[Closed] The helmet debate rumbles on in the mainstream media

Pembo

How would you know if your head injury had been exacerbated?

Fortunately, whenever I have clattered my head it hasn't resulted in a head injury, probably because I was wearing a helmet - well you did ask.

It is, however, a bit disappointing that the Spokes article cites that well known 'neutral, unbiased' source of information, cycle-helmets.org as a reference.

Thing is though, Spokes aren't trying to make an anti-helmet case; they're making an anti-compulsion case, which is a very different kettle of fish. The former really requires proof that helmets aren't a good idea- the latter only requires a lack of proof that helmets are a good idea. And from my position on the fence that seems a reasonable position to take.

Still, it's a complicated place to put yourself. Would they, frinstance, refuse an advert from the downhill world cup? Or from a tweedlove kids event? It's not all road riding, easy xc, and adult decisions. Not all events have control over their rules, and some have different circumstances to others.

Holy crap.Not yet [i]another[/i] helmet debate started on STW. Jeez how tedious, there must be something else to discuss on a Sunday afternoon. I wear a helmet, I don't wear a helmet, a helmet could save you, a helmet won't save you... surely [i]we[/i] have all made our decision by now???

As NW puts it there's 2 issues here.
1. Do they actually protect against head injuries?
2. Would compulsion be advantageous to the community?

The answer to 1 is simply yes. The best available evidence in medical literature is a metanalyses which is level 1. These combine all the best available studies on a subject, collate the samples and perform statistical analysis to 95% confidence. This means that if the statistics are less than 95% certain the study is regarded as inconclusive. The best metanalysis on cycle helmet efficacy has been published in the Cochrane library which is widely regarded as the best available evidence and its difficult to argue with.
[url= http://www.thecochranelibrary.com/userfiles/ccoch/file/Safety_on_the_road/CD001855.pdf ]This[/url] found

Helmets provide a 63 to 88% reduction in the risk of head, brain and severe brain injury for all ages of bicyclists.

This is real life data based on the collation of all case control studies. This is not any form of simulation. This is the best evidence that there is.
This over-rides any concerns about rotational forces, risk compensation etc because this data is drawn from real cyclists injury rates and their rate of helmet use.

Now for 2.
This is where there is scope for debate.
This is where people attempt to weigh up whether the survival advantage of wearing a helmet, is counterbalanced by the drop in cyclists numbers. The drop in cyclist numbers may cause more deaths related to sedentary lifestyle and its cardiovascular impacts.
Unfortunately most of this data is quite old and centres around an Australian paper by Robinson.
Australian authorites have refuted this paper no end and as most people know Australia has had compulsion in place for 20 years.
The legislation and evidence has been reviewed in Australia many times in that 20 years and yet it persists to this day.

It is very rare to see cyclists in Australia not wearing helmets and thats not because its law, but because its now part of cycling culture.

As you say people have their minds made up and you simply do not want to listen to the evidence - you have made that clear.

This is real life data based on the collation of all case control studies. This is not any form of simulation. This is the best evidence that there is.

Its a very flawed piece of biased work that is widely discredited

1) it still contains the self selecting sample / only a part of the data set as it only includes people who crash and sustain injury - hence false positives. this is a major flaw in studies of the type used

2) its only using a very limited range of studies and the people who did the cochrane study were the authors of most of the studies used.

3) it completely ignores some factors - risk compensation, helmets exacerbating injury amongst other factors

4) it assumes that those who have crashes are representative of the cycling population whereas other studies show that actually the two populations are very different in nature and also studies show that helmet and non helmet wearers are different populations

That cochrane study is actually completely discredited as a result of major flaws in it. It is certainly a long way from the proof you claim it to be and a long way from a decent bit of work

[url= http://www.cyclehelmets.org/1243.html ]critique of the cochrane review[/url]

This over-rides any concerns about rotational forces, risk compensation etc because this data is drawn from real cyclists injury rates and their rate of helmet use.

No it does not because these studies cannot tell you if these factors are significant or not as they specifically discount the existence of them before any analysis. the studies also only have a part of the population so we do not know if the helmet wearers have a higher rrate of crashing.
.

