StrangeWill

One thing I really hate about helmet design...

trombone

I wanted to add another point to this. Wearing a helmet can cause you to take more risks. Risk compensation is a real phemonena - essentially it means that people will tend to take the same level of percieved risk. So if you add more safety equipment, people tend to behave in a way that is more risky.

It really happens. It's been observed in children; installing spongy impact-absorbing materials under climbing frames leads to children climbing higher.

Interestingly, it has also been shown that people often assume additional risk far in excess of the ability of their safety equipment to mitigate. That is to say people feel invulnerable when wearing protective equipment, and therefore take risks far in excess of that which the safety equipment is capable of mitigating against.

There is a real possibility that VeloFleet undertook what was risky behaviour because he was wearing a helmet. Had he not been wearing one, he might have not put himself in that situation.

If you normally wear a helmet, try riding without it for a while. I do wear a helmet (its a legal requirement here), but recently for various reasons rode without one. I was genuinely astonished to find I rode more cautiously. I really really encourage you to try this experiment - anc consider whether you are perhaps engaging in risk compensatory behaviour far in excess of the ability of a helmet to help you.

There's something on this here, but google away. There's loads of research on this, which I only really started looking into after my helmetless riding experience.

StrangeWill

Got any resources there trombone?

Of course that is all behavior issues anyway, and can be nullified by self-control.

Winston Payne

I have no doubt that helmets may influence behavior, or helmetless-ness might lead one to ride more carefully. I love riding without one, just like sex without a condom is more sensual. Not to pull religion into this, but the Catholic church in Africa uses the same argument against condom promotion, claiming that condoms may actually cause illicit sexual behavior. But in reading Curnow's review, the conclusion that helmets don't work is off base. He is critical of the studies, but you should read Thompson's comments on the article. Curnow's response (2007, same journal) further stresses the need for more studies. More recent studies not reviewed in the Cochrane report show high correlation of increasing helmet use and decreasing rates of head injury. Helmets do offer some protection and this is verified statistically over and again.

If you have access to a university, you can get these online. These most recent. The servers won't accept if there isn't a subscription, so I'll paste in the key points or partial abstracts:

Berg, P. and R. Westerling (2007) A decrease in both mild and severe bicycle-related head injuries in helmet wearing ages - Trend analyses in Sweden. Health Promotion International 22(3):191-197
"The objectives of this study were to analyse the trends of bicycle-related head injuries based on their main diagnosis and external cause of injury by different age groups. Our study area was the whole population of Sweden from 1987 to 1996. Outcome evaluation was based on data from the Swedish National Hospital Discharge Register concerning all bicycle-related injuries from 1987 to 1996, which presented 49 758 reported in-patient care. The trends in incidence rates (IRs) were studied with regression analyses. The results show that children under 15 years had the highest IRs. For these children, the IR decreased by 46%. The head injuries in children decreased both in collisions with motor vehicles and in other accidents. Similarly, the IR of concussion and skull fracture decreased. For non-head injuries, there were no significant changes for children. On the other hand, the incidence of both head and other injuries for adults aged 16-50 years increased. Ages above that showed no significant changes. Our conclusions are that the decrease in IR for bicycle-related head injuries refers to children in ages for whom bicycle helmet use during the period increased. This could not be explained by any general decrease in bicycle-related accidents or by any changes in the distribution of injuries after collision with motor vehicles. The increasing helmet use among younger schoolchildren probably contributed to the decrease in head injuries."

Abu-Zidan, F.M. et al. (2007) Factors affecting severity of bicycle-related injuries: The role of helmets in preventing head injuries. Emergency Medicine Australasia 19(4):366-371.
"Objectives: To identify factors that affect the severity of bicycle-related injuries in patients with head injury compared with those without, so as to find whether the effect of using helmets extends beyond head protection, and to explore a direct protective effect of helmets on head injuries. Methods: A total of 297 patients with bicycle-related injuries were studied. A generalized linear model was used to test the effect of age, sex, helmet use, cause of injury, year of injury, place of injury and whether the injury occurred on public or school holidays on the Injury Severity Score (ISS) in those patients who had head injury and those without. A logistic regression model was used to define the factors that contribute to head injury, while adjusting for ISS. Results: Factors affecting ISS in the generalized linear model in those who had head injury were: cause of injury (P = 0.01) and there was a trend for helmet use (P = 0.06). The significant factors that have affected ISS in the no head injury group were age (P = 0.002) and place of accident (P = 0.03). Logistic regression has shown that with each increase of 1 point in the ISS the odds of head injury increases by a factor of 1.22 (95% confidence interval 1.13-1.31) and the use of helmets reduces the odds of head injury by a factor of 0.48 (95% confidence interval 0.23-1.03). Conclusions: The reduced severity of injury in helmeted patients is because of protection of the head and not other body regions." (duh)

