LesterOfPuppets

Snohomish repealed theirs, except in the skate park. That's the kind of precedent that I can get behind. Better to not pass MHL in the first place, but...

mconlonx

If we're talking about the societal cost regarding insurance and covering the cost of treating the uninsured, head injury as a result of bicycle use is small fry. Again, automobile accidents are either the leading cause or the second leading cause of head injury depending on which sources you use.

I'm completely comfortable with my principles--any time a MHL proposal comes up in my state or town, I am more than willing to present facts and figures indicating that an amendment covering all road users, including automobile operators and passengers, should be added. It's a useful argument as an anti-MHL advocate. Not my fault the figures work to my favor; not my fault people see helmet use in automobiles as silly while the same people think helmet use by bicyclists is a good thing.

Sure, we can address different risk categories, but why start with outliers like cyclists and motorcyclists? Why not go for the very obvious low-hanging fruit, automobile drivers and passengers? Since they are the worst transgressors, the most head injured, the greatest cost to society, shouldn't we start with them first?

Answer: Because it's not politically feasible. Wearing helmets in cars is just silly, right? So once you point out the discrepancy regarding societal costs, usually MHL advocates grumble and fade into the background while their silly bill fails to make it out of committee. As it should.

You have completely misinterpreted my reply if you think that I connected helmet wearing while cycling to driving a car. I am addressing political expediency and the complete farce of a majority acting against the interests of a minority, while ignoring the hypocrisy involved.

Ultimately, I'm saying that all road user should be required to use helmets or none should be. If helmets are necessary for cyclists or motorcyclists, then they are rather obviously needed for motorists who represent the majority of head injury and societal costs.

mconlonx

This is why it's effective and important to bring automobile operators and passenger statistics to the table when any gov't agency is considering a MHL. Since the figure are so skewed, indicating that helmet use in cars should be even more mandatory, and since most people think this is a perfectly silly idea, it is an effective political tactic. In practice.

Preach it, brother!

Ozonation

I was challenged to present evidence that helmets make a difference, and I found multiple studies that conclusively stated helmets can and do make a difference, and in many cases, a statistically significant difference. What you - or I - believe to be true is irrelevant.

This is verging on a straw man argument by simplifying the risks of biking and helmet use against other unrelated and far more prevalent activities (unless you never take a bath at all!). As Brian Ratliff has argued, the discussion is about the use of helmets within the context of biking. And in the example you use, probably half the population of the country is climbing one flight of stairs each day as part of their daily routine, which quite likely far exceeds how much biking is done in aggregate.

I'm not sure what data you're referring to, or how you conclude that helmets have such a narrow applicability. In the following multi-year, large sample study, the conclusions are clear. Helmet use reduced head injury risk by 74%, and the more severe the injury, the greater the reduction. And furthermore, this reduction was found for different types of head injuries.

=============================================================================
Accid Anal Prev. 2013 Apr;53:78-88. doi: 10.1016/j.aap.2013.01.005. Epub 2013 Jan 16.
The effectiveness of helmets in bicycle collisions with motor vehicles: a case-control study.

Bambach MR, Mitchell RJ, Grzebieta RH, Olivier J.

Source

Transport and Road Safety Research, University of New South Wales, Australia. m.bambach@unsw.edu.au

Abstract

There has been an ongoing debate in Australia and internationally regarding the effectiveness of bicycle helmets in preventing head injury. This study aims to examine the effectiveness of bicycle helmets in preventing head injury amongst cyclists in crashes involving motor vehicles, and to assess the impact of 'risky cycling behaviour' among helmeted and unhelmeted cyclists. This analysis involved a retrospective, case-control study using linked police-reported road crash, hospital admission and mortality data in New South Wales (NSW), Australia during 2001-2009. The study population was cyclist casualties who were involved in a collision with a motor vehicle. Cases were those that sustained a head injury and were admitted to hospital. Controls were those admitted to hospital who did not sustain a head injury, or those not admitted to hospital. Standard multiple variable logistic regression modelling was conducted, with multinomial outcomes of injury severity. There were 6745 cyclist collisions with motor vehicles where helmet use was known. Helmet use was associated with reduced risk of head injury in bicycle collisions with motor vehicles of up to 74%, and the more severe the injury considered, the greater the reduction. This was also found to be true for particular head injuries such as skull fractures, intracranial injury and open head wounds. Around one half of children and adolescents less than 19 years were not wearing a helmet, an issue that needs to be addressed in light of the demonstrated effectiveness of helmets. Non-helmeted cyclists were more likely to display risky riding behaviour, however, were less likely to cycle in risky areas; the net result of which was that they were more likely to be involved in more severe crashes.
=============================================================================

Does this mean that every such study is perfect and that there will not be a study which counters the above? Of course not. However, the above conclusions appear consistent with those reached from across multiple studies, ranging from retrospective studies, to experimental studies, to computational modeling, undertaken by a range of professionals, from multiple countries, and peer reviewed in different discipline journals. The overall efficacy of helmet use is therefore compelling.

