[Closed] Bicycle helmets reduce risk of serious head injury by nearly 70%, study finds

You do realise TJ is back?? 😯

I've missed TJ on helmet threads. He's right you know.

You do realise TJ is back

It's a test designed to provoke an emotional response

No they don't
Yes they do
roptational injuries
make cars aim for you
No they don't
Yes they do
roptational injuries
make cars aim for you
No they don't
Yes they do
roptational injuries
make cars aim for you
No they don't
Yes they do
roptational injuries
make cars aim for you
No they don't
Yes they do
roptational injuries
make cars aim for you

Save yourselves!

*Runs*

Save yourselves!

Put a helmet on? Or take it off? I need a multi page thread to inform me

What the stats do not say is what proportion of injuries were head injuries.

Protecting the head reduces the chance of the head being injured, that's a no brainer. But this statistic doesn't provide perspective on how wearing a helmet holistically reduces the chance of being seriously injured.

Me personally, I almost always wear a helmet, although of all the times I have fallen off I have never hit my head. I learnt to tuck my head in when I fall through Judo training which has come in surprisingly useful throughout life. I think it would be really useful to teach people how to fall properly as part of school P.E lessons.

Having stated this I have no doubt jinxed myself into smashing my head the next time I ride my bike!

No they don't
Yes they do
roptational injuries
make cars aim for you
No they don't
Yes they do
roptational injuries
make cars aim for you
No they don't
Yes they do
roptational injuries
make cars aim for you
No they don't
Yes they do
roptational injuries
make cars aim for you
No they don't
Yes they do
roptational injuries
make cars aim for you

4 pages, and fade....

Think of the wife's, husbands and children, close the tread now to prevent angry people taking out their internet rage on their loved ones.

No they don't
Yes Yes Yes
personal choice
they do
roptational injuries
should be compulsary
should be compulsary
should be compulsary
personal choice
make cars aim for you

Remix

MIPS with everything

Seriously though. I... I... nah.

*Switches off computer*
*Goes for a ride*
*Hopes not to add to the statistics*

Okay, let's get this started properly. From the meat of the article

Helmet use [b]is associated with[/b] odds reductions of 51% for head injury, 69%...

From the headline though (and repeated in the opening sentence)

Bicycle helmets [b]reduce risk[/b]....

As a non-expert, who hasn't read the study, that reads to me like a study finding a correlation and a journalist interpreting that as causation.

Random hypothesis: Helmet use is more prevalent among experienced cyclists, and they are more expert at dealing with crashes - inexperienced, helmetless cyclists more likely to impact hard and head first with the road / other vehicles, expert, helmeted cyclists roll, ninja-like and only catch the road with a glancing blow to the head.

No idea if the above is true, but it might be. The point is, that helmetless cyclists come off worse than helmeted ones does not, of itself, prove that it is the wearing of the helmet that causes the better outcome.

[retires to safe distance]

I'm deeply sceptical.

It's a 'round up' study of over 40 other surveys, none of which found these results.

It's been produced by a team in one of the few states with a Mandatory Helmet Law and whose funding comes from the state.

I'll leave it there I think.

I learnt to tuck my head in when I fall through Judo training

Good point. I also did Judo as a child and of all the times (in the 40 years since) I have fallen over/off bike/got knocked off bike etc,. I have never hit my head.

Haven't used a Hane Goshi or a Tamoe Nage ever since though however but good to get something from it other than s set of coloured belts.

I learnt to tuck my head in when I fall through Judo training

The last helmet I wrote off, I broke my arm protecting my head.

The one before that was a crash that happened so quickly I was on the floor before I knew what was going on. The back wheel caught a small stump in the middle of a berm just as I pumped, stopping the bike dead, so I went headfirst into the berm just ahead of the front wheel at full speed.

The one before that I went over the front in a chute of rocky steps, I actually had time to aim my head at the rock whilst falling because it seemed preferable to my face because I could see the exact pointy rock I was about to land on.

I'm skeptical..

Try an experiment...

Hit yourself on the head with a hammer, really hard.

[url=

are so old hat - airbags are where it's at.[/url]

I don't care what any one thinks or any stats say.