Richter, M. et al. (2007) The Current Injury Situation of Bicyclists—A Medical and Technical Crash Analysis. J Trauma. 2007;62:1118 –1122
"In bicyclists, head and extremities are at high risk for injuries. The helmet use rate is unsatisfactorily low. Remarkably, two-thirds of the head injuries could have been prevented by helmets. More consequent helmet use and an extension of bicycle traffic lanes for a better separation of bicyclists and motorized vehicles would be simple but very effective preventive measures." (duh)


Lastly, there is this regarding improving helmet design pointed out by Curnow:
[B]Depreitere, B. et al. (2007) Lateral Head Impacts and Protection of the Temporal Area
by Bicycle Safety Helmets. The Journal of TRAUMA

Winston Payne

oops, too long
Lastly, there is this regarding improving helmet design pointed out by Curnow:
[B]Depreitere, B. et al. (2007) Lateral Head Impacts and Protection of the Temporal Area
by Bicycle Safety Helmets. The Journal of TRAUMA Injury, Infection, and Critical Care June 2007.
"The common designs of commercially available bicycle helmets do not prevent direct contact loading on the temporal and zygomatic arch region and this contact loading is potentially harmful. The present preliminary study strongly questions the effectiveness of these helmets in providing accurate protection of the temporal and zygomatic area." The go on to recommend an equestrian style helmet.


In any case, reducing head trauma also relates to avoiding impacts with vehicles, something that is only partially in the control of the cyclist. For that matter, I couldn't control the squirrel that put me into the ditch. I like that a helmet will at least reduce some risk, but of course not all. Behavior also needs to be safe or you negate any possible benefit that a helmet affords. To get back to condoms, one has a 1/100 to 1/1000 chance of contracting HIV from an infected person in a single sexual encounter, but with a condom used properly that risk goes to near zero. (Yes, of course bicycle helmets don't reduce risk to zero.)

closetbiker

the opening lines in Curnow's paper says,

Effective interventions for care of health need to be based on scientific evidence... To constitute evidence, data should also support a hypothesis in accord with scientific laws and knowledge.

The point is criticism of studies that take no account of the mechanics of brain injuries and the helmets role in preventing them, which is why I also posted a study on that topic. (https://members.pcug.org.au/~psvansch/crag/h-i-mech.htm)

If you're going to say, it's physics, you should really understand the limits of the the physics involved, like in the baseball bat example you provided.

As far as likely hood of receiving a head injury, I think we'd all be in the same boat by saying each one of us is a unique story and we all should respect an individuals choice if after sober consideration, one would feel the need to wear a helmet would be better suited for a trip down the stairs than a ride on a bicycle.

GreenPremier

I think the point of the WHOLE argument is, helmets provide preventative protection. They're not bullet proof and they don't garauntee you 100% safety, but they do help at times. This is what I've concluded from keeping up with this thread. Whether you choose to wear one or not, is your choice. Depending on where you ride, the chances of crashing or getting hit by a car are slim. I live in a smallish city of about 60k people, it's nothing like DC. I think I would wear a helmet everywhere if I lived in DC just because people drive like idiots. Around here in Iowa City, IA, people don't drive so stupid and a helmet isn't always necessary.
Take it or leave it. I agree with both sides of the argument, but saying someone is STUPID for NOT wearing a helmet is pointless.

closetbiker

I think the point of the thread is the lack of respect an individual receives when having made a choice that is different from anothers choice.

