Do you wear a helmet?

[elapid]

Have you read any of the non-medical research?[/QUOTE]

Firstly, this is not medical research alone. It is scientific, but most of the studies are epidemiological, not medical.

Secondly, I've told you why I wear a helmet. I haven't read the non-scientific research, but then again I don't give non-scientific studies much credence either. I am happy wearing a helmet because I know it reduces the risk of both death and more serious brain injury in the majority of situations I expose myself to as a commuter, recreational rider and occasional racer. I do this to be as safe as possible, but also to ensure that I don't end up causing undue emotional and financial hardships for my loved ones. I don't mind if you do or don't wear a helmet, but the scientific studies, of which there are many, support the use of helmets for cyclists as long as they are worn properly.

 

[elapid]

I did a quick PubMed search of "bicycle and helmet" with 514 scientific papers written on the use of helmets in bicycle users. I read the first 40 abstracts and all but one paper concluded the helmet use decreases the risk of serious brain injury; brain injury rates have decreased since helmet use became compulsory in countries like Australia; and the most common reason for cyclists presenting to hospital following a crash was head injuries in countries without compulsory helmet laws (Japan, Taiwan, Sweden and Israel were the papers I read) and that the incidence of head injuries in these countries was unacceptably high. Other papers concluded that the ability of a helmet to protect against brain injury depends on proper positioning of the helmet and, depending on the study, this varied between 46-100%.

Have you read any of the non-medical research?[/QUOTE]


Firstly, this is not medical research alone. It is scientific, but most of the studies are epidemiological, not medical.

Secondly, I've told you why I wear a helmet. I haven't read the non-scientific research, but then again I don't give non-scientific studies much credence either. I am happy wearing a helmet because I know it reduces the risk of both death and more serious brain injury in the majority of situations I expose myself to as a commuter, recreational rider and occasional racer. I do this to be as safe as possible, but also to ensure that I don't end up causing undue emotional and financial hardships for my loved ones. I don't mind if you do or don't wear a helmet, but the scientific studies, of which there are many, support the use of helmets for cyclists as long as they are worn properly.

 

[Anonymous]

Hi Dim. In all seriousness, can I ask why you don't wear a helmet?

its us old folk.. we are a funny type...

i am considering one.. i think its just an old school thing, when i rode and raced low level they wernt compulsory, so generally we didnt bother wearing one, tended to wear one time trialling becuase it was on public roads, but for road racing didnt bother as it was generally closed, or restricted roads with no cars etc.. even then most people didnt bother with much more than a strap skull cap.. i vaguely remember regs coming in saying we had to wear them for one discipline but im damned if i can remember if it was road racing or TT's.. back then the shops barely even sold them, im sure if i dug out a cycling mag from 1985 there will be naff all helmets in the classifieds

i stopped riding seriously (well as seriously as local club riders get) in about '95 and had never worn one up to then.. (ask anyone who was riding 85-95 if they wore a helmet and virtually nobody did..)

Only really the last year or so i have been back on a bike again, and only the last 6 months have been out riding any more than to the shops and back.. even now only doing about 20-50k runs out, at very sedate 20-25k speeds with the wife recreationally on a mountain bike on fairly sensible roads, or cycle tracks so just havnt invested in one yet..

yes i know.. irresponsible..

that said, the fitness is gradually returning (and im down to about ten fags a day, and virtually off the alcohol, and the calf muscles are starting to re-appear), and a road bike is once more being toyed with - its amazing how it all comes back to you how much you enjoyed being on two wheels.. i wouldnt consider riding a road bike without a helmet.. i guess mentally, tootling along sensibly at 20k i figure im safe, if i didnt get a serious bump caning along at silly speeds on the cornish hills all those years ago im safe now...

so yes, irresponsible i know.. you will all be very pleased when i get one... i shall wear one before i get a road bike again...

its actually really bizarre having clocked up thousands of miles on a bike over ten years (averaged about 250 miles a week back then) to never have worn one..

do they make your head hot.. ?

