Advocacy & Safety - light not heat

In the great helmet debate, I have been looking to shed some light on what proportion of ALL head injuries (Traumatic Brain Injuri/TBI) are caused to cyclists, ie how big a problem are cycling head injuries, compared to other sources of head injury.
Its is remarkably difficult to get these figures. The only site with anything sensible to say on the issue is at
http://www.health.state.ny.us/nysdoh/research/injury/part3/etrnktbi.pdf

For NY state in 1990-93, the mean annual figures for leading cause of TBI :

Falls 5995
Motor Vehicle Crash 4938
Assault 2635
Pedestrian 1459
Bicyclist 842
Struck by object/person 780
Self inflicted 67
unintensional firearm 40
Machenery 33
Poisoning 20
Cutting instrument 16
Fire/flame 12
other 1023
TOTAL 17,860

(dont add up the figures, there are rounding errors)
Out of 17,860 hospitalisations, 842 were cyclists.

As a general guide, the mortality rate for TBI is about 10% of the hospitalisation numbers

More numbers for you statisticians at
http://www.health.state.ny.us/nysdoh/research/injury/injury.htm

How do they account for a bicyclist who was assaulted by a motor vehicle, and fell?

Self inflicted??? Like banging your head against a wall when motorists frustrate you?

I doubt there will ever be a statistical analysis that can demonstrate the truth or falsehood of this premise:

A cyclist riding as a vehicle, legally and as part of the normal flow of traffic, is as safe or safer than operators of other vehicles.

The statistics about injury, head or otherwise, do not distinguish between someone riding as an "effective cyclist" and someone who gets whacked entering an intersection riding in the wrong direction, running a red light, in the dark, without lights.

And I, for one, am not interested in being lumped into the same statistical group as a wrong-way rider who gets killed because he's too stupid to live.

RichC

Originally posted by Rich Clark
And I, for one, am not interested in being lumped into the same statistical group as a wrong-way rider who gets killed because he's too stupid to live.

I remember my teenage kids telling me a few years ago about
a classmate of theirs.

"We're concerned about So-and-so," they said.

"Why, what's the problem?" I queried, sensing the urgency in their voices.

"She's had a car accident!" they explained.

"Oh, my! Is she--is she hurt?"

"Not too badly."

"I'm so relieved!" I sighed. But my children weren't so quick to relax.

"Yeah," they countered, "but this is their third car accident in a year!"

:eek:

Originally posted by Rich Clark
I doubt there will ever be a statistical analysis that can demonstrate the truth or falsehood of this premise:

A cyclist riding as a vehicle, legally and as part of the normal flow of traffic, is as safe or safer than operators of other vehicles.

The statistics about injury, head or otherwise, do not distinguish between someone riding as an "effective cyclist" and someone who gets whacked entering an intersection riding in the wrong direction, running a red light, in the dark, without lights.

And I, for one, am not interested in being lumped into the same statistical group as a wrong-way rider who gets killed because he's too stupid to live.

Another brilliant post from Rich C. :thumbup: As I said in another thread, there are lies, damn lies and statistics.

I've got to agree with Rich too! A I've posted before, it's always your behaviour that leads to a problem (or not), not the mode of transport (or whatever you're engaged in).

I've also been bashed for laying out stats like the one that started this thread off and found if someone doesn't want to change thier mind, no stats will change thier mind. This is a little funny to me because I was once convinced that there were far more accidents for bicycles than there were and when I started to look into some stat claims I found different points of views for the same stats and ended up realizing that bicycling accidents are not something that someone should worry about any more than any other accidents that happen that we don't worry about at all.

Everyone also seems to miss the huge advantage of health gains from cycling which make the small risks well worthwhile to run. For as much as we worry about accidents, odds are we'll survive the odd case of road rash and end up living with a far better quality of life than someone who doesn't get the exercise a cyclist gets.

