Cycle helmets save lives says a consultant paediatric neurosurgeon from Bristol – just a fortnight after a brain surgeon in London said that there was no point in riders wearing “flimsy little helmets” to protect their heads.
Michael Carter of Bristol Children's Hospital says he treats an average of three children a month who have suffered a head injury while cycling that he believes would not have happened if they had been wearing a helmet, reports the Bristol Post.
His views conflict with those of Henry Marsh of St George’s Hospital in Tooting, South London, who as we reported last month said that helmets had not benefited patients in his care who had been involved in bike crashes.
Mr Marsh told the Hay Festival: “I ride a bike and I never wear a helmet. In the countries where bike helmets are compulsory there has been no reduction in bike injuries whatsoever.
“I see lots of people in bike accidents and these flimsy little helmets don’t help.”
He also cited research by Dr Ian Walker from the University of Bath who found that motorists gave less space to riders wearing helmets, because they perceived them as being safer than those without the headgear.
But Mr Carter insisted that the case against wearing helmets was “weak” and often founded on research that was small in sample size. He also said his experience at work contrasted with that of Mr Marsh.
In support of his views, he cited Cochrane Review studies which combine the results of a number of studies from around the world.
He said: "We get an enormous number of cycling accidents coming in here. The vast majority of head injuries seen are not life threatening. But often [they are] painful and disruptive and require inpatient treatment. Generally it's easy to see that they could have been reduced or prevented if they were wearing helmets."
Among criticisms levelled at Cochrane Reviews in the area of cycle helmets, however, is that they are not truly independent since some reviewers have focused on their own studies and discount others, and that they do not address rotational injuries.
Another concern expressed at some studies from jurisdictions where helmets are compulsory is that they fail to analyse any perceived drop in head injuries among cyclists in the context of reduced levels of riding bikes once people have become legally obliged to wear a helmet.
CTC and Sustrans both oppose compulsion in the UK because they believe the overall health benefits associated with cycling in relation to the population as a whole outweigh any reduction in the number of cyclists they believe would follow helmets being made mandatory.
Mr Carter cited one recent instance where a youngster was struck in the head by a wing mirror and he maintained that had they been wearing a helmet, they would have been uninjured.
The circumstances of the incident were not reported, so it is unclear whether the child rode into the car, or the vehicle struck the youngster, in which case the incident could perhaps have been avoided altogether had the driver given the cyclist more room.
Unlike Mr Marsh, who has been cycling for 40 years and sports a cowboy hat while on his bike, Mr Carter no longer rides one following three separate incidents last year in which two of his friends were seriously injured and another killed.
While some might see that decision as being one based on his individual experience, unfortunate as it is, rather than looking at the wider picture, he asserts that his home city is unsafe for bike riders.
"Bristol is advertised as a cycling friendly city,” he said. “But it's actually an old Victorian city with small narrow roadways and a large volume of traffic. The roads were never designed for motorists and cyclists to use together.
"Cycle paths are incomplete throughout the city and this poses a real risk to cycle traffic. Wearing a helmet is simple and cheap. It's a minor inconvenience that at worst might be uncomfortable on a hot day, but at best might save your life."
Add new comment
122 comments
I'm in the 2 Camp
Myths and facts cycle helmet website:
https://sites.google.com/site/bicyclehelmetmythsandfacts/
2.5 - on the fence, just wear one for "proper" rides, not town trips.
2 - pro choice pro helmet.
Well even if the impact energy is not absorbed, surely the styrofoam distributes the force over a greater area of skull compared to bashing your head directly on concrete.
Though presumably regardless of how concentrated or distributed the impact on your skull is, your brain will still bounce around inside it in the same way? And isn't that what causes the worst damage?
Am not sure at all about the medical/mechanical, as opposed to sociological/moral, side of it.
Where's a brain surgeon when you need one?
Most of what you want the helmet to do is slow the deceleration rate down, which will hopefully reduce the injury your brain receives when it smashes into (nearly) your skull. That can happen even if the helmet splits, see here for some more details and better explanations than i'll manage
http://www.helmets.org/liners.htm
Yes its can spread the force, dependent on design, and the argument about not absorbing the impact is not strictly correct - there is energy absorbed my the compression prior to the split, and the split itself takes energy out of the system. The degree to which energy is taken from the impact will be effected by a number of factors, including the split, but to say it's the same as not having the foam in the way is nonsense (even ignoring lacerations). The helmet may have contributed to potential rotational injuries however, another something which is not part of the statistics i've seen so far.
Myth 33: The weight of bicycle helmet can increase the severity of rotational injuries in a crash.