However, some of those same studies also showed that helmet laws did reduce injury incidents. Another study concluded that the oft cited argument that helmet laws reduce cycling or promote greater risk taking was weak and conflicting, and that helmet laws should be promoted.

Bicycle helmet use in Canada: The need for legislation to reduce the risk of head injury.
Authors:Hagel, Brent E.[SUP]1[/SUP],Yanchar, Natalie L.[SUP]1[/SUP] info@cps.ca
Sourceaediatrics & Child Health (1205-7088). Nov2013, Vol. 18 Issue 9, p475-480. 6p. 2 Charts.
Abstract (English):
Bicycling is a popular activity and a healthy, environmentally friendly form of transportation. However, it is also a leading cause of sport and recreational injury in children and adolescents. Head injuries are among the most severe injuries sustained while bicycling, justifying the implementation of bicycle helmet legislation by many provinces. There is evidence that bicycle helmet legislation increases helmet use and reduces head injury risk. Evidence for unintended consequences of helmet legislation, such as reduced bicycling and greater risk-taking, is weak and conflicting. Both research evidence to date and recognition of the substantial impact of traumatic brain injuries support the recommendation for all-ages bicycle helmet legislation.

BUT I think I finally figured out what this entire helmet thread is about, and I must be getting old because I should have realized it from the beginning. It isn't really about helmets per se, because even many non-helmet wearers acknowledge that a helmet is at least somewhat effective. It's not even really about safety or the law in a general sense, because I don't see anybody complaining that as a bicyclist they should not obey the laws of the road or arguing that a bike light at night is bad legislation.

It boils down to the premise that you do not want anybody telling you what to wear. To me, this is mystifying. When driving, nobody complains about fastening their seat belt. It works, and it's been shown to work. It doesn't mean it will prevent you from getting killed 100% of the time, but it does reduce risks and helps you, for example, from being ejected from the car. When I visit an industrial facility or construction site, I wear personal protective equipment (PPE): hard hat, safety boots, etc. I can still be killed, but they greatly reduce the risks of injuries in all sorts of other hazardous scenarios. But even in non-risk scenarios, we still accept outside influences without much debate. Going for an interview? Wear a suit.

And yet, somehow, biking and helmet use has generated nearly 6500 posts in this current thread alone. As I said from the outset, wearing a helmet seems to be a rational thing to do. I am traveling at much higher rate of speed than when I am walking or even running; I am physically "off the ground" and therefore cannot recover from a fall as readily; I am often not separated from motor vehicles - probably the greatest risk there is; a helmet therefore seems to be prudent safety equipment, just like having a light at night. I can severely injure an arm or a leg and still carry on with my life to some degree. A debilitating brain injury only takes a split second to occur, however, and can severely degrade my ability to function on an intellectual and emotional level. THAT scares me.

Piet de Jong's studies are often cited in the debate that helmet laws are ineffective. Are his studies invalid? Probably not, and I don't have the expertise to dispute him at any rate. But the studies I found were all from 2013, and from a physical interpretation, they are again compelling for supporting helmet use. And in an interview with New Scientist from 2009:

However de Jong, a native of bike-loving Holland, makes clear that he would not discourage people from wearing helmets. "I go to Holland and places like that, and I don't wear a helmet," he says. "I used to live in London, and I wore a helmet all the time."

If we can draw any insight from this, context is key. Many cite Copenhagen as the example of how there are hordes of cyclists and very few helmet users - and supposedly, few head related injuries. But that city has an ethos, infrastructure, and multiple governance structures to facilitate cycling as an everyday activity. My Ontario city cannot even connect two bloody bike paths together to form one contiguous bike loop even though this was identified as deficiency over a decade ago. So, I wear a helmet because I cannot trust the infrastructure and attitudes of others in my city to prevent me from becoming an injury statistic.