Unfortunately most of this data is quite old and centres around an Australian paper by Robinson.

again incorrect - there is data from a wide number of similar total population surveys that show the same - no / little protective effect.
http://www.ctc.org.uk/DesktopDefault.aspx?TabID=4689

I suggest you actuality look at the recent data and debates on this - but I bet yo will not. Please just open your mind and eyes.

BMA position / debate http://www.ctc.org.uk/DesktopDefault.aspx?TabID=4690

Dont be silly now. You cannot discredit Cochrane. It represents the best available unbiased evidence on any medical subject.
People may have attempted to discredit it for their own reasons but if their account was reasonable there would be a revision and there hasn't.

The current [url= http://www.bma.org.uk/health_promotion_ethics/transport/promotingsafecycling.jsp?page=3#.T8uWwhB5mSM ]BMA position[/url] is:

The BMA, as a part of its policy to improve safe cycling supports compulsory wearing of cycle helmets when cycling for children and adults. The Association wants to see an increase in voluntary use prior to the introduction of cycle helmet legislation and supports initiatives that so increase such use.

Stupid, stupid, Spokes. I always quite liked them though I'm not sure they ever really achieve very much.

I've always said if you don't believe a helmet can protect you in a crash, come round and we can do some simple experiments on the street with your head, a bike and some tarmac or a wall, with and without a helmet, and see which you prefer with hindsight.

I'm pretty sure the whole anti-helmet thing is led by the older stubborn touring type rider who didn't grow up with them and doesn't like being told what to do by younger people.

If the UK was like Copenhagen in terms of cycling safety Spokes might have a point, but the focus needs to be on making cycling safe in the UK by changing the attitudes of road users and the transport infrastructure, not trying to lull innocent cyclists into a false sense of security and into danger on the roads just to satisfy the misguided opinions of a few individuals who happen to be in a position of 'regard'.

Hugor = the cochrane reviwew is flawed and discredited. I gave you reasons why and a link to a decent piece of analysis. Of course you can discredit the cochrane review. Its almost meaningless it is so flawed

the BMA debate is far wider than that

You tell me this. if head injuries are reduced by such large amounts by helmets why can this not be seen in the head injury rates pre and post compulsion?

But of course you will not engage o this as it is so obvious the massive flaws in the evidence once you actually look at the data

Haven't read the above as no doubt full of arguments 🙂 but thought I'd share my experience.

Came off last January on the road whilst doing 20mph. Helmet was cracked in 2 places.

Had I not been wearing my helmet I'm 99% sure I wouldn't be typing this today (or if I was it wouldn't be comprehendible).

I've used about three helmets I think and very sure they have saved me a lot more damage, at the very least I would not have much scalp/hair left and have terrible cuts if I hadn't been wearing one.

Bigjim - no doubt good at preventing cuts and bruises. Its the preventive effect for major injury that is far more debatable

Hugor - a summary of the evidence

a review

http://www.cyclehelmets.org/1230.html

I'm not going to let this consume my whole evening again.
I come here to hear about people's amazing rides not argue with someone who misquotes the medical bodies and discredits the best available medical evidence.
Unfortunately I can't help but be drawn into this debate as my daily job involves putting people back together again and telling them their disabilities are permanent.
I feel some sense of obligation if someone comes on here telling people they are safer without a helmet to set the facts straight. What they do with those facts is their business.
Are you safer with a helmet? Yes
Is there a survival advantage to the broader community for compulsion? The evidence is inconclusive.
I'm outta here.

The Spokes take on this does seem pretty silly - as someone else noted there is a pretty good chance the events in question are only doing it for insurance reasons.

Spokes are like many bike related organisations - a mix of good stuff with stupid/reactionary stuff. I agree with their take on some stuff but there is a fair bit I don't - so other than buying the maps I haven't had anything to do with them. Plus their website is so bad I find it difficult to spend any time on it.

A real shame those websites don't even attempt to be objective. 60 seconds reading TJ's second links shows up holes and bias.

hugor - Member
Are you safer with a helmet? [u]In my opinion, albeit I am unable to establish this evidentially,[/u] Yes

FTFY

TJ. Do you [i]really[/i] think cyclehelmets is a neutral source of information?

Well hugor - you would have more respect from me if you actually listened to both what I say and what the evidence says. But no - you have a closed mind on this and you do not want to hear.

I do not misquote the medical bodies.

I do not say anyone is safer without a helmet.

