Ben Goldacre - Helmet 'Bad Science'

[Linford]

Not really. That last sentence was a throwaway closing remark, as any normal reader would have realised. The issue we were/are talking about is why it isn't recommended that pedestrians/infants wear protective helmets.

You're just doing what you always do: picking up on peripheral details rather than dealing with the central issue or answering direct questions. Why you do it when it gets you no respect is anyone's guess.

I apologise if my posts don't meet yours or anyone elses expectations, but I post what 'I' feel is pertinent, and do so to satisfy 'My' curiosity and nobody elses.
The problem with you and the other protagonists engaging in this thread is that you/they appear to colour all of your/their responses with the disagreements of past exchanges...or in other words...bearing a grudge and showing it in any exchange.

 

[ufkacbln]

It is relevant given what he is asking other healthcare providers to do ...would you not agree ?

Entirely relevant....

If you are going to ask - then ask all or none - whenever a head injury comes in then the patient should be asked whether they were wearing a helmet....regardless of whether they were pedestrian, driver, cyclist or passenger.

At present the hypocritical and non-evidence based practice of only asking cyclists is unprofessional and should be seen as unacceptable.

 

[ufkacbln]

The question is whether health care professionals should be expounding ill informed non-evidenced and unproven tripe as "professional opinion"

 

[Linford]

I must have missed the exchange where Linford mentioned that one.

Shall i take that as an apology ?

Whilst we are at it, this is what Headway says about cycle lids

• After introducing a helmet law for children under 14, the US state of New Jersey reported that bicycle-related fatalities for that group fell by 60%. For riders over 14, who were not required to wear helmets, the reduction was a mere 5% in the same period. (Trends in Pediatric and Adult Bicycling Deaths Before and After Passage of a Bicycle Helmet Law, Wessen et al)

 

[Linford]

Does your source say anything about any reduction in rider numbers?

You have the stats on that ? ... please share

 

[pubrunner]

As a society we have a mindset, that cycling is dangerous and needs a helmet, whilst walking or travelling by car are safe and the idea of suggesting helmets is laughable. The two questions are, what are the relative levels of risk and how much riskier does something have to be to justify the protective apparatus.

^^^. I can well see your point, but I'm not sure it is entirely accurate. I don't think that people do think that cycling is dangerous; what they think is dangerous, is coming off the bike unexpectedly - for whatever reason. When we cycle, we are surely at greater risk than walking, simply because we are sharing the road with other users, who are bigger, stronger and faster than we are ? . . . and many of these other road users, regard cyclists as being of secondary importance. By contrast, when we walk, we simply at 'risk', from the vagaries of other pedestrians.

With regard to levels of risk and 'how much riskier does something have to be ?' - this is impossible to answer, since our (individual) competence at any activity, will vary greatly. On the forum rides in which I've taken part, I'm well known for descending like Reginald Molehusband . . . pretty slowly ! . Technically, walking is much easier than cycling . . . . . . .though I've done a few 'technical' fell races, where some (non-runners) might suggest that helmets should be worn, in case of falls. Very close to where I live, is a hill called Gyrn Moelfre; most years, it is used for the the British Downhill MTB Championships. All the riders have to wear helmets . . . and these are people with incredible skills . . . but there are always falls to be seen. By contrast, I frequently run down the same paths (not at the same time ) , but I would never wear a helmet.

By comparison with cycling, I notice that virtually all horse riders wear helmets. Whilst riding on the road, horse riders tend to go far slower than cyclists, since they are highly unlikely to be cantering or galloping on Tarmac. Is horse riding 'dangerous' and more so than cycling ? Again, (IMO) it depends on personal competence with regard to any given activity; a highly skilled horse rider may not be so confident, whilst cycling on a busy road.

Of course Adrian, we can always test this theory . . . make a journey up here and I'll take you horse riding; you could be taken trotting and then cantering . . . but would you want to wear a 'crash hat' ? .

 

[pubrunner]

Mrs Adrian just used to laugh at my attempts at learning to trot. I could manage sitting on the back like a sack of spuds but that was it.

Were you wearing a helmet ?

 

[ufkacbln]

You have the stats on that ? ... please share

Headway and statistics?



They are almost as credible as the BHIT



Headway have no idea when it comes to helmets fudge the figures when it suits them - a classic is their petition to No 10:

t is estimated that 90,000 on-road and 100,000 off-road cycling accidents occur every year in the UK, of which a disproportionate number involve children under 16.

Child cyclists in the UK deserve the same protection as those in countries such as USA, Canada and Australia which have introduced compulsory helmet laws for children.

Headway - the brain injury association along with other national charities and the British Medical Association, believe that cycle helmets can save lives and prevent lifelong disability.

When you actually look at the figures in the original paper this is a gross and deliberate misrepresentation of both the figures and the context

When this was queried the reply was that:

The statistic relating to the 90,000 on-road and 100,000 off-road
accidents comes from the following reference: Bicycle Helmets 1 - Does
the dental profession have a role in promoting their use? Chapman HR,
Curran ALM. British Dental Journal 2004;196(9):555-560.

The actual paper stated that :

EPIDEMIOLOGY OF HEAD INJURY AFTER BICYCLE ACCIDENTS
Across all ages in the UK it is estimated that there are 90,000 road-
related and 100,000 off-road cycling accidents per year. Of these
accidents, 100,000 (53%) involved children under 16, suggesting
that children are at greater risk of injury during cycling than adults.
In the UK, there were between 127 and 203 cycling fatalities
per year between 1996 and 2002, of which 70–80% were
caused by traumatic brain injury (TBI).The most recent Gov-
ernment death and serious injury figures2 are summarised in
Table 1. In children under 16, two-thirds of cycle-related deaths
occur in road traffic accidents (RTAs) with the remaining third
occurring whilst the child is cycling off road. The majority of
injuries, however, occur when children are cycling off road3–6
and, of these, traumatic brain injury (TBI) is the most likely to
have long-term consequences.