The full title of the thread (before it was shortened was, Spring Airheads... helmets cramp my style) was indicative of some who feel their opinion is the right opinion and if you don't agree with the right opinion, you must be an airhead.

there is nothing wrong with wearing a helmet but often those who do look down on those who don't and justify their opinion with a bunch of whacky reasoning as to why their opinion is the superior opinion

(BigDave)

I ride mostly on a local trail and the people are real friendly and wave to each other. When I see someone without a helmet I tap mine instead of waving. It makes me feel better anyway. After seeing two accidents I never ride without one.

alhedges

How often do they respond with the middle finger salute. Because that's how I would respond to someone who was so arrogant to presume to criticize me in public.

closetbiker

I would consider such a person to be ignorant and judgemental as well as arrogant and would treat them the same way I would treat a passing motorist telling me to "get on the side walk"

GreenPremier

No kidding. Big Dave, that's a real d*uche bag move. Respect that the person is riding a bike and not be a tw*t by tapping your helmet...jesus, I can't believe that sh*t...

Winston Payne

I don't want to be confrontational, if I was, I apologize. I don't care if anyone decides not to wear a helmet. That doesn't make one stupid. It's one's own decision. I don't feel it's my right or responsibility to convince anyone, except my kids, to do anything different. It's just that most, if not all, of the supporting material you've posted is, as far as scientific literature is concerned, well out of date. As important as Curnow's article may be, to use a 2003 review of another group's evaluation on the state-of-the-art at the time as the be-all end-all argument for your decision is, well, unscientific. The studies that van Schaik cites (in the link you provide) are solid experimental studies, but are non-clinical. In the last 15 years, there has been a dearth of clinical studies that show clearly that wearing a helmet reduces the risk and severity of brain injuries.

Per physics, you may quibble with this, but a blow to the head carries the same physical force no matter if it comes from a bat, the rearview mirror of truck, or the pavement. Every action has an equal and opposite reaction. Of course, there are attenuating circumstances such as whether or not the helmet slides on the pavement or if the head is jerked in whichever direction. What is unclear, however, is how that force may injure the brain. For example, whether or not a concussion or hematoma, diffuse or focal occurs may or may not be related to the site of impact or its force. Not to mention that successive concussions are progressively more detrimental no matter where the impact is located. This, I think is where van Schaik and Curnow in the links you provide get stuck - it's exceedingly hard to replicate all of those variables in a lab, which is why clinical studies are necessary. And the clinical studies do not thus far lead the researchers to conclude that 1) wearing helmets provide no protection or 2) that wearing helmets is more dangerous than not.

You might be interested in the studies that are being done at UNC on football helmets and brain injuries.
https://college.unc.edu/features/dece...-07.0451328104
They show pretty well how complex the relationship of local impact and magnitude to severity of injury is and how there is much we need to know. On the other hand, as people who get hit in the head a lot, the benefit of having an external buffer to diffuse that impact, for a football player, even a bicycle helmet, provides qualified protection even though it's difficult to quantify how much protection.

This is interesting, too. https://www.medpagetoday.com/Emergenc...dicine/tb/6277

"...the proportion of brain injuries was highest for horseback riding (11.7%), ice skating (10.4%), all-terrain vehicles (8.4%), tobogganing or sledding (8.3%), and bicycling (7.7%)."

Most of those recreational activities are not associated with helmets, except bicycling. You'll never see the Marlboro Man in a helmet. Okay, he died of cancer. But he knew the risks and weighed them. (Yes, I conflated the risks of smoking to cycling, but all in good fun. I used to smoke before I rode a bike.) In my experience, if walking down stairs were a recreational activity, you might see it, too, among the riskier of sports.

noisebeam

What about respecting the lack of understanding some may have regarding the capabilities and limitations of cycling helmets?
A cyclist dies with a head impact severe enough to cause death helmet or not. Or perhaps unclear.
Friends, family, co-workers, loved ones who are ignorant with good reason about the facts/politics of cycling helmets may have one less 'what if' to nag them if the cyclist had been wearing a helmet.

Certainly not a practical reason, but one that may carry some weight unless one spends much of ones time educating those around them about helmets.

Al

VeloFleet

Good, some actual advice for once instead of attacking someone's intelligence level...ty Winston and trombone.

What qualifications does everyone have that allow them to attack me personally about a snap decision that I made when there really wasn't time to think about the options? Maybe next time I could stop, find a computer, and login to ask the expert advice of those that have, for lack of better terms, called me stupid? Way to create a welcoming community of riders, mechanics, and general bike enthusiasts...all of which I am.