Yes, we can (and should) delve into the socio-economic benefit cost debate as Brian, FBinNY, and others have pursued. But an internet forum is a tough place to have any sort of insightful debate. I suspect if we had this discussion in a pub with a beer after a long ride in the crisp winter air, we probably wouldn't disagree all that much. So whether you don a brain buffer or not, stay safe.

mconlonx

I'm still waiting for the bare-headers to respond to your most recent volley of pro-helmet studies...

Especially the one which claims that helmets mitigate or at least don't exacerbate head injury as a result of oblique strikes, a leading cause of diffuse axonal injury/concussions.

Skye? Razrskutr? Chasm51? Closetbiker? Care to look those over and offer refutations?

Ozonation

No, what you are expressing is anecdotal experience in that you, as a singular individual, have not experienced any negative effects. The longer you ride however the greater the chance that something can happen. Furthermore, the majority of the studies strongly suggest that the chances of a fatal or serious head injury increase if you do not wear a helmet. But it cannot be shown that you, B.Carfree, will necessarily be THAT human being to experience that injury.

Ozonation

Hi mconlonx... let me do some of the leg work for you. Research is supposed to be objective, non?

As a starting point for the refutation, I did a search of the Engineering Village database, the PubMed database, and the ProQuest Science and Technology database. Between these three, they index thousands upon thousands of current and past journal articles. I used three main key words, based on your earlier comment: "bicycle", "helmet", and "angular". Any article that somehow referenced all three terms should have appeared in the search.

Surprisingly, in all three databases, a distressingly small number of journal publications appear. The one I suspect that is cited most frequently and the one referenced by www.cyclehelmets.org/1039.html is:

======================
The efficacy of bicycle helmets against brain injury

Curnow, W.J.[SUP]1[/SUP]

Source: Accident Analysis and Prevention, v 35, n 2, p 287-292, March 2003; ISSN: 00014575; DOI: 10.1016/S0001-4575(02)00012-X; Publisher: Elsevier Ltd

Abstract:
An examination is made of a meta-analysis by Attewell, Glase and McFadden which concludes that bicycle helmets prevent serious injury, to the brain in particular, and that there is mounting scientific evidence of this. The Australian Transport Safety Bureau (ATSB) initiated and directed the meta-analysis of 16 observational studies dated 1987-1998. This examination concentrates on injury to the brain and shows that the meta-analysis and its included studies take no account of scientific knowledge of its mechanisms. Consequently, the choice of studies for the meta-analysis and the collection, treatment and interpretation of their data lack the guidance needed to distinguish injuries caused through fracture of the skull and by angular acceleration. It is shown that the design of helmets reflects a discredited theory of brain injury. The conclusions are that the meta-analysis does not provide scientific evidence that such helmets reduce serious injury to the brain, and the Australian policy of compulsory wearing lacks a basis of verified efficacy against brain injury. © 2002 Elsevier Science Ltd. All rights reserved.(50 refs)

==========================

What is this original article by Attewell, Glase, and McFadden then that seems to have fallen out of favour? It is this one:

==========================
Accid Anal Prev. 2001 May;33(3):345-52.

Bicycle helmet efficacy: a meta-analysis.

Attewell RG, Glase K, McFadden M.
Source
Covance Pty Ltd, Ainslie, ACT, Australia. covance@tpgi.com.au

Abstract
Bicycle helmet efficacy was quantified using a formal meta-analytic approach based on peer-reviewed studies. Only those studies with individual injury and helmet use data were included. Based on studies from several countries published in the period 1987-1998, the summary odds ratio estimate for efficacy is 0.40 (95% confidence interval 0.29, 0.55) for head injury, 0.42 (0.26, 0.67) for brain injury, 0.53 (0.39, 0.73) for facial injury and 0.27 (0.10, 0.71) for fatal injury. This indicates a statistically significant protective effect of helmets. Three studies provided neck injury results that were unfavourable to helmets with a summary estimate of 1.36 (1.00, 1.86), but this result may not be applicable to the lighter helmets currently in use. In conclusion, the evidence is clear that bicycle helmets prevent serious injury and even death. Despite this, the use of helmets is sub-optimal. Helmet use for all riders should be further encouraged to the extent that it is uniformly accepted and analogous to the use of seat belts by motor vehicle occupants.

===========================

However, after the Curnow (2003) article, the Attewell et al. article (2001) upon which Curnow (2003) reached his conclusions has been re-examined in 2011.

