glenn forger
Guest
She taken the page down?
Helmets; The Paramedics View
- Thread starter Richard A Thackeray
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KneesUp
Guru
Just blocked your IP I suppose.
mcshroom
Bionic Subsonic
- Location
- Egremont, Cumbria
These debates, as always seem to try and take one unmeasurable low frequency event and ignore the measurable overall effect of helmet compulsion (or strong encouragement). That she felt the need to embelish the blog with pictures of the aftermath of someone being hit by a tipper truck is just a little bit of side dishonesty.
It's time for Roger Geffen again methinks (I know it's long, but stick with it)
It is well established that, if you weigh up the life-years gained through cycling (due to increased physical activity) versus the life years lost (due to injury), the health benefits of cycling far outweigh the risks involved. One widely quoted figure for the UK, acknowledged by Government, puts the benefit:disbenefit ratio for the UK at 20:1. Other ratios for other countries are higher still. (N.B. some of the academic references reduce the ratio by including the negative effects of pollution - however that's obviously irrelevant to the helmet debate. If you remove the pollution effect, the other references all come out with ratios above 20:1). But let's take 20:1 for the sake of argument.
From this, recent research shows that, if you tell people to wear helmets (whether by law or simply through promotion campaigns) and this reduces cycle use by more than 1 unit of cycling (e.g. one cyclist, or one km cycled) for every 20 who continue, this is absolutely guaranteed to shorten more lives than helmets could possibly save - even if they were 100% effective at preventing ALL cycling injuries (i.e. leg, arm, shoulder injuries as well as head injuries) for the remaining cyclists. That maximum threshold, beyond which you would be doing more harm than good, then drops further still - down to c2% - once you take account of the proportion of cycling injuries which are non-head injuries. And this is still assuming that helmets are 100% effective at preventing head injuries.
In fact, the evidence on the effectiveness of helmets has become increasingly sceptical over time. A recent literature review by Rune Elvik, an internationally recognised authority on road safety, found that the estimates of helmet effectiveness have progressively decreased over time, with the most recent studies showing no net benefit. In this same report he documents evidence that helmets increase the risk of neck injuries. In a separate report, Elvik has also found that helmet-wearers suffer 14% more injuries per mile travelled than non-wearers. The reasons for this are unclear, however there is good evidence that (at least some) cyclists ride less cautiously when wearing helmets, and that drivers leave less space when overtaking cyclists with helmets than those without.
The only clearly documented effect of enforced helmet laws (e.g. in Australia, New Zealand or parts of Canada) is to substantially reduce cycle use, typically by about a third. Reductions in cyclists' head injury have been similar to the reductions in cycle use, suggesting no reduction in risk for the remaining cyclists, and in some cases this appears to have worsened. In addition to the possible explanations in the para above, this may also be becuase reductions in cycle use undermine the "safety in numbers" effect for the cyclists who remain - see see www.ctc.org.uk/safetyinnumbers. A clear relationship has been shown between cycle use and cycle safety - cycling is safer in places where cycle use is high (e.g. the Netherlands or Denmark - or within Britain, in Cambridge or York). Telling people to wear helmets, instead of creating safe cycling conditions, is contrary to the aims of encouraging more, as well as safer, cycling.
From this, I hope it is clear that the effectiveness or otherwise of helmets is not the main point. As explained above, even if helmets were 100% effective, you would still be doing more harm than good if you deter more than c2% of cycle use by telling people to wear them. That's because the risks of cycling are not especially high, and the health benefits are SO much greater. You are about as unlikely to be killed in a mile of cycling as a mile of walking - do we also need walking helmets? - no, of course not! The idea that you need helmets to cycle is both a symptom of our massively exaggerated concern about the "dangers" of cycling, which results in such pitifully low cycle use in Britain.
In short, if we want to maximise the health, environmental and other benefits of cycling, we need to focus on creating safe conditions, and thus increasing cycle use. Resorting to helmets simply tackles the symptoms of the problem, not the causes, and thus deters people from cycling. This is pretty much guaranteed to shorten more lives than it could possibly save. Faced with both an obesity crisis and a climate crisis, the last thing we should be doing is driving people into increasingly car-dependent, obesogenic lifestyles.
