No, more like: this has devolved into politics, no one is right, no one is wrong -- why bother.

Mandatory helmet laws take yet another swift kick in the gut:


[h=1]The possible effect on frequency of cycling if mandatory bicycle helmet legislation was repealed in Sydney, Australia: a cross sectional survey.[/h]Rissel C, Wen LM.
[h=3]Source[/h]School of Public Health, University of Sydney, New South Wales. chris.rissel@sydney.edu.au

[h=3]Abstract[/h][h=4]ISSUE ADDRESSED:[/h]Australia has national, state and city targets to increase levels of cycling. The possible effect of repealing mandatory bicycle helmet legislation on the frequency of cycling in Sydney is examined.
[h=4]CONCLUSIONS:[/h] if only half of the 22.6% of respondents who said they would cycle more if they did not have to wear a helmet did ride more, Sydney targets for increasing cycling would be achieved by repealing mandatory bicycle helmet legislation. A significant proportion of the population would continue to wear helmets even if they were not required to do so.

FULL ABSTRACT HERE:


http://www.ncbi.nlm.nih.gov/pubmed/22497060

That's fine. No helmet sceptic here, to my knowledge, has ever suggested that you shouldn't make an informed choice.

I'm betting you're less likely than most to fall off, though...

Well, there's some bad news there: the evidence is that helmets probably increase rotational damage, which is the main cause of serious brain injury. Scalps seem to have evolved so that they will slide a bit under stress, then tear, avoiding rotating the head. Regular helmets suppress this mechanism. There's also evidence that drivers act more aggressively towards riders wearing helmets and that wearing a helmet reduces the senses of balance and hearing. Finally, "extreme" downhill mtb models aside, helmets don't cover the face - which is where you are most liable to get lacerations in a low severity accident. And where they'll be most socially disabling (not to to be mention how easily jaws break and how expensive and very, very terrifying dentistry is.) So rationally speaking, you'd probably better off with a face mask than a helmet for this sort of accident. Or indeed a nice tasty chocolate teapot - which you could at least use as a post-accident snack and moral boost.

Otoh, you could read this http://bicyclesafe.com/ , make sure that if you ride in rain that you use either disc brakes or brake pads that still work in the wet like Kool Stop Salmons, and spend a few minutes sometime learning how to emergency brake properly (most people can't.)

good point, but there's ridiculous and then there's ridicule less.
if the ideal is I won't waste my time with you guys then the statement would look like . . .
"nothing to add, goodbye."

Serious brain injury, even if caused by hypotheses of rotational injury caused by helmet use, would be reported as... wait for it... a serious injury. I.e. not what I'm referencing.

Is there any other evidence of drivers treating helmeted riders any different than that one study in England, which also found that wearing a wig might help?

Cycling is a relatively safe sport, with low incidence of serious injury, the type where helmets would not help...

On my commuter, I do not have disk brakes, nor do I have specifically wet weather brake pads. And don't really have issues stopping even when there's some precipitation about. But then again, I've got some skill training under my belt and regularly practice emergency braking and debris avoidance, along with being generally situationally aware.

So why don't you read it as such and respond in kind, unlike your previous response...?

responding in kind, to the act of a hairball being hacked up would have worked out better?
thanks I'll keep that in mind next time.






helmets

Yes, I know that: I'll try to dumb this down for you:

- Helmets pay a safety benefit by reducing lacerations if you have an accident...

- At the probable cost of an increase in concussions and other more serious rotational injuries.

So there is a safety trade-off rather than a simple safety gain.

A major problem with helmets is that the only people funding studies on any scale are the helmet makers. So studies that *could* show problems like this are pretty much missing and we have to make guesses from almost no evidence. Fortunately, cycling is safe, so it's not a big thing.

It's physically impossible to overcome the disadvantages of a wet pad and rim with "training." The better you are at braking, the more you'd have noticed this. Salmon kools are cheap and unlike normal pads they grip wet rims about as well as they do dry ones.

Safety trade-offs... "probable". Gotta do better than "probable." Incidence of helmet-caused rotational injuries among serious bike-related injuries? Also wondering about data regarding increased concussions as a result of helmet use...

