GIFCo147

For the Buffalo News...
https://www.buffalonews.com/cityregion/story/469553.html

Very nice opinion piece on bike helmet use, with a happy ending!

alhedges

Given that even helmet manufacturers don't believe that bike helmets will help in a collision with an automobile, I'd have to say it is a very uninformed editorial.

gcottay

Evidence of a helmet manufacturer stating the belief that bike helmets will not help in a collision with an automobile is to be found where?

A rider can certainly suffer head injury while riding a helmet. Just as certainly, a helmet offers some level of protection.

Tommyr

Helmets can only help, not hurt. They are not made for high impact situations. I wear one. Don't wear one, I couldn't care less. It's YOUR head/brain.

Dan The Man

Talk about sensationalist:
Bicycle helmetlessness is the latest epidemic that will destroy our children.

cudak888 

Soap opera journalism. Nonsense such as that warrants a complaint to the author and to the editor - news is news, in the same fashion that business is business; flaky sensationalist garbage has no place in either.

-Kurt

Square & Compas

Here we go again. The helmet proponents and the helmet opponents are pitted against each other yet again in a never ending debate as to how effective a helmet is/is not, that a helmet will/will not help in the event of an accident.

Here's an idea. Just drop it.

GIFCo147

This is actually filed as commentary, not news. (Note "Commentary" in red letters above the article).
And, although the article is a bit dramatic, It does make the point that helmets do save lives.

From the American Academy of Pediatrics...
Bicycling remains one of the most popular recreational sports among children in America and is the leading cause of recreational sports injuries treated in emergency departments. An estimated 23 000 children younger than 21 years sustained head injuries (excluding the face) while bicycling in 1998. The bicycle helmet is a very effective device that can prevent the occurrence of up to 88% of serious brain injuries

https://aappolicy.aappublications.org...ics;108/4/1030

GIFCo147

Advocacy and Safety seemed like an appropriate place to post on use of bike helmets.

closetbiker

A poorly researched and sensationalist opinion.

I wrote a piece for my local paper on helmet use. I did a little more research.

Just how risky is riding a bicycle anyway? The health benefits of riding a bicycle far exceed the risks, and I've yet to actually see any data that shows a cyclist being at greater risk of head injury than any other individual.

A study published in the British Medical Journal found, "The likelihood that a given person walking or bicycling will be struck by a motorist varies inversely with the amount of walking or bicycling. This pattern is consistent across communities of varying size, from specific intersections to cities and countries, and across time periods."

Dr. Dorothy Robinson, senior statistician of the University of New England, Australia, published her research in the British Medical Journal on the effects of Australia's helmet law. The research showed there was no statistically significant decline in head injuries, and a significant drop in ridership levels.

Dr. Ian Walker, a traffic psychologist from the University of Bath, published research showing motorists pass cyclists wearing helmets significantly closer than cyclists not wearing helmets and the New York Times reported that along with the rise of helmet use in America, there was a larger rise of head injuries to cyclists.

One explanation for this is something called "risk compensation"; a behavior explained in a study by Indiana's Perdue University. Cyclists and motorists believe the cyclist is safer when wearing a helmet and therefore take unnecessary behavioral risks instead of achieving safety through careful driving or riding practices.

Since the introduction of our helmet law, the number of deaths to cyclists in B.C. hasn't changed at all because in virtually every case of brain injury or death to a cyclist, a collision with a motor vehicle was responsible. And a bicycle helmet is simply no match for such collisions.

A bike helmet is designed to absorb a maximum impact of only 20 km/h, and researchers from the Imperial College of London explained when a cyclist is knocked off a bicycle by a motor vehicle, this frequently results in the head being spun and subjected to torsional (twisting) effects. A helmet does nothing to prevent this injury caused by rotation of the brain (an effect similar to Shaken Baby Syndrome.)

The New Zealand Medical Journal has also published research showing that in most cycling deaths that involved brain injuries, there were other significant internal injuries that contributed to death as well, which is certainly something no helmet can prevent.

Wearing a helmet should be a means to an end, rather than an end unto itself. In order to reduce brain injury and death to cyclists, the most effective method would be to reduce collisions with motor vehicles.

At best, the issue is far from clear-cut and the debate rages on. If helmets were as effective as many feel, the evidence would be clear. It isn't clear because head injuries to cyclists who wear helmets reveal results that are not what the promoters said would happen.

That still doesn't mean they are useless. It means they, like all things, have limitations and we should know what those limitations are. There is a sticker inside your helmet that says even in low speed impacts, the helmet cannot be relied on to prevent injury. It's there for a reason.

Square & Compas

I am not saying you should wear a helmet, I am not saying you should not wear a helmet. I wear one. Because it is a personal choice and I know for myself it is a good idea. Far be it for me to try and ram my opinion down someone else's throat on the matter. All to often when the debate really heats up one side trys to suppress the opinions of the other and vice versa.

What I get sick and tired of is both the proponents and opponents trying to shove their ideals and opinions down everyone's throat about the matter.