 

[BigChain]

I only wear a helmet when participating in group events where helmets are required. I have little faith that these cheezy foam structures actually do much at all to help avoid major injury in a crash however as a "skid lid" it probably would be effective. I also feel the manufacturers put alot of mis-information about there effectiveness out there and most fall for it. I look at the costs of the helmets most desired by bikers and think to myself what a ripoff. Prices exceeding well above $100 is BS. I think that's why most of my friends I ride with don't wear them either. It really is insulting not to mention really ****es me off that any products targeted to bikers are priced so far out of line. It's not that I can't afford it, I can easily afford it, I'm just not that stupid. I say let the manufacturers keep it. But, that's getting into another topic so I'll stop there.

I hope you never have a serious crash. But if you do you'll certainly be wishing you had even a cheap helmet on. I crashed a few years ago at 45kmh, going over the handlebars and crashing my head straight into a huge rock. Apart from being lucky not to break my neck I had no head injury at all, not even concussion. I wish the rest of my body had been padded as well as my head as I suffered two broken wrists, cracked ribs and severe trauma around my pelvis. Without the helmut the least I would have suffered was a fractured skull and probably brain damage. Death would have been a high possibility. Today's helmets are not like the old racing helmets. They are designed to both skid and break under the impact absorbing significant amount of force. You'd have to be nuts not to wear one.

 

[elapid]

its us old folk.. we are a funny type...

i am considering one.. i think its just an old school thing, when i rode and raced low level they wernt compulsory, so generally we didnt bother wearing one, tended to wear one time trialling becuase it was on public roads, but for road racing didnt bother as it was generally closed, or restricted roads with no cars etc.. even then most people didnt bother with much more than a strap skull cap.. i vaguely remember regs coming in saying we had to wear them for one discipline but im damned if i can remember if it was road racing or TT's.. back then the shops barely even sold them, im sure if i dug out a cycling mag from 1985 there will be naff all helmets in the classifieds

i stopped riding seriously (well as seriously as local club riders get) in about '95 and had never worn one up to then.. (ask anyone who was riding 85-95 if they wore a helmet and virtually nobody did..)

Only really the last year or so i have been back on a bike again, and only the last 6 months have been out riding any more than to the shops and back.. even now only doing about 20-50k runs out, at very sedate 20-25k speeds with the wife recreationally on a mountain bike on fairly sensible roads, or cycle tracks so just havnt invested in one yet..

yes i know.. irresponsible..

that said, the fitness is gradually returning (and im down to about ten fags a day, and virtually off the alcohol, and the calf muscles are starting to re-appear), and a road bike is once more being toyed with - its amazing how it all comes back to you how much you enjoyed being on two wheels.. i wouldnt consider riding a road bike without a helmet.. i guess mentally, tootling along sensibly at 20k i figure im safe, if i didnt get a serious bump caning along at silly speeds on the cornish hills all those years ago im safe now...

so yes, irresponsible i know.. you will all be very pleased when i get one... i shall wear one before i get a road bike again...

its actually really bizarre having clocked up thousands of miles on a bike over ten years (averaged about 250 miles a week back then) to never have worn one..

do they make your head hot.. ?

Thanks for your answer. Helmets are no fashion statement - hot, sweaty, helmet hair. The newer ones have plenty of vents which help with air flow and decreasing heat. I'll put up with it though - I'm no fashion statement anyway!

 

[ladyvader]

Yes, I wear on. I'm one of few that do near where I live.

 

[philcrisp]

Have you read any of the non-medical research?

Firstly, this is not medical research alone. It is scientific, but most of the studies are epidemiological, not medical.