And yet the no-helmet brigade has no end of studies to prove their points, all kinds of excuses for pro-helmeteer studies...

Wet out today, couple of emergency braking situations, stock (sucky) Cane Creek pads, no issues other than squealing... which probably indicates sub-optimal braking conditions, but still worked fine.

------------------------

People, in general, have an unwarranted belief that helmets provide a "magic pill" level of protection -- buy a helmet and it will protect you from serious injury. Obviously unfounded, ill-conceived, and just plain wrong. But like with bike-specific infrastructure, merely providing a placebo will encourage people to ride who might not otherwise because, "It's too dangerous." Based again on the incorrect supposition that "cycling is dangerous," and that a helmet will mitigate that danger.

So, pertinent question is: is the safety gained by increased ridership and more riders on the road wearing helmets for the wrong reasons offset by the inherent hypothetical dangers of wearing helmets?

I'll raise you. I usually wear a helmet, but often don't on short rides about my neighborhood. A couple of months ago I pulled up to one of the four way stops sprinkled about our fair city's streets. Coming the other way was a father, hauling his young son on a tagalong bike. I stopped. After I did so, the father blew the intersection without so much as a tap on his brakes. As he passed (cutting me off in the process) the son asked "daddy, why isn't that man wearing a helmet?". The father replied "because he's an idiot." I turned about, rode alongside them, and said "hey kid-- ask your dad why he blew that stop."

For some reason this did not elicit a response.

Hmmm, helmets don't do anything except protect from abrasions...why don't you ask your local emergency room doctors and technicians if that's true. Nothing like spreading lies at the risk of seriously injuring or killing someone here who believes in what is being said and stops wearing helmet. Great advice.

For what purpose? In case you haven't got the drift yet, serious testing of cycling helmets is almost entirely non-existent. There's no test (or epidemiology) based reason to think that they'll reduce lacerations. As for riding with a light fastened to one - nope, they're not tested that way at all. All I can do is to counsel you that any helmet-based safety strategy that you follow within the parameter's you described will be based on guessing - one can say that the neither the benefit or the cost in serious injury will be large, but everything else is a guess. As long as you're aware that, fine. But when you make an assumption that the helmet has to make a positive contribution... well, "Silence Of The Lambs" made that ass-u-me thing very well-known, yes?

Yes, there's a reasonable amount of epidemiology on helmet effectiveness "in the willd." That's because this just requires analysing figures that are gathered anyway.

Someone has reading difficulties!

Repeating myself:

http://www.cyclehelmets.org/1081.html
In a recent Court case, a respected materials specialist argued that a cyclist who was brain injured from what was essentially a fall from their cycle, without any real forward momentum, would not have had their injuries reduced or prevented by a cycle helmet. This event involved contact against a flat tarmac surface with an impact energy potential of no more than 75 joules (his estimate, with which I was in full agreement). The court found in favour of his argument. So a High Court has decided that cycle helmets do not prevent injury even when falling from a cycle onto a flat surface, with little forward momentum. Cycle helmets will almost always perform much better against a flat surface than any other.

..Referring back to the Court case mentioned early, the very eminent QC under whose instruction I was privileged to work, tried repeatedly to persuade the equally eminent neurosurgeons acting for either side, and the technical expert, to state that one must be safer wearing a helmet than without. All three refused to so do, stating that they had seen severe brain damage and fatal injury both with and without cycle helmets being worn. In their view, the performance of cycle helmets is much too complex a subject for such a sweeping claim to be made.

In fact, what your ER docs would say doesn't matter. They don't even know if the people they treat were wearing helmets or not (doh!) let alone how many joules a helmet absorbs. What matters is that the brain injury specialists who do know how well helmets work say that you're being very, very silly when you expect them to stop serious injury.

There is so much evidence and testing on the internet to prove that helmets are 70% effective at preventing brain damage or death then non helmets. Some stats are false in nature to mislead people into think there is no real reason to wear a helmet. All you have to do is a web search and statistic after statistic, study after study, testing after testing will prove that helmets are necessary in accidents. And ER docs know when a patient arrives that was injured without wearing a helmet, either because the first responders made note of it or the injuries make it obvious. So duh, doctors are not stupid, and joules vs injury is totally different.