What I do say is the the actual evidence is flawed and contradictory and there is no decent evidence of helmets reducing head injuries. All 100% true

If yo actually want to reduce morbidity then you would want evidence based practice.

Your support for helmet compulsion would result in increased morbidity - well founded fact as a dozen might be saved from dying from head injuries but a hundred would die from diseases of inactivity.

If you think that cochrane review is best evidence then you show how little you really know. I do note yo have not even attempted to answer the flaws I show in it.

[b]Go on - answer me this. if helmets reduce head injuries by 60+% why is this not see in the longitudinal studies pre and post compulsion?[/b]

I feel some sense of obligation if someone comes on here telling people they are safer without a helmet to set the facts straight.

~
so do I which is why I expose the myths and flaws in the evidence and say that there is no decent proof of helmets reducing head injuries - as that is true.

Saying helmets reduce in jury absense of good evidence that they do takes emphasis away from measures that would actually reduce injury

You should be arguing for more and better research and better standard of helmets as well as other measures that reduce deaths to cyclists such as enforcing traffic law

imnotverygood - Member

TJ. Do you really think cyclehelmets is a neutral source of information?

No - it clearly needs to be considered with a pinch of salt - however the other side of the debate is equally biased

I don't care what TJ says/links to. I have enough personal experience to know that not wearing a helmet would have left me in a bad way more than once. If you come off a bike and your helmet is trashed and your head is not why wouldn't you?

This really is a thread for the same old bores that really can't help themselves. I'll be donning my foil helmet and nothing new to see here glasses 🙂

[img] [/img]

Correct - I allowed myself to be sucked in didn't I

doh!

I dont ride on the road so i'm not likely to get taken out by other road users....my MTB riding is exclusively off road, judging by the number of scrapes, scratches and knocks my helmets (particularly the full face for DH) have taken i'm glad i wear one as i reckon my scalp would be a lumpy bumpy scarred mess by now and several rides would've been cut short due to cuts....helmets arent perfect though....my other half rides horses and their rules on hats are just changing too....fixed peak hats (traditional) are to be banned in competition, they found that face planting from a horse and landing on the peak caused the neck to hyper-extend....there will be constant evolution in cycling helmets, personally i think the safest looking style for general riding are the almost round ones that a lot of the dirt jump and enduro guys wear, no peaks and encompasses most of the skull....never been a fan of the roadie, mushroom on the head style....often feel 'whats the point' when i see that style.

To the original point.....

Refusing to promote an event if they insist on helmet wearing is poor judgement. Racing tends to be at higher speeds with more riders in close proximity to each other.

In DH etc there is enough hassle trying to get kids to do there f'in chin straps up. Certainly wouldn't want to have a pop at Val Di Sol or Fort William without one on.

I am happy as an individual that my brain is precious enough to give some extra protection to. I also wear knee/shin on the mtn bike and will wear more depending on the situation. As for more chance of knee injuries I think the recovery rate is better for those.

In Perth WA they are considering changing the compulsory rules so that on certain routes under a certain speed a helmet is not compulsory. Instant Confusion!!

As for cars taking more liberties with a rider wearing a lid, it sounds like steaming bull****. Most drivers claim to have not seen the bike at all, let alone what the rider was wearing.

As always there are a range of possible injuries that can be picked up on/off a bike. The only way to avoid them all is to stay at home. To take protection against one of the more serious is wise. I know it will not prevent all injuries hence I don't ride like I'm invincible.

Ah yes, the weekly debate about the half inch of polystyrene. Oh well, I don't have any work to do today anyway.

As for cars taking more liberties with a rider wearing a lid, it sounds like steaming bull****. Most drivers claim to have not seen the bike at all, let alone what the rider was wearing

The evidence that this is the case is far more compelling than the evidence that helmets will do you any good in a crash.

Anyway, just to balance the "if I hadn't been wearing a helmet I would have been dead" arguments that get trotted out every time. Do any of you really have a similar experience of crashing without a helmet to compare it to?

I remember a mate of mine jumped on my back when we were walking between pubs. I started running forwards but then lost my balance and fell forward. He went flying over the top of me and his head went straight into the edge of a kerb. The thud was sickening.

Apart from a mild concussion he was fine. Had he had a similar crash on a bike while wearing a helmet I'm sure he would now be as evangelical about helmets as many others on here.

