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White cycle helmetCycle helmets save lives says Neurosurgeon - in ongoing helmet row
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."
Simon joined road.cc as news editor in 2009 and is now the site’s community editor, acting as a link between the team producing the content and our readers. A law and languages graduate, published translator and former retail analyst, he has reported on issues as diverse as cycling-related court cases, anti-doping investigations, the latest developments in the bike industry and the sport’s biggest races. Now back in London full-time after 15 years living in Oxford and Cambridge, he loves cycling along the Thames but misses having his former riding buddy, Elodie the miniature schnauzer, in the basket in front of him.
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122 comments
I walked into a kitchen cupboard door a couple of weeks ago. I think that wearing a helmet would have saved my life.
Wearing helmets in the kitchen should be compulsory.
Pro's wear helmets for the same reason I do. That they are mandatory for competition therefore you have to wear them, this extends to training, as you need to be conditioned to using it.
My kids wear them because I believe they do work at the low speeds and with less distance to fall.
The medical advice, like all medical advice, changes constantly.
There's something askew in the arguments for and against helmets. For several years I rode motorcycles and no-one would argue against wearing helmets (although once upon a time some did). Bikers were very careful with their helmets, choosing bright colours (almost never black), testing standards in excess of the minimum and (increasingly) full-face. They never put stickers on them, as the glue risks weakening the structure. In cycling, the argument against seems to be they are flimsy and give a false impression of providing better protection than they do. If so, the response to this shouldn't be not to wear helmets, but to improve the ones that are worn. With so much investment going into advances in cycle technology it's a scandal that the industry continue to market helmets against a EU testing standard that is not fit for purpose (i.e. protects against impacts from a stationary fall rather than impacts at average cycling speeds). Volvo were a company that made their reputation from taking a different view of safety that the rest of the car industry. I wish one of the helmet manufacturers would do the same for cycling helmets, and I'm sure they would find that actually a lot of people care more about their chances of reducing injury than the merits of a argument against wearing protective headgear based on an inadequate safety standard used as a means to market high-margin low-efficacy wearable products.
From NHS statistics the vast majority of head injuries occur as a result of either falling over, assault, or being in a motor vehicle crash.
Also most child head injuries occur in the home, or in playgrounds.
About two thirds of adult head injuries involve alcohol.
The reality is that head injuries from cycling are a tiny fraction of what the NHS deals with.
However the medical profession continually bleats on about cycling helmets but never ever mentions head protection for going to the pub, walking down stairs, travelling in a motor vehicle, playing in a playground, etc.
I never quite understand the obsession with cycling helmets, if the medical profession wanted to reduce the incidence of head injuries in the general population then there are far better ways of achieving this.
When talking about helmets for cyclists, then you should also include helmets for pedestrians as well. No difference.
http://www.theguardian.com/uk-news/2014/apr/23/duchess-cornwall-brother-...
I am sure that the neurosurgen also took into account that the children would have been less likely to be involved in an accident if they weren't wearing a helmet, oh wait. Probably not.
Once again, let us ignore the facts and stick to anecdotes, after all they make much better sound bites.
The pros wear helmets. Your argument is invalid.
As do professional racing drivers, so do you wear a helmet in your car?
The pros are going really fast and pushing the boundaries because they're racing. I wear a helmet when I'm racing or training, because it's a risky activity. I've crashed when racing, or training for racing, many times.
Riding on the road is a different matter. I wear a helmet sometimes, sometimes not.
The pros wear what the sponsors tell them to wear. There's a lot og money in selling helmets.
the neurosurgeon merely "believes" that some head injuries could be avoided by children wearing helmets. Well children wearing them is probably reasonable. When the speed is very low and the children are very small and the head injuries are them falling off and banging their own heads on something then a cycle helmet is useful.
Helmets are rated for 50 joules of impact resistance. So lets say an average 6 year old weighing 20kg has a bash at 7mph (v =~3m/s). we use the good old energy impact formula you learned at school E = M x V(2) / 2
Half mass x velocity squared. Mass is 20 Velocity is 3. So it's 20 x 9 = 180 /2 = 90.
So that will have an effect the helmet will absorb about half the impact of a 6 year old falling off a bike at 7 mph.
The trouble emerges when you increase the speed and the mass. Then they don't get anywhere near protecting you from the forces involved.
So yeah ok kids on bikes might get some use from a helmet in a low speed impact.
Adult cyclists in any kind of impact with a car get such a tiny amount of protection as to be pointless.
Smart car with no passengers hits you at 20mph then the same calculation is
800Kg x 9 m/s squared over 2. =32400 joules. Your helmet is good for the first 50. That's if it's low speed and doesn't actually crack.
Rabbits feet work almost as well as do St Christopher's medals and a double splash of holy water.
doctors only push stuff the manufacturers pay them too so wouldn't take this Carter fellow to seriously if I were you however given the abuse the NHS metes out to its patients wearing a helmet during a hospital stay might well reduce injuries. Take your camelbak in too so you don't need to drink the flower water out of the vase
At last. Some common sense. That wearing a helmet made you more at risk from car drivers has never had anything to do with the impact of head on pavement versus head encased in polystyrene on pavement argument. That Marsh wears a cowboy hat doesn't surprise me. He probably wears a bike helmet on a horse and a beret in the bath.
Those that think helmets can't make a difference under any circumstances have either yet to hit their head on the road - of have hit the road with their head already.
I refer you to my footer...
Hit the ground plenty of time, hit trees, branches, rocks etc as well.
So from my experiences. on two occasions i have had glasses take a chunk out of my cheek, i have had stitches twice on my chin, i have had my upper lip supper glued back together, i have had an iodine soaked brillo pad used to scrub my face*
So obviously my head has hit the ground a few times.
and how many helmets have i actually damaged, one, the last crash didn't leave a mark on the helmet even though i broke my Oakleys and that was on a muddy road. Was i wearing a helmet for all those other crashes? no.
Other injuries, well neck pain when i missed judged the height of a branch, the helmet got caught and i got my head yanked back. a bee sting when a bee flew in the vent and didn't go out again.
I suppose it did stop me getting a bat caught in my hair i guess when i hit one when heading home after a late shift.
Helmets make a decent place to mount head lights, obviously a small metal lump strapped to the shell makes a very effective impact magnifier.
To be clear if you want to wear a helmet do so, if you don't do so. I would rather you ride a bike than worry about helmets, hi viz, etc. Why should pedestrians and cyclists play the drivers game and let them off for their shit driving?
* very odd sensation, they used local anathesthetic so whilst it should have hurt just a bit messy as the blood got splattered around.
All well and good, but who's actually trying to stop you from wearing a helmet? If we're going to have the whole helmet debate at all, can we at least stick to what that debate is really about - the proposition of a compulsory helmet law? There are really very few people who'll claim that a helmet will never offer any protection whatsoever in any circumstances. And nobody - literally nobody - is trying to stop you from wearing a cycle helmet if you choose to do so.
However, there are very vocal groups actively campaigning to stop you from legally getting on a bike if you're not wearing a helmet. And that, right there, is the debate. Whether or not cycling in even it's most innocuous form is, statistically, so inherently dangerous that it should be enforced by law that protective head gear needs to be worn at all times. (It isn't). And whether cycle helmets are such an effective preventative measure against the majority of causes of serious injuries inflicted on cyclists on our roads that they justify their specification in such a law (they're not). And whether or not a compulsory helmet law would discourage significant numbers from taking up cycling in the first place, and whether or not that would have implications for public health, road congestion, pollution and the environment...
Yes wearing a helmet is not a bad idea and will offer you some protection in certain circumstances. By all means wear one if you want to (I nearly always do), and recommend them to others if you feel that way inclined (I sometimes do that too). But recommending something and making it a legal obligation are two very different things. And the second one shouldn't happen unless the statistical, scientific, societal and political considerations in it's favour are absolutely compelling. Which, as far as legal helmet obligation goes, is not even close to being the case.
Oh, and until the case for obligation is compellingly made, please stop vilifying those who choose not to wear helmets. It's their choice and they're really not doing anything wrong.
No problem with not wearing a helmet. I'm all for choice. What I don't accept is the twaddle that they never make any difference when in certain circumstances they do.
As for wearing them in a car or on foot? Red herring time wasting nonsense. Grow up.
Why?
Indeed. if we want to reduce serious head injuries we should talk about fitting helmets to the people most likely to receive one, and that's people inside cars.
So why would we say that was a waste of time? Well the obvious reason being, it's never going to happen. We're never going to make car occupants wear helmets because then travel by car might be perceived as dangerous or something we should stop doing and we can't have that. Every argument we apply to cycling (which is an intrinsically safe activity) for safety equipment, we can easily apply to driving but the resistance to those suggestions is immense. Even on a cycling forum presumably occupied by cycling aficionados, the resistance is high.
What is really pointless is listening to neurosurgeons talk about helmets. They're not helmet experts, they only get to see people who've been in certain types of accidents, they don't see dead people or people who just get back up and carry on. They see a tiny fraction of people who bang their heads and see an even tinier fraction of people who happily cycle about the place completely free of injury and harm.
That's red herring, time wasting nonsense.
Someone who thinks throwing insults will do as a substitute for a rational argument, tells _others_ to grow up?
+1000
First off, I usually take references to 'common sense' as meaning 'what I am about to say will consist entirely of unsubstantiated assertions and will be a waste of your time'. That term really needs to die a death.
And who thinks 'helmets can't make a difference under any circumstances'? That's a classic straw-man, no?
All sorts of things might make a difference under all sorts of circumstances, that's completely besides the point, or you'd wear a helmet for getting out of the bath and stab-proof vest when going for a walk round London.
Anyway, neither this guy nor the previous anti-helmet one are authorities on the topic of road safety and public health in general, regardless of how many bad brains they've looked at. Its odd the way professionals get treated as experts on things that are only tangentially related to their day job.
(Not to say they shouldn't express a view or construct an argument, just that the media and people in general seem to attach peculiar levels of significance to them just 'cos they have something to do with brains)
I have had too bad falls in the last 18 months where I have trashed the helmet yet had no head injuries. In both cases I hit the ground hard and I believe that without the helmet someone would have been calling an ambulance for me. Of course a helmet won't protect against everything but I can't understand why you would not wear something that's adds protection without interfering with the enjoyment of cycling.
You wear it when in a car and urban walking too, to be consistent?
I don't - but then when I drive, I drive a car with air-bags and whilst wearing a seat-belt... perhaps some type of neck restraint might be more appropriate should I take further measures.
As a pedestrian I try and pay particular attention when crossing roads and much of my urban walks are in 20mph zones. So for me, the risk factors are radically different and wearing a helmet for all three activities would not be 'consistent'.
some numbers
https://www.gov.uk/government/uploads/system/uploads/attachment_data/fil...
So getting worse for non drivers?
Definitely not looking good is it?
Pretty crap that, can't even drive and not safe on the roads...
are cars safe in an urban environment with that sort of breakdown?
that is a lot of accidents!
and people keep on banging on about helmets, I would suggest there are more pressing concerns if you want to tackle road safety!
Indeed, some old favourites there and some new ones which are interesting. Not sure the relevance to my point mind, but still all good.
F*** helmets, they are a distraction from the real debate, why do www allow car drivers free reign, why do we accept that killing people is acceptable?
Lets have a real debate, how can we stop people dying, not this phoney debate about hi viz and helmets.
Fine - quite agree with your feelings. I was merely responding to a comment which I felt was mis-applying statistics to make a point. Not sure why I happen to be the lucky one you chose to jump down their throat.
That you think the fact you can't understand is relevant is why you are a tosser. It isn't, for others it does make things less enjoyable and convenient and more expensive.
Why is it that almost all the stupidity is on the side of helmet-promoters? You can say "there is statistically significant evidence they are useful" and leave it at that.
Do you have to be so offensive towards other peoples views? Why are you right, the other person wrong?
Oh I don't know - I think some might consider calling someone a 'tosser' because they disagree, in a perfectly polite manner, with your view as a pretty good indicator of stupidity.
They really do cover everything when you study to become a brain surgeon don't they? I wonder how many days they spend reading ANSI specifications on helmets, protection levels, impact speeds, etc...
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