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#121
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published helmet research - not troll
"Steven Bornfeld" wrote This is something that the anti-helmet partisans continue to repeat, and I'm not sure what you mean by this. I am inclined to think you're saying that folks feeling relatively protected will engage in riskier behavior. I think this is speculative; the same argument the right uses in this country to attack dispensing of condoms. I've seen plenty of risky behavior from both helmeted and non-helmeted riders. Of course this is anecdotal, but I doubt anyone would seriously contend that people drive more recklessly because they are wearing seat belts. I've heard the statement, in this newsgroup and others, several times. Voiced various ways, but the same sentiment [not verbatim, but close enough] "I ride harder if I have the helmet on" "I'm a little more careful if I don't have the helmet on" "Cycling is just too dangerous without a helmet" "I would never, ever, ride a bike without a helmet" And the ever popular "Organ donor" or "Darwinism in action" Pete |
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#122
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published helmet research - not troll
"Shayne Wissler" wrote Clearly, they're not in the protection business; they're in the business of selling helmets. Assuming a free market, it would be in a helmet manufacturers best interest to be in the business of both, for the same reasons. In the current mixed-economy it still makes sense for a helmet manufacturer to be principally concerned with the performance of the helmet and to let profits flow from that--it's the only honest way, and it in fact still could lead to becoming a market leader. Performance (in a crash) doesn't really count, because there are 1) few enough crashes to matter, and B) no design with current materials that would actually sell. Significant, measurable increase in protection would necessitate a revolution in materials, or a larger helmet. The first is pie in the sky, and the second won't sell. Pete |
#123
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published helmet research - not troll
Just zis Guy, you know? wrote: Here you are wrong: not only do people contend this, it is actually a mainstream view. Taxi drivers in Germany and Denmark were found to drive more aggressively in cars fitted with ABS. Drivers who did not habitually wear seat belts were found to drive faster when persuaded to wear seat belts. Seat belt legislation has never resulted ina reduciton in road deaths, but it did lead to the biggest recorded increase in pedestrian, cyclist and rear-seat passenger deaths in the UK. The arrival in the second-hand market of the first generation of cars with drivers' airbags has seen a sharp rise in fatalities of front seat passengers of young male drivers. It is very difficult to prove cause and effect in these cases, as most of these laws were instituted in times of rapidly increasing automobile use. I can tell you unequivocally in the area in which I have expertise--facial injuries--that I have never seen a patient with facial injuries following an auto accident that had been wearing a seat belt--never. But the dangers in cycling are low. This is a tough sell to me. We both know people who have died or been seriously injured in bicycle accidents. I would view effective cycling instruction in the same way. For that matter, one must demonstrate competence before being licensed to drive a motor vehicle. In spite of this training many drive with a blatant disregard to the real dangers. Because the danger is not to them, or at least they get all the benefit of the aggressive driving (!) and only part of the risk.. Another issue is cultural; in the UK, and in Europe and most of the rest of the world, the bicycle is seen as a legitimate means of transportation. In the U.S. it is overwhelmingly still seen as a toy. As a consequence of this, very few cyclists--even those who bicycle for legitimate transportation follow even basic transportation regulations. A great reason to challenge that failing :-) We do what we can. I'm following the polls. (As an aside, while on a bicycle tour I once rode through a red traffic signal in London--a transgression for which I was vigorously chastised by several pedestrians. I didn't do it again.) Heh! Red lights are treated as "give way" by all comers, motorised and cycling, in London :-) I assume that the way increased cycling will improve safety is first that there are less motor vehicles on the road. - drivers see more cyclists so are expecting them - drivers are more likely to be cyclists and know how to behave around them I can say that this is not my experience. I have been attacked more frequently when cycling in groups than I have been cycling alone. I have been attacked more frequently on roads where cyclists are abundant than on roads where they are not. Furthermore, I would assume that once cycling reaches a certain critical mass it will have a political constituency to effect changes in access, motor vehicle regulations etc. No, I don't think so. There's no money in it. If the numbers are there the power and then the money will be. I have analysed UK child hospital admissions returns and found that there is no significant difference in the proportion of head injuries suffered by road cyclists and pedestrians, despite helemt wearing rates only around 15%. Again, I must ask if this pertains to total number of incidents, proportion of head injuries among total injuries, head injuries per unit time, etc. This is a complicated issue; I trust that you have looked at the design of the studies as apparently some of the journals have not. That's why