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news
Helmet Row (picture copyright Simon MacMichael)Study claims cyclists wearing helmets less likely to die from injuries
A new study has found that most people who are injured while riding bikes in the United States were not wearing a cycle helmet at the time of the incident, and that people who were wearing one were less likely to die from their injuries.
Published in the journal Brain Injury, the study analysed data relating to 76,032 cycling injuries between 2002 and 2012 from the National Trauma Data Bank.
They found that only one in five adults (22 per cent) and one in eight children (12 per cent) were recorded as wearing a helmet when they were injured.
Women (28 per cent) were more likely then men (21 per cent) to have been wearing a helmet, and white cyclists (27 per cent) than black or Hispanic riders (6 and 8 per cent respectively).
Helmet wearers were 44 per cent less likely to die from their injuries than people who did not wear one, and the study also found that their injuries were less severe and that they spent less time in intensive care and were released from hospital sooner.
Co-author Shahrzad Bazargan-Hejazi of the Charles R. Drew University of Medicine and Science and David Geffen School of Medicine at UCLA told Reuters: “Non-users of the bike helmet are more likely to be less educated or aware of the protective nature of the helmet; to be risk-takers and have a perception that they can handle risky road situations; and consider wearing helmet not a practical thing to do, or not a cool thing to do. Affordability is also a factor for people from lower socioeconomic status.”
The study called for greater efforts to be made to encourage people to wear helmets while cycling, and Bazargan-Hejazi added: “Once on the road we do not have much control over the road condition or the environment, which can be the cause of all sort of accidents.
“However, we have relative control over our behaviour and action. We can use safety gears to protect ourselves against uncontrollable road conditions and environment, and bike helmet is one of those useful protective gears.”
In the US, 21 states have statewide helmet laws, in all cases applying only to younger cyclists (typically, under-16s).
The helmet debate invokes passions on both sides, and while there are regular calls to make cycle helmets mandatory for all riders, cycling campaigners point out that introducing such legislation discourages people from cycling and thereby has a more negative effect on public health overall.
Other studies have also shown that motorists tend to give more space when overtaking to cyclists who are not wearing helmets, meaning that those who do wear one may be at greater risk of being involved in a collision in the first place.
Cycling advocate Chris Boardman has also said that helmets “are not even in the top 10 of things you need to do to keep cycling safe” and that the focus on the issue not only distracts from areas such as putting safe infrastructure in place, but also actively discourages people from cycling since it reinforces the misconception that cycling is inherently dangerous.
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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72 comments
Oh, here we go again.
The only things to conclude are; 1. Not everyone in the US dies from gun shot injuries. 2. Helmet privilege is a thing.
I guess if 76K cases over 10 years isn't statistical enough for you then all data is anecdotal. Just let them be. I have a feeling nothing here is going to change. We will see again in 5 weeks.
It is far too easy to get the results you want by selecting the evidence that shows what you want, and this is a meta-analysis, not original research, so all you have to do is pick the right papers. As pointed out by myself and others, this study cites Thompson, Rivara and Thompson (TRT) whose research has been described by one academic as a case study in how not to do research. TRT are notorious for their totally unscientific, biased approach.
Take the paper quoted in this research, the Cochrane report by TRT. Now, Cochrane reports, because of their scientific rigor, were looked on as the gold standard for research. Cochrane reviews have very strict rules; the authors must be neutral and the studies they look at must be wide ranging. TRT are the world's biggest helmet zealots and they selected mostly their own papers and excluded anything which might prove them wrong. Cochrane reports are now seriously devalued.
Anyone using this Cochrane report to support their case is clearly biased and unscientific.
Looking at the data it seems that there was no significant difference in injury severity between helmet wearers and non helemet wearers but there was a difference in both hospital and ICU Length of Stay and mortality.
Helmet wearers spent less time in ICU, less time in hospital and were less likely to die as a result of their injuries.
This could be due to demographics, these were markedly different between helmet wearers and non helmet wearers.
Alternatively wearing a helmet may have a protective effect against life threatening injuries.
Rich, much as I love your helmet loving, this study already tells you that those wearing helmets were more affluent. Being America they got better care ergo better results...
Firstly, I acknowledged the demographic difference as a potential confounding factor.
The non-helmet wearers however, had longer "Length of Stay" in both hospital and ICU.
Their care would almost certainly have cost more as a result. ICU is at least $2000/day.
Emergency care is not based on insurance.
That's part of the catch-22 of American Healthcare. The non-insured can't get timely treatment for their ailments so they end up presenting as emergencies, they then have very expensive emergency care which they cannot afford so they defualt on the bill and insurance premiums for everybody else rise to cover the default.
This makes insurance even less affordable so more people can't get timely care and present as emergencies. Etc etc.
Apparently loving an Australian is controversial, so Rune Elvis* hit them with a sporgsmalet.
*Other Nordic tribute acts are available.
(Danish is not my first language)
It seems to be the time of the squirrel, I see many more at this time of year, with them becoming even more active and seemingly throwing themselves under my wheels as October and November approach. I'm seeing a lot more of the poor unfortunate ones on the roads too.
There was an explosion in the number of pheasants last month, who seem to like to foolishly run in front of the bicycle for far longer than would seem sensible, before moving off in a sideways direction and relief for all.
Lot of Red Kites out there too. Magnificent creatures.
