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-   -   The helmet thread (http://www.bikeforums.net/advocacy-safety/771371-helmet-thread.html)

Six jours 02-07-12 07:57 PM

Quote:

Originally Posted by Six-Shooter (Post 13821805)
another endless round of statistics

And then the other side responds with their own endless round of statistics, and then you rip their stats, and they rip yours, and twelve pages later we end up right back where we started.

Meanwhile, the individual remains the only one qualified to asses his or her own risks and respond to them appropriately - and we all ought to be suspicious of anyone who wants to make those decisions for us.

martl 02-08-12 02:20 AM

Quote:

Originally Posted by Six-Shooter (Post 13821805)
I don't know if this counts as compelling, but these conclusions of some formal meta-analyses and general surveys of helmet studies might be interesting:

http://www.infrastructure.gov.au/roa...ic_Crash_5.pdf:

Very well, i knew that one, and a lot of those studies oused as input, too. These studies try to find out whether a bicycle helmet can give me better protection against head injuries.

But i was asking for a compelling reason to wear a helmet when riding a bike.

A helmet is something usually no one wears at "normal", everyday activities, at least i see few people wearing one when participating in traffic (say by foot or in a car), i don't see people ice-skating with a helmet, or tobogganing, or climbing ladders.

If someone handed helmets out to ladder climbers, or car drivers, and then did a survey, the results would look similar than those in the study you cited. Because head injuries will occur if the number of people evaluated is big enough, and possibly/hopefully a bike helmet would show impact on those.

But we don't wear helmets when climbing stairs aor driving cars. We wear helmets in situation which bear a *much higher* risk for our dear skulls than usual. Or in situations we believe to be. Like mountain climbing, where the guy above you can and will send small rubble down your way, or similar.

So again, why should i wear a helmet when riding a bike?

hagen2456 02-08-12 02:31 AM

Quote:

Originally Posted by Six-Shooter (Post 13821805)

Sorry, I can't resist it: all the research you link to has apparently been included in the Elvik paper. Read his introduction. It is extremely instructive, in particular in regards to bias, not least time trend bias. Once read, one tends to take previous papers and research with more than a grain of salt.

The Dutch SWOW report does not seem to include the findings of Elvik, but refers to older research.

So, it's not "another endless round" etc. Elvik really DOES take into account some aspects NOT included in earlier papers, and it has a big influence on the conclusions: bicycle helmets are at most marginally effective in preventing harm.

Six-Shooter 02-08-12 07:29 AM

Quote:

Originally Posted by Six jours (Post 13823229)
And then the other side responds with their own endless round of statistics, and then you rip their stats, and they rip yours, and twelve pages later we end up right back where we started.

Meanwhile, the individual remains the only one qualified to asses his or her own risks and respond to them appropriately - and we all ought to be suspicious of anyone who wants to make those decisions for us.

Just putting them out there for those interested. Make of them what you will. But it's rather lazy to just write off scientific evidence, pro or con.

Six-Shooter 02-08-12 07:30 AM

Quote:

Originally Posted by martl (Post 13824454)
So again, why should i wear a helmet when riding a bike?

To offer some measure of head protection in case you fall :) But your rationale for or against is your own. It's not my business. You asked for a reason, so I offered some reviews of the scientific evidence.

Six-Shooter 02-08-12 07:50 AM

Quote:

Originally Posted by hagen2456 (Post 13824473)
Sorry, I can't resist it: all the research you link to has apparently been included in the Elvik paper. Read his introduction. It is extremely instructive, in particular in regards to bias, not least time trend bias. Once read, one tends to take previous papers and research with more than a grain of salt.

The Dutch SWOW report does not seem to include the findings of Elvik, but refers to older research.

So, it's not "another endless round" etc. Elvik really DOES take into account some aspects NOT included in earlier papers, and it has a big influence on the conclusions: bicycle helmets are at most marginally effective in preventing harm.

One needs to take anything written about bicycle helmets with a grain of salt, it seems :) I've learned to be leery of the research and extremely leery of partisan sites, Wikipedia, blogs, etc.