I'm facinated as to why cycling get such a bad rap as opposed to other dangers but in our car centered society I'm convinced it's a form of discrimination against the cyclist. I don't see the same fears of cycling in Europe or Asia as in Canada or the U.S. and that's consistent with the cycling as an everyday, normal form of transportation in those countries.

Originally posted by closetbiker
I'm facinated as to why cycling get such a bad rap as opposed to other dangers but in our car centered society I'm convinced it's a form of discrimination against the cyclist.

I'm trying to figure it out, too. Personally I think it's merely an extension of the old "cyclists hold up traffic" myth (oh yeah, like that traffic Jam on the Sundale Bridge was really going anywhere if I hadn't been there, duh!). Basically, a lot of people don't want us to use public roads, and a lot of this scaremongering is their attempt to justify that position.

Of course, there is also the old redneck position of "bigger is better". The belief that if you're not massively huge, then "you're gonna die, you're gonna die!" Over 100,000km and I'm still around - never even had a broken bone - and I've never bought into that belief at all.

However, the most bizarre thing I ever saw was in a guidebook that was supposed to be promoting cycling on the Great Ocean Road last year. "Do not ride on total fire ban days". I'm still trying to figure that one out.

I think the stats show that over 95% of TBI is not cycling related. ChrisL has a good point about how cycling related ones break down into
Children learning to ride
Adults learning to ride
BMX stunt riding
MTB extreme sport riding
Competition riding
Riding illegally/stupidly
Just Riding Along

Originally posted by closetbiker
I've also been bashed for laying out stats like the one that started this thread off and found if someone doesn't want to change thier mind, no stats will change thier mind. Stats are often inconclusive.

I found different points of views for the same stats...That is exactly the point.

and ended up realizing that bicycling accidents are not something that someone should worry about any more than any other accidents that happen that we don't worry about at all.Just exactly what accidents do we not worry about at all?

Everyone also seems to miss the huge advantage of health gains from cycling which make the small risks well worthwhile to run.People don't miss the huge advantages.

I'm facinated as to why cycling get such a bad rap as opposed to other dangers but in our car centered society I'm convinced it's a form of discrimination against the cyclist. I'm convinced that many cyclists percieve it as discrimination. Cyclists have something of a 'siege mentality' and are overly sensitive to slights or percieved slights in the press and elswhere.

I'm a soccer fan living in the US and, believe me, many soccer fans are just as bad or worse. Just about any comment anybody makes anywhere is percieved as a slight and part of some kind of conspiracy. They rant and rave, whine and moan, about percieved discrimination. It's a characteristic of many groups that aren't seen, or don't see themselves, as "mainstream". It's comforting to see yourself as a "victim".

To a lesser extent, cyclist do the same thing. Some of it, at least, is as much their preception as it is reality.

Originally posted by Chris L
Personally I think it's merely an extension of the old "cyclists hold up traffic" myth (oh yeah, like that traffic Jam on the Sundale Bridge was really going anywhere if I hadn't been there, duh!). Basically, a lot of people don't want us to use public roads, and a lot of this scaremongering is their attempt to justify that position.

Yep, I've got to agree. Also, as I've said before, I feel much better as to why there is fear after I read The Culture of Fear by Barry Glassner. I had read The Book of Risks by Larry Lauden and Are We Scaring Ourselves to Death? : How Pessimism, Paranoia, and a Misguided Media Are Leading Us Toward Disaster by H. Aaron Cohl recently, but I thought the psychology of Glassner's book was better for me.

Even with the good job our local advocacy groups have done around here with education, awarness and even (I can't believe I'm going to say this), enforcement (they-police and the courts- do take the side of cyclists if all the p's and q's are in order) I still get the overwhelming experience of motorists pressing the view that we should not be on the roads.

I had a co-worker rail on to me about how when she was coming up behind me in traffic, after work, I was riding on the road! She said I should be on the curb or side walk. This is a woman I've worked with for 18 years and she's seen me ride in for every one of those years. Meanwhile, she's a heavy smoker, and has had 3 car accidents in the time I've worked with her. After she told me I was going to get killed riding in the road like that, I just said, with each of our habits, we'll see who outlives who here.