GIFCo147

And yet, the American College of Emergency Physicians, American Academy of Pediatrics, World Health Organization, and the American College of Surgeons actively promote helmet use as beneficial!

closetbiker

and they say,

"The bicycle helmet is a very effective device that can prevent the occurrence of up to 88% of serious brain injuries"

any use of this 88% stat shows a gross ignorance of the research.

First this figure has been admitted by the authors of the study it came from is incorrect (It also didn't help that the author had been involved in helmet promotion before conducting the study). Analysis by an independent statistician of the full data set showed that the figures for lower-body injuries were similar; in other words, the helmeted riders were "protected" as much from broken legs as from head injuries. The study does not distinguish facial injuries from other head injuries, although helmets would not prevent the former. The figure was later adjusted significantly downward by the authors yet the 88% figure is still quoted, revealing gross ignorance of those quoting it.

The proper use of the (incorrect) figure would be up to 88% as in there were 3 groups of children who simply fell off their bicycles and went to health care facilities and only the group of 0-4 year olds represented this high figure. The groups of 5 - 10 year olds had a 42% reduction and 10 - 14 year olds had a 23% reduction, but even this figure is a misrepresentation of the odds ratio.

The authors calculate an odds ratio and present it as meaning that helmets prevent this proportion of injuries. This is false because odds ratios tend to overstate relative positions. For example, suppose that in a sample of 100 men, 90 have drunk wine in the previous week, while in a sample of 100 women only 20 have drunk wine in the same period. The odds of a man drinking wine are 90 to 10, or 9:1, while the odds of a woman drinking wine are only 20 to 80, or 1:4 = 0.25:1. Now, 9/0.25 = 36, so the odds ratio is 36, showing that men are much more likely to drink wine than women. But actually men are only 4.5 times more likely to have drunk wine than women.

It might also be of significance to note that not a single helmeted cyclist in this study had been struck by a motor vehicle. Not so for the group of cyclists without helmets. The authors were quoted to have said, "We cannot completely rule out the possibility that more cautious cyclists may have chosen to wear helmets and also had less severe accidents".

So the AMERICAN ACADEMY OF PEDIATRICS should do a little more careful research instead of simply parroting previous research that they haven't checked to be valid before publishing.

GIFCo147

The AAP has cites NINETEEN SOURCES for the development of this policy statement.
This does not appear to be a case of the organization parroting one bad study.


1. Rodgers GB Bicycle and bicycle helmet use patterns in the United States in 1998. J Safety Res 2000; 31:149-158
2. Centers for Disease Control and Prevention, National Center for Health Statistics. 1998 Mortality Tapes. Hyattsville, MD: Division of Data Services, National Center for Health Statistics; 2000
3. US Consumer Product Safety Commission. National Electronic Injury Surveillance System (NEISS). Bethesda, MD: US Consumer Product Safety Commission; 1999
4. Centers for Disease Control and Prevention. Injury-control recommendations: bicycle helmets. MMWR Morb Mortal Wkly Rep. 1995;44(RR-1):1-17
5. Thompson RS, Rivara FP, Thompson DC A case control study of the effectiveness of bicycle safety helmets. N Engl J Med 1989; 320:1361-1367 [Abstract]
6. Thompson DC, Rivara FP, Thompson RS Effectiveness of bicycle safety helmets in preventing head injuries. A case-control study. JAMA 1996; 276:1968-1973 [Abstract]
7. Thompson DC, Nunn ME, Thompson RS, Rivara FP Effectiveness of bicycle safety helmets in preventing serious facial injury. JAMA 1996; 276:1974-1975 [Abstract]
8. Sacks JJ, Kresnow M, Houston B, Russell J Bicycle helmet use among American children, 1994. Inj Prev 1997; 2:258-262 [Abstract/Free Full Text]
9. National Center for Chronic Disease Prevention and Health Promotion. Behavioral Risk Factor Surveillance System (BRFSS). Available at: http//www.cdc.gov/nccdphp/brfss. Accessed August 19, 2001
10. Howland J, Sargent J, Weitzman M, Barriers to bicycle helmet use among children: results of focus groups with fourth, fifth, and sixth graders. Am J Dis Child 1989; 143:741-744 [Abstract]
11. Parkin PC, Spence LJ, Hu X, Kranz KE, Shortt LG, Wesson DE Evaluation of a promotional strategy to increase bicycle helmet use by children. Pediatrics 1993; 91:772-777 [Abstract/Free Full Text]
12. Schieber RA, Kresnow MJ, Sacks JJ, Pledger EE, O'Neil JM, Toomey KE Effect of a state law on reported bicycle helmet ownership and use. Arch Pediatr Adolesc Med 1996; 150:707-712 [Abstract]
13. Ni H, Sacks JJ, Curtis L, Cieslak PR, Hedberg K Evaluation of a statewide bicycle helmet law via multiple measures of helmet use. Arch Pediatr Adolesc Med 1997; 151:59-65 [Abstract]
14. Hatziandreu EJ, Sacks JJ, Brown R, Taylor WR, Rosenberg ML, Graham JD The cost effectiveness of three programs to increase use of bicycle helmets among children. Public Health Rep 1995; 110:251-259 [Medline]
15. US Department of Health and Human Services. Healthy People 2010. Vol 1 and 2. 2nd ed. Washington, DC: US Government Printing Office; 2000
16. National Highway Traffic Safety Administration, National Center for Injury Prevention and Control, and Federal Highway Administration. National Strategies for Advancing Bicycle Safety. Washington, DC: US Department of Transportation; 2001
17. Safety Standard for Bicycle Helmets. 63 Federal Register 11711-11747 (1998) (codified at 16 CFR §1203)
18. Powell EC, Tanz RR Tykes and bikes: injuries associated with bicycle-towed child trailers and bicycle-mounted child seats. Arch Pediatr Adolesc Med 2000; 154:351-353 [Abstract/Free Full Text]
19. American Academy of Pediatrics. Child Bicycle Safety Act. Available at: https://www.aap.org/policy/m956.html. Accessed August 19, 2001