I wear a helmet to protect my head in a fall. On a mountain bike because i've landed on or hit my head in falls previously, on a road bike because there is a chance of hitting my head in on hard objects like kerbs if I come off the bike and when snowboarding because i've fallen badly and hit my head previously.

I know for a fact that hitting my head in a fall when wearing a helmet hurts less than not wearing a helmet.

I do not think that wearing a helmet will save my life if a bus hits me at 50 MPH.

There, thats my bit done.

Edit: I also don't care if people choose not to wear a helmet. That's up to them.

Hit yourself on the head with a hammer, really hard.

No need, stick with this thread long enough and you'll achieve the same effect.

Same helmet discussion, only thing is a new study. What's different about this study?

I'm deeply sceptical.
It's a 'round up' study of over 40 other surveys, none of which found these results.
It's been produced by a team in one of the few states with a Mandatory Helmet Law and whose funding comes from the state.
I'll leave it there I think.

Me too!

We need bike helmets with a car airbag type protection for front-on impacts (like say... into the rear of a dustbin lorry 😉 ), which still allow to see where we are going when we are travelling safely. 😆

[i]I also don't care if people choose not to wear a helmet. That's up to them.[/i]

What? Like [i]personal choice[/i]?

I was riding home the other day. There were 2 girls going the opposite direction on those Pendleton style bikes. One was on the path, the other was on the road. The road side one had no helmet, normal (not riding) clothes, one hand holding a drink the other on the bars.. A car went past really bloody close! I thought "Ooh".

Try an experiment...

Hit yourself on the head with a hammer, really hard.

Are you being serious?

Are you being serious?

no, sorry, have you actually done it?

[img] [/img]

In all the times I've fell off I've only hit my head once. I don't think it would of done any lasting damage but it would of bloody hurt.

A helmet has stopped quite a few head to branch interface moments.

And it gives me somewhere to mount bike light too.

I've never seen a turtle.

[i] I don't think it would of done any lasting damage but it would of bloody hurt.[/i]

Maybe it damaged your ability to write proper English? 😀

Can we maybe discuss this new meta study, rather than anecdotes and the same stuff over and over?

Anyone able to access the actual study?

Are you being serious?
no, sorry, have you actually done it?

I was wondering if that was a serious argument in favour of helmets. But I expect you knew that.

In a similar vein, Mafeking has been releived.

I'm still not going to wear a helmet though.

Have you to pay money to read it. I can't access. The co-author has a blog here with lots of stuff tho
https://injurystats.wordpress.com/

Joking aside, log term effects from multiple minor knocks/concussion are scary

http://www.nytimes.com/2016/05/25/sports/dave-mirra-cte-bmx.html?_r=0

A helmet has stopped quite a few head to branch interface moments.

But as to the study, usual rules apply:
correlation and causation are not the same.
Advising people that helmets may help if you crash - knock yourself out.
Making a case for compulsion - literally knock yourself out.
Try some victim blaming shit about the cyclist being at fault for not having a lid on when you drove your car into them - GTFO.

[quote=HoratioHufnagel ]Try an experiment...
Hit yourself on the head with a hammer, really hard.

There is no hammer

For me the question is why would you not wear a helmet?

These days they are pretty darn light an unobtrusive. I've been through a cars windscreen....it hurt.

I've gone down an Alpine black run, over the bars and landed square on the top of my head, it hurt..... a lot.

[quote=D0NK ]Making a case for compulsion - literally knock yourself out.

But it does make the case more difficult for those who oppose mandatory helmet wearing, they said.
“The legislation of mandatory helmets for cyclists is a controversial topic and past research on its effectiveness has been somewhat mixed,” the study said. “Irrespective of past research, the results of this review do not support arguments against helmet legislation from an injury prevention perspective.

it's a good job that isn't the argument being used against mandatory helmet laws then

[quote=scud ]For me the question is why would you not wear a helmet?

Well if we're doing the full bore helmet thread, then the usual reply is: why would you not wear a helmet when doing various other activities?

Sometimes, I don't.

Because I'll never ride through Paris, in a sports car, with the warm wind in my hair.

Do people put hammers on trails?

They will start on skiing next ..... 🙁

Well if we're doing the full bore helmet thread, then the usual reply is: why would you not wear a helmet when doing various other activities?