===========================

Accid Anal Prev. 2011 May;43(3):1245-51. doi: 10.1016/j.aap.2011.01.007. Epub 2011 Feb 12.

Publication bias and time-trend bias in meta-analysis of bicycle helmet efficacy: a re-analysis of Attewell, Glase and McFadden, 2001.

Elvik R.
Source
Institute of Transport Economics, Gaustadalléen 21, NO-0349 Oslo, Norway. re@toi.no

Abstract
This paper shows that the meta-analysis of bicycle helmet efficacy reported by Attewell, Glase, and McFadden (Accident Analysis and Prevention 2001, 345-352) was influenced by publication bias and time-trend bias that was not controlled for. As a result, the analysis reported inflated estimates of the effects of bicycle helmets. This paper presents a re-analysis of the study. The re-analysis included: (1) detecting and adjusting for publication bias by means of the trim-and-fill method; (2) ensuring the inclusion of all published studies by means of continuity corrections of estimates of effect rely on zero counts; (3) detecting and trying to account for a time-trend bias in estimates of the effects of bicycle helmets; (4) updating the study by including recently published studies evaluating the effects of bicycle helmets. The re-analysis shows smaller safety benefits associated with the use of bicycle helmets than the original study.

============================

This article by Elvik (2011) post dates the critique by Curnow (2003) by eight years. It does not invalidate the original work by Attewell et al. (2001); instead, it concludes that there are smaller safety benefits. I accessed the Elvik article itself, and the author comments on page 251:

Do bicycle helmets reduce the risk of injury to the head, face or neck? With respect to head injury, the answer is clearly yes, and the re-analysis of the meta-analysis reported by Attewell et al. (2001) in this paper has not changed this answer. As far as facial injury is concerned, evidence suggests that the protective effect is smaller, but on balance there does seem to be a slight protective effect. The risk of neck injury does not seem to be reduced by bicycle helmets. There are only four estimates of effect, but they all indicate an increased risk of injury. When the risk of injury to head, face or neck is viewed as a whole, bicycle helmets do provide a protective effect.

What does this suggest? The conclusion that Curnow (2003) and which is referenced on www.cyclehelmets.org to partially disprove the effectiveness of a bicycle helmet is not entirely valid: the original study by Attewell et al. (2001) on which Curnow's 2003 critique was challenging is still credible. (I realize that www.cyclehelmets.org references one other article on oblique strikes.) However, does this mean that Attewell et al. (2001) study is without issues? No - Elvik (2011) does go on to caution about limitations of the Attewell et al. (2001) article, particularly given that newer studies present contradictory or different conclusions.

Research progresses. The volley of "pro helmet" articles as you called them that I sourced were all published in 2013 and 2012, meaning that the data used was probably more recent, the articles likely benefitted from the much earlier studies ("lessons learned") and that the analysis techniques were likely up-to-date.

However, angular acceleration might still therefore be a critical and underexplored issue. If we examine the following abstract from 2013, it implies that angular acceleration may not have been fully addressed to date, or at least conventional helmets might help, but not help a whole lot.

========================
Accid Anal Prev. 2013 Oct;59:109-17. doi: 10.1016/j.aap.2013.05.019. Epub 2013 May 25.

Angular Impact Mitigation system for bicycle helmets to reduce head acceleration and risk of traumatic brain injury.

Hansen K, Dau N, Feist F, Deck C, Willinger R, Madey SM, Bottlang M.
Source
Biomechanics Laboratory, Legacy Research Institute, Portland, OR 97232, United States.

Abstract
Angular acceleration of the head is a known cause of traumatic brain injury (TBI), but contemporary bicycle helmets lack dedicated mechanisms to mitigate angular acceleration. A novel Angular Impact Mitigation (AIM) system for bicycle helmets has been developed that employs an elastically suspended aluminum honeycomb liner to absorb linear acceleration in normal impacts as well as angular acceleration in oblique impacts. This study tested bicycle helmets with and without AIM technology to comparatively assess impact mitigation. Normal impact tests were performed to measure linear head acceleration. Oblique impact tests were performed to measure angular head acceleration and neck loading. Furthermore, acceleration histories of oblique impacts were analyzed in a computational head model to predict the resulting risk of TBI in the form of concussion and diffuse axonal injury (DAI). Compared to standard helmets, AIM helmets resulted in a 14% reduction in peak linear acceleration (p<0.001), a 34% reduction in peak angular acceleration (p<0.001), and a 22-32% reduction in neck loading (p<0.001). Computational results predicted that AIM helmets reduced the risk of concussion and DAI by 27% and 44%, respectively. In conclusion, these results demonstrated that AIM technology could effectively improve impact mitigation compared to a contemporary expanded polystyrene-based bicycle helmet, and may enhance prevention of bicycle-related TBI. Further research is required.
===============================