Secondly, I've told you why I wear a helmet. I haven't read the non-scientific research, but then again I don't give non-scientific studies much credence either. I am happy wearing a helmet because I know it reduces the risk of both death and more serious brain injury in the majority of situations I expose myself to as a commuter, recreational rider and occasional racer. I do this to be as safe as possible, but also to ensure that I don't end up causing undue emotional and financial hardships for my loved ones. I don't mind if you do or don't wear a helmet, but the scientific studies, of which there are many, support the use of helmets for cyclists as long as they are worn properly.[/QUOTE]


OK I used to wear one religiously, I was one of the first people in my club to buy a hard shell c1988. Then I started reading the reasearch a few years ago. This is what I found. (and if there is stuff that I've missed then I'm genuinely interested in hearing about it)

The medical literature relies on the analysis of admissions to hospitals and consistantly reports that riders who voluntarilty chose to wear a helment are less likely to suffer head injury. These studies are usually open to confounding factors, was it the helmet or some other factor(s) that are responsible for the observed difference.

Then when you look at data from a population level, and some of the statisticians involved would be very unhappy to see their work described as unscientific, it appears that it is impossible to demonstrate any benefit from helmet use. Head injuries and helmet use are both rising the USA while bicycle use is falling for example.

Btw, when comparing jurisdictions, deaths and serious injuries per km appear to rise with helmet use, althougth we should remember that correlation does not imply causation.

Given the foregoing you'll understand why I think Ms Atherton's reaction to her crash misses the point entirely. HEAD UP WOMAN!!

http://www.cyclingnews.com/news/atherton-injured-in-collision-with-vehicle

 

[elapid]

The medical literature relies on the analysis of admissions to hospitals and consistantly reports that riders who voluntarilty chose to wear a helment are less likely to suffer head injury. These studies are usually open to confounding factors, was it the helmet or some other factor(s) that are responsible for the observed difference.

What a load of rubbish. The population studies you mention are epidemiological studies. These are included in the 514 papers I mentioned as explicitly stated in my previous post, and in fact predominate over "medical" studies. Secondly, all studies have confounding variables. I read the abstracts of the most recent 40 scientific (not medical, but scientific including epidemiological) studies and 39 of these concluded that helmet use minimizes the risk of head injury. Lastly, links please to your enlightening studies. I'll link all 514 studies if you want.

 

[mr. tibbs]

I've bounced my head off the road/cars too many times to NOT wear a helmet. Happily, I was wearing a helmet every time, so I can still annoy you all with muh posts on teh interbuttz.

I'm always amazed that people rail against helmet use--especially when they question a helmet's effectiveness. It's like being shot at while wearing body armor VS being shot at while in your skivvies. The body armor helps. It really does. A helmet relies on the same priniciple (and the road NEVER misses).

 

[lostintime]

I didn't start wearing a helmet every day until 2002 or so. I would only wear one in races and where it was required. I only raced in the 80's . . and the helmets then sucked. . . . too hot for me. Todays helmets though. . . heat is a non issue . . if it was I would not wear one. The true test is the dog days of summer . . temps in the 90's. . . humid. . . and I can't tell it's on.

Yes, I've had numerous crashes and accidents which . . . a few concussions . . . all of which a helmet would have done me no good. I had worse trauma from banging heads playing football as a kid.

Overpriced . . overhyped . . . yes and no . . . . depends on who you ask and when. Wear one or not . . . there's no wrong choice. It might keep you alive for a few more years . . .it might not.

Peer pressure and marketing have surely made helmets into more than they really are. . . a piece of foam on your head that may or may not have any say in the quality of your life.

That's life.

 

[philcrisp]

What a load of rubbish. The population studies you mention are epidemiological studies. These are included in the 514 papers I mentioned as explicitly stated in my previous post, and in fact predominate over "medical" studies. Secondly, all studies have confounding variables. I read the abstracts of the most recent 40 scientific (not medical, but scientific including epidemiological) studies and 39 of these concluded that helmet use minimizes the risk of head injury. Lastly, links please to your enlightening studies. I'll link all 514 studies if you want.

Interesting 5 out of the first twenty state that bicycle helmets are known to be effective as a given.