Which is a great question and why it is always asked and highlights the fact that a lot of people think (incorrectly) that cycling has a higher risk than other activities where they would never where a helmet.

Why are there no studies to show that x% of people driving would have been less injured if wearing a helmet, x% of people falling on slippery surfaces would have been less injured if wearing a helmet etc,.

Helmets clearly save your head in certain situations but why the focus on just wearing them when cycling?

Hey Molgrips / Horatio. I've got access to the journal. Let me know if you want me to send you a pdf of the study. It's very stats heavy though!

Beagy 🙂

aracer - Member
D0NK » Making a case for compulsion - literally knock yourself out.
But it does make the case more difficult for those who oppose mandatory helmet wearing, they said.
“The legislation of mandatory helmets for cyclists is a controversial topic and past research on its effectiveness has been somewhat mixed,” the study said. “Irrespective of past research, the results of this review do not support arguments against helmet legislation from an injury prevention perspective.
it's a good job that isn't the argument being used against mandatory helmet laws then

Indeed.

aracer - Member
scud » For me the question is why would you not wear a helmet?
Well if we're doing the full bore helmet thread, then the usual reply is: why would you not wear a helmet when doing various other activities?

Also, a fair point.

I wear helmets usually, but for riding to the shops, why would you bother?

Why not? An extra thing to carry around in the shop, it gets sweaty and smelly a lot of the time, I can't be arsed, the average benefit to my health from the ride to the shops will exceed the average detriment from head injuries even without a helmet. And for those thinking that comparing the consequences both ways is apples/oranges, if I die from a head injury or suffer debilitating injuries, it's just a chance. Conversely I could've had a heart attack or cancer if I hadn't, it's just a chance. I could never ride a bike and live to 120, I could never wear a helmet and never crash until I was 120. (Both are fairly unlikely)

[quote=kerley ]Why are there no studies to show that x% of people driving would have been less injured if wearing a helmet, x% of people falling on slippery surfaces would have been less injured if wearing a helmet etc,.

Quite. I should think that it would be possible to come up with an almost identical study to this regarding the protective effects of helmets for any activity where there are head injuries (it appears to be a meta study, so that's on the proviso that all the other studies need to be done first). What such results don't do is provide any new argument in favour of helmet legislation, or even in favour of encouraging helmet use for cycling any more than they do for any other activity where similar levels of injury prevention might be found.

I've had a quick skim of the study - thanks Beagleboy - and there doesn't appear to be much wrong with it in itself. TBH the findings aren't exactly surprising - and the conclusions even stop short of the sort of definitive statements used in the article - the final sentence of the conclusions is:

These results support the use of strategies to increase the uptake of bicycle helmets as part of a comprehensive cycling safety plan.

...and in the section on compulsion the final sentence is even more equivocal:

Any comprehensive cycling safety strategy should consider the promotion or legislation of bicycle helmets only in concert with other injury prevention strategies.

Though as discussed above, I'm sure you could substitute driving for cycling in either of those sentences.

a lot of people think (incorrectly) that cycling has a higher risk than other activities where they would never where a helmet.

(I normally tell him to keep it on but he can take it off himself and it seems like he feels a bit self concious being the only kid in the park with a lid on)

The trouble with kids wearing helmets for doing things like that is the risk of strangulation when the helmet gets caught on something. I hate doing risk assessment on gut feeling, but with the little evidence I have I'd tend towards them being safer without a helmet. It's not like him banging his head on the bars does any long term damage, so it's only the risk of hitting his head from a fall you're mitigating.

My MIL was telling me that cyclists should be forced to wear hi-viz jackets so that drivers could see them.
😯

Can't read the full paper (might see if I can blag access through Uni) but this from the abstract leaped out at me:

The reduction was greater for serious or fatal head injury.

So according to this study, helmets are better at preventing more serious head injuries, they have less effect on milder head injuries?

That seems odd. Depends how the injuries are categorised of course (and may well be categorised differently in different sources) but you'd generally expect a piece of safety equipment to be most effective in mild cases, and decrease in effectiveness as the severity increases. Especially as the helmet standards only really test for relatively mild 12mph impacts.

I wonder if it's down to variation in reporting of injuries, and variation in reporting of helmet wearing in incidents?

Professional race car drivers have to wear helmets.