I have a couple of intelligent friends who are fair weather riders and they insist on riding as little as possible on the roads and when they do ride on the roads they ride on the wrong side despite my explanations as to why that is such a dangerous thing to do. In thier minds, bikes don't belong on the road and when they do get on them, it's only for briefly as possible and because they don't believe bikes belong on the roads, the rules of the roads do not apply to them.

These are the people who end up being a stat.

:(

Originally posted by closetbiker
I have a couple of intelligent friends who are fair weather riders and they insist on riding as little as possible on the roads and when they do ride on the roads they ride on the wrong side despite my explanations as to why that is such a dangerous thing to do. In thier minds, bikes don't belong on the road and when they do get on them, it's only for briefly as possible and because they don't believe bikes belong on the roads, the rules of the roads do not apply to them.

Yes, this is yet another factor in the perception of cycling as being "dangerous". The behaviours mentioned above tend to be the "recommended way" that people are being told they have to ride. They are told this by people who have never ridden around the block in their life.

They are told that cycling in traffic is "dangerous" by people who have never actually attempted it. Of course, nobody bothers to ask those of us who actually do it every day. After all, why would they, we're stupid, we ride in traffic, our death is inevitable (of course, so is everyone else's, but what does that matter?). Is it any wonder people perceive cycling as dangerous?

The whole point is that any activity you do is going to be more "dangerous" if you don't do it properly. Heck, slicing vegetables at home is dangerous if you put your finger in the wrong place - I don't see any "dangers of slicing vegetables" articles in the media.

Originally posted by Rich Clark
I doubt there will ever be a statistical analysis that can demonstrate the truth or falsehood of this premise:

A cyclist riding as a vehicle, legally and as part of the normal flow of traffic, is as safe or safer than operators of other vehicles.

The statistics about injury, head or otherwise, do not distinguish between someone riding as an "effective cyclist" and someone who gets whacked entering an intersection riding in the wrong direction, running a red light, in the dark, without lights.

And I, for one, am not interested in being lumped into the same statistical group as a wrong-way rider who gets killed because he's too stupid to live.

RichC

A fundamental issue with statistics and their use is observational equivalence- for any set of observations there are an infinite number of models which can explain the results. What a good practitioner of statistical art would do is first come up with a conjecture about some issue, such as bicycling on the road is more dangerous than driving a car. then he would develop a set of hypotheses which might reflect that conjecture, such as:

The fatal accident rate per passenger mile is higher for bicycles traveling on highways than it is for automobiles.

Then he would gather data- often the data is not well gathered or reliable, and that is a limitation of any analysis.

finally he would test the hypothesis using the data. If his test showed a high level of confidence that the hypothesis was true, he would have supported the hypothesis, and should publish teh results. Equally important, but far more often neglected, if the test yields ambiguous results he should report that too. If ambiguous results are not reported then randomly tested data will show spurious relationships. If we are looking for a 95% level of confidence, then one out of twenty times we should get a spurious correlation. If only positive results are published, then nonsense will be accpeted as truth.

so where do we fall down on statistics:

Choosing the wrong model- not much we can do about that
Bad input data- getting better data requires resources which may not be available
Not using the framework here- typically, such researchers look for correlations and then develop models- a really bad way to do business, and all too common
Not publishing ambiguous results.

I look at tons of safety data and pu tthem into statistics. We have to make "best guesses" sometimes in order to help decisionmakers. I think we do a much better job in the safety analysis community than the public gives us credit for.

Originally posted by JRA

I'm convinced that many cyclists percieve it as discrimination. Cyclists have something of a 'siege mentality' and are overly sensitive to slights or percieved slights in the press and elswhere.

My issue with the press in unbalanced reporting. Every single cycling fatality around here is greeted with the inevitable articles and editorials about the "dangers of cycling". We're greeted with politicians calling to have cyclists banned from this road or that road "for their own safety". Of course, in the mean time there's been 100 or so driving fatalities, and nobody ever rambles on about the "dangers of driving" or suggests banning cars from any roads.