I've also noticed that they seem to weigh a lot more at this time of year. As a comparison, I selected three squirrels and put the youngest one onto some rabbit fur lined scales - it weighed more or less half a pound. The next one was a bit older and I weighed it using some dog fur scales and it was about one pound. The last one I popped onto some hippo-skin lined scales and it was one and a half pounds.
This proves that the squirrel on the hippopotamus is equal to the sum of the squirrels on the other two hides.
squirrelhelmet.jpeg
The real question as I see it is whether a squirrel on a bicycle wearing a helmet is more likely to be able to outrun the (Yorkshire) whippet pursuing it than the squirrel on a bicycle not wearing a helmet. From my observations, whether a squirrel is or is not wearing a cycle helmet is unlikely to give it any protection should it be unfortunate enough to be caught by a (Yorskhire) whippet.
Can't they just be friends?
glensquirrel1web1.jpg
In the case of my whippet, absolutely not. He views (grey) squirrels as a menace to respectable society.
.
squirrel1-640x457.jpg
Look at those big staring eyes, sharp teeth and menacing sneer. Perhaps you can understand why my whippet sees this as prey to be pursued at high velocity.
I once tried to feed a digestive biscuit to a grey squirrel in a local park. I held it out, the squirrel came closer. It gently took hold of my fingers with its cute little hands, then sank its ratty yellow little teeth into them - I dropped the biscuit, which it then grabbed and with which it ran away (cackling, I'm sure...).
Squirrels! I hates 'em! I hates 'em all!
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squirrel-612369__340.jpg
Yes! Even that one!
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V7AZJ2HSZQYC7B32YCUZ6N6LAQ.jpg
Is that like how to prove that witches are made of wood?
I have yet to see a paper describing the friction coefficient of a squirrel and I feel science is poorer for it
We need a venn diagram. One that also includes squirrels cycling and wearing helmets.
I tried to chase a squirrel named Vern on my bike the other day. I've got no idea how he could reach the pedals.
1085.jpeg
How is it that that every subject descends into some sort of sciurine debate?
Descends or ascends?
They say themselves that those who don't wear a helmet are more likely to be risk takers. This implies to me that the populations they study are not putting themselves into equivalent situations, and will likely receive a different variety of injuries. This study seems to be closer to the correlative "x gives you cancer" headlines which link people whose lifestyle includes x (as well as y and z), and increased cancer risks. Better studies with matched populations and controls are difficult to do!
The answer to this type of study always seems to be "there's not much in it", I wear a helmet for the vast majority of my riding, but am very much against compulsion to do so.
My two observations from their text:
1. Anybody citing Thompson, Rivara & Thompson is struggling to justify their point
2. They state 21% of males reporting a head injury were wearing a helmet. Also 22% of males wear a helmet. So the proportion of males with a head injury is essentially the same as those wearing a helmet. So wearing one isnt reducing the likelihood then?
I quickly lost the will to delve deeper.
Completely concur. The simple test for the validity of cycle helmet research is infallible; if they quote Thompson, Rivara and Thompson, it isn't.
IMG_1761.JPG
Conveniently overlooking the fact that they found that: "Helmet wearers were 44 per cent less likely to die from their injuries than people who did not wear one, and the study also found that their injuries were less severe and that they spent less time in intensive care and were released from hospital sooner."
If you fall off and bump your noggin, you're likely to sustain injury, but the finding of this fairly extensive study is that that injury will be, on average, less severe if you're wearing a helmet.
Something to consider, I've tied you to a chair and I'm going to drop a lump of kerbstone on your head (I don't know why, just a psychopath I guess) that weighs about ten lbs from a height of eight feet. That roughly simulates the effect of falling off your bike at a standstill (maybe you forgot to clip out or something). Now, I'm giving you a free choice as to whether or not to put on a cycle helmet before I d rop it. Will you take it? No "this study says XYZ" or debate about compulsory helmets (which I oppose), just will you wear the helmet or not in that scenario, yes or no?
How about a counter-proposal.
I'll tie you to the same chair, but rather than dropping a kerbstone, I'll be swinging it around a bit. However, if you're wearing a helmet then I'll be aiming to go closer to your head than if you're not. Would you rather trust my judgement of distance or the protective effect of the helmet?
Crikey, the helmet use debate really is as toxic as vaccines and climate change now. It seems that people see themselves as "pro" or "anti" and refuse to look at any evidence to the contrary - look at the example on this thread where someone has refused to read the rest of the paper because it included a reference they object to in the introduction.
To further the analogy where we are tying people in chairs, the best thing to do is not to sit around and imagine in our heads whether swinging people around or dropping kerbs results in more injuries, but to look at ooh, lets say 70,000 cases where people have been injured whilst strapped in chairs and see what factors were independently associated with fewer/less severe injuries.
We all know about risk compensation and yes it is a real effect, but it is still entirely possible that wearing a helmet results in less severe inuries overall.
As a general plea, is it possible to limit discussion on this thread to ACTUAL CRITICISM OF THE PAPER?
As a starter for 10, of course this is a retrospective observational study so at best all it can demostrate is correlation, not causation. It is entrely possible that those choosing to wear helmets in this study were naturally better/more cautious/less frequent riders than those not wearing helmets. The problem is that unless you were to prospectively randomise people to enforced helmet (or not) use, this bias is impossible to eradicate, so we are left with having to perform this type of study. Are there any such in the literature with a similar sample size that show an opposite effect? If not, why not?
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