I accessed the entire article, and Hansen et al. (2013) conclude their article by commenting:

Contemporary bicycle helmets with standard EPS liners may not be optimized to mitigate head angular acceleration caused by oblique impacts representative of a realistic bicycle crash. AIM hel- mets with a suspended aluminum honeycomb liner that decouples the outer helmet shell from the inner helmet liner can significantly reduce angular head acceleration and neck loading in an oblique impact compared to EPS-based bicycle helmets. AIM helmets can furthermore reduce linear head acceleration in response to a nor- mal impact. A computational model predicted that the improved mitigation of linear and angular head acceleration by AIM helmets would reduce the risk of TBI. In summary, these results demon- strated the feasibility and efficacy of a bicycle helmet design that is directed toward mitigation of angular acceleration to provide bet- ter protection from brain injury than contemporary bicycle helmets with EPS liners.

What do I interpret from this? I'm not a biomechanic expert, but while Hansen et al.'s (2013) conclusion suggests that conventional helmets may not be optimized to handle angular acceleration, it is not conclusive that conventional helmets do "nothing" in such circumstances. However, they might not do a very good job. (One of the previous studies I found suggests however that current bicycle helmets are still effective in oblique strike scenarios.) What is more interesting is that a new technology has been developed and can be incorporated into helmet design that does effectively address angular acceleration.

So, if we examine the broad scope of literature, I draw the following conclusions with respect to bicycle helmets and their effectiveness in injury prevention:
1) Conventional helmets are effective in reducing head injuries due to linear acceleration scenarios.
2) Conventional helmets seem to range from being assessed as minimally effective up to nominally effective for reducing head injuries due to angular acceleration scenarios.
3) There is ongoing development to produce helmets that are even more protective in reducing injuries due to angular acceleration scenarios.

Brian Ratliff

One last word for me before I'm finished saying my part.

https://www.nhtsa.gov/cars/rules/import/FMVSS/

In this link lies the safety regulations for cars. Section 200 deals with passenger crash protection. There are 12 separate regulations applicable to all passenger cars dedicated to protection from head injury, including head restraint (head rest), seat belts, and airbags amongst other things. You want to add another? If you bring up helmets for drivers, in addition to all the requirements for seats, seatbelts, airbags, head restraints, roof crush resistance, steering wheel collapse, windshield behavior, etc., you will rightfully be laughed out of the room.

Contrary to regulations on passenger cars being "not politically feasible", there are enough rules and regulations on the safety systems in cars to safely double the car's price. And traffic accident fatalities have decreased drastically as a result. What more do you want to ask? What's a $20 helmet compare to all that? Or are you just jealous that cars get cool airbags and stuff for head injury protection and we only get to wear a plastic hat? Maybe this is more your style.

howsteepisit

No the Auto systems are passive. You want to mandate cycle helmets in an attempt to mitigate nearly insignificant healthcare cost Compare the total cost of head injuries to cyclists to federaL and private health care spending. In addition there ae any number of more risky/higher cost things that people do such as overeating, high sugar diets, skiing, walking on icy sidewalks, and so on. No thank you to mandating safety measures to help mitigate all the things that create risk of serious injury/disability. I will not even start in on tobacco.

In this case, we'll just disagree, as you want a more intrusive government than I.

B. Carfree

That's what my reference to living well out on the bell curve was referring to. If that's your level of reading comprehension, which appears to be about right based on what I have seen, then no wonder you are having such trouble understanding what people are writing.

Also, how do you figure that the longer one rides the greater the chance that something can happen? Do you really think cyclists don't gain skills and knowledge with experience? Go back and look at the differences in injury, severity of injury and death rate for children on bikes compared to adults.