Fact 33: A bicycle helmet weighs very little. It's not like wearing a heavy motorcycle helmet. There has never been any evidence of increased rotational injuries caused by a bicycle helmet.
From the website link I posted ealier
It's not the weight i'm thinking of, see my post just above this.
The argument is not so much that the weight can increase the severity of rotational injuries, it's that:
1. The helmet increases the size of your head. So there is a bigger chance of hitting the road with your (helmeted) head in such a way that your head rotates quickly.
2. Cycling helmets tend to grip the road, increasing rotational forces (see this study: http://www.bhsi.org/chinstrp.pdf ). Your skull is covered by fairly flexible skin (you can move it over your skull with your hand). This means that you are more likely to slide your unhelmeted head, rather than have it grab the road, while the rest of your body turns around it. There is a motorcycle helmet manufacturer trying to combat this by making helmets with a skin-like layer on it: http://www.phillipshelmets.com/
Because your website chooses to argue a straw man, rather than argue in good faith, it's not a good source of information.
Then I would suggest you contact the website and ague with him. Most of the arguments against the use of cycle helmets also fall into the straw man category. And if rotational forces are a factor then this would show itself in the pro peloton. I am not aware of a single incidence of this within cycle racing however I am willing to be proved wrong.
You need to man up and own the stuff you post. Posting stuff and then saying that you don't stand behind it is trolling-like behavior.
I'm not against the use of helmets, but rather against the silly arguments used by helmet-advocates. In my opinion/experience, the people who really believe in helmets (despite the lack of convincing evidence) tend to be the most illogical. Saying that people are against the use of helmets when they also want to look at the downsides of helmets is a good example.
The reporting of cycling accidents doesn't go into that level of detail. Or can you tell me which injuries of Weylandt were translational and which were rotational? Regardless, the number of fatal racing accidents is pretty low, not high enough for statistics. Especially since we are really talking about edge cases, where a helmet has a chance to save a life.
I hear rotational injuries cited frequently, but have never read about an instance of one. Surely if they are so prevalent, professional cyclists would be getting them all the time? Mark Cavendish seems to hit the deck regularly, but never seems to be suffering a 'rotational injury' afterwards.
'Stiff neck' might get some more hits. It's one of those things i've heard discussed and which, on the surface, make sense - e.g. the helmet is wider than your head, so if something slows it down relative to the direction of travel of your head then it would exert more force than the same slowing down at the surface of your skull; helmets have loops and holes which can catch things and cause twisting and so on.
What i've not seen yet, but i'm still looking for, is any good data about whether this actually happen.. so i'm not fully swayed one way or another even though it might make 'sense' on the surface. If anyone *does* have any links, i'd be very interested in seeing them tah.
OK, how about we have a little straw poll? I reckon you can divide opinions down into four positions here. Just post which one you fall into:
1 - Pro compulsion: helmet use should be a legal requirement, you shouldn't be allowed on a bike without one.
2 - Pro choice, pro helmet: helmet use should remain a personal choice as it is now, and I usually or always choose to wear a helmet.
3 - Pro choice, anti helmet: helmet use should remain a personal choice as it is now, and I usually or always choose not to wear a helmet.
4 - Pro helmet ban: helmet use should banned. No one should be allowed to wear a helmet when riding a bike.
My guess is that category 2 will be bigger than category 3, but I'm not sure by how much. I'm also willing to bet that practically nobody will fall into category 4. But what I'm intrigued about is how many people, here on a cycling website, would class themselves as category 1.
I'm 2 - Pro choice, pro helmet.
2.5 - pro choice, wear a helmet if I'm on a club run or technical offroad
2.5 pro choice, anti helmet but mostly wear one anyway out of superstition and a desire to minimise nagging/victim-blaming. This might constitute hypocrisy, not sure.
2. Pro-choice, usually helmet.
2 and a half - I wear a helmet when I'm racing or training, but very rarely for commuting
Well, thanks for taking part I know it's hardly a scientific sample, but it's interesting that everyone who answered said they were a 2-2.5 (if we're going to decimal places, then I guess I'm about a 2.3). Which makes me feel a little better - maybe the cycling community isn't as bitterly divided over this it sometimes appears. But doesn't it make you wonder how we manage to disagree so violently over something that, on the face of it, we largely agree on...