It's half an inch of polystyrene. Stop putting so much faith in it and hopefully drivers will stop assuming it's some sort of magical amulet.

druidh - Member
TBH - I was more interested in what folk thought about what Spokes were doing than just rehearsing the same arguments.

I don't have a problem with it. The Scotsman headline is slightly misleading - as it states Spokes withdrawing support from events where helmet wearing is encouraged. In fact spokes are withdrawing support from events where it is compulsory. It seems Spokes would have no objection to an organiser saying "We encourage you to wear an appropriate, properly fitted cycle helmet." I'd be surprised if insurers can't be convinced that 'complying with the highway code, including encouraging (but not mandating) helmets' is enough.

I'd certainly support the assertions that spokes made:

- some drivers do seem to give you a wider berth without a helmet.
- most people are unaware that helmets are designed for road-head interfaces at <12 mph not car-head interfaces at 30 mph.
- people are more sub-consciously inclined to take higher risks wearing a helmet

I'd also add that more than half the helmets I see aren't fitted properly - which means the rider has higher expectations of its effectiveness than the manufacturer.

In my experience Spokes are more interested in 'general' cycling than MTB and the arguments for/against helmets in a forest at 10 mph are quite different from on a road at 25; however as the thread a few weeks ago showed MTB fatalities are extremely rare despite the fact not everyone wears helmets, many who do are ill fitting and serious crashes on downhill are likely to be at speeds above the design speed of the helmet.

However, my son's cycling club insist on helmet usage during their training sessions. Correct fitting is checked every time, and the speeds they ride at and type of surfaces are probably pretty much what helmets are designed for. There are plenty of spills and I think if I was on the committee I would be insisting on helmets. They don't get funding from Spokes, but it would be a shame if other funders followed suit - when there is definitely an argument for helmets in some circumstances. Interestingly I arrived at his club the other night without a helmet (normally I do have one, but I had left it in the car which my wife was using at the time) - and a couple of the kids pointed out my error... ...it did make me wonder if we are brainwashing children into believing helmets make people safe.

Latest update. A slight increase from 307,000 in April:
[img] [/img]

http://singletrackworld.com/forum/topic/the-helmet-debate-rumbles-on-in-the-mainstream-media

http://singletrackworld.com/forum/topic/would-you-helmet-nazi-content#post-3139927

http://singletrackworld.com/forum/topic/psa-another-study-on-the-efficacy-of-bike-helmets#post-3128520

http://singletrackworld.com/forum/topic/thank-god-for-helmets#post-3071801

http://singletrackworld.com/forum/topic/so-i-decided-to-write-off-my-helmet-today#post-3015561

http://singletrackworld.com/forum/topic/will-the-uk-every-be-like-this#post-3001646

http://singletrackworld.com/forum/topic/no-helmet#post-2983986

http://singletrackworld.com/forum/topic/my-helmet-is-very-deformed-graphic-photo-content#post-2963127

http://singletrackworld.com/forum/topic/the-woman-who-tragically-died-in-dent-on-the-letjog-ride#post-2956453

http://singletrackworld.com/forum/topic/helmets-2#post-2941835

http://singletrackworld.com/forum/topic/cyclist-hit-15-times-with-hammer-by-driverfor-riding-too-slow-up-a-hill#post-2943106

http://singletrackworld.com/forum/topic/this-really-makes-you-want-to-wear-a-lid#post-2919841

http://singletrackworld.com/forum/topic/good-or-bad-advert#post-2894537

http://singletrackworld.com/forum/topic/james-cracknell-wear-a-helmet-video#post-2783611

http://singletrackworld.com/forum/topic/bmxers-idiots#post-2758996

http://singletrackworld.com/forum/topic/motorcyclist-protesting-helmet-laws-dies-in-bike-crash-while-not-wearing-helmet/page/3

http://singletrackworld.com/forum/topic/wear-a-helmet-kids#post-2705179

http://singletrackworld.com/forum/topic/psa-helmet-debate-on-radio-2-now#post-2584202

http://singletrackworld.com/forum/topic/if-helmets-were-to-be-made-compulsory#post-2573922

http://singletrackworld.com/forum/topic/helmet-on-your-child-always#post-2482018

http://singletrackworld.com/forum/topic/some-very-sad-news#post-2476001

http://singletrackworld.com/forum/topic/the-great-helmet-debate#post-2432920

http://singletrackworld.com/forum/topic/kids-cycling-to-school-without-helmets-is-it-me-or#post-2368335

