies and the risk profiles of the groups are comparable then this could be very good evidence in favour of helmet use.