The Dutch report summarizes and discusses Elvik at some length.

I think one should be careful with Elvik's article and note that

a) his own earlier meta-analysis has "reported a 64% reduction in the risk of head injury when a hard helmet is worn and a 41% reduction in risk when a soft helmet is worn."
b) he is re-analyzing the interpretations of one specific paper
c) he concludes "Do bicycle helmets reduce the risk of injury to the head, face, or neck. With respect to head injury, the answer is clearly yes." His re-analysis of Attewell "has not changed this answer."
d) He found only four estimates of neck injury, each suggesting an increased likelihood, therefore when head, neck, and face injuries are lumped together, the total protective effect of a helmet seems reduced (or evened out when you just consider just those four studies).
e) look at his actual numbers in tables 1 and 2, which, with adjustments for the new studies and potential bias, still show a substantial odds ratio for head injury protection. Of course, the neck injury statistics raise a big question for further research.

It will be interesting to see what he and other researchers find as we move forward.

Six-Shooter 02-08-12 08:12 AM

FYI, here are links to the four "new" (in the sense of not included in Attewell) studies, with abstract quotes.

Hansen et al. http://www.ncbi.nlm.nih.gov/pubmed/14630577
Quote:

The use of hard shell helmets reduced the risk of getting injuries to the head. Children less than nine years old that used foam helmets had an increased risk of getting face injuries. All bicyclists should be recommended to use hard shell bicycle helmets while cycling.
Hausotter http://www.biomedsearch.com/nih/Bicy.../10718089.html
Quote:

Therefore, there are many bicycling victims in casualty hospitals. The head being exposed and unprotected, head and brain injuries are the most frequent ones. Just as in professional and sports activities, protection of the head and neck also when bicycling has been urgently recommended and its effect repeatedly confirmed by recent statistical results. Wearing helmets by motorcyclists has clearly reduced the severity and frequency of head injuries since it became compulsory. A legislative initiative for wearing bicycle helmets as well is therefore necessary.
Heng et al. http://www.ncbi.nlm.nih.gov/pubmed/16645684
Quote:

Bicycle helmet use was low in our sample of injured patients. When worn, protection against injury was demonstrated. A campaign to promote use of bicycle helmets should be targeted at non-residents and older bicyclists. Authorities should consider compulsory helmet laws for bicyclists and expanding anti-drunk driving campaigns to target alcohol-intoxicated bicyclists.
and I believe this is the English version of Amoros et al. http://injuryprevention.bmj.com/cont...31815.abstract
Quote:

This study confirms the protective effect for head and facial injuries, even though soft-shell helmets have now become more common. The reduction of risk is greater for serious head injuries. The study is inconclusive about the risk for neck injuries.

rydabent 02-08-12 08:57 AM

Just amazing. Here we are at 56 pages on this I think is the forth thread on why trolls think we shouldnt wear helmets when cycling. Isnt it time for them to get a life????

martl 02-08-12 09:13 AM

Yes, you're right, it is written in the bible we should wear one, how could i be so stupid?

hagen2456 02-08-12 09:30 AM

Quote:

Originally Posted by Six-Shooter (Post 13824916)
One needs to take anything written about bicycle helmets with a grain of salt, it seems :) I've learned to be leery of the research and extremely leery of partisan sites, Wikipedia, blogs, etc.

The Dutch report summarizes and discusses Elvik at some length.

I think one should be careful with Elvik's article and note that

a) his own earlier meta-analysis has "reported a 64% reduction in the risk of head injury when a hard helmet is worn and a 41% reduction in risk when a soft helmet is worn."
b) he is re-analyzing the interpretations of one specific paper
c) he concludes "Do bicycle helmets reduce the risk of injury to the head, face, or neck. With respect to head injury, the answer is clearly yes." His re-analysis of Attewell "has not changed this answer."
d) He found only four estimates of neck injury, each suggesting an increased likelihood, therefore when head, neck, and face injuries are lumped together, the total protective effect of a helmet seems reduced (or evened out when you just consider just those four studies).
e) look at his actual numbers in tables 1 and 2, which, with adjustments for the new studies and potential bias, still show a substantial odds ratio for head injury protection. Of course, the neck injury statistics raise a big question for further research.