Obviously no helmet can protect you 100% that's why you need to know how to ride a bike defensively. But not wearing a helmet is asking for trouble.

Right. Testing on the Internet. That'll help.

Perhaps you'd like to quote an actual study that "proves" that helmets reduce death and brain damage by 70%? Then we can discuss the quality of that study's methodology and data.

No.

Nah. Some of it, yes, but there's been quite a bit of research done by more or less independent individuals and groups. Problems seem to stem from personal bias and poor methods. As far as I can judge, Elvik's paper is one of the better, and it does in fact back up your (and my) skepticism.

1. I am a doctor.
2. I treat people with neurological injuries.
3. I *have* read the research -- in great detail. I don't just read the abstracts. I read the articles. I look up the references. I examine the statistics.
4. Duh, I'm not an idiot.
5. I have concluded, on the basis of the available research, that helmets may ameliorate minor scalp injuries (i.e. abrasions), while at the same time increase the risk of Diffuse Axonal Injury, which is the most important etiology of brain damage in cycling accidents. Furthermore, epidemiological research to date clearly indicates that demands for increased helmet use result in decreased cycling; and cyclist volume is a risk factor which overrides negligible factors such as helmets.
6. Cycling is a safe activity, and, in fact, cyclists tend to have longer lives than the non-cycling population.
7. Therefore, I do not recommend that my patients or other cyclists wear helmets.

None of the other physicians I have spoken with who recommend helmets have done anything close to an exhaustive examination of the literature. If they have been exposed to any clinical research whatsoever, it has been data such as ED statistics or case studies, both of which notoriously suffer from unreliability. Furthermore, since helmet use seems, on first blush, to make sense, a fairly high degree of confirmation bias is in operation here.

Now, if you don't agree with my conclusions, fine. But don't even try to tell me that the research proves that helmets "work." Because it doesn't, and they don't.

I think I'll bookmark this post.

So how do you know which studies are accurate and which are not? Is it because, as I suspect, some support your presuppositions and others - the "false and misleading" ones - don't?

The standard of debate has risen in the last day or so. And while I don't want to disparage the intelligence of those who disagree with me, (that is the helmeteers' prerogative) it is interesting, isn't it, that almost all the data and analysis comes from the helmet sceptics, and all the anecdote and unsupported assertion comes from those who think it obvious that helmets must work. Confirmation bias does seem to be the determining factor, here.

In cycling accidents where there is evidence of diffuse axonal injury, would not wearing a helmet have helped? How prevalent are such injuries among cyclists? How many lesser injuries have been exacerbated by helmet use into a more serious brain injury where brain injury might have been prevented without the use of a helmet?

While the research cited in this thread definitely indicates that ridership decreases in places where MHLs are enacted, how does a pro-helmet culture where helmet use is not mandated affect ridership? NYC has seen gains in ridership, USA is overwhelmingly pro-helmet.

Do gains in safety due to increased ridership offset the dangers of wearing a helmet? There are those out there who believe incorrectly that cycling is dangerous and insist that a helmet will save them from the all dangers on the road. They wouldn't be riding a bike without one...

You say that helmets ameliorate minor scalp abrasions, but then go on to say that helmets don't work. Which is it? What's more prevalent--scalp abrasions among non-helmet wearers or diffuse axonal brain injury among helmet wearers?

Cycling is a safe activity. Helmet or no.

Do you recommend to your patients or other cyclists that they not wear helmets?

This has got to be the dumbest thread ever.

Who cares? Wear helmet. Don't wear a helmet. Just go outside and ride a bike.

What a waste of bandwidth.

because that question would cost me hundreds of dollars and they wouldn't have a clue what a helmet coulda, woulda or shoulda done. they're in business to treat injuries, not determine force factors and reduction of impact variables.
I might be more pro-helmet but for this scar on the back of my head. I got it after I rolled off my bike and got up with a head wound and a helmet in perfect condition. then before I got home to clean up ALL the blood, I was told twice "it's a good thing you had your helmet". sure.