Helmets do not do as much as you think. They are not really very good for the types of accidents that bicycles have. For example, see: http://www.bicycling.com/senseless/index.html
I don't know, I have personally fallen off a bike travelling at around 25km/h and hit the side of my head on the pavement. If I wasn't wearing my helmet(and that was a regular, $40 helmet) I don't know if I would be still here - the helmet cracked,but my head was still completely intact,so I guess they have to work to some extent.
I have two pieces of relevant experience. Firstly I hit my head on the side when I was about 16 on a bike with no helmet, in a slow speed accident. I had unpleasent concussion, about 10 minutes of retrograde amnesia and 5 minutes or so of post traumatic amnesia. Some weird vomiting symptom about 3 days into recovery which would have been cause for serious concern if it repeated itself. I think I was off school for a whole week.
I passed through high school with my usual marks (top end of the middle), and onto an undistinguished but advanced university education. Another friend was involved in a human versus baseball bat assault (skull fracture I think) around the same time and had big problems for a few years.
I also worked in brain injury rehab for 4 years or so in my mid 20s. During that time I would have interacted with hundreds of patients with severe traumatic brain injuries. During that time I saw one paitent with a bike related TBI. Bike at full speed versus cow. I don't remember if he was wearing a helmet but his potential as a person was dramatically reduced, although nothing easy to observe casually.
I used to be for compulsory bike helmet laws. These days I think the indirect risks of a reduced number of cyclists on the road (as evidenced by the australian experience) outweigh the direct risks of a small number of TBIs. I wear a helmet when I have longer distances to travel, or need to make use of dangerous main roads (I tend to cycle on wide underutilised sidewalks where possible). For short distances I don't wear a helmet. It's a risk, but a small one.
Argh, this kind of anecdotal evidence makes me crazy. Helmets aren't skulls. You have no idea whether the forces that caused the helmet to crack would have caused similar injury to your head had you not been wearing the helmet, nor do you have any idea whether the forces the helmet managed to absorb before failing are a significant fraction of the forces your head experienced during the accident. Nothing about your experience is sufficient grounds for the conclusion you draw at the end of your comment (that "they have to work to some extent"), nor can any single accident experience provide such grounds.
Let me rephrase that - if I, somehow, had to be in that accident again and fall head-first to the pavement, I would once again choose to be wearing a helmet, and I don't need a scientific research to make that choice. If you don't like that it's anecdotal - well, I can't help that.
And I think that hitting the pavement with the helmet instead of my head is indeed how the helmet should work, so it most certainly "works to some extent".
Unless you want to argue that I would have been just as fine hitting the ground at 25km/h without a helmet?
Or is your entire(and only) point that no one should ever mention anything they have ever experienced unless they can back it up by research by an approved institution?
"Unless you want to argue that I would have been just as fine hitting the ground at 25km/h without a helmet?"
Why not? Humans are pretty resilient. Maybe you wouldn't have, but I see no reason to dismiss so easily the possibility that you might have been fine.
Mentioning personal experience is fine, but you shouldn't make broad statements from it unless the experience actually justifies it.
Think of it like this: somewhere out there is a story that's the opposite of yours. Some guy wrecked his bike and hit his head without a helmet and was fine afterwards. He then concludes that helmets don't work. His reasoning is no different from yours, yet reaches the opposite conclusion. Clearly the reasoning must be flawed.
I am your guy hitting his head after a cycling accident and being fine afterwards. Would it surprise you that, in spite of being fine, it is right AFTER this accident that I decided to start wearing a helmet? Judging by your argument, you would call me illogical.
Why would I call you illogical? Did you conclude that wearing a helmet was a good idea based solely on your anecdotal experience, completely ignoring wider realities? Or did you actually think it through and not base your conclusion on a single event?
Argh, this kind of arguing makes me crazy. It makes it seem like your only reason for commenting is to make yourself feel superior.
Can you seriously say that it would be better to fall on your head and scrape along the pavement without a helmet?
I would prefer to slide along my helmet, not my skull.
So, "they have to work to some extent" is an entirely reasonable thing for him to say. Either I lose some hair and skin or I scrape a helmet. It's obviously doing something. Common sense.
First, wearing a helmet is going to alter the kinetics of your head during the accident, possibly for the worse.
Second, wearing a helmet can alter the behavior of people around you in ways that impact your safety. For example, car drivers may drive less carefully around a helmeted rider.
Third, wearing a helmet can alter the behavior of the wearer.
Now, does that mean that helmets don't improve safety? I would guess they probably do. But let's make the argument based on sound reasoning and data, not insults and "common sense".