This is as silly as all those studies claiming incredible negative health effects from relatively high fat diets in which, on a more detailed reading and analysis, turned out to be insignificant compared to the impact of exercise; if activity levels were not extremely carefully controlled for, the whole thing fell apart since exercise is the very large dog in heart disease and diet is the tiny tail. Which brings us back to MHL's. These are known to depress ridership. The public health costs of increased morbidity and mortality due to the increase in sedentary transportation has to be subtracted from whatever small savings a MHL would lead to in the area of brain injuries. That's looking like a negative number. Now, if we implemented mandatory helmet laws for motorists and their passengers, any decrease in driving would have positive impacts on public health of its own which would supplement any benefit due to reducing brain injuries in car wrecks.

Ozonation

You know B.Carfree... despite the differences in opinion I might have with other forum posters, like mconlonx, FBinNY, and others, I actually do respect their opinion, and I have tried to keep my comments insult-free. And for the most part, I try to end on a positive note. When you wrote your bell-curve comment, I had no idea if you actually understood the concept, or were using it colloquially as many people do. And you will note that I pointed out - as you did - that despite the many studies supporting helmet use - you as an individual might not experience any trauma. If you did disagreed with what I wrote, or thought I had somehow wronged you, then by all means point it out: I am humble enough that I will apologize.

However, you instead chose to insult my reading comprehension. So, rather than debate a point, or perhaps correct me if I'm wrong, you've decided to debase my intellect. Thanks - I so appreciate this. I actually think I deserve an apology.

Since you think my level of comprehension is so pitiful, please feel free to re-examine the many studies I have posted regarding helmet injury and share with the rest of us your own, informed analysis.

Happy trails.

B. Carfree

Let's grant your half the population climbing a flight of stairs each day. Let's use the American Community Survey as the basis for 0.6% of the population riding their bikes each day (just commuting numbers, but hopefully close enough for this arithmetic problem). How long does it take to climb a flight of stairs? I'm going to use eight seconds; use whatever you think is reasonable, but that's a mighty slow pace (if the flight is ten vertical feet over twenty feet of run, then that's a pace of two mph). Hey, they have to go down too, so let's give them fifteen seconds on the stairs per day.

Now, back to those 0.6% who are cycling. How much time are they spending riding and how does that compare to the time spent on stairs? Unfortunately we're back to having to assume things, since I haven't been able to find decent data for trip distance. However, let's use something short, like three miles one way, so we're in no danger of overestimating the time spent on bikes. I think ten mph is a pretty common speed estimate used for transportational riding, even the wayfaring signs for bikes use this. So, three miles at ten miles per hour times two (return trip) times 0.006 (correcting for the percentage of the population who ride) gives us about thirteen seconds.

How does that thirteen seconds the average person spends on a bike per day stack up against the fifteen seconds spent on the stairs? It sure doesn't seem reasonable to dismiss stairwell risks by virtue of your claim of time spent on stairs far exceeding the time spent on bikes, at least to me.

Go ahead and change the assumptions of walking speed and cycling distance. You're not going to change the ratio much. Perhaps those stairs are more dangerous than you thought. Maybe you should be advocating for mandatory stairway helmets.

Ozonation

Let me get this straight... you are accusing me of poor reading comprehension? I was in no way dismissing stairwell risks. What I was referring to was dataset proportionality, and how using isolated statistics can under-represent or over-represent a perceived or real risk.

But whatever. You win. I will accede to your logic. Please take the time, however, to assess the many studies I posted: the authors in those externally reviewed articles are far smarter than I and therefore, deserve your time to debate with them rather than with me.

Brian Ratliff

I lied, I'm not done having fun with this discussion (so serious business in bikeforums.net for some as it may be).

We are talking about stairs now? Why? What does stairs have to do with cycling? You are like my wife when she asked me "why are you buying more books? Don't you already have enough?" I mean, all the books are different... Likewise, you ask the question: "why aren't you advocating for stair/shower/car helmets? Don't you want to decrease head injuries?" Well, yes, but I am interested, for this discussion at least, on decreasing head injuries for cyclists, you know, specifically. We can discuss stair helmets some other time if you'd like.

Stop changing the subject!

Also I notice that none of the individualists have taken up my idea for a pledge to pay cash for any head injury while cycling helmetless. Nobody gonna put money where their mouth is? I wear a helmet when I ride, that I voluntarily paid for; my money is where my mouth is. What would someone have to pay you to take up this pledge? For Mr. Lester, it was $350/mo. Anyone else care to offer an opinion? Or are we all admitting that you all simply like being free-loaders for the sake of convenience and hairstyle? I mean, it's simple. You claim your choice doesn't affect me. I want you to live up to that claim by not using your insurance, paying cash out of pocket, if you crash while helmetless and need medical care for a head injury.

