Monday 2 January 2012

A Tough Nut: Should We Have To Wear Helmets?

 
A call from a FB friend (and fellow cycle blogger) to sign a petition opposing the move by the Womens Institute to vote on compulsory cycle helmet use got me into a bit of a debate last night. It was all good natured but it really surprised me how polarised opinions can be and also how willing some are to accept anecdotal evidence or hearsay. I have reproduced it below for your amusement and/or comments

Anyway, let's not go the way of Australia and New Zealand by insisting on helmet use and seeing are already pitifully small cycling rates fall even further. If you don't want to be forced to wear a helmet all the time for every single cycle trip please sign the petition. And if you want to access some papers and arguments re helmets then this is a good site - cyclehelmets.org

Thanks
Me: Already signed it. And I wear a helmet!

NH:  I guess most people I know will have signed, it's close to 1,000 signatures now. I always wear a correctly fitting helmet for my commute but there's no way it should ever be made compulsory.

RP:  can i ask why? Interested that's all

Me: coz they dont do much to protect, can make some injuries worse, reduce cycling rates and can cause some drivers to pass more closely.

NH: Yeah, it's much safer to cycle in traffic wearing a long blond wig

Me:  tis true. gets you noticed...!

Me: ‎...not that i've tried it or anything!

CD: Places where compulsory helmet wearing has been enforced have seen [sic] fanfic reduction in head injures. There is no evidence to support assertions of vehicle passing closer or injuries made worse. Both evidence and anecdotal reports overwhelmingly support helmet use. They do make a big difference. Interestingly the only discussions I have ever heard are from people who don't seem to want to wear helmets. 

Me: CD.  

I do chose to wear a helmet for most of my cycling but the evidence is questionable IMO. First of all no helmet is designed or tested to withstand damage from impacts above 12 mph and wouldn't make much difference it you are taken out by a vehicle at 40+mph i'm sure you'll agree! Diffuse axonal injury from rotational injury can be increased by helmets, there is evidence from Australia and NZ that legislation forcing helmet use does reduce rates of cycling and a small study did demonstrate some correlation that vehicles passed more closely if you wore a helmet although tis true it may due to other factors such these cyclists being more confident and 'professional' compared to a non helmet wearers. I'll try to find the reference. Further, most of the recent deaths in London were cyclists wearing helmets. They didn't help much there in these tragedies. The Netherlands do not have many helmet wearers and their cycling rate is vastly more than ours and accident rate far smaller. Helmets do have their place but they are not a panacea by any means. Anyway, did you have a good ride today?  

Me: Here's the link. A small study but thought provoking. http://www.sciencedirect.com/science/article/pii/S0001457506001540   

RP: Again talking from total ignorance an interest but do they not reduce head injuries in most cases and in the Netherlands are there not a lot more dedicated cycle lanes?

ES: mine saved me from a nasty egg when a taxi hit me last month! There are 5 other resolutions and as this one has been up before the chances are it won't be voted for!

Me: RP
You'd think so but they are not designed to withstand impacts above 12mph. If the skull comes to a sudden stop the brain carries on moving inside causing a degree of diffuse axonal injury. No helmet can claim to prevent that. The polystyrene absorbs so much impact then breaks. They can certainly reduce skin and soft tissue damage but bone and helmet work in different ways. The fact a helmet might break on impact and the skull didn't does not mean the skull would have been fractured without the helmet.

The Netherlands have much better cycling infrastructure and do separate cyclists from vehicles a lot more than the UK. They choose to do this and not to promote helmet use. They have much increased cycling rates with all the associated societal health benefits. That surely speaks volumes. Helmet benefit is debatable and there are far more effective means of increasing road safety for cyclists and I do wear a helmet!

What is your interest? Do you cycle?
 


CD: I love lighting the touch paper and stepping back!!!

NH: ES - Please don't tell me the taxi was a white focus estate  

NH: Wearing a wig gets you more space on the road than a helmet http://www.bath.ac.uk/news/articles/archive/overtaking110906.html
I sometimes affect a wobble when riding if I feel especially threatened by passing traffic

RP:  No, just nosey. But just got little one a bike and would always tell him to wear a helmet

Me: Kids are different. They don't go as fast when small and are more likely to fall off. They are who helmets do work for.