You had been downvoted at the time of my reply. I don't know why - you make some good points.
> But let's make the argument based on sound reasoning and data, not insults and "common sense".
I strongly agree. When someone talks about homeopathy it's easy to dismiss it as nonsense, and we only need a few studies to tell us it's nonsense. But when someone makes a calm, sensible claim with a reasonable method of action ("helmets protect the brain") it's more important to get good quality science to investigate these claims, to eliminate our biases and to eliminate confounding factors.
Imagine a crash where someone's head scrapes along the ground. Now give that person a helmet. With the wrong materials the helmet will "snag" the ground. This could mean that the head sticks while the body keeps going, risking severe spinal injury.
While the science around driver perception of helmet-wearing cyclists is weak it's a reasonable statement - "drivers give less room to people wearing helmets because they assume a better rider". That could be testable in driving simulators, and that would give use good quality data.
It's nice to hear anecdote. "I wear a helmet because ..." or "I don't wear a helmet because ..." are good things to hear. It gives context to the data and the science. But these are not reasons for everyone to follow the advice.
It's fun to watch a crowd of nominally intelligent people so thoroughly mix up arguments with the conclusions.
If you make a bad argument in favor of wearing helmets, then it's a bad argument regardless of whether helmets are effective. But the moment you call it out, you get nothing but people talking about how irresponsible you are for recommending people not wear helmets.
The exact same thing is going on over in the Arafat discussion. People make crazy arguments about how Arafat (or other people) was killed and then, when called out on it, act like it's the conclusion being attacked, not the reasoning.
Some people overlook the potential for concussions or traumatic head injuries, anything except massive skull damage, when considering safety headgear. Cycling is a very diverse activity and many only consider safety issues they expect to encounter.
I agree, the lack data really makes it _impossible_ to decide who is in the right here. I propose an experiment: go ram your head into a brick wall with and without a helmet. (To reduce the variance of your estimate, you'll probably want to perform ~10ish trials.) Then report back, and we'll finally get to the bottom of the extremely nagging and tough to judge question of whether wearing a helmet is an improvement when it comes to smashing one's skull into inanimate objects.
I guess I would trust common sense in this case. I mean I've been hit in the shins with a hockey puck while wearing shin pads a few times, they seemed to work. This is anecdotal, but I don't think a double-blind study is needed to show that shin pads protect your shins from hockey pucks.
I personally know people who object to helmets, and refuse to wear them even though we have a helmet law in my city.
I'm not entirely in agreement, but there is logic to this line of reasoning:
1. Helmets, and helmet laws give the impression that cycling is a dangerous activity, and discourage people to cycle.
2. the biggest thing you can do to increase the safety of cycling, is create cycling infrastructure and put more cyclists on the road (I believe this is backed up by hard data, but I have no citations).
3. It follows from 1 & 2 that helmet laws make cycling less safe for all of us by decreasing the number of cyclists on the road.
There is more to their argument than that, but that's the one I personally find most convincing. I still wear a helmet though, so clearly I'm not entirely convinced.
As a side note, research has shown it may be safer in the sense that drivers give more birth to helmet-less cylclists. They see those with helmets as more professional and better equipped, and apparently pass them at higher speeds and closer clearances.
Your first point is a strange one. Are you saying that cycling is not dangerous enough to warrant wearing a helmet? If so, then the other points are moot, and you could have simplified your argument to just "there's no need to wear a helmet".
If on the other hand, you believe that cycling is dangerous enough to wear a helmet, then you're effectively saying that people shouldn't wear them in order to 'lure' other potential cyclists into cycling. That's just ludicrous!
So if they can help reduce injury, shouldn’t they be mandatory, just like motorbike helmets? Australia tried it in the early 90s and the result was a 15 to 20 per cent drop in the number of hospital admissions for head injuries. That would have been great, but it also reduced the number of cyclists by around 35 per cent.
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A recent study in the British Medical Journal showed that cycling has a positive health impact around 77 times larger than the potential for serious injury; essentially, there’s a small chance that you’ll come a cropper, but a very large chance that you’ll reduce your likelihood of suffering mental illness, heart disease and obesity. That means the laws were hugely counterproductive
actually, it has been shown in the Netherlands that wearing the helmet is yes safer, but laws requiring helmets discourages some people from riding out of a variety of reasons. In aggregate, the GP is stating that looking at the cycling system in light of greater participation is a more effective/better solution than requiring helmets.
It would not necessarily be inconsistent to oppose mandatory helmet laws while wearing a helmet oneself.