So why don't the public have to on the roads? 😕

[quote=bencooper ]Can't read the full paper

you can now 😉

I wonder if it's down to variation in reporting of injuries, and variation in reporting of helmet wearing in incidents?

I've not yet gone through it in fine detail (and not sure I will), but I suspect there's quite a large element of reporting bias relating to that at least.

So according to this study, helmets are better at preventing more serious head injuries, they have less effect on milder head injuries?

That seems odd. Depends how the injuries are categorised of course (and may well be categorised differently in different sources) but you'd generally expect a piece of safety equipment to be most effective in mild cases, and decrease in effectiveness as the severity increases. Especially as the helmet standards only really test for relatively mild 12mph impacts.

It isn't odd - most helmets are designed with safety standards that aim to prevent your skull from being cracked open, hence they are designed to withstand hard impacts - a 12mph 90 degree impact is actually pretty hard. This translates to materials that tend to cause energy spiking during low speed impacts as the material cannot deform easily enough during low energy events.

you can now

Aye, thanks for that 😀

This translates to materials that tend to cause energy spiking during low speed impacts as the material cannot deform easily enough during low energy events.

But the ANSI etc standards are for low speed impacts, that's what helmets are built and tested for.

What I found interesting was this,

Some authors have posited that helmet use exacerbates
the occurrence of diffuse axonal injury (DAI), which has
prompted biomechanical research into helmet use and angular
acceleration......this review found a DAI diagnosis is rare among cyclists in a crash. There were no
DAI diagnoses reported by Dinh et al. (0/110), McIntosh
et al.25 (0/137) or Malczyk et al. (0/239), whereas
Javouhey et al. reported DAI in 2.3% of cyclists (28/
1238). Sethi and colleagues reported DAI in 2/225 unhelmeted
cyclists and 1/110 helmeted cyclists (OR ¼ 1.02,
P ¼ 0.99), and Bambach et al. identified only 0.1% (8/
6745) of cyclists in a motor vehicle collision that met one
criterion for DAI. There is some evidence in the motorcycle
helmet literature that travel speed interacts with helmet effectiveness,
i.e. there is a threshold where helmet use
switches from beneficial to detrimental. However, this
study estimated a switch at 124 km/h which is only possible
under extreme conditions on a bicycle.

I don't have one of those fancy pants 'MIPS' helmets, but now I know to keep my speed below 124km/h if I ever do get one!

why would you not wear a helmet when doing various other activities?

I'd wear one for climbing or skiing. Most other things that I do don't involve high speeds or mixing with other large high speed objects.

But the ANSI etc standards are for low speed impacts, that's what helmets are built and tested for.

When have you ever crashed at 12mph into a kerb at a perfect 90 degree angle?

If you did so without a helmet, you would be ****ed.

[quote=molgrips ]Most other things that I do don't involve high speeds or mixing with other large high speed objects.

Neither does climbing.

But how about the ones which do, like driving?

Is it not mandatory for cyclists to wear helmets?

Where have I been on this, I really thought for road use you had to wear one.

Why are they different to mopeds?

I dislike paywalled science, but recognise that publishers have to make money somehow.

Those that have access: Does the review examine overall risk or estimate reduction of risk in a smaller sample? The abstract seems to suggest 64000 injured cyclists were included, whereas cycling UK's stats indicate 2 million daily cycle users [url= http://www.cyclinguk.org/resources/cycling-uk-cycling-statistics#How many people cycle and how often?]stats[/url].

To a bear of little brain, that seems to indicate that helmet use plays a part in reducing the risk of a vanishingly infrequent event (although the event itself may have substantial consequences).

Also, for the statisticians, how does 'odds reduction' of 0.31 for serious head injuries equate to 70% reduction as claimed by the headline?

Pro-choice, btw.

It's all about choice. I tend do but don't always

rosscore - Member
Is it not mandatory for cyclists to wear helmets?

Where have I been on this...

Australia?

Neither does climbing

Falling does, though, whether it's you or rocks from above.

I learnt to tuck my head in when I fall through Judo training

You're obviously not going fast enough when you crash. I've written off two Giro Air Attacks this year in racing crashes over the bars, First was at 30 mph, second was at 20. Never had time to react and really have no recollection of the impact. I also put one into the side of a car at 20 mph last year. All three worked as they should (crushed not shattered). I'm a huge fan, personally. Will read the article anyway.