These (http://www.ncbi.nlm.nih.gov/pubmed/...nel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum) doesn't state in the abstract that changes in use were considered. See (http://www3.interscience.wiley.com/journal/117968953/abstract)

Did you read this one? (http://www.ncbi.nlm.nih.gov/pubmed/...nel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum) "ISSUE ADDRESSED: To evaluate the effects on public health in Australia of compelling people to wear a bicycle helmet while cycling. METHODS: The processes of introducing compulsory wearing of bicycle helmets, evidence of their efficacy relative to scientific knowledge of brain injury, effects of compulsory wearing on public health and official actions to uphold the policy are examined. RESULTS:It is shown that action to make the wearing of a bicycle helmet compulsory was a response to fear of death and chronic disability from brain injury, and it was taken at a time when cycling was increasing and the risk of casualty was falling. It appears that governments did not verify the efficacy of helmets and disregarded research which found that they can increase brain injury. After the legislation was introduced, rates of cycling declined sharply with loss of benefits for health, but the risk of casualty increased. CONCLUSIONS: Compulsion to wear a bicycle helmet is detrimental to public health in Australia."

I could go on. Try this site (http://www.cyclehelmets.org/index.html) They are the only people I've found in this debate prepared to link to their opponents.

 

[elapid]

Interesting 5 out of the first twenty state that bicycle helmets are known to be effective as a given.

These (http://www.ncbi.nlm.nih.gov/pubmed/...nel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum) doesn't state in the abstract that changes in use were considered. See (http://www3.interscience.wiley.com/journal/117968953/abstract)

Did you read this one? (http://www.ncbi.nlm.nih.gov/pubmed/...nel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum) "ISSUE ADDRESSED: To evaluate the effects on public health in Australia of compelling people to wear a bicycle helmet while cycling. METHODS: The processes of introducing compulsory wearing of bicycle helmets, evidence of their efficacy relative to scientific knowledge of brain injury, effects of compulsory wearing on public health and official actions to uphold the policy are examined. RESULTS:It is shown that action to make the wearing of a bicycle helmet compulsory was a response to fear of death and chronic disability from brain injury, and it was taken at a time when cycling was increasing and the risk of casualty was falling. It appears that governments did not verify the efficacy of helmets and disregarded research which found that they can increase brain injury. After the legislation was introduced, rates of cycling declined sharply with loss of benefits for health, but the risk of casualty increased. CONCLUSIONS: Compulsion to wear a bicycle helmet is detrimental to public health in Australia."

I could go on. Try this site (http://www.cyclehelmets.org/index.html) They are the only people I've found in this debate prepared to link to their opponents.

You've presented one paper, an opinion piece, that is anti-helmets. Please by all means go on because I would like to see more than one paper that demonstrates helmets are of no use in protecting against brain injury.

The website you linked was very informative. Have you read the articles for and against helmets? I just read the abstracts of the first 10 papers in the against helmet category. Two papers are pro-helmet use, such as Ming and others in "Trends in helmet use and head injuries in San Diego County: The effect of bicycle helmet legislation" conclude that "Helmet legislation increased helmet use in the targeted child population and the effect was carried over to the adult population. Helmet use has a protective effect against serious head injury." The Cochrane Review found similar findings. And of the remainder of the first 10 papers, most stated that helmet use resulted in less head injuries but did not change the incidence of torso and limb injuries (duh - not as though a helmet is going to protect me from fracturing my leg), that helmet use gave children an additional sense of security in risk-taking situations, and, in one case, that there was not a difference in the incidence of head injuries.

As I have stated previously, I don't particularly care if you do or do not wear a helmet. You can grab on to that one paper that shows no difference in head injuries if you do nor do not wear a helmet, but I'll stick to the 100s of papers that show otherwise.

 

[usedtobefast]

I've bounced my head off the road/cars too many times to NOT wear a helmet. Happily, I was wearing a helmet every time, so I can still annoy you all with muh posts on teh interbuttz.

I'm always amazed that people rail against helmet use--especially when they question a helmet's effectiveness. It's like being shot at while wearing body armor VS being shot at while in your skivvies. The body armor helps. It really does. A helmet relies on the same priniciple (and the road NEVER misses).

and damn if it is not hard

 

[quadsRme]

Yes I wear a helmet.
it is optional around here but it sure beats an early exit.