To John Halstead: I am very happy to communicate with you or anyone else on the helmet issue. As for evidence, the references supporting every claim in the text above can be found in CTC's review of the evidence: http://beta.ctc.org.uk/files/cycle-helmets-evidencebrf_1.pdf. There is also a (shorter) CTC policy statement on the subject here: http://beta.ctc.org.uk/file/public/cycle-helmetsbrf_0.pdf
I hope that this persuades you that it is more important to encourage people to cycle, than to worry about whether or not they wear helmets when doing so!
Best wishes
Roger Geffen
Campaigns & Policy Director, CTC
It's time for Roger Geffen again methinks (I know it's long, but stick with it)
It is well established that, if you weigh up the life-years gained through cycling (due to increased physical activity) versus the life years lost (due to injury), the health benefits of cycling far outweigh the risks involved. One widely quoted figure for the UK, acknowledged by Government, puts the benefit:disbenefit ratio for the UK at 20:1. Other ratios for other countries are higher still. (N.B. some of the academic references reduce the ratio by including the negative effects of pollution - however that's obviously irrelevant to the helmet debate. If you remove the pollution effect, the other references all come out with ratios above 20:1). But let's take 20:1 for the sake of argument.
From this, recent research shows that, if you tell people to wear helmets (whether by law or simply through promotion campaigns) and this reduces cycle use by more than 1 unit of cycling (e.g. one cyclist, or one km cycled) for every 20 who continue, this is absolutely guaranteed to shorten more lives than helmets could possibly save - even if they were 100% effective at preventing ALL cycling injuries (i.e. leg, arm, shoulder injuries as well as head injuries) for the remaining cyclists. That maximum threshold, beyond which you would be doing more harm than good, then drops further still - down to c2% - once you take account of the proportion of cycling injuries which are non-head injuries. And this is still assuming that helmets are 100% effective at preventing head injuries.
In fact, the evidence on the effectiveness of helmets has become increasingly sceptical over time. A recent literature review by Rune Elvik, an internationally recognised authority on road safety, found that the estimates of helmet effectiveness have progressively decreased over time, with the most recent studies showing no net benefit. In this same report he documents evidence that helmets increase the risk of neck injuries. In a separate report, Elvik has also found that helmet-wearers suffer 14% more injuries per mile travelled than non-wearers. The reasons for this are unclear, however there is good evidence that (at least some) cyclists ride less cautiously when wearing helmets, and that drivers leave less space when overtaking cyclists with helmets than those without.
The only clearly documented effect of enforced helmet laws (e.g. in Australia, New Zealand or parts of Canada) is to substantially reduce cycle use, typically by about a third. Reductions in cyclists' head injury have been similar to the reductions in cycle use, suggesting no reduction in risk for the remaining cyclists, and in some cases this appears to have worsened. In addition to the possible explanations in the para above, this may also be becuase reductions in cycle use undermine the "safety in numbers" effect for the cyclists who remain - see see www.ctc.org.uk/safetyinnumbers. A clear relationship has been shown between cycle use and cycle safety - cycling is safer in places where cycle use is high (e.g. the Netherlands or Denmark - or within Britain, in Cambridge or York). Telling people to wear helmets, instead of creating safe cycling conditions, is contrary to the aims of encouraging more, as well as safer, cycling.
From this, I hope it is clear that the effectiveness or otherwise of helmets is not the main point. As explained above, even if helmets were 100% effective, you would still be doing more harm than good if you deter more than c2% of cycle use by telling people to wear them. That's because the risks of cycling are not especially high, and the health benefits are SO much greater. You are about as unlikely to be killed in a mile of cycling as a mile of walking - do we also need walking helmets? - no, of course not! The idea that you need helmets to cycle is both a symptom of our massively exaggerated concern about the "dangers" of cycling, which results in such pitifully low cycle use in Britain.