And while we are on anecdotes. a clubmate died two weeks ago of complications from a head injury whilst on a (helmetless) pootle back from the pub on her Pashley. She fell into the road at almost no miles per hour and fractured her skull. It's not all high speed stuff, sadly 🙁

I'm always skeptical of meta-analyses. Need to find BIG effects for validity (see Rory Collins's recent statin review, for example)

Also, for the statisticians, how does 'odds reduction' of 0.31 for serious head injuries equate to 70% reduction as claimed by the headline?

it's 1 - the odds ratio for the amount of reduction. SO 0.5 would be 50%, 0.75 would be a 25% reduction.

Beagleboy - could you send me a copy of the paper (email in profile)? I'd be interested in taking a look. I have a degree in maths from many years ago, hopefully i haven't forgotten ALL of it 🙂

My MIL was telling me that cyclists should be forced to wear hi-viz jackets so that drivers could see them.

If you MIL cannot see cyclists she needs to get glasses or needs to stop driving. Have you discussed that with her?

This review is like a black swan for me, but cannot help notice a few things:
1. The strongest evidence of helmet effectiveness comes from 'children' (as in under 16 years old) with two obvious examples - [url= http://www.sciencedirect.com/science/article/pii/S0039606015003116 ]Gulack 2015[/url] and [url= http://search.proquest.com/openview/0f95b56905f6d00322dcc3f91a1889df/1?pq-origsite=gscholar ]Lindsay 2014[/url] providing around 40% of the data points;
2. Main author clearly has an interest in the area, as he has previously tried to [url= http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0075424 ]discredit Ian Walker's study on driver behaviour around helmeted vs non-helmeted cyclists[/url]. All this coming from NSW, not subjective at all...

Most other things that I do don't involve high speeds or mixing with other large high speed objects.

So you don't drive, but do you think people who do drive should wear helmets and if not why not?

The last helmet I wrote off, I broke my arm protecting my head.

The one before that was a crash that happened so quickly I was on the floor before I knew what was going on. The back wheel caught a small stump in the middle of a berm just as I pumped, stopping the bike dead, so I went headfirst into the berm just ahead of the front wheel at full speed.

The one before that I went over the front in a chute of rocky steps, I actually had time to aim my head at the rock whilst falling because it seemed preferable to my face because I could see the exact pointy rock I was about to land on.

I'm skeptical..

The only way to find out is to repeat the crashes after learning all the break falls and honing them to instinctive perfection by getting a black belt who is twice your size to throw you on the floor hard and fast several thousand times.

Anyway I am not trying to make out that learning to fall is going to make anybody infallible and not require a helmet, but i think that learning it in Schools would save lives and reduce injuries, would probably have far more benefit than wearing helmets brings. Surely the average person is more likely to need to break their fall at some point in their adult life than they will need to throw a javelin, or play hockey etc

There was some rubbish floating around on the internet a few years ago about cats falling from buildings and surviving and how over a certain height they lived and had minor injuries.

All based on some study by a New York Vet on the people who had taken their cats in after a fall.

Problem with that was no one took any of the dead cats into a vet, they were scraped off the pavement and disposed of.

So the idea that cats falling over a certain number of floors was completely flawed as there was a huge unknown number of the cats that died.

Helmets is the same, who reports a minor crash with a dented helmet? You buy a new one and go and ride.

Doesn't matter how many studies you do, the figures you get are for the accidents that are serious enough to get reported and none of the figures for who just walked away and logged on to CRC.

No one will ever know. Wear one, don't wear one. Your choice, I wear one as I only get one brain and want to give it as much chance as possible.

who reports a minor crash with a dented helmet? You buy a new one and go and ride.

People who are surveyed?

Read the methodology before you criticise. I haven't read it, so you might be right, but don't jump to conclusions.

Copied from BTL in the Guardian:

thelonggrass
22 Sep 2016 11:16
0 1

The data on helmets is led from the hospital looking out. Definitely from this point of view helmets help. In the UK we might reduce cyclist fatalities from 113 to around 60-70. However there are 25 million bike owners in the UK, and 3.6m cycling at least once a month. So at a typical cost of a helmet of £30, compulsory helmets would cost the population between £110m-£750m. So the first question is that value for money, or could we improve cyclist safety better by spending £100m on something better?