http://singletrackworld.com/forum/topic/compulsory-helmet-law-in-ni#post-2236497

http://singletrackworld.com/forum/topic/how-smug-will-tj-be

http://singletrackworld.com/forum/topic/helmets-possibly-the-last-word

http://singletrackworld.com/forum/topic/anyone-else-hear-peter-thatchel-on-jeremy-vine-calling-for-compulsary-helmets/page/2

bigjim - Member
Stupid, stupid, Spokes. I always quite liked them though I'm not sure they ever really achieve very much.

I've always said if you don't believe a helmet can protect you in a crash, come round and we can do some simple experiments on the street with your head, a bike and some tarmac or a wall, with and without a helmet, and see which you prefer with hindsight.

Where did Spokes say a helmet WON'T protect you in a crash?

I'm pretty sure the whole anti-helmet thing is led by the older stubborn touring type rider who didn't grow up with them and doesn't like being told what to do by younger people.

But you would be at least partly wrong. I wouldn't say I am anti-helmet (I wear one for 99% of my riding) but I would object to being made to wear one to ride the 400m to the local Tesco, and would be less likely to use my bike for that if it impacted my convenience. The inevitable consequence is to revert to the most convenient form of transport - the 1.5 tonne, steel box with in build oil burner. I grew up as one of the first people I knew to wear a helmet. I've bothered to understand where a helmet might help and might not and take educated risks.

If the UK was like Copenhagen in terms of cycling safety Spokes might have a point, but the focus needs to be on making cycling safe in the UK by changing the attitudes of road users and the transport infrastructure,

well firstly bear in mind that Spokes has a Lothian remit not UK wide and circumstances may be different locally, e.g. they claim a 7 fold increase in cycle commuting within their patch since 1977; they also seem to take a pragmatic approach and try to change the things they can rather than simply get upset about why the UK is not the Netherlands or Denmark.

not trying to lull innocent cyclists into a false sense of security and into danger on the roads just to satisfy the misguided opinions of a few individuals who happen to be in a position of 'regard'.

But that is precisely what Spokes are doing. They are highlighting that cyclists may be under a false sense of security (and/or non cyclists in a false sense of danger) possibly because of misguided information from those in a position of regard (e.g. the BMA, or helmet manufacturers).

What it seems to me, Spokes do not want to see, is helmet usage become compulsory as precisely the type of cycling they have spent the last 35 yrs promoting will be most affected, that is: "cycling, as part of a sustainable transport and access strategy". They are not telling anyone to stop wearing a helmet - simply suggesting that cycling without a helmet is not inherently unsafe, and that imagery of all cyclists wearing helmets discourages people who may not have been on a bike for 30 yrs from getting our their 1.5 ton steel boxes, or off their sofas and using bikes.

Well said Poly.

there is lots of evidence that helmet promotion even reduces participation. This is why the change in the BMA stance caused such outrage amongst many doctors as the various debates show. My GP does not wear a helmet cycling

There is good evidence to suggest that helmet compulsion in ther UK would cost a couple of hundred lives a year thru reduced cycling while only saving a handful thru reduced head injuries.

It does amuse me the way for the helmet evangelists pro helmet research is the gold standard and must be right whereas anything that is sceptical must be rubbish - wheras people who actually approach this with an open mind can see flaws and quality evidence on both sides. [b]This is why I say the research is often poor quality and contradictory as well as counter intuitive and one of the key things we should be agitating for is more an better research including better testing of helmets
[/b]
some interesting analysis here. Note the reductions in cycle usage after legislation
http://www.cycle-helmets.com/helmet_damage.html
http://www.ipa.org.au/publications/2019/australia%27s-helmet-law-disaster

Well, I've enjoyed reading this thread.

I always wear a helmet these days. Despite never owning one until my late 20s I'm now of the opinion that the day I don't put it on will be the day I clobber myself. I'm a little bit OCD like that.

Open-mindedness on the subject is a good thing though. And what Spokes have done is raised public awareness on a little known alternative take, allowing the general public to question what it is they put on their heads, and why.

Through that, we might get a more complete set of data on the subject, and in the meantime more people may become interested in cycling.