Honestly, at the peak of rush hour in bumper to bumper traffic, I had no choice but to cut that way or ride the sidewalk. Tell me, when was the last time you had to take physical risks to get paid? It really puts things into perspective when you say to yourself "Go for it, cause this doc needs to get filed by 4:30 and it's 4:25. If it doesn't get it, I look bad, the company looks bad, and neither of us get paid"? I was given this task by the dispatcher because I was the only one capable of beating that deadline. Was I to say, "I'll never make it cause the city is a parking lot...call them back and tell them we can't do it."? Or better yet, should I have just taken my time and not cared if it got in or not? Sorry, not my style. So until anyone can say that they've been in a similar situation, please don't question someone's intelligence level.

Out of curiosity, how many people that have responded to my post live in an urban area?

Also, how many people ride to work?

How many treat their bike not only as a recreational device, but also as a tool for earning a paycheck?

Of those people that ride to or for work, when is the last time you were doored by a driver that failed to look in their mirror before opening their door because they had their phone stuck to the side of their face?

closetbiker

Didn't think you were, so no sweat. We learn through confrontation, so it's a good thing (as long as certain decorum is observed).

I always thought something was "out of date" if it is no longer relevant, but in the case of brain injury we're discussing here, it still is relevant. The types and intensity of forces and energy applied are very relevant to the condition of what it is applied to. Current helmet standards are tested by extremely rudimentary tests while the biomechanics of what happens to a cyclists head in collisions and falls are extremely complex. Most clinical studies of cyclists arriving in ER's take in no account and could not possible know of at what force the victim was hit. An ER's job is to simply treat the condition. If a helmeted child came after falling over sideways onto a drive way and an unhelmeted courier came in after a full on collision at high speed with a car and the child had less severe injuries than the courier, would it be a reasonable conclusion that it was the helmet that made the difference? I think not.

I'm not saying that a helmet is of no use, causes injuries (although there is a case to made that a larger circumference of an object being a larger target and an oblong shape may contribute to a bigger risk of a torsion injury) or one should not wear one, just that there are physical limitations to them that shows up in injury reports when people use them. The top part of your head is covered and that provides some protection, but it is mostly superficial protection.

I'm still in wonderment that so many people can be conned at "the dangers" of cycling when the risks of head injuries are no greater than other daily activities and the very act of cycling lowers the incidence of brain injury by a large degree.

closetbiker

I have great respect for these people. They are often the ones that make me laugh the most.

(although to be fair, sometimes they make me cry the most too)

closetbiker

looks like you posted to the wrong thread by mistake here

clg

I had been riding for years without a helmet but I'm older now and perhaps smarter. I have been riding to work to give my knee a break; runner for many years, so I bought a helmet after a friend told me his wife insisted that he wear one. She told him she didn't want to wipe his ass for the rest of his life and that really made me rethink not wearing one. I have to say I wasn't too impressed when saw how they were constructed and wondered how much protection they really afford? Another thing that gave me pause was the little label that I assume is to be placed in the helmet to notify next of kin? I would be interested in hearing more about helmets and how they may differ in the protection they offer.

chipcom 

You mean if I wear a helmet I'll never have to witness an accident?
These things truly have magical powers I had never imagined!

Al Criner

Helmets are important for kids - kids are small, oblivious to risk, not always alert, not as strong as adults so they don't always control bikes well, and they fall down a lot. When they were real young my kids could ride a 20"-wheeled kiddie bike on a flat sidewalk and fall down for no obvious reason. Protecting little heads makes sense. I took a bad fall on a hill as a young kid and knocked myself out (many years ago, pre-helmet era). My teen-aged daughter busted a helmet last fall when she took a tumble on an asphalt bike trail. I am glad she had the helmet on.

For adults, well, pavement is still pretty hard. There are clearly pros and cons to helmets but if you crash on your bike you will have a better chance for a good outcome if you have some protection on your cranium. Bike helmets are not going to protect you from very high-speed impacts - they are not meant to. Let's not waste our time analyzing statistics on bicycle vs. truck crashes - the cyclist loses every time, trust me. If you hit a crack/hole/debris or drop your chain and lose control or whatever you can easily bounce your head on the ground and that helmet will be nice to have.