It will be interesting to see what he and other researchers find as we move forward.

What is interesting - and might interest our very own troll, Rydabent, too - is that it takes into acount the effect on neck injuries, finding that when they're included, the total benefit of helmets is close to zero.

njschmidt 02-08-12 10:18 AM

I wanted to add to this discussion because of a personal experience that happened to me yesterday. I have a very short commute (about a mile) to work, and I have never worn an helmet during it. Yesterday morning as I was going to work I decided to go a new way just to stir things up a bit. Along this new way, I went through what I thought was just a shallow puddle (I had driven this way before, and had not noticed any big pot holes or anything like that). Unfortunately, at the bottom of the puddle, was a crevice just large enough for my front tire to get stuck in. I fell off, managed to turn my body so that I landed on the meaty part of my upper back, but heard a loud "clunk" as the back of my head met concrete.

I didn't lost consciousness, I got up, had a slight ringing in my ears, but was able to continue on to my office. For some backstory, a couple years ago I had a friend whose son slipped off his motorcycle as he came to a stop over some loose gravel and lightly knocked his un-helmeted head (never lost consciousness). He got back up, seemed fine, continued on home. After going to bed, he never woke up (brain bleed killed him in his sleep). Fearing a similar situation and because I was still feeling dizzy an hour after the incident, I visited the local walk-in clinic, where it was decided I needed a CT scan. Luckily, everything is fine, although the doctor said that I might continue to be dizzy and have an headache for another 2 weeks (he said I might even throw up... Yay).

The point is, had I been wearing an helmet, I would not have made hard, direct contact with the concrete, I do not believe I would have had a concussion, and I would not now be paying $2000 in medical fees. It will take me many months of saving gas money by bike commuting to offset these medical costs, but I guarantee that I will be doing it with an helmet on (that is, once I'm no longer feeling dizzy and deem it safe for me to ride again).

Just my $0.02.

Six-Shooter 02-08-12 11:34 AM

Quote:

Originally Posted by rydabent (Post 13825133)
Just amazing. Here we are at 56 pages on this I think is the forth thread on why trolls think we shouldnt wear helmets when cycling. Isnt it time for them to get a life????

56 pages and you're still calling people trolls every time you post :(

Six-Shooter 02-08-12 11:42 AM

Quote:

Originally Posted by njschmidt (Post 13825445)
I wanted to add to this discussion because of a personal experience that happened to me yesterday. I have a very short commute (about a mile) to work, and I have never worn an helmet during it. Yesterday morning as I was going to work I decided to go a new way just to stir things up a bit. Along this new way, I went through what I thought was just a shallow puddle (I had driven this way before, and had not noticed any big pot holes or anything like that). Unfortunately, at the bottom of the puddle, was a crevice just large enough for my front tire to get stuck in. I fell off, managed to turn my body so that I landed on the meaty part of my upper back, but heard a loud "clunk" as the back of my head met concrete.

I didn't lost consciousness, I got up, had a slight ringing in my ears, but was able to continue on to my office. For some backstory, a couple years ago I had a friend whose son slipped off his motorcycle as he came to a stop over some loose gravel and lightly knocked his un-helmeted head (never lost consciousness). He got back up, seemed fine, continued on home. After going to bed, he never woke up (brain bleed killed him in his sleep). Fearing a similar situation and because I was still feeling dizzy an hour after the incident, I visited the local walk-in clinic, where it was decided I needed a CT scan. Luckily, everything is fine, although the doctor said that I might continue to be dizzy and have an headache for another 2 weeks (he said I might even throw up... Yay).