The other difference is that in the coverage of driving fatalities (just the newsreports, for they rarely receive any editorials - except to blame the government for not fixing a particular road), we hear all the reports about the thing the driver was doing wrong. Yet a cyclist can run a red light, riding against the flow of traffic at night with no lights wearing dark clothes - and all we will hear is "cycling is dangerous". Yes, in that situation the cyclist would be in the wrong, but please, tell us specifically, don't just say "cycling is dangerous/stupid" - this is a slight against all those who cycle correctly. This is not balanced reporting.

That may or may not be discrimination. It may be brought about by the fact that the media will attract more readers for a position of banning cycling than banning driving. Either way, the effect is still the same


Originally posted by JRA
I'm a soccer fan living in the US and, believe me, many soccer fans are just as bad or worse. Just about any comment anybody makes anywhere is percieved as a slight and part of some kind of conspiracy. They rant and rave, whine and moan, about percieved discrimination.

Without wanting to drift too far off topic, I'm a soccer fan in Australia - another place that hasn't caught up. The unbalanced reporting is the same on this issue. I've lost count of the number of articles in magazines and newspapers referring to it as "wog ball" because the game was not invented in Australia. Well, hey, neither were cricket or the two rugby codes. In fact, even "Australian Rules" football is based on Gaelic football, which the Irish started. Yet these are considered "Australian games" and soccer isn't. Tell me how that works.

Originally posted by Chris L
My issue with the press in unbalanced reporting. I'm not going to defend the press. Much of the reporting is atrocious or worse. But reporting on bicycling is no worse than reporting on other subjects.

...and all we will hear is "cycling is dangerous"...- this is a slight against all those who cycle correctly. This is not balanced reporting.I agree. It's not balanced reporting. But there's not necessarily an intentional bias. It's bad reporting, which is the norm.

That may or may not be discrimination.It's more likely incompetence than discrimination against cycling.

It may be brought about by the fact that the media will attract more readers for a position of banning cycling than banning driving.I doubt it's even that. It's probably just that the writer doesn't know beans about cycling and, what's more, doesn't care. (substitute the word "soccer" for "cycling" in the previous sentence, and it still works :D) To put it another way, the writer has a bias. But, as I said before, it's not necessarily an intentional bias.

If a cycling advocate writes a story about a cycling accident, it's likely to be biased in favor of cycling. If a non-cyclist writes the story, it will have a different bias. It's not discrimination; it's bias. Everyone has some kind of bias.
--------
We've gotten off the subject of stats. I don't want to drift off the subject of cycling, but since it came up : --

In fact, even "Australian Rules" football is based on Gaelic football, which the Irish started. Yet these are considered "Australian games" and soccer isn't. Tell me how that works.I don't know how that works, but I'm familiar with how things work in the US.

We have this sport of baseball. Promoters of that sport were so concerned that it would be thought to be a foreign sport or, worse, a British sport (Oh, the humanity! :D), as soccer supposedly is, that they made up a story that Abner Doubleday invented it. This "official" story is a fabrication, but is believed by many. (Baseball is an adaptation of the British game of rounders).

I only mentioned soccer because I see such stong parallels between the attitudes toward press coverage that some cyclists have, and the attitudes that some US soccer fans have. It goes like this: "It a conspiracy. They're out to get us. The press is against us. All they ever do is bad-mouth us. We're victims"

I'm not buying it. There is no conspiracy and not all that much discrimination. It's in the mind. Neither cycling nor soccer (in the US) is mainstream. A lot of people do not understand either and, what's more, do not want to understand.

There IS a lot of misinformation and even disinformation, but it's not a conspiracy. It's mostly just bad reporting and uninformed and/or biased opinion.