Now, we are all grownups and if you don't want to wear one, then don't. This is obviously becoming a religious issue. I think the only other discussion on BF that is this contentious is how to lubricate your chain. We aren't going to convince each other to change our positions.

chipcom 

Wah. I've ridden in many urban areas, I did some messengering as a kid, I've been riding to work for over 30 years. I haven't been doored because I stay the F out of the door zone and am extra careful when I have to be in the door zone. Most importantly, I don't let the problems of my employer cause me to make stupid decisions that might endanger my own life...at least not since I got out of the Marine Corps.

Sorry pal, I'm glad you're ok, but if you think you're gonna get paddy-cake and warm showers for doing something stupid just cuz you ride a bike, you're gonna have a lot of disappointments in life...depending on how long you live. Wise up, quit whining and pay attention to what you are doing. Don't let hurry and impatience make your decisions and minimize those 'snap' decisions by planning for Murphy...rather than being his biatch.

closetbiker

You're exactly correct. Helmets are made for kids and not for adult, high speed cycling or collisions with motor vehicles. Brian Walker of Head Protection Evaluations, the principal UK test laboratory for helmets, says views on helmets have gotten out of hand and has written on the subject

https://www.cyclehelmets.org/papers/c2023.pdf

he writes on what they are designed for and medical experts commenting on the biophysics of brain injury and bicycle helmets.

No question it would be nice to have one if you were to hit that portion of your head when you fall. Superficial injury is not pain-free injury, but as grown-ups we should all be free to decide what we want if it doesn't harm others and not suffer the disdain of others who feel they know better than we do, when in fact, they don't.

drumthebenway

Six Jours:

I'm now responding to your post of a few days ago. I only infrequently check the forum here so please excuse my late reply.

First of all, I never said that everybody who cycles without a helmet is stupid. I said that it would be stupid for me to ride without one. (Sorry for the lack of clarity on this point.) I've been hit by cars twice. In each case I was unable to avoid the accident -- I don't think Lance Armstrong would have been able to avoid it either -- and in one of the instances the helmet prevented a head injury. No doubt about it.

You also wrote: "Not to mention the millions of daily riders in places like Holland and Belgium who would no more put on a helmet for a bike commute than they would a Nomex suit for a walk to market." It's actually a valid point. I live in Austria in a rural village. People have been biking here for a long time. There are some old ladies who "ride" around every day without a helmet, just as they've been doing for years. But over the course of their lives things have changed, more cars have come in, people are driving more, there are more car-related injuries and fatalities -- and maybe they should actually adjust their behavior accordingly and wear helmets. I don't know.

Also, you say that someone wearing a helmet while riding to the market is over-equipped to the point of paranoia. That's simply not true. An accident can happen any time, especially where cars are involved.

As for telling people to **** off, as you so nicely put it, I'd suggest that you calm down. This is an internet forum where people from all walks of life can contribute. Quite often something is said without being articulated clearly enough (I'm especially guilty of this) and your hasty, vitriolic outburst doesn't really add to the discussion.

I do agree with chipcom that it ultimately comes down to personal choice. The notion of regulating helmet wearing seems a bit authoritarian to me. I'd much rather live in a convivial society that didn't make it necessary for me to ride with a helmet, one in which the road weren't such a dangerous place. But for now I'll stick with the helmet. Again, this is my decision.

closetbiker

It's great that you're behind an individual making their own choices, but it's telling that more than a few times you mention in your post about the increased possibility of, or actually being hit by cars as a reason for wearing one. You might want to read a bit more on the subject because bicycle helmets are not made to withstand impacts or prevent injuries from impacts with motor vehicles.

You're also correct to point out that accidents can happen at any time and a little extra protection may be a good thing, but you should also try to understand the relative risk of such a thing happening to anyone doing anything. Simply riding a bicycle does not necessarily increase your risk of this happening. The risk usually rises related to the behavior of what someone is doing, so it's far more effective to reduce head injury by a means other than a helmet, whatever one happens to be doing.

It seems many people's primary goal is to increase the rate of helmet wearing, but it's easy to forget a helmet is simply an end to a means, rather than remembering that the goal is to simply reduce injury.