+1 I'm no doctor, but what from what I've read, if you get a knock on the head and seem to be fine, still get it checked out to prevent a tragedy like you describe. http://www.nlm.nih.gov/medlineplus/e...cle/000028.htm See symptoms section

Glad you're essentially ok.

You make a good point about the expense and hassle involved in even a relatively minor injury.

hagen2456 02-08-12 12:14 PM

Quote:

Originally Posted by njschmidt (Post 13825445)
I wanted to add to this discussion because of a personal experience that happened to me yesterday. I have a very short commute (about a mile) to work, and I have never worn an helmet during it. Yesterday morning as I was going to work I decided to go a new way just to stir things up a bit. Along this new way, I went through what I thought was just a shallow puddle (I had driven this way before, and had not noticed any big pot holes or anything like that). Unfortunately, at the bottom of the puddle, was a crevice just large enough for my front tire to get stuck in. I fell off, managed to turn my body so that I landed on the meaty part of my upper back, but heard a loud "clunk" as the back of my head met concrete.

I didn't lost consciousness, I got up, had a slight ringing in my ears, but was able to continue on to my office. For some backstory, a couple years ago I had a friend whose son slipped off his motorcycle as he came to a stop over some loose gravel and lightly knocked his un-helmeted head (never lost consciousness). He got back up, seemed fine, continued on home. After going to bed, he never woke up (brain bleed killed him in his sleep). Fearing a similar situation and because I was still feeling dizzy an hour after the incident, I visited the local walk-in clinic, where it was decided I needed a CT scan. Luckily, everything is fine, although the doctor said that I might continue to be dizzy and have an headache for another 2 weeks (he said I might even throw up... Yay).

The point is, had I been wearing an helmet, I would not have made hard, direct contact with the concrete, I do not believe I would have had a concussion, and I would not now be paying $2000 in medical fees. It will take me many months of saving gas money by bike commuting to offset these medical costs, but I guarantee that I will be doing it with an helmet on (that is, once I'm no longer feeling dizzy and deem it safe for me to ride again).

Just my $0.02.

Concussions are primarily the result of oblique, not direct, impacts. Hemorrhages can happen on direct impacts, but it is in fact extremely rare.

Just my $0.02.

hagen2456 02-08-12 12:25 PM

Quote:

Originally Posted by Six-Shooter (Post 13824982)
FYI, here are links to the four "new" (in the sense of not included in Attewell) studies, with abstract quotes.

Hansen et al. http://www.ncbi.nlm.nih.gov/pubmed/14630577


Hausotter http://www.biomedsearch.com/nih/Bicy.../10718089.html


Heng et al. http://www.ncbi.nlm.nih.gov/pubmed/16645684


and I believe this is the English version of Amoros et al. http://injuryprevention.bmj.com/cont...31815.abstract

#1: Case-control design. You must by now be aware of how problematic that is.
#2: Ditto.
#3: "...head and brain injuries are the most frequent ones". What??? I think we can disregard that one. :P
#4: Recommends hard-shell helmets. Good luck with getting people to cycle in the future, if that becomes mandatory.

Ah. Typical. I mixed up the order of the links. But I guess you get the drift etc. etc.

Six-Shooter 02-08-12 03:08 PM

Quote:

Originally Posted by hagen2456 (Post 13826006)
#1: Case-control design. You must by now be aware of how problematic that is.
#2: Ditto.
#3: "...head and brain injuries are the most frequent ones". What??? I think we can disregard that one. :P
#4: Recommends hard-shell helmets. Good luck with getting people to cycle in the future, if that becomes mandatory.

Ah. Typical. I mixed up the order of the links. But I guess you get the drift etc. etc.

Re: #3, looks like some translation software may have been at play. The original was in German.

Anyway I posted those to make it easy to see the four "new" studies Elvik included in his re-analysis of Attewell's original meta-analysis. If there's a problem with these articles--the ones that Elvik used to calculate smaller net benefits from helmets and greater potential for neck injuries--tell him, not me :)

njschmidt 02-08-12 03:32 PM

Quote:

Originally Posted by hagen2456 (Post 13825941)
Concussions are primarily the result of oblique, not direct, impacts. Hemorrhages can happen on direct impacts, but it is in fact extremely rare.