Originally posted by FOG
What a good practitioner of statistical art would do is first come up with a conjecture about some issue, then he would develop a set of hypotheses which might reflect that conjecture

So would it be resonable to concede that the BMA and the AMA primary concerns would be the overall good health of their respected countries?

Originally posted by JRA
There IS a lot of misinformation and even disinformation, but it's not a conspiracy. It's mostly just bad reporting and uninformed and/or biased opinion.

I agree, there's every chance it is not a conspiracy. However, whether it's a consipiracy or just plain media bias/incompetence, the effect is still the same.


Originally posted by JRA
Neither cycling nor soccer (in the US) is mainstream. A lot of people do not understand either and, what's more, do not want to understand.


Then perhaps they should stick to writing articles that they do understand. There is no law saying that they have to write 100 "cycling is dangerous" editorials every time a cyclist is killed. If the subject really bores them that much, why cover it at all?

Originally posted by closetbiker
So would it be resonable to concede that the BMA and the AMA primary concerns would be the overall good health of their respected countries?

I have met many folks involved in attempting to maintain or improve safety, and very few have anything but the most honorable motives. What they do have is huge blindspots. Consider the issue of highway railraod grade crossing closure- the safety advocates will attempt to close as many crossings as they can. They are honestly and fervently worried about safety. They are also virtually blind to the adverse impacts of their actions. A 1/2 mile detour may be an inconvenience in a car, but it becomes a serious detour on a bicycle and a major obstcle to pedestrians. The safety advocates are very concerned dedicated people, but they have a limited vision when it comes to tradeoffs.

I think the medical associations are like that. When it comes to health policy, they really do want safety. If you want to see the dark side of their policies, it isn't in safety recommendations, but in limiting competition. Doctors do not want broader privileges for other health care workers such as nurse practitioners and midwives, and really don't want simple competition from telemedicine.

Originally posted by FOG
I think the medical associations are like that. When it comes to health policy, they really do want safety.

So you would agree with the BMA that the benefits of cycling outweigh the risks to individuals by a factor of 20 to 1?

Or the AMA's study that said, "Even after adjustment for risk factors, those who did not cycle to work experienced a 39% higher mortality rate than those who did."?

Originally posted by closetbiker
So you would agree with the BMA that the benefits of cycling outweigh the risks to individuals by a factor of 20 to 1?

Or the AMA's study that said, "Even after adjustment for risk factors, those who did not cycle to work experienced a 39% higher mortality rate than those who did."?

I would agree with them. I would also suggest that if living longer is your main concern, that wearing a helmet, and cycling defensively are worth the effort and expense.

Originally posted by closetbiker
So would it be resonable to concede that the BMA and the AMA primary concerns would be the overall good health of their respected countries? It'd be safe to conclude that. It doesn't make their studies any better (or worse) than anybody else's. And it doesn't make their statistics any more relevant to a given issue than anyone else's. And it doesn't make the studies that other do invalid or irrelevant.

Originally posted by FOG
What they do have is huge blindspots.And no methodology is perfect. Which is why it's important to look at many studies to see if they come to similar results.

Originally posted by closetbiker
So you would agree with the BMA that the benefits of cycling outweigh the risks to individuals by a factor of 20 to 1?I've yet to see anyone on these forums dispute the fact that the benefits of cycling far outweigh the risks. You're preaching to the choir here.

But the benefits of cycling, however great, are not a good reason not to wear a helmet when you do it.

Originally posted by FOG
I would agree with them. I would also suggest that if living longer is your main concern, that wearing a helmet, and cycling defensively are worth the effort and expense.

and so would I. If you look back at my previous posts you would see I've said I believe to ride safe first, wear a helmet second as I've also posted (@http://www.bikeforums.net/showthread.php?s=&threadid=20743&perpage=15&pagenumber=6), I'm not saying that wearing a helmet doesn't make good sense.
:)

Originally posted by JRA
It doesn't make their studies any better, worse or more relevant than anybody else's.