I'm not sure what I think about the laws. But I do question the claim that helmet laws are primarily responsible for the drop-off in cycling in the US over the last several decades. I would want to see some strong evidence for that before accepting it. Just off the cuff, I would expect it has more to do with the fact that people prefer cars, and that US government policy is to keep the price of gas as low as possible.
>create cycling infrastructure and put more cyclists on the road //
I think you mean put more cyclists on dedicated cycle lanes segregated from traffic. Surely they're far safer than mixing cyclists with automobiles.
Mildy humorous anecdote: First and only time I've hit my head cycling was my first time out wearing a helmet, hit a low branch as I'd not allowed for the extra clearance.
He probably would have received a mild to moderate traumatic brain injury. The common case for a moderate injury is a year or three of recovery, if you're reasonably lucky.
Next week: "I stood on a rusty nail and my foot got sore, I'll try not to do that again" guy gets taken apart for not standing on 1,000 nails in a double blind study to get statistically significant results of nail-standing-induced badness. And no, I don't know how one would introduce the double blind element either :-)
Honestly, sometimes sharing experience and telling stories is just that. Wish HN would stop picking on people for such contributions.
When I fell sans helmet, I rolled on the ground but my head never contacted the ground because my shoulder was in the way. I still wear a helmet for long distance or traffic rides.
It's slightly more complex than that. If the helmet cracked then the force of the collision was transferred to your skull. Admittedly cracking the helmet would have taken some force out of the collision, but the moment it cracked it became useless.
This is why you throw away a 'used' helmet. It is the process of cracking - or even merely deforming - that is the protective act. That it's useless after cracking doesn't mean it hasn't done it's job. It's like saying the crumple zone of a car is useless because it crumpled in the accident.
> If the helmet cracked then the force of the collision was transferred to your skull.
This does not make any sense at all. Your skull absorbs some force in all cases. The exact mechanics of what happens are definitely complex, but compressed and cracked polystyrene is still better than hitting your head directly on concrete, just as hitting your head on asphalt is. That is of course leaving aside the question of how much force was absorbed before it cracked and what was left afterwards, but in all cases it's not a binary assertion.
That article does not appear to be making the argument that helmets are worthless, only that they don't protect against concussions.
The $40 helmet is one of the great success stories of
the past half-century. Like seat belts, air bags,
and smoke detectors, bike helmets save countless
lives every year. They do a stellar job of preventing
catastrophic skull fractures, plus dings and scrapes
from low-hanging tree branches and other common nuisances.
Likewise, US safety standards haven't been updated to reflect more modern medical research on their seriousness.
>"Here's the trouble. Stat #3: As more people buckled on helmets, brain injuries also increased. Between 1997 and 2011 the number of bike-related concussions suffered annually by American riders increased by 67 percent, from 9,327 to 15,546, according to the National Electronic Injury Surveillance System, a yearly sampling of hospital emergency rooms conducted by the U.S. Consumer Product Safety Commission (CPSC)."
>"Of course, concussions are more readily diagnosed now than they were 15 years ago. That likely accounts for some of the increase. It's also possible that some of the 149 fewer riders killed every year survived to get lumped into the brain-injury category. But that still leaves thousands unaccounted for. We're left with this stark statistical fact: The concussion rate among bicycle riders has grown faster than the sport." //
So, yes 9327 -> 15546 is a 67% increase and as they rightly say the increased survival rate contributes as does the improved diagnosis.
>"that still leaves thousands unaccounted for" //
Except they already said that daily commuting had increased over years 1995 to 2009 by 60%. Which seems rather like it would account for a whole heap of those thousands of extra injuries; that there are a lot more cars might account for a lot more injuries occurring too.
It's an interesting piece and the MIPS helmets probably are better but overall it just looks like it's there to sell the most expensive bike helmets as being the only possible option, especially the emotional CTA in the final para.
Not quite what that article is saying. A better characterisation would be "helmets are better than nothing, but don't do much for the most frequent kind of head injury in bike accidents". Helmets do do good things for some of the types of accidents that bicycles have.
It's an important distinction to make, because some people will use it as an excuse to peddle the idea that helmets are worse than not wearing one. It's a great article, well-written and researched, but it should be noted that the author concludes by saying he still has his daughter wearing an old-style helmet while he waits for a next-gen one to become available.
Wow. What an interesting article. Every time I think about quitting my daily HN addiction I come across something like this. Thanks for the link. Very interesting.
Thanks you for posting this link. After having a family member go thru a concussion this year, I see how difficult they are to deal with. I hadn't even thought about this in terms of bicycle helmets. I'm going to replace ours now that I know more about it.