Or do you all keep changing the subject because you don't like seeing yourself as being hypocritical...

FBinNY 

You'll be waiting for a while before I come back. Brian R. has exhausted my patience for theoretical/philosophical debate on this issue, which for me has achieved "dead horse" stratus.

As far as I'm concerned accident and/or cost data are secondary to thye issues I care about, which are whether bicycling is safe in the general sense (I think it is, though it takes some willingness to ride smart), and/or whether mandatory helmet laws are warranted or are good public policy.

I have no dog on the fight of whether or to the extent helmets work and suggest that anyone concerned about his personal safety consider them. OTOH, I feel that bicycling is generally safe enough that helmets aren't indicated, but that depends on the type of riding, and the skill of the rider. For example, I don't ride in close formation with anyone except a few trusted riders and never in groups larger than 3-4 max. If I rode in large packs on club rides I'd rethink the helmet issue.

LesterOfPuppets

I kinda figured you wanted to promote cycling helmets for the betterment of society. There are other activities for which helmet use could reduce TBI hospital visits at a much greater rate, thus making the world an even better place.

Think of the children.

If you want me to sign a waiver I better get something out of it. I'm not going to sign away anything for nothing no matter how unlikely it is that the situation will ever occur.

I've worn a helmet in every bike race and most charity rides I've ridden in (there was one in the '70s that didn't require helmets.)

I own one and wear it often but still feel that asking people to give up healthcare insurance because they don't meet my preferred PPE levels is ridiculous.

How would you feel if it was required by law that everyone wear full face DOT-approved helmets for bicycling? It's only a little step up in the PPE spectrum, afterall. Think of how much MORE harm could be prevented.

Could've saved Charles Christensen's life during that bicycle race at PIR.

Brian Ratliff

Right, and you gave your price.

And why do you think I'd have attachment to a hunk of styrofoam? I am not trying to advocate putting styrofoam on everyone's head, I am exploring the reduction of head injuries to cyclists! You do understand there is a difference, right? One is an outcome, the other is a method. Putting hand rails in showers is probably more appropriate to reduce head injuries while showering than putting on a purpose-defeating hat. But alas, there are no place for hand rails on a bicycle!

LesterOfPuppets

If I hit the lottery I'd probably throw a million dollars at getting Vancouver, WA MHL repealed. There's another price for you. Freedom ain't cheap, bro!

We could always outlaw bicycles. They're really too dangerous, anyways.

I'm glad you're not attached to styrofoam helmets. They're good for zero-mph clip-in falls and some other crashes but don't really offer all that much protection for road riders. Plenty of sensible people realize this. Even as recently as 2005 some riders were riding some parts of the Tour de France without helmets.

Brian Ratliff

So, if someone gave you a bunch of money for free you'd make the sacrifice. Brilliant.

You change the subject again!

LesterOfPuppets

I have a holistic way of looking at the helmet issue.

I'm more of a forest guy, you're more of a tree guy (maybe leaf guy, in this case). No biggie. I went down your hairsplitting rabbit hole, not gonna be mad that you're mad that I wanna view this with a wider perspective.

LesterOfPuppets

I've made plenty of sacrifice in the civil disobedience realm. Enduring all of two police interrogations based upon my failure to wear a bicycle helmet in Vancouver, WA.

mconlonx

No, I don't want to add another safety regulation regarding cars. Nor do I want to add another safety regulation regarding bicycles. I am, at the very least, consistent...

Were I to choose helmet use in either cars or on bikes based only on head injury figures though, it would have to be the leading cause of head injury, cars. For all the safety regulations regarding cars, crashes are still the leading cause of TBI. But since suggesting helmets in cars might get me laughed out of the room, I am bewildered the reaction isn't the same when helmet laws are proposed for cyclists.

And if I was to address any mandatory safety regulation regarding bicycles, mandatory helmet use would be way down on the list, after cycling safety and general road use training akin to what we demand of other road users.

Again, LAB teaches that helmet use if fifth on a list of safe bicycle operation, so why would you rather mandate helmet use over much more safety-effective rider training?

GP

What's the minimum you'd need to win to give the million? I'm guessing that if you won a $2 scratch off you'd only throw in a buck.

Brian Ratliff

Why not both?

mr_bill

My Bells. Most of you will probably guess wrong on the one on the left.

-mr. bill