I stated the figures as I did. Cyclists admissions 49% head injury, pedestrians 46% head injury, 15% helmet wearing rate. So: cyclists and pedestrians suffer roughly the same proportion of head injuries. The ratio is pretty much unchanged with helmet use. By comparing the ratio you normlaise out exposure. You can do similar calculations with severity ratios and show that the proportion of cyclist inuries which are severe are unaffected by helmet use. I'm still not understanding this. This is percentage of total admissions? Percentage of accident admissions with head injury? By contrast, Liddites claim "head injuries fell in Australia following the law" which is literally true, but they fell by less than the fall in the number of cyclists. Look at graph 2 he http://agbu.une.edu.au/~drobinso/bhacc.htm You're supposed to try to disprove, not prove, your initial premise. In this case the researchers [...] decided on the outcome before they started. Well, sure. That's the way it is supposed to be. But drug trials are not conducted by folks looking for the drugs not to work. Of course, one cannot do a double-blind study on this. But this is a very serious charge against the NEJM, and I would have expected to hear about it. It's not a particularly serious charge against them, actually; it's a study with an error in it. It happens all the time. It is an indictmentof their peer review process, though. But not as bad as the Cook & Sheikh paper in Injury Prevention. I have to disagree. If I understand the error as you state it, it is both blatant and elementary. Any responsible editor should have seen it. Having not seen it beforehand, in a journal of the pedigree of NEJM, the editor should have been history. This does NOT happen all the time, thank God. Well, as you say, there's cycling, and then there's cycling. I made a decision after a serious crash in my first year racing that I was finished. It's a bargain you make with yourself--I won't race again and THEN I'll be safe. I was not spared a head injury by my helmet, but I probably saved myself having my eyes cut up by the broken glass I fell into. Sure. I don't do technical downhill - too risky. I fact the kind of riding I do it's very unlikely a helmet would ever be of benefit, not least because I ride with my arse a foot off the ground :-) Now, this is likewise the kind of statistic that bothers me. I am assuming that you are speaking of cardiovascular risk. OK. But the choice should not be cycling vs. couch potato. I have never seen a study actually pretend to predict life extension based on a particular volume of cardiovascular exercise anyway. However, for those who cycle for fitness instead of purely for transportation (as I do) one cannot assume that someone who stops cycling will do no other aerobic exercise. There are other confounding factors, such as that those who bicycle or do other forms of aerobic exercise are less likely to smoke. I have seen studies that attempt to correct for this, but they are mostly fantasy. Sure - but the message is sound. Cyclists live longer than average; this would not be possible if cycling were extraordinarily dangerous. This may or may not be true. I have no reason to believe that the cycling population is heterogeneous. I do have reason to believe that avid cyclists (the ones most likely to enjoy a health benefit) are considerably more affluent and get better medical care than the general population. These are the proportions of all admissions which are due to head injury. So, if you have a bike crash, you are not markedly more likely to suffer head injury than if you are hit as a pedestrian. This assumes that the total number of person-hours spent cycling is roughly equivalent to the total number of person-hours spent as a pedestrian. No it doesn't, because it compares like with like. You have already been injured: is your injury more likely to be a head injury if you are a cyclist? Answer, not really. Are you more likely to be injured per se as a cyclist? Probably not, inless there is a motor vehicle involved. The risk levels comparison: 10% of cycling is on road, 90% off road. This is a simply amazing statistic. In the U.S. even most mountain bikes are never ridden off road. Includes bike paths and trails. You might be surprised :-) Not likely in the U.S. Bike trails are relatively rare here. Furthermore, even roads with dedicated bicycle paths frequently carry motor vehicles as well. So what would you change? As you've pointed out, cars are heavily regulated because of the greater danger. The industry is more powerful economically and politically. So what would be the focus of improving bicycle safety vis a vis automobiles? First, enforce traffic regulations (for all road users) inna zero tolerance stylee. Second,make sure that quality bike training is available for all. And third, make sure that anybody who drives badly gets a chance to find out how the other half live as they do without their license for a while. That's a noble sentiment. I fully expect to die before seeing this though. Thanks for your interesting and thorough discussion. This is obviously an important issue for you. The issue of helmet mandates is frankly unimportant to me. What is important is the truth regarding helmets and bicycle safety, for myself and my family. As someone who has been permanently injured in crashes I'm sure it is something on which we both can agree It is a matter of life and death, literally. I spend between one and two hours every weekday riding my bike on the roads, and I have kids. I cannot afford not to take an interest :-) Guy Hold on--I thought this was a relatively safe activity! ;-) Steve |
#124
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published helmet research - not troll