Secondly, the view from the hospital out ignores the exposure rate. So it fails to consider the risk per individual or per individual journey. The UK has about 9000 hospital admissions for cyclists per year of which 2,800 are serious injuries with 110 fatalities. This is from a population of 3.6m regular/occasional cyclists (may actually be 6.6m). So one estimate of the likelihood of being KSI because of not wearing a helmet is about 0.04% per year - ignoring cycling time and journey length. Accidents are also disproportionally likely for those under 14 and over 65 and those cycling more adventurously (mountain bikes or racing). These are not high levels of risk (there were 30 fatalities related to angling in 2011 as a comparison), and may be better dealt with in other ways - reducing the factors that cause accidents for instance.

It also ignores a problem that requiring helmets may reduce the amount of cycling (I've seen estimates of a 13% drop in journeys). Since for cycling there is a safety in numbers effect - more cyclists leads to fewer accidents - so forcing helmet use might not be a positive trade off against other benefits from cycling itself. For example there were 9,500 estimated deaths in London from air pollution. Bikes on the road would reduce the car fumes that aggravate asthma and other lung problems so the net cost of discouraging cycling could be many times higher than the reduction in fatalities.

Since adults continually have to balance and judge risks, my feeling is that the scale of the problem is small for the relative burden that would be imposed, and so it is better to let cyclists choose.

You're obviously not going fast enough when you crash. I've written off two Giro Air Attacks this year in racing crashes over the bars, First was at 30 mph, second was at 20. Never had time to react and really have no recollection of the impact. I also put one into the side of a car at 20 mph last year. All three worked as they should (crushed not shattered). I'm a huge fan, personally. Will read the article anyway.

And while we are on anecdotes. a clubmate died two weeks ago of complications from a head injury whilst on a (helmetless) pootle back from the pub on her Pashley. She fell into the road at almost no miles per hour and fractured her skull. It's not all high speed stuff, sadly

I'm always skeptical of meta-analyses. Need to find BIG effects for validity (see Rory Collins's recent statin review, for example)

Yup, Im an expert at Judo, Karate and high speed running, but, I have never banged my head, because Im an expert. On a bike, I try too hard sometimes and have also totally knackered a couple of helmets. On one occasion, I am absolutely certain Id have been lucky to survive.

Its a choice but one I whole heartedly support. Also, folk who dont ride with helmets arent welcome with me as it would be me who has his sunday spoiled getting the senseless bod to the hospital. 😆

Why do Bike parks make helmets mandatory? Why is all cycle sport like that?

Why do Bike parks make helmets mandatory? Why is all cycle sport like that?

Liability?
Because racing on bikes will lead to crashes and is much higher risk than when riding along the road not racing?

All motor sport has mandatory helmet use too but it all goes quiet when you ask why you don't where a helmet when driving your car. Tell me again, why don't you?

The answer is because people think car driving is a normal everyday thing that everyone does, whereas riding a bike is an unusual and probably dangerous activity.

Which tells you a lot about what attitudes we need to change, really.

I haven't read it, so you might be right, but don't jump to conclusions.

I did read it, pretty much sourced from multiple medical databases and peer reviewed studies. The studies are valid but biased, based on reported medical incidents.

Interesting point about surveys, don't know how you'd get a representative group though.

Still a futile argument.

I'm not sure but I get the feeling most are saying 'no' to helmets? Or maybe they are saying 'yes' to choice? I'm not sure. I hardly ever see anyone not wearing a helmet. A few roadies and the very very occasional offroadie. Surrey is hardly a small proportion of cyclists either. I fell off road riding last year and smashed my helmet on the side. I really don't want to think of the outcome if I hadn't been wearing it. My choice is to wear one but I do think there should be choice.

I learnt to tuck my head in when I fall through Judo training

You're obviously not going fast enough when you crash.

It's not all high speed stuff, sadly

All motor sport has mandatory helmet use too but it all goes quiet when you ask why you don't where a helmet when driving your car. Tell me again, why don't you?

Motorsport, they are going over 100mph and in general doing much riskier stuff than general highway driving, helmet wearing is one of the things done to mitigate the risk back down a bit.