In short, if we want to maximise the health, environmental and other benefits of cycling, we need to focus on creating safe conditions, and thus increasing cycle use. Resorting to helmets simply tackles the symptoms of the problem, not the causes, and thus deters people from cycling. This is pretty much guaranteed to shorten more lives than it could possibly save. Faced with both an obesity crisis and a climate crisis, the last thing we should be doing is driving people into increasingly car-dependent, obesogenic lifestyles.
To John Halstead: I am very happy to communicate with you or anyone else on the helmet issue. As for evidence, the references supporting every claim in the text above can be found in CTC's review of the evidence: http://beta.ctc.org.uk/files/cycle-helmets-evidencebrf_1.pdf. There is also a (shorter) CTC policy statement on the subject here: http://beta.ctc.org.uk/file/public/cycle-helmetsbrf_0.pdf
I hope that this persuades you that it is more important to encourage people to cycle, than to worry about whether or not they wear helmets when doing so!
Best wishes
Roger Geffen
Campaigns & Policy Director, CTC
slowmotion
Quite dreadful
- Location
- lost somewhere
I haven't even looked at the comments, just the original story up-thread. Actually, I feel quite strongly about some kind of integrity....OK, I'm old and a bit less "flexible" about morality than some people, perhaps. To post a fiction with an invented story and cobbled stock images that actually involved a real death is pretty low, wouldn't you say? I don't care what the nutter feels, or doesn't feel about helmets. Utterly bogus.
KneesUp
Guru
I'm not a number, I'm a free man. (Or rather, the macro picture, whilst interesting statistically, is not relevant to the micro picture of me and my head - if wearing a helmet has no effect on whether I cycle or not, then doing both is optimal)
mcshroom
Bionic Subsonic
- Location
- Egremont, Cumbria
... and the 14% more likely to suffer an injury bit?
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glenn forger
Guest
Leave helmets out of it, is anyone seriously stupid enough to think that a real paramedic would encourage people to shout at cyclists who don't have a helmet on? Come on, this is a sad Walter Mitty-type fantasist dishing out recklessly stupid advice.
KneesUp
Guru
Sort of. When she asked why I don't wear my helmet I was glad she didn't ask me because there is no good answer. I own a helmet, it fits, it might save me from life changing injury (or it might not, but it won't make it worse) and I don't wear it. There seems to be no good answer as to why not. It's just one more thing to do in the morning, but in reality it's not much of a thing. I've been meaning to start wearing it again (I wore one in the mid 90s when not many did, and I wore one when I started cycling again recently - I'm not sure why I stopped) but hadn't got around to it. I suppose I last wore it about two months ago. I probably stopped when it was hot, actually.
I have responsibility to my family. If the worst happens and I get killed, I don't want them to be thinking 'we should have nagged him to wear his helmet' or whatever. Or that I was taking needless risks. Wearing it will also set a good example to my daughter who is much more likely to fall off her bike than I am.
I doubt I'll wear it pootling about on family rides because I perceive the risk there to be minuscule (low speed, no traffic etc) but no doubt there are stats to show that those situations are the very ones where a helmet will make a difference
KneesUp
Guru
Do you find pedestrians shouting at you to be dangerous? I can't say I pay much attention on the odd occasion it happens.
glenn forger
Guest
You disagree with the evidence that helmets greatly increase the risk of rotational injuries that could snap your spine?
glenn forger
Guest
Wait, you're claiming a real emergency services employee would recommend shouting at cyclists?
ha ha ha ha!
KneesUp
Guru
That needs more research, as pointed out in the quote. If we don't know why that is, there isn't much we can say.
slowmotion
Quite dreadful
- Location
- lost somewhere
Oh well, time to go up to bed.
Let me see.....oh bugger, I can't find my helmet....
Let me see.....oh bugger, I can't find my helmet....
KneesUp
Guru
Where did I make that claim? I didn't mention emergency services employees at all. I asked you a question.
mcshroom
Bionic Subsonic
- Location
- Egremont, Cumbria
So just to confirm. You are happy to use a device that has little or no proven efficacy in the belief that it might help, but will dismiss a 14% disbenefit because it's not fully explained. Correct?
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