As long as you have something to protect, you should wear a helmet. Those that choose not to wear a helmet, don't have anything to protect.

 

[philcrisp]

Last paragraph of the San Diego paper abstract in full reads:

"Helmet legislation increased helmet use in the targeted child population and the effect was carried over to the adult population. Helmet use has a protective effect against serious head injury. Probably due to several of its limitations, the current study did not confirm that helmet legislation alone significantly reduced head injury rates in San Diego County during the study period."

Unless we ran a slightly different search in PubMed, in the first 30 results I got the Curnow paper, a large number which did not seek to establish the results of helmet use. 4 that did, a Cochrane review which appeared twice (not the Thompson and Rivera paper, which you might expect to), 3 the IE wouldn't load and then it started playing up. 1 I hadn't seen before which appear to back you up. It's the first that doesn't have the normal faults.

Calling the Curnow paper an "opinion piece" may be fair but it was published in a pier reviewed journal.

Try this for an overview of the anti helmet position. http://www.cyclehelmets.org/papers/c2022.pdf in particular in Australia.

If you haven't got time it runs like this. The most convincing explanation for reductions in head injuries to cyclists post compulsion is form reductions in bicycle use. This chucks many of the benefits of increased cycling to society away. Like I said the Berg and Westerling paper is the first time I've seen population level data that appears to support the promotion of helmets.

 

[elapid]

I've read that one before. It has some good information. One of the recent Cochrane Reviews (http://www.ncbi.nlm.nih.gov/pubmed/18646128?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=4&log$=relatedreviews&logdbfrom=pubmed) stated in their conclusion: Bicycle helmet legislation appears to be effective in increasing helmet use and decreasing head injury rates in the populations for which it is implemented. However, there are very few high quality evaluative studies that measure these outcomes, and none that reported data on an possible declines in bicycle use. Cochrane Reviews are often meta-analyses, which are the most rigorous examination and collation of the literature and only scientific studies that meet a certain standard are included. So while cyclehelmets.org have produced some interesting results, these results do not stand up to the scrutiny of a meta-analysis and, perhaps more importantly, the last data collection was 1994-1996. Considering that we are now 13-15 years on from this, saying that there is no rebound effect is a little premature.

This is a good one: http://www.ncbi.nlm.nih.gov/pubmed/10796827?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=4&log$=relatedreviews&logdbfrom=pubmed

Regardless, I am not here to convince you to wear a helmet or not. That is a decision for you to make and feel comfortable with. I know I feel safer wearing a helmet and that I am more likely to not sustain life and perhaps career threatening head injuries as a result. I also know that it will not save me from non-head injuries, it will not save me if I am hit at > 40 kmh particularly from behind, and that some motorists may even get closer than normal because of a general perception that we are safer. But I will still wear a helmet.

 

[philcrisp]

Aah the famous Thompson, Rivara Thompson team. Two of whom submitted a Cochrane review paper that included four (out of the total of seven) of their own papers that relied on two data sets, one of which had serious concerns in respect of the control group.

But we are still back to the holes in each sides data. The pro papers usually don't completely remove possible confounding factors, notably for appetite for risk, the antis are reliant on relatively small numbers of datasets because not enough traffic counts etc were done.

Are you aware of any studies that claim a positive impact for helmets on the ksi per km figures (which for those who don't know is aka the casualty rate)? There is this elephant in the room about the correlation (which I know isn't perfect) between helmet use rates and the casualty rate when comparing jurisdictions.

I'll continue to rely on the principle of vehicular cycling and defensive driving, do everything you can not to be at the scene of the accident.

 

[richwagmn]

Oh yea. Can think of at least two incidents personally that could have ended badly if I wasn't wearing one.

You never want a head injury if you can avoid it. Having a family member who had one (not from cycling) and has never "recovered" from it is all the convincing I need.