NH: Until they understand all the risks and can reason why they aren't wearing one they should wear one.

Me: CD
You being provocative on purpose? Very bad!

ML:  Personally, a helmet has probably saved me from pretty bad head injury twice (so far). On the first occasion I was virtually stationary, and on the second occasion I was moving far faster than 12mph. My view is - if you want to wear one, then wear one. If you don't want to, don't. Kids should be encouraged to wear them at all times. If you have an accident and you're not wearing one, then you're probably buggered.

Me. ML

I'm glad you survived your incidents and I too chose to wear one for a number of reasons. I am totally against making them compulsory though. Out of interest how do you know the helmet actually made the difference?

NH: Thanks ML. you and James Cracknell influence my decision most heavily.

ML: the first incident, I was knocked (briefly) unconscious - with the helmet on. The second incident, my helmet shattered. The staff at A&E assured me that I'd have been pretty, pretty badly hurt if I wasn't wearing one.

WL: I remember the same argument with motorbikes 20 years ago. My helmet has saved my life twice! once at 25 mph and the other at 5mph both time my helmet was trashed but my brain survived (feel free to argue otherwise ES ;o)) If you dont wear a helmet you've no protection, no argument and more importantly almost no compensation!!!

Me: NH

You mean James Cracknell who had a fractured skull, a period of coma and who now cannot drive due his post injury siezures? The helmet might have made a difference to injury severity sustained but that cannot be proven either way. What is certain is that the helmet didn't stop the tanker clipping him in the first place and didn't magically save him.

A tragedy certainly but not convincing proof for helmets i'm afraid.
 


Me: WL

Motorbike helmets and cycle helmets do not compare. You would have no compensation because they are mandatory. That is the point - you have to wear them!

NH: So why do you wear a helmet ?

Me: ML
On the first you became unconscious therefore you had sustained brain injury. The helmet did not prevent that. On the second the helmet broke. This may or may not have prevented skull/brain injury. I work in A&E and I will tell you it cannot be stated to have saved you from injury only that it may have made a difference.

NH:  May have made a difference is good enough for me thank you

Me: NH

For three reasons. 1. It makes my wife feel better. I wear it for her. 2. It is a very useful mount for bullet cams and my little cycling vids. 3. Most important (for me) I can mount a front and rear Knog light on it in addition to my other lights. I wear it coz it helps me be seen!

Me: Ahh. 31 comments. Had enough. My head hurts. *maybe my helmet is too small!* Goodnight.

NH: I like the videos, we should all be made to record our jouneys and therefore helmets should be mandatory.

ML: May have made a difference is good enough for me, too. Do you wear your seatbelt when you drive, ?

Me: ML

Of course. There is good evidence for 3 point seat belts and they are required. Although it can be argued all the safety gubbins in cars do make drivers feel safer and so they drive faster. Nothing is cut and dried!

 Oh no! I'm responding again. Goodnight.
Me: Just remember. Vehicles are the biggest danger to cyclists. Let's not fall into the trap of making cyclists responsible for mitigating dangerous driving. More pedestrians are killed by motorists than cyclists. Should we force them to wear protective gear if walking near a busy road? Helmets do have a place but they are not all they are cracked up to be (pun intended). 

Off to bed now.

11 comments:

  1. The move to compulsary seat belts for drivers almost backfired against ROSPA. The number of extra pedestrian and cyclist casualties almost wiped out the gains in numbers for car drivers.

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  2. Mike said...
    'The move to compulsary seat belts for drivers almost backfired against ROSPA. The number of extra pedestrian and cyclist casualties almost wiped out the gains in numbers for car drivers.'

    Would you be able to provide a reference for that?

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  3. I think it would be fair for cyclists to wear helmets when and only when all cars have their air-bags removed and all cars are fitted with air-spikes - metal spikes that shoot out toward the driver from the steering wheel in the event of a collision.

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  4. Excellent thread! May I reproduce it on my blog? With your kind permission?

    Useful and interesting debate + info.

    By no means I think a helmet will keep me alive if I was hit by a lorry at 40mph or crushed by one. But I do wear one, I guess it's a like a 'linus blanket'. If we had (UK) the same segregated cycle lane provisions as the Dutch I very likely would not feel the need to wear one.