Just my $0.02.

I would say that it was between a direct-back-of-the-head hit and an oblique hit (the bump and scab are closer to my left ear). The CT scan failed to indicate hemorrhaging. I'm not sure the exact type of trauma experienced by the friend's son who died.

hagen2456 02-08-12 04:59 PM

Quote:

Originally Posted by Six-Shooter (Post 13826671)
Re: #3, looks like some translation software may have been at play. The original was in German.

Anyway I posted those to make it easy to see the four "new" studies Elvik included in his re-analysis of Attewell's original meta-analysis. If there's a problem with these articles--the ones that Elvik used to calculate smaller net benefits from helmets and greater potential for neck injuries--tell him, not me :)

Makes it so much more astonishing that after all, the conclusion is that the net benefit - including neck injury - is close to zero.

hagen2456 02-08-12 05:04 PM

Quote:

Originally Posted by njschmidt (Post 13826772)
I would say that it was between a direct-back-of-the-head hit and an oblique hit (the bump and scab are closer to my left ear). The CT scan failed to indicate hemorrhaging. I'm not sure the exact type of trauma experienced by the friend's son who died.

If he simply fell with his bike while stationary - and that's how I read it, wrongly perhaps - he's one of the few who are extremely unlucky when hitting their head. Happens in all kind of situations: at home, on the sidewalk, when biking etc.

What is first of all being discussed here is not really if a helmet may help in certain situations. It may. Rather, what some of us doubt is BOTH that there's much more reason to wear it when biking than when walking or taking a shower, AND that they have the effect claimed by so many, including authories.

Six jours 02-08-12 08:28 PM

Quote:

Originally Posted by Six-Shooter (Post 13824858)
Just putting them out there for those interested. Make of them what you will. But it's rather lazy to just write off scientific evidence, pro or con.

As a "veteran" of the last four or five iterations of this thread, what you deride as laziness is, in fact, experience. Your list of links is hardly unique, and have been dissected ad nauseum.

As has been demonstrated over and over and over, one can "prove" anything one likes with statistics. It's a pointless exercise.

Drummerboy1975 02-08-12 10:33 PM

Look what I just got in the mail today. Thanks mconlonx!

http://i1217.photobucket.com/albums/...208_190038.jpg

http://i1217.photobucket.com/albums/...208_190045.jpg

Six-Shooter 02-09-12 08:22 AM

Quote:

Originally Posted by Six jours (Post 13827983)
As a "veteran" of the last four or five iterations of this thread, what you deride as laziness is, in fact, experience. Your list of links is hardly unique, and have been dissected ad nauseum.

As has been demonstrated over and over and over, one can "prove" anything one likes with statistics. It's a pointless exercise.

If you've made your personal decision and presumably/hopefully aren't interested in forcing it on others, and have decided one can't learn from the science on the matter, why keep participating in the thread?

Six jours 02-10-12 07:32 PM

One man's "science" is another man's bull****. And one reason I still participate in this thread is to point out when folks are using bull**** to promote their own agendas.

mconlonx 02-10-12 09:30 PM

Quote:

Originally Posted by njschmidt (Post 13826772)
I would say that it was between a direct-back-of-the-head hit and an oblique hit (the bump and scab are closer to my left ear). The CT scan failed to indicate hemorrhaging. I'm not sure the exact type of trauma experienced by the friend's son who died.

Your friend's son may very well have survived his fall with a motorcycle helmet, but a motorcycle helmet is a very different beast than a bicycle helmet. A bicycle helmet is not proof against concussions and are not built to prevent them--you could very well have been wearing one and still suffered a concussion. Or it might have helped...

mconlonx 02-10-12 09:32 PM

Quote:

Originally Posted by Drummerboy1975 (Post 13828482)
Look what I just got in the mail today. Thanks mconlonx!

Hey, you're very welcome, man! :thumb:


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