 

[coffeebean2]

Absolutely wear one every time. I've had two crashes that resulted in serious head trauma. The last was May 2008 - crashed going around a corner and was knocked unconcious. The left side of my face was skinned up (ala Jens Voight). I had a concussion. My helmet was cracked in 17 places. I hate to think what my skull would have looked like without the helmet.

 

[benpounder]

A helmet is not going to save me if I am hit at 60 kmh or fall while descending at 80 kmh, but I know it will help in some situations, many of them I encounter daily when commuting or training.

In 1976 I was smeared by a car going 60mph. Being tossed 180ft, I was lucky, and yes I had many a Jens Voight style injury.

That said, if I am riding about town, I opt out of a brain bucket. (Check where I live - any big city is a different story.) Any real ride, any real skiing, and the cranny condom is surely affixed. In fact, the worst head 'trauma' I ever had was on a snowboard in 1986 - Gave up snowboarding and kept the helmet.

 

[Old Derailleur-in-the-mist]

HI. Just a quick correction to your opening..... " started riding in Australia where helmets were compulsory. I have lived in the US and now Canada where helmets are not compulsory".....
In Canada it varies by province. In BC where I live it IS compulsory.
I agree however. It saved MY life in 2006. I have also seen the other side of it. In the 80's I had a friend; a beautiful, 25 year old professional who was riding her bike home (helmetless) from a 10k run, hit a crack going about 10kmh, bonked her head on the curb and the next time I saw her she had a facial droop, withered arm, and speech impediment. I'm a small town doc and also saw a 4 year old who was riding with his mum on the sidewalk, suddenly veered onto the street and was hit on the head by the bumper of a very slow-moving car. Cracked the helmet. Mum brought the kid in to the ER (less than 100meters away) Scared but completely unhurt.
With the quality and aerodynamics of the current generation of helmets there is NO excuse for going without.

 

[BigChain]

HI. Just a quick correction to your opening..... " started riding in Australia where helmets were compulsory. I have lived in the US and now Canada where helmets are not compulsory".....
In Canada it varies by province. In BC where I live it IS compulsory.
I agree however. It saved MY life in 2006. I have also seen the other side of it. In the 80's I had a friend; a beautiful, 25 year old professional who was riding her bike home (helmetless) from a 10k run, hit a crack going about 10kmh, bonked her head on the curb and the next time I saw her she had a facial droop, withered arm, and speech impediment. I'm a small town doc and also saw a 4 year old who was riding with his mum on the sidewalk, suddenly veered onto the street and was hit on the head by the bumper of a very slow-moving car. Cracked the helmet. Mum brought the kid in to the ER (less than 100meters away) Scared but completely unhurt.
With the quality and aerodynamics of the current generation of helmets there is NO excuse for going without.

+1. Commonsense prevails.

 

[elapid]

In 1976 I was smeared by a car going 60mph. Being tossed 180ft, I was lucky, and yes I had many a Jens Voight style injury.

That said, if I am riding about town, I opt out of a brain bucket. (Check where I live - any big city is a different story.) Any real ride, any real skiing, and the cranny condom is surely affixed. In fact, the worst head 'trauma' I ever had was on a snowboard in 1986 - Gave up snowboarding and kept the helmet.

My first reaction to your story was holy sh*t, I cannot believe you survived that. My second reaction was you're one lucky son of a b*tch. And finally, I'm jealous of where you live. Cheers!

 

[elapid]

I'll continue to rely on the principle of vehicular cycling and defensive driving, do everything you can not to be at the scene of the accident.

I wish you luck and accident-free cycling. While I am relatively confident of my own abilities, especially when riding solo or with certain friends, I know I have no control over anything other than myself on the bike. I also know that if it comes down to me versus a car, I'm going to lose. I'll take helmet hair and sweat any day.

 

[Irenaeus]

Have you considered a full-face helmet?

Hello,

With Jens Voight's facial injury fresh in mind, I'm curious what folks here think about full-face helmets that off-roaders are much more likely to wear.

Irenaeus