    My main reason for wearing one, as touched on in your thread, is exactly the idea that if at a fall (a slow speed), my helmet would crack and my head not, I would be happier that the helmet broke rather my head indeed. Do you think that cranial injuries (is that how it's called?) can be reduced by the helmet bearing the brunt of an impact?

    LC :)

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  5. LC

    Just read my previous comment and realise it could be misconstrued if taken out of context. Of course I meant you are welcome to reproduce any aspect of the post and not reproduce in any other way!

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  6. As a Dutchie, the Great Helmet Debate often amuses but always exasperate me.

    Ask a person if, when carrying an uncooked egg in his breastpocket, wether that egg would protect his head when, say, being hit by a car, and that person would say that, of course, a raw egg in his pocket wouldn't, couldn't protect him. "Even if it broke?", you would ask. "Especially if it broke!", he would say. The idea that something as fragile and inherently breakable could somehow protect you from harm would be considered ludicrous.

    Then ask him if that same egg could protect him from braindamage if you would ducttape it on top of his head. You will get the same negative answer. He'd probably shoot you an incredulous look as well as a few suggestive remarks about 'sympathetic magic'.

    But ask him if he thinks a styrofoam helmet would protect him from getting braindamaged after being hit by a car and he will launch into descriptions of having fallen of his bike once and his helmet breaking and that this was proof, *proof* I tell you!, for the helmet's noggin'-safing abilities.

    Magic feathers, indeed.

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  7. Whilst I do not believe helmet use should be compulsary I think you guys are dilusional in believing that you are just as safe not wearing a helmet as you with one?

    I can somewhat stomach the argument it may cause some form of neck injury by over extending the spine in some cases. However to actually believe the fact it would not prevent head injury amazes me?

    Would it stop major brain injury in a big head on collision? doubtful, but neither does a motorbike helmet in all fairness. It will however cushion the impact and make whatever injury is caused that little less nasty

    Anyway, what damage does wearing one cause? I am yet to see cyclist fully clad in lycra look any less rediculous without a helmet than with one! Just as a note I cycle 6-700 miles a year and wear a helmet for every mile. My wife works with headway the brain injury charity and after hearing some of their clients stories I never want to risk being in their shoes

    your call, but personally me or my kids do not get ona bike without one

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  8. Been sniffing around this site for over an hour, very interesting and relevant blog, cheers.

    A 41-yr old cyclist returnee with three years' experience of road and tow-path riding in and around east London I've had three minor prangs. All my own fault and in each I fail to see where a helmet's protection would ever be required- I've dropped downwards and sideways, landing on side, shoulder, arm or leg. I don't cycle behind buses at high speed, I don't often find myself in a situation where a road sign, tree or brick wall is zooming, unseen, towards me. The only possible situation where head protection may be useful would be if I was on a single, country lane and some mad driver is coming at me at speed and head-on; but in this accident, a cycle helmet would behopelessly inadequate.

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    Replies
    1. Hi Karl

      Just back from my hols so catching up on replies. Glad you like the blog. Hope to be writing some more soon.

      Cheers

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  9. I know I'm quite late in this discussion, so sorry about that. But I am seemingly one of the few people who can say (with proof!) that a cycle helmet saved my life. Better still, it broke whilst doing it!

    I was quite young at the time, about 15 years ago in fact (I'm now 26) when I was hit by a car at 90 degrees. The car, travelling between 35-40 mph (according to accident investigation on the scene) hit my rear wheel at a junction, causing my bike to spin and me sailing into the windscreen head first.

    Two things saved me, the anti shatter windscreen, which meant that I had very few glass cuts and my helmet. The doctors estimated that I must have hit the windscreen at about 4 times my body weight, so how my neck survived I don't know. The styro foam on my helmet was cracked in two, with only the plastic shell holding it in place.

    Now, I was still a bit of a mess for a while. Massively concussed for days, 3 broken ribs (I then proceeded to do a "Klinsmann" on the road it seems) and very stiff joints for a couple of weeks. But NO BRAIN DAMAGE. Replay that accident without me wearing that helmet and I think it's pretty safe to say that would have been my skull in two.

    Personally, I wear a helmet now - I'd be a bit stupid not to. Do I think it should be compulsory? No not really. It's your life at the end of the day, do with it as you wish.

    But I thought I needed to get my 2p's worth in about helmets not saving lives, as it most definitely saved mine.

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