Surgeons in Scotland debate the helmet issue - do they increase cyclists' safety or not?

nadimk wrote:

Cycling carries a risk of head injury. Do you deny that?

pretty much everything carries a risk of head injury.

nadimk wrote:

helmet design is stupid these days.

But we should still all wear them, right?

nadimk wrote:

This debate needs sanity and evidence, not opinion and anecdote.

I'd agree with that, but you didn't actually provide any evidence. just your opinion.

helmets are a massive red herring. they're not what's required for safe cycling. the evidence for that is abundant: just go to a country where cycling is safe, relatively speaking, and look at what they're wearing. And then look at where they get to cycle.

If you want to make cycling safe, have a look at the hierachy of hazard control and do the most important things first: http://en.wikipedia.org/wiki/Hierarchy_of_hazard_control

you'll note that personal protective equipment is the last thing you should consider to mitigate risk, as it's generally the least effective.

I'm still waiting for health advisors to point out that you are more likely to sustain a head injury due to mugging if you are NOT wearing a helmet.
It is for this reason that pedestrians should ALWAYS wear a helmet - especially outside pubs where so many head injuries occur.
Anyone who opposes this very simple and practical safeguard is just putting pedestrians in danger and filling up our busy A&E wards on a saturday night.

Remember this simple slogan: GFAW WAH.
Going For A Walk? - Wear A Helmet!
It's just common sense really.

Fully in favour of non compulsion. In 95/100 cases better some padding than none at all but still - it's a personal choice.

It's as simple as that and doesn't need this lengthy, tedious hairsplitting every time.

Of course, in most of Northern Europe, where cycling is a normal means of commuting, they regard helmet wearing as just silly.
They also regard not having decent cyclepaths and proper laws to protect cyclists as insane.
But... what would they know? They're just cyclists who aren't dictated to by a car-culture and regard cycles as transport rather than an Extreme Sport.

It's like Christmas came early, a helmet debate and Rapha launch on the same day!!

If only Rapha made helmets.

This helment debate is about as contrived as those new Andex adverts in which they claim the nation is divided between two different methods using toilet paper (when, by the way, did it become an acceptable thing for a corporation to ask us how we wipe our arses?)

Can helments occasionally help prevent injures in certain very limited types of accidents? Yes. Should they be made compulsory or promoted in such a way that makes cycling appear to be an inherently dangerous pursuit? No.

But it keeps coming up. Again and again. Why? Because it is a gift to so many people who are in a position to make it a hot topic. Not getting many page views on your tedious regional specialist web site? Start a helment debate! Secretly dislike cyclists who are adding a few seconds to your journey times each morning? Start a helment debate! Want to detract attention from your government's fundamentally pro-car policies despite their incompatibility with the green policies you like to spout? Start a helment debate! Need to sell your warehouses full of cycling helments that are going out of fashion? Start a helment debate!

I wish I'd put my lid on before I'd started reading this thread, because my head REALLY hurts now.

Oh and for the record, two sheets per wipe and front to back.

The only thing i have to add to this is that Mr Oliver operated on my broken pinkie, which i broke in a crash in a bike race. - How's that for a claim to fame?!

p.s. I was wearing a helmet but it didn't save my pinkie :'(

Most of the "evidence" for helmets' benefit is based on the "I fell off and broke my helmet but my head was OK" type of comment; or on the basis of a doctor or health professional saying that a helmet saved someone's life.

A broken helmet gives no indication of the level of damage that would happen to a head without one. A doctor is not qualified know whether a helmet saved a life in any particular situation.

There is simply no evidence that helmets significantly reduce rates of injury but there is plenty of evidence that helmet compulsion reduces cycling rates and as such is significantly harmful to public health.

For all the "show us the evidence" requests above I suggest a visit to http://cyclehelmets.org/ where plenty of evidence is detailed with references.

My advice is look at actual evidence, think about it, make up your own mind and let everyone else do the same!

Comparisons to the Netherlands seem a bit silly considering the much better cycling infrastructure they have.

Like others, I'd like to see some information on the injuries that helmets can cause.

I remember in my youth no one wore helmets. If you just dicking about in the streets or you were a pro. I also remember the streets were littered with dead children and dead pro cyclists, hundreds of them. The Tour De France would loose several riders every year - sometimes dozens - all killed by head injuries. Im amazed i myself made it to adult hood and that there were any pro cyclists left to race in the pre helmet era - such was the casualty rate.
Since helmets have become more common no one has ever died whilst riding a bike.
Thank heavens for helmets.

Please stop writing about helmets.

Please http://www.writetothem.com and ask them to stop building crap cycle lanes, if you haven't recently.

Any choice wearing a seat belt No

Any choice wearing a crash helmet on a motor cycle No

At least you have a choice on a cycle all I am reading here are the same old arguments about choice not about safety.

Until they are made compulsory some will, some wont.

So if you crash at 60mph on a motor bike and hit a sign post smash your chest and abdomen then bleed out before help arrives motor cycle helmets shouldn’t be compulsory should they as they don’t always work.

The above statement is the same as what people are saying about cycle helmets and makes as much sense as some comments on here, not a lot. By the way don’t say that kind of accident couldn’t happen as that is exactly what happened to a friend of mine about 20 years ago.
Do I wear a helmet yes. Why? Beacause I have a choice and every little helps.

Very interesting reading and comments as well. But while arguments against mandating helmet use - because the resulting drop in cycling (poorly studied, IMHO) results in lower average fitness and hence more public "danger" - ignores the reality that when YOU fall, it is YOUR head. Not an average public head. YOUR head.

So, I agree with the UK status quo. No mandated helmet use for adults. Public education. And I always wear a helmet. I care more about my head than yours. I mean you might smoke, too. Or jump lights. Ride with headphones or at night with no lights. You take yer chances, I'll take mine.