Do you really believe that thousands of Physicians across multiple disciplines (Peds, Surgeons, Emergency) and the World Health Organization are that easily mislead?

closetbiker

... and there are at least as many of equally reputable bodies that disagree.

Trombone made a good post on how some papers can be of low quality on the "Helmets cramp my style" thread


Some things are certain though. A claim of a bicycle helmet being a very effective device that can prevent the occurrence of up to 88% of serious brain injuries has never been shown to be true in real world applications.

As an example, New Zealand instituted an all-ages mandatory helmet law that has been vigorously enforced. Dr. Nigel Perry charted head injury among cyclists with the rise in helmet use against head injury amongst the general population to see the effects of wearing helmets made for cyclists.



Now, does that look anything like an 88% reduction in injury?

Use a little common sense, don't have a closed mind, and you'll find there is much debate and disagreement on the topic, it's not black and white, and that the 88% figure quoted has never been replicated in areas that have instituted mandatory helmet use. (in my own province that has had an all ages mandatory helmet law for over 11 years there not been a drop in serious head injuries from before the law was enacted. the only difference in the death reports now is that the dead cyclists are now wearing helmets)

I acknowledge that a bicycle helmet has some merit (and have worn one for over 20 years), but to claim a helmet reduces serious brain injuries by 88% is a big red flag that who ever is making such a claim hasn't done their homework.

I've done a bit more work to show (from an independent source) how the issue is divided.

The British Government's Department for Transport have a page on the debate

https://www.dft.gov.uk/pgr/roadsafety...?page=11#a1050

On the page, it says,

Britain's National Cycling Strategy Board made a statement of policy on cycle helmet wearing in January 2004,

This falls more to my feeling on the issue. That the benefits of cycling outweigh the risks, that cycling increases health. Even brain injury can be reduced by cycling without a helmet because the larger risk is of acquisition through lack of exercise that cycling provides. By simply riding, your chances of receiving brain injury are being reduced.

An excellent site for cyclist safety is bicyclesafe.com

Here the author tackles the helmet issue nicely

So when an opinion piece reduces the importance in a collision between a 12 year old and a truck to simply the cyclist should be wearing a helmet I'd say the writer is looking for a short, quick, easy answer that doesn't exist and misleads the public into believing in something that hasn't been shown to be effective. I'd say, that's dangerous.

atbman

UK researcher, Dr. Mayer Hilman, studied all(?) the fatal cyclist head injuries for one year. He found that close to 92% of them would have died, even without the head injuries, as the impact with a motor vehicle had done things like crushing the rib cage, cause massive internal chest/stomach cavity bleeding, etc., etc.

Which isn't to say that a helmet cannot, ever, save one's life, or prevent/reduce serious injury, simply that the pro-helment case has been overstated as a means of making serious inroads into the numbers of head injuries experienced by cyclists.

Unfortunately, Dr. Hilman's studies have also shown that, since a hgher proportion of vhicle and pedestrian fatalities are caused by head injuries, governments should clearly pass laws which require them to wear them, with the consequent reduction in health care and other costs related to head injuries and fatalities.

Naturally, the US and UK publics will wholeheartedly endorse such policies. Won't they?

crhilton

Gotta love special interest stories: They have their own dialect of english.

I'm not gonna disagree that this kid might have been saved by his helmet. I'd yield to the people who saw the scene and his helmet. However, anecdotes are still just anecdotes.

closetbiker

We'll never know if the helmet did any good, and although some claim it did, they most probably did based on emotions.

There was study done up here that examined every collision between bicycles and motor vehicles over a 3 year period.

Every death of a cyclist was from a collision with a motor vehicle but certainly not every collision with a motor vehicle resulted in death. In fact, the most common outcome in these collisions was, no injury at all. In over 6,000 collisions between the 2, there were only 18 deaths. That's a 97% survival rate.

It seems statistically unlikely that a helmet saved a life and seems even less likely considering they are made for falls that do not involve a third party (i.e. motor vehicles).

CB HI

Yes, it can be very dangerous to ride a helmet in the road.