Snoopy *is n wrote:
What I have just stated in not definitive proof of anything. But I do want to suggest that correlating cycle use with the introduction of cycle helmet laws is not just the statistical exercise it might appear to be. Although they haven't been mentioned in the current thread, the best measurements correlating reduction in cycle use and helmet laws come from Australia. What was seen there was a significant step drop exactly concurrent with the introduction of the law. The counts in Victoria (IIRC) used trained observers before and after the law, monitoring use in the same places under the same weather conditions. Other data came from automatic devices placed on bridges commonly crossed by cyclists. And while correlation does not prove causation, they did do telephone surveys asking people about their cycling. Respondents said they were cycling less because of the law. As I've said before, it's unreasonable to expect anything but a drop in cycling upon imposition of a MHL. The only question is how large the drop will be. I say this because it's certain _someone_ will say they won't cycle if they have to wear a helmet. (Also, you'll probably have some parents who will say "Damn, if it's _that_ dangerous, I'm not letting you cycle at all!") But it's hard to imagine anyone saying "Gee, now that a helmet is a requirement, that makes me want to take up cycling." -- --------------------+ Frank Krygowski [To reply, remove rodent and vegetable dot com, replace with cc.ysu dot edu] |
#125
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published helmet research - not troll
Pete wrote: "Steven Bornfeld" wrote This is something that the anti-helmet partisans continue to repeat, and I'm not sure what you mean by this. I am inclined to think you're saying that folks feeling relatively protected will engage in riskier behavior. I think this is speculative; the same argument the right uses in this country to attack dispensing of condoms. I've seen plenty of risky behavior from both helmeted and non-helmeted riders. Of course this is anecdotal, but I doubt anyone would seriously contend that people drive more recklessly because they are wearing seat belts. I've heard the statement, in this newsgroup and others, several times. Voiced various ways, but the same sentiment [not verbatim, but close enough] "I ride harder if I have the helmet on" "I'm a little more careful if I don't have the helmet on" "Cycling is just too dangerous without a helmet" "I would never, ever, ride a bike without a helmet" And the ever popular "Organ donor" or "Darwinism in action" Pete I can't say this doesn't happen BUT in my experience, risk-averse folks are careful. People who don't care won't care to protect themselves. That means reckless folks won't wear helmets, and they'll ride recklessly. Have I seen reckless riders with helmets? Sure. But I tend to doubt they are reckless because of the helmet. They are reckless because...they are reckless. Steve |
#126
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published helmet research - not troll
Steven Bornfeld wrote:
I only suggested to those who opposed mandatory helmets by saying that other measures were more important to safety that their objections had more to do with freedom to choose than it did to the efficacy of helmets. For me, it's not simply freedom to choose. To illustrate - and hopefully not get the discussion off track: There are other issues regarding which I disagree with the lack of freedom to choose, but I don't get very concerned. And example would be air bags in cars. From the reading I've done, they are not the panacea they are proclaimed to be - that is, IIRC, they offer only about 8% improvement in survival over a properly fastened seat & shoulder belt, yet they cost far, far more and they have the capability of killing people. (Certainly, "First do no harm" should apply to safety devices as well as physicians!) However, I'm not going to devote time to that particular freedom-to-choose issue. I think the societal negatives are relatively minor. The overpromotion of bike helmets is, to me, another matter. It does harm society by discouraging cycling. It tends to place the blame for certain injuries on victims. It distracts from more effective (and bicyclist-friendly) tactics that would do greater good for cycling safety and for cycling in general. It falsely portrays ordinary cycling as extremely dangerous. And, as icing on the cake, it uses false logic and incompetent science - something that would irritate me about most issues. So it's not just a freedom issue. Sure, that's there, as well, but there are lots of freedom issues that lead me to say nothing more than "Oh well." -- --------------------+ Frank Krygowski [To reply, remove rodent and vegetable dot com, replace with cc.ysu dot edu] |
#127
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published helmet research - not troll