You've said, Statistics are only as good as the people who interpret them. I agree. The BMA and AMA are respected institutions that have proven their credibility. I wouldn't dismiss their recomdations so lightly over other groups that may not be as proven.


Originally posted by JRA
I've yet to see anyone on these forums dispute the fact that the benefits of cycling far outweigh the risks.

I've certainly seen posts, after even suggesting that a head injury happening when riding your bike is about as likely as a head injury doing anything else where we don't wear helmets, like...

helmetless riders DO NOT belong on streets with cars, buses and trucks and they are the reason why bicycling is considered a dangerous activity... A HELMET CAN MEAN THE DIFFERENCE BETWEEN LAUGHING ABOUT IT OR HAVING YOUR MOM CHANGE YOUR DIAPERS AND SPOON FEED YOU...

so I have to wonder about those feelings that suggest riding without a helmet is fraught with peril and not beneficial to health.


Originally posted by JRA
But the benefits of cycling, however great, are not a good reason not to wear a helmet when you do it.

I would agree with the BMA when they say, it would not be in the interests of health to make helmets compulsory, because it is likely to reduce the number of people choosing to cycle.

I also agree with Canadian physician Thomas J. Demarco when he says, it is increasingly evident that the principal alterable variables in with respect to society's health are lifestyle and environmental factors...Riding a bike is obviously not without risk, but this risk, is almost universally overestimated by the general population. Bicycling is not as dangerous as popularly perceived. Furthermore it does not contribute to the aforementioned litany of personal and public health problems. Whenever someone chooses to cycle rather than drive, both personal and public health benefit. Cyclists, therefore, are allies of the medical profession. We should be doing all we can to encourage the activity. Increased participation in this activity would not only benefit the national health and environment, but also would contribute significantly to road safety. Cycling is not a problem -- it is a solution. We should not be discouraging it by advocating laws that will drive cyclists from our roads. Let us not risk killing the goose that lays the golden egg.

:beer:

Originally posted by closetbiker
The BMA and AMA are respected institutions that have proven their credibility. I wouldn't dismiss their recomdations so lightly...
I wouldn't dismiss their recommendations either, and I never said that I would. I said their studies are no more valid or relevant than someone else's. I wouldn't dismiss other studies that are done by someone else. Even if they disagree, both studies could be valid.

Originally posted by closetbiker
I've certainly seen posts.., like...When you're responding to a post of mine, I'd appreciate it if you would make it clear when you are quoting someone else, and not me. To not do so could be misleading.

Originally posted by closetbiker
I would agree with the BMA when they say, it would not be in the interests of health to make helmets compulsory, because it is likely to reduce the number of people choosing to cycle. I agree with the BMA on that too and, again, I never said that I didn't. As I have said several times before, I oppose mandatory helmet laws. The fact that I advocate wearing a helmet by choice does not mean I advocate a law.

so I have to wonder about those feelings that suggest riding without a helmet is fraught with peril and not beneficial to health.Once again, closetbiker, it's not a feeling I have, or ever said I had.

We should not be discouraging it by advocating laws that will drive cyclists from our roads. Let us not risk killing the goose that lays the golden egg. And, once agian, closetbiker, that's not something I advocated.

So much for light and not heat. Heat will evidently follow helmet discussions wherever they go.

I agree with you on helmet laws and on the benefits of cycling, but I very much favor the voluntary use of helmets. Helmets save lives and prevent serious injury.

Originally posted by JRA
I agree with you on helmet laws and on the benefits of cycling, but I very much favor the voluntary use of helmets. Helmets save lives and prevent serious injury.

We do agree on these fundamental points.

By checking my most recent response to Fog, just above my response to you (I've said I believe to ride safe first, wear a helmet second as I've also posted (@http://www.bikeforums.net/showthrea...15&pagenumber=6), I'm not saying that wearing a helmet doesn't make good sense), we aren't really that far apart on what we disagree on. :)

By the way, I'm still waiting for you to show the posts where you claim that I have indeed, criticised, even ridiculed, those who choose to wear a helmet.
:confused: