Tuesday, June 19, 2012

Helmets Help. Period.

Well the coroner's report came out with a recommendation to mandate helmets for all people riding bikes. As soon as I read the article I knew all the crazies would come out of the woodwork. You're stomping on our rights! It's more dangerous walking down the street - mandate helmets for that!

Well, having suffered quite a few brain traumas in my lifetime I tend to take an interest in these "discussions". I put the word in quotes because the way I see it there's really no argument. A bike helmet likely saved my life. It absolutely prevented a serious injury. Not having one on while riding a bike seems like a ridiculous notion. But that's just me - and a few hospitals few of other people.

I had a grand idea for a blog post about my position on this so I could share it with those of you who don't have me as a friend on Facebook (where it was written in several comments to a FB friend with vastly different opinions on the matter). Then, his last comment sealed the fate of this post. Regarding a law that requires helmets for cyclists: "I've got a beef with helmet legislation without data to back it up."

That got me thinking, and I asked him point blank: what's the magic number? What data has to exist for it to be OK? Who gets to set that threshold? I would argue that the fine doctors who get to see all the patients (dead and alive) would have a pretty good idea, and they seem to think it's the way to go. I'm sure it's all just a clever rouse though, you know, to get more people into the ER and funding their research. Oh wait... they're recommending helmets and suggesting that FEWER people will pass through their walls, freeing up valuable resources and people for other less preventable injuries? Their data is bullshit and they must be up to no good.

All sarcasm aside I only have one point to say and that is this:
A cyclist wearing a helmet is safer than one without.

18 comments:

  1. However, it has been shown that mandatory helmet rules reduce the number of cyclists on our streets. As well it has been shown that increasing the number of cyclists actually decreases the number of incidents as drivers are more aware of them. I am pro-choice on the helmet issue, and will sometimes ride with one, and sometimes not.

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  2. BTW I agree you are safer wearing one than not.

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  3. I drove past you riding without one yesterday! tsk tsk.

    If only more people engaged in debate on Canadian politics like they do on this issue. Government in contempt of parliament and accused of electoral fraud? Meh. Make me wear a helmet when I don't want to? Screw you, where's the next protest?!

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  4. I thought I was going to see some kind of dissertation :)

    So I take it you'll be advocating mandatory helmet legislation for the following:
    * walking (faster than 8 km/hr, particularly on ice)
    * jogging
    * swimming
    * soccer, basketball, baseball (when you're not in the batters box)
    * skateboarding, roller blading, scootering
    * operating a motor vehicle, especially one that has airbags
    * .... oh and how about tubing :)

    So what's your magic number? Is even one head injury enough for legislating bubble wrap for everybody who moves?

    Butters your logic is flawed.

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  5. http://www.youtube.com/watch?v=bzE-IMaegzQ

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  6. last one - http://www.youtube.com/watch?v=2ZNLb_SBbuA

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  7. There are specially designed helmets that you can wear when water skiing and tubing and such. Had I known they existed beforehand I'd have worn one. And yes, when I'm in a boat I WEAR a life jacket, I don't just keep one nearby.

    Walking, jogging... there's no increased risk in those activities. The human body was designed to have its own safety features in place. Hands, arms, fine motor skills, reflexes... these are all ways we protect ourselves. A human doing things we've evolved to do is pretty safe. Unfortunately evolution takes a long time and the human head isn't thick enough to take a higher speed tumble off a seated device designed to propel us forward. Maybe non-helmet advocates are just a notch up on the evolutionary ladder and have thicker skulls? (hmmmm... quite possibly)

    Studies have shown that repeated headings of a soccer ball cause brain injury. They stopped teaching in in minor soccer as a result. Sports that involve multiple opponents pitted against each other have their own issues. Games have to change in order for them to be safer. Also for the record, when on deck in minor baseball (i.e. waiting to bat) you must have a helmet on.

    Skateboarding, roller blading, and scootering are all in the same category as bikes: none of them have anything else providing increased safety for the person who's now in a more vulnerable state. All the other things you mention are either not putting the person in a state of increased risk and/or they have other mechanisms in place to help reduce the risk.

    So, to the question at hand (actually, questions) I ask quite plainly: What data would you need to see to support a mandated helmet law? Where is the tipping point that turns the argument from bunk to something that you'd support?

    Personally, as a non-conspiracy theorist, I don't think the government wants to reduce the number of people on bikes. I think they want to keep their citizens safe. More people means more taxes. Cracked skulls and injured people mean greater health care costs and less tax revenue.

    Safer = better.

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  8. Now look what you've made me do. That was almost a dissertation ;)

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  9. You want data? You can't handle the data! http://cyclehelmets.org/1250.html

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  10. A highlighted section from the article:

    When changes in cycle use are taken into account, Alberta’s helmet law seems to have increased the risk of both head and non-head injuries.

    Evidence of increased risk per cyclist seems paradoxical. However, there is strong evidence that helmet laws lead to increased risk taking. For example, many males (Messiah et al, 2012) and cyclists accustomed to wearing helmets (Phillips, Fyhri and Sagberg, 2011) have been shown to cycle faster when wearing a helmet. In addition, drivers were found to leave less room when overtaking helmeted cyclists (Walker, 2007). UK researcher, Dr Ian Walker, was hit twice by vehicles when carrying out his research, both times when wearing a helmet (Eureka, 2006). With only 44% as many children cycling as before the law, it is also possible that relatively safe cycling activities were discouraged more than riskier types of cycling.

    Karkhaneh, 2011 ignores the large and obvious reduction in cycle use when discussing the effect of the law on injuries. The thesis also makes light of the 56% overall reduction in children’s cycling. As shown in Table 4, the greatest decreases were at schools (68% decrease), on commuter routes (41% decrease) and in residential areas (37% decrease). These were the only locations with statistically significant increases in percent helmet wearing of children (see Table 3.1 of Karkhaneh, 2011), suggesting that the increases in helmet wearing were achieved mainly by discouraging cycling by children who dislike helmets, rather than persuading them to don helmets and continue cycling. Convincing parents that cycling is so dangerous that every child must wear a helmet at all times may also may also lead to the conclusion that it is safer still not to allow children to cycle at any time.

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  11. The health impact of mandatory bicycle helmet laws

    If there is a reduction of 2% or more in number of people who cycle because of the law, then it results in a net loss in public health (due to the health benefits gained by cycling). And that number assumes that helmets are 85% effective at preventing head injuries, and there are some studies that show that they are as low as 15% effective, and that they might even create an increase in neck injuries.

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  12. @Jonathan - Thanks for the link and data! After digging I found out the calcualions in my fb status update were wrong by a factor of 5, that this case study is excellent.

    Hey Butters --> What's the math tell you now? Or are you still basing your decision on emotion?

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  13. If mandatory helmets for cyclists is a good idea, maybe we should make it mandatory for golphers too! And seatbelts and handrails in golf carts!

    It appears that in the UK, golfing is almost as dangerous as cycling!

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  14. If you want a magic number, I would say when the net gain in public health by mandating is greater than not. See this paper which details formula for calculating net public health loss/gain.

    Currently the reduction in the number of riders due to required helmets would have to be less than 2% to be close.

    The Alberta study shows that mandatory helmets can reduce # of cyclists by more than 50%!

    Ergo it is worse for net public health to have MANDATORY helmet laws.

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  15. That's a good read Jonathan. I liked his approach. A few things, and then my final words on the matter:

    A very salient point I cannot dispute is the design of the helmet. My own experience (and hence bias) has shown me the current model works. If that's not generally true then for the love of Pete someone come up with one that DOES do its job - that is, protecting the head from a collision or fall on a bike under the conditions in which a cyclist will experience.

    The other thing I noticed is that there are so many factors involving human behaviour and our subconscience that make this a remarkably sticky problem to sort out. I happen to think a good start would be to take that out of the equation (see previous point). The rest will evolve hopefully a lot faster than humans have.

    Speaking of which, it's becoming a bit like watching an argument between evolution supporters and Christian Fundamentalists.

    Jim writes, "I could cherry pick papers that support my points, but people who disagree with me could do the same." Not just "could", Jim. But will, have, and currently are.

    So with that I'm taking the advice of someone close to me and attempting to not give a shit if anyone outside my family wears a helmet or not. We'll take our chances, you take yours. You win. Here's a gold star.

    P.S.
    For cryin' out loud, be safe - however you feel you should. At the end of the day I prefer most humans, especially you guys, to be well enough to comment on my blog :)

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