Yes, cycling can be dangerous, but as already pointed out, so are many other activities. Like living.

Have read a fair bit of the scientific evidence on the subject I prefer to ride with a helmet. I do however support the rights of others to enter the Darwin awards by not wearing a helmet so am not currently in favour of compulsion.

I also think Spokes stance on not advertising events which require helmets pretty stupid but sadly quite typical of the pro-cycling lobby.

steve - doesn't sound like you've read much of the evidence.

http://www.ski-epic.com/amsterdam_bicycles/

Is it the lack of a helmet that makes cycling more dangerous or is the design of roads and attitude of the road users? If you get run over by a lorry a helmet isn't really going to make a bit of difference to the outcome. We should be looking at the cause of the problem rather than trying to mitigate it with a piece of polystyrene.

http://cyclinginfo.co.uk/blog/734/cycling/cycling-rates-by-country/

steve - doesn't sound like you've read much of the evidence.

I did. I even read that pseudo-scientific nonsense that TJ continually posts about.

that condition imposed on them by insurance companies.

RoadCC forum members have done some enquiring on this and they found it was a crock pushed by the organisers who were blindly following poorly carried out risk assessment recommendations.

I have no problem with recommended use of helmets where the risk assessing has been competently completed. It is similar to office fit-out jobs where everyone wears hi-viz and they are on the second floor and no-one interacts with vehicles or is working at a height where visibility of other trades could be compromised.

Well, I've enjoyed reading this thread.

I always wear a helmet these days. Despite never owning one until my late 20s I'm now of the opinion that the day I don't put it on will be the day I clobber myself. I'm a little bit OCD like that.

Gotta agree here,
I can't NOT get on a bike even witout a minimum of protection which for me is a DJ pot and gloves... if I'm going for a proper ride then it's full face, and knee/shin armour. Call it OCD.

Had a mate who was riding back to Peebles from GT after sessioning the FR park, swapped his full face for a std helmet for the ride back, got 300yrds from his house dropped off a kerb and his wheel collapsed by the time the wheel fully disintegrated and he twigged what was happening he was 3/4 of the way across the road he was in a prefect position to launch his face into the opposite kerb as his forks dug in, cue smashed cheekbone, fractured jaw & nose and a LOT of bruising. He always said that IF he had kept his full face on he would not have suffered those injuries. OK fluke accident but I would far rather have a pot on than not and take my chances

I don't care about being called a pussy for wearing all the protection I do, even for the most innocuous ride as you never know what is going to happen.

As for legistating helmet wear then for me if you are at a pukka trail center then it should be compulsory otherwise personal choice.

whilst I always wear a helmet for offroad and road riding - often i don't for commuting...

so nice sometime to ride in civvies and without a helmet... makes you feel like a person who is just using a bike rather than a 'cyclist'

The evidence that this is the case is far more compelling than the evidence that helmets will do you any good in a crash.

If you mean the experiment conducted by Dr Ian Walker, you are obviously easily compelled.

Feel free to educate me

[i]One[/i] bloke riding a bike fitted with a measuring device riding up & down the same bit of road wearing either a helmet, no helmet, or a long blonde wig.....

All the Walker study is is an interesting indicative discussion piece. NO more than that. Fails all the standards just about for rigour and reliability. He doesn't claim any more than that for it

However it is an interesting piece and consistent and may explain part of the answer as to why the protective effect predicted for helmets is hard to see in whole population studies.

Fair enough. However, since everyone else is presenting their anecdotes as evidence I feel it's only fair if I'm allowed to do the same.

I remember getting into an argument in a pub once with some ignorant ****. What he was saying was that it was ok to hit cyclists if they were being annoying since "they're wearing helmets".

So the Cohrane review is bobbins but we can draw conclusion from a report you admit

Fails all the standards just about for rigour and reliability.

where the author has misled but now does not

He doesn't claim any more than that for it

You seem to be using odd scientific standards here.

Junkyard - thats not what I said.

The cochrane review is badly flawed. it claims to be gold standard but falls far short for a whole variety of reasons. explained ad nauseum

The walker piece is an interesting discussion piece, the author clearly states it limitations in the paper he wrote and all I said of it was

and [b]may[/b] explain [b]part[/b] of the answer

I did not say you can draw conclusions from it.