They have simply quoted the figure for ALL cycle accidents and implied that they are all serious head injuries!

When you actually look at the figures in the paper 100,000 becomes - 150!

Of course 150 accidents in ALL cyclists will be even less if you just count children, and even less still if you look at non- vehicular accidents, probably as few as 20 or 30

If the "evidence" is so strong - why lie like this, at least after the complaints at least they now add a second paragraph on the page you quoted

Oh and of course one assumes that Headway realise the paper they quoted and in doing so endorse is actively seeking helmets with facial protection.

Headway whether aware of it or not are promoting full face helmets!

 

[ufkacbln]

^^^. I can well see your point, but I'm not sure it is entirely accurate. I don't think that people do think that cycling is dangerous; what they think is dangerous, is coming off the bike unexpectedly - for whatever reason. When we cycle, we are surely at greater risk than walking, simply because we are sharing the road with other users, who are bigger, stronger and faster than we are ? . . . and many of these other road users, regard cyclists as being of secondary importance. By contrast, when we walk, we simply at 'risk', from the vagaries of other pedestrians.. (Cut by me)

The problem is individual risk for each time you go out.


Walking to the end of my drive becomes far more of a risk if there is ice and / or snow as there is a greater chance of falling over

However because I ride a trike, this same increase does not occur when I ride to the end of the drive.

There is also experience and training

RoSPA compared children who undergone cycle training against a control group that had not been trained. Despite cycling less, not cycling to school, and showing a lower usage of roads, the control group had an accident rate 3 -4 times higher than the trained group.

Arguably that makes training more effective than helmets!


Training is effective and makes accidents less likely, thus dealing with causes.

 

[pubrunner]

I don't think competence or the inherent 'dangerousness' of the pastime has much to do with whether people generally feel themselves to be at risk or not . . .

'Competence' has everything to do with the 'dangerousness' of a pastime; since we all have different levels of ability in any given area, it naturally follows, that the levels of risk are far greater for some, than for others.

As I mentioned on a previous posting, I see international MTB riders at events held on a local hill; it could be argued, that it is safer than riding on the road - no cars or lorries to worry about and the chance of a softer landing. The one thing in common, is that they all wear helmets. These are very skilled riders . . . I'd suggest that it is highly unlikely, that at my low level of MTB competence, the level of 'danger' that I'd face would be the same as for them and as a result, I'd feel myself to be at greater risk of harm, than they would.

To believe otherwise, would simply be 'wishful' thinking.

 

[ufkacbln]

More Headway lies.....

They also have a paragraph on LInford's page:

he number of pedal cyclists killed or seriously injured (KSI) in road accidents in 2007 was 2,564. This included 136 deaths. 522 children were among the KSI total. (Cycle Helmets, Lee AJ, Mann NP, Arch Dis Child 2003)

Again quoting ALL injuries and implying that they are head injuries.

The paper is here and again the quote from Headway does not actually occur in the paper, even by implication. They do not even mention 2007!

 

[ufkacbln]

Shall i take that as an apology ?

Whilst we are at it, this is what Headway says about cycle lids

After introducing a helmet law for children under 14, the US state of New Jersey reported that bicycle-related fatalities for that group fell by 60%. For riders over 14, who were not required to wear helmets, the reduction was a mere 5% in the same period. (Trends in Pediatric and Adult Bicycling Deaths Before and After Passage of a Bicycle Helmet Law, Wessen et al)

Now lets look at this one, and again let a little reality creep in

During the peak years reported in the paper for helmet wearing, deaths increased for child cyslists!For a full review of the paper - see here

Headway doesn't really do well in this does it?

 

[Linford]

Personally I don't think introducing horse-riding helmet wearing into this discussion is all that helpful - about as unhelpful as also considering racing drivers wearing helmets perhaps. The helmets themselves are very different - they tend to be heavier, they are often held in place with a chin cup, and many come down low at the sides over the temple area - but I'm not going to bother finding the safety standards here. The risks are also very different: whether you're riding a horse alone or in a group, at whatever pace, a fall can (and often does) put you in among flying hooves clad in metal so the parameters involved and protection needed are a bit different.

When I had horses, for my own reasons I always wore a helmet, but I rode daily with plenty of people who didn't bother for all the same reasons that cyclists put forward. I don't think competence or the inherent 'dangerousness' of the pastime has much to do with whether people generally feel themselves to be at risk or not - oh hang on, I remember, that's what this thread was originally about (not whether helmets work or not).

Chin cups on horseriding lids have been banned for years by the BHS/Pony Club etc due to their ability to break the wearers jaw. The fixing system is just like the majority of cycling hats now. The law regarding horseriding lids is that it is compulsory for riders under 14 to wear them when on the public highways. The concession was made at this cut off point due to the hunt crowd wanting to wear top hats. I feel that anytime someone is handing a horse they should wear a lid...Human skull down to 3mm thick in places, Horses skull, many times the mass and 25mm thick in places. Bang heads with a horse and humans will always come off worse.

 

[david k]

I think introducing horse riding into the discussion is only as much of a side track as introducing pedestrians, IMO

 

[Linford]

Now lets look at this one, and again let a little reality creep in

During the peak years reported in the paper for helmet wearing, deaths increased for child cyslists!For a full review of the paper - see here

Headway doesn't really do well in this does it?

Ah, you chose and anti helmet website for your reference, and not a pro saving lives one....a fundamental mistake and you will never see any balance to their assertions.