Frank Krygowski wrote: Steven Bornfeld wrote: I only suggested to those who opposed mandatory helmets by saying that other measures were more important to safety that their objections had more to do with freedom to choose than it did to the efficacy of helmets. For me, it's not simply freedom to choose. To illustrate - and hopefully not get the discussion off track: There are other issues regarding which I disagree with the lack of freedom to choose, but I don't get very concerned. And example would be air bags in cars. From the reading I've done, they are not the panacea they are proclaimed to be - that is, IIRC, they offer only about 8% improvement in survival over a properly fastened seat & shoulder belt, yet they cost far, far more and they have the capability of killing people. (Certainly, "First do no harm" should apply to safety devices as well as physicians!) However, I'm not going to devote time to that particular freedom-to-choose issue. I think the societal negatives are relatively minor. The overpromotion of bike helmets is, to me, another matter. It does harm society by discouraging cycling. It tends to place the blame for certain injuries on victims. It distracts from more effective (and bicyclist-friendly) tactics that would do greater good for cycling safety and for cycling in general. It falsely portrays ordinary cycling as extremely dangerous. And, as icing on the cake, it uses false logic and incompetent science - something that would irritate me about most issues. So it's not just a freedom issue. Sure, that's there, as well, but there are lots of freedom issues that lead me to say nothing more than "Oh well." As I said, if there is no significant safety issue, there is no need to speak of regulation at all. Steve |
#128
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published helmet research - not troll
Frank Krygowski wrote: Steven Bornfeld wrote: Just zis Guy, you know? wrote: But the dangers in cycling are low. This is a tough sell to me. We both know people who have died or been seriously injured in bicycle accidents. I've literally lost count of the people I know who died or were seriously injured while riding in motor vehicles. I imagine this is true of most people. Yet most people don't ever say "Damn - riding in a motor vehicle is really dangerous." They obviously think the danger is low. Clearly, knowing one or more injured people proves little about an activity's relative danger. It's much more instructive to dig for data on, say, injuries or fatalities per hour exposure. True, the data's hard to find. But the available data for cycling seems to belie the "Cycling is dangerous" nonsense. I don't doubt this. Personally, I hear discussion about the sorry state of autmotive safety all the time. I am lucky enough to know no one personally who has been seriously injured in an auto-only accident. Obviously, this doesn't mean it doesn't happen. By the same token, I know several people who have suffered life-threatening injuries cycling, about half of them with no motor vehicles involved. I am not about to soft-pedal (nyuck, nyuck) the dangers of either. Steve |
#129
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published helmet research - not troll
Steven Bornfeld wrote:
Just zis Guy, you know? wrote: But the dangers in cycling are low. This is a tough sell to me. We both know people who have died or been seriously injured in bicycle accidents. I've literally lost count of the people I know who died or were seriously injured while riding in motor vehicles. I imagine this is true of most people. Yet most people don't ever say "Damn - riding in a motor vehicle is really dangerous." They obviously think the danger is low. Clearly, knowing one or more injured people proves little about an activity's relative danger. It's much more instructive to dig for data on, say, injuries or fatalities per hour exposure. True, the data's hard to find. But the available data for cycling seems to belie the "Cycling is dangerous" nonsense. -- --------------------+ Frank Krygowski [To reply, remove rodent and vegetable dot com, replace with cc.ysu dot edu] |
#130
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published helmet research - not troll
Frank Krygowski wrote: Steven Bornfeld wrote: Pete wrote: "Steven Bornfeld" wrote This is something that the anti-helmet partisans continue to repeat, and I'm not sure what you mean by this. I am inclined to think you're saying that folks feeling relatively protected will engage in riskier behavior. I think this is speculative; the same argument the right uses in this country to attack dispensing of condoms. I've seen plenty of risky behavior from both helmeted and non-helmeted riders. Of course this is anecdotal, but I doubt anyone would seriously contend that people drive more recklessly because they are wearing seat belts. I've heard the statement, in this newsgroup and others, several times. Voiced various ways, but the same sentiment [not verbatim, but close enough] "I ride harder if I have the helmet on" "I'm a little more careful if I don't have the helmet on" "Cycling is just too dangerous without a helmet" "I would never, ever, ride a bike without a helmet" And the ever popular "Organ donor" or "Darwinism in action" Pete I can't say this doesn't happen BUT in my experience, risk-averse folks are careful. People who don't care won't care to protect themselves. That means reckless folks won't wear helmets, and they'll ride recklessly. Have I seen reckless riders with helmets? Sure. But I tend to doubt they are reckless because of the helmet. They are reckless because...they are reckless. The issue is more subtle than just "reckless with [or without] helmets." The question is, when a helmet is put on a person's head, how does their recklessness _change_? Even a cautious person can exhibit risk compensation, and they regularly do it. Again, even someone saying "I would never ride a bike without a helmet" is admitting to risk compensation. They are admitting to increasing what they perceive as risky behavior, because they perceive a degree of protection. Interestingly, if they underestimate the degree of protection, but accurately estimate the increased riskiness of their behavior, they still come out ahead. But in a climate where the most-quoted claim of helmet benefit is so outrageously high (85%) there must be lots of people who overestimate the real protection. "85%? Hell, that's close to 100%! I'll _never_ get a head injury if I wear this thing. Banzai!!!" I'm sure that happens all the time! ;-) Steve |
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