BTW - quite a few US states do not have helmet laws for motorcyclists. There seems to be a divide in who wears helmets and who doesn't. Young men don't. Harley riders don't. A nurse friend tells me the A&E workers refer to them as "organ donors".

Ah, more fallacies:

"You don't get a choice about seat belts or motorcycle helmets, do you?" - no, but cars and motorcycles are different things, with different issues, to bicycles. E.g., for one thing there are *NO HEALTH BENEFITS* to using a car or motorcycle (the contrary).

"Statistics, smishtics, it's *your* head - if you happens to *you* you'll want a helmet". Except, if lots of helmet use depresses cycling rates (e.g. by making cycling appear more dangerous than it actually is and so less attractive), then the lower cycling rates result in more cars that can hit you, and less political will to actually fix any of the problems cyclists have (with road safety, infrastructure). So you may be making things worse for cyclists, such as yourelf, and cycling, for a benefit that will matter to you only in a statistically unlikely event (if you cycle sensibly, and control your speed, e.g. on hills, etc.). Further, do you apply the same logic to when you go for a walk?

I've tried to collate some links on this blog post:

http://pjakma.wordpress.com/2011/10/28/the-case-against-bicycle-helmets-...

You can find links to meta-studies there which suggest the net effect of helmets on injury is *minimal*, because the decrease in head injuries is accompanied by increases in other injuries (facial, neck). The bibliographies in the meta-studies will lead you to the primary studies describing these things.

I try add further studies in the comments when I find them.

Here in Victoria, Australia we started the whole helmet compulsion thing, tragically for common sense, without evidence. Now the evidence suggests the only benefit was to reduce the number of cyclists on the road as the figures for reductions in accidents are similar.
If you really want bike safety, look to the Netherlands. I rode there and in Denmark and Sweden over a few weeks and concluded that the whole area but Netherlands in particular is safer because of one thing, protective laws.
Our government had a chance to apply such laws in the 70's as they actually knew about the changes going on in the Netherlands but the whole debate was hyjacked by our motoring advocacy group, the Royal Automobile Club of Victoria (RACV.
The RACV and the government worked together to create the first bike helmet laws thus ensuring that no motorist in Victoria would have to ever suffer laws that required him to be deferential around a bike rider.

Not that it makes any difference to peoples views but over the years i've done my job (close to 26) i believe i can count on one hand the number of head injuries sustained by pedestrians tripping over (its usually wrists, shoulders, knees) and likewise for muggings / robberies (usually threatened with violence / knife) whereas bike accidents run nearly into the 100's and the vast majority suffer some sort of head style injury even with a helmet.

These are MY experiences, not fact or scientific proof. I wear a helmet because i want to, its everyones choice and no Govt should ever try to change what is fundamentally an individuals choice unless undeniable proof is brought forward to justify a decision.

The case of Fabio Casartelli seems a case in point. He would be alive today (most likely) if he had been wearing something on his noggin. I sort of feel that you don't need to wear a helmet, but given they are light weight and do not impinge performance that they might protect me better than a cloth cap, or styling gel.

But what I would like to know is the stats of head injuries per population of cyclists, compared to other activities. As other people have mentioned it would be a red herring if, for example, there were more hospitalisations due to head injuries from dog walking over cycling. The problem is that we sit in a well on unknowing.

Also, it would also be interesting to know what injuries are sustained by various cycling populations, the regularity of an injury and the experience of a rider. I suspect that people popping to the shops (with few bike handling skills and heavy bikes) suffer injuries more readily than road cyclists. So perhaps the issue is to get people learning bike handling and making them aware of road safety issues, rather than slamming a lid on their head. Perhaps even banning heavy bikes which quite possibly add to the risk factors.

I have no gripe with wearing a helmet or not. I've not needed to wear one, and recognise that there are dangers involved. But putting facts and statistics out there will at least focus this debate (of which I have none).

As other statistics and statisticians have shown, it's all about our attitude to risk. Those brought up to look out for the bogeyman (remember him?) will think 'Be careful' and wear a helmet, those who think 'life is an adventure, and I'd rather die tomorrow than miss out on the thrills', won't. This is the attitude of the ones who smoke, in spite of all the known risks, too. My gripe is that the health service, and the emergency services, pick up the pieces for free whatever the attitude of the suckers who got themselves sick or injured, and as a non-risk-taker (except when I'm in a nice safe car with a ton of steel all around me!) I feel I'm paying more than my fair share of the cost.

Taking advice from an orthopaedic surgeon over that of a neurosurgeon for a problem which affects the brain is like asking an opthalmologist versus a urologist as to the benefits or otherwise of wearing a box during cricket! The opthalmologist will probably tell you that wearing a box is beneficial only if you really want to prevent yourself from crying after a direct hit to the goolies... but crying won't kill you, will it.
I can't believe you guys are seriously "debating" this! For a developed country, there are still a lot of things that I don't get about the UK... this and the Royals are about as laughable as they come!
Try this on for size... anyone who buys their eggs in egg cartons should wear a helmet. Don't be taken by the advice of an orthopaedic surgeon... they don't have anything to protect... I should know... I'm an anaesthetist.

I'm sorry if this has already been said before, maybe we need to look at the word "safety".

Does a helemt make a fall safer? Yes to a point.
Does it make me feel safer? Yes
Does is make me ride in a safer manner? Not always. I take more risks than I would without.
Does it make the other idiots on the road safer? Nope.
Does it make the idiots on the road drive/walk/cycle safer? Nope!

How does an inanimate object improve the suicidal/murderous tendancies of those organic sqishy things around it?

The safer things are made, the more of a risk people will take.

Compulsory crash helmets for car occupants would reduce head injuries save lives.