A lot of people said they were helmets for racing, myself included. That's where the danger lies because racing inherently takes the bicycle to the limits of adhesion and sometimes beyond, resulting in an off. Riding on the road is a lot less dangerous and all the crash data available points to this. Bear in mind also that the full face MX lid I wear for racing (it's a road legal motorcycle helmet) is rather more protective than any standard bicycle helmet. I've also got a skate lid I wear when I'm riding my BMX at the skatepark and again, it's a lot more protective than any shell helmet.
I strongly oppose compulsion for helmet use for normal road cycling because all the statistics say this won't help tackle safety for cyclists and that the real improvement will come from addressing motor vehicle driver behaviour.
I've said it before and I will say it again; I firmly believe in helmets. I speak from experience as I have had two significant accidents which would have been far worse if I had not been wearing one.
I don't need convincing of the arguments either way, I don't go out without one, not even round the corner......
After reading numerous articles about this debate, two things stand out to me:
1. No incontravertible evidence exists that helmets save lives.
2. No incontravertible evidence exists that helmets do not save lives.
Any judgement formed on this basis is therefore a personal opinion. That your opinion and mine might be different, does not mean you are right and I am wrong.
I feel quite strongly about this subject after witnessing a friend of mine have a fall from her road bike on a corner, which didn't involve a car. She knocked herself unconscious and cracked her helmet in the process - the crack in her helmet would have been a crack in her skull had she not been wearing it. I just don't get why people are so arrogant to think it won't happen to them. It's just not worth it. You are not invincible. (I wrote a post on this over on my blog and was surprised to hear via twitter how many people are so against helmets...mainly mountain bikers, I might add). I value my brain and think it's worth protecting.
Well said. Completely agree - the same happened to me, my life was saved by the presence of a helmet and since I've been a firm advocate!!
I'd say for adults to choose not to, fine, risky prerogative, but I'm of the opinion that regardless of those choices, young people should all be taught to wear them. I'm not sure I like the fact that role models come out with statements against their use.
But would you agree that young people should also be taught not to use cars unless absolutely unavoidable?
The choice to drive a car creates far, far more danger of adverse health consequences than the choice to cycle without a helmet (for the former, 5,000 premature deaths a year due to pollution alone).
I have a feeling you might "shoot my fox" by the clever trick of just agreeing - but why the greater emphasis on the helmets rather than the cars?
I don't understand, in general, why some adverse health effects are mostly ignored while people bang on about others.
I'm sure you understand really. We have constructed a society in which people believe that they MUST drive a car, and so are compelled to downplay the risks associated with this potentially lethal act in order to the pain that would result from recognising the truth.
I absolutely think young people should be taught the dangers of cars, and motorbikes, just as they should be about the use of any other vehicle. But my point is 8 year olds aren't given licenses to motor vehicles, they're given their cycling proficiency - at this age why shouldn't we begin teaching young people about the dangers (overall) of the road? Encouraging helmet use at this point in their lives gives them a firm glimpse into road safety of all aspects.
This is a conversation about helmets so that's where my emphasis stems from here - my opinions on cars and young people (if you know anyone from the Isle of Man, they'll probably have similar opinions to me...) are for a whole other conversation/day/year ;P
For the record I don't drive. I've been hit by too many cars to be arsed about using one for getting around. I do, however, enjoy motorsports - so I'm not going to bang on about anything hypocritical on being anti emissions etc etc etc. People breathe in fumes, people get hit by cars, people ride their bikes into walls....some people drive their cars into walls, the list goes on - educating new cyclists/drivers/racers on the dangers and risks available to them is key, the choices they then make as adults is absolutely their own decision - if they choose to wear a helmet, great, if they choose to drive safely, even better.
I'm not a vehement "EVERYONE WHO ISN'T WEARING A HELMET IS SATAN" type, I'm also not fussed about other people's choices, I do firmly believe setting a safe example to young cyclists is a good idea, though.
Prove the helmet saved your life? It MAY have done, it may have reduced the injury, it may have saved you getting a graze.
You can't know that in your crash your helmet was effective.
there is also the pro helmet question of which standard, why are helmets being sold today LESS effective than those being sold 20years ago. When I started mtbing, everything was buy Snell, it was the best standard, today, apart from Specialized?, you won't find a snell helmet and the current EN-BS standard is far less demanding.
The paramedics stated the impact on the helmet saved me from life threatening injuries which would have a strong likelihood of either ending or dramatically changing my life. TBF I took that as gospel, I ain't no Dr but that squishy bit at the back of my head that the helmet just about protected is pretty much the most vulnerable bit, I'm damn glad I was wearing one and this isn't a "pro helmet argument" here this is simply me stating the fact that I would never have liked to have known the outcome, be it negative or not, of that crash had I not been wearing one.
Pages