Trikki Beltran's bad concussion and his helmet

(PeteCresswell) wrote:
Per Bill Sornson:
Depending on what "vanishingly rare" means...

A guy I windsurf with even wears a helmet when he windsurfs.

He's a orthopaedic surgeon with a significant amount of ER experience on people
that have been involved in accidents.

His take: "Remember, when you wear a helmet, it's against an event that may
occur only once in your entire lifetime."

I don't wear a helmet windsurfing unless I'm out in conditions beyond what I'm
used to - like winds beyond the low thirties - but this guy is no dummy and he
is so vastly-experienced that I've got to take notice of his rationale.

Let me say at the outset that I know nothing about windsurfing safety.
But I'm curious, again: To which activities does he apply that
rationale?

From time to time in these discussions, we've had physicians,
psychologists and even ambulance drivers who told tales of head injured
cyclists and said "If you'd seen what I've seen, you'd wear a bike
helmet!!!"

What I've done is ask them what percentage of serious head injuries
they've dealt with came from bike crashes. In almost every case,
they've slunk away, never answering. One psychologist, however,
admitted that he'd seen almost no cyclists. He agreed his practice
matched national data, with cyclists below 1%. A local head injury
therapist I met also agreed, saying most of her clients were motorists,
with only one cyclist - a racer - in 7 years.

I don't know about windsurfing. Perhaps in the Columbia Gorge
windsurfers are 5% of serious head injuries. But my bet is that, like
in the rest of America, motorists are about 50%.

IOW, I bet your surgeon is making the same mistake that most Americans
make: judging the familiar to be safe, simply because it's familiar, or
because it's not fashionable to think it's dangerous; and judging the
unusual to be dangerous, simply because it's unusual - or it's
fashionable to wear the headgear.

And that last illustrates a problem cyclists now have. I really do
believe that the image of cycling has suffered due to helmet marketing.
"Why, of course cycling is dangerous! If it weren't, why would they
wear helmets?"

- Frank Krygowski

catzz66 wrote:


There's plenty of faulty logic on any side of the argument, such as
jumping to the conclusion that people take more risks if they wear
helmets.

:-) And we are to believe that's "faulty logic" because an anonymous
poster says it is?

Read the book "Risk" by John Adams. Risk compensation is so
well-proven it's foolish to deny it. We've had plenty of statements
indicating risk compensation in these discussion groups. And IIRC, Guy
has the results of a study indicating it's a fact for kids on bikes
wearing helmets.

Don't assume that because YOU don't know something, it must be wrong.
By that standard, the greater your ignorance, the greater your
authority. That is _certainly_ faulty logic!


Also, that if all you might get is an unpleasant mild
concussion that there is no reason to wear one.

Don't demonize cycling. Even mild concussions are so unlikely, it's
hard to find a cyclist that's suffered one. Again, things like that
occur once every half-million miles of riding, if that. You'll _never_
ride half a million miles.

- Frank Krygowski

Just zis Guy, you know? wrote:
On Mon, 18 Jul 2005 08:30:20 -0500, catzz66
wrote:


There's plenty of faulty logic on any side of the argument, such as
jumping to the conclusion that people take more risks if they wear
helmets.


Barry Pless, editor of Injury Prevention, used to argue exactly that,
especially in the case of children.

And then he co-authored "Risk compensation in children’s activities: A
pilot study" (Mok D, Gore G, Hagel B, Mok E, Magdalinos H, Pless B.
2004. Paediatr Child Health: Vol 9 No 5 May/June 2004), in which the
conclusion was reached that

"The results indicate that risk compensation may modify the
effectiveness of (protective equipment) for children engaged
in sports and leisure activities. Conversely, the findings
also suggest that those wearing PE may be a cautious
subgroup."

So perhaps they haven't so much jumped to the conclusion as been
reluctantly forced to it?


Guy
--
http://www.chapmancentral.co.uk

"Let’s have a moment of silence for all those Americans who are stuck
in traffic on their way to the gym to ride the stationary bicycle."
- Earl Blumenauer


To use it as a generalization is the leap. People are so complex that
anything "may" be true for some people, as your quote suggests. I don't
have any problem with that.

David Damerell wrote:
Quoting The Wogster :

The anti-helmet lobby has under-emphasized the ability of a helmet's
life saving abilities in a crash. They then think that the helmet is
useless in all cases, and fight against them.


Who are the anti-helmet lobby who fight against them? There's an
anti-compulsion lobby and a lobby opposed to their portrayal as the be-all
and end-all of cyclist safety, but I don't know of anyone who wants to
stop people wearing the things. Do you?


Semantics, okay the anti-compulsion lobby. I can be funny, in cars, I
believe in seat-belt laws but only for the driver, because a seat-belt,
can keep the driver in his/her seat and able to possibly regain control
after a crash. Other then the driver, and small children, it really
should be personal choice. I would probably wear one anyway, used to it
now. With bikes (and motorcycles too), I don't believe in helmet
compulsion, inform people of the risks, and let everyone come to their
own conclusions. The pro-helmet compulsion lobby, is mostly funded by
the helmet manufacturers, and it's cheaper then marketing.

but not in all cases. The safest is to ride with a helmet, using the
same riding style as if you don't have one.


Unfortunately you can't do that. Even people who know about risk
compensation risk compensate.

I don't really see that, considering that road-rash, broken bones, cuts
and puncture wounds are far more likely in a crash, and I don't want
those either.


W

Werehatrack wrote:
On 17 Jul 2005 20:22:44 -0700, wrote:


Good question. I know of one instance where a guy's helmet was stolen
in the middle of a bike tour.

He rode on. Are there people here who would actually stop riding?

Are there people who'd see if there was one available that they could
borrow before they took that step?

Are there people who might make a different decision if the ride was
rural vs urban, trail vs street, night vs day, short vs long, etc?

I suspect that the answer to each of these could be "yes" in some
circumstances.

And yet, the common "safety" advice is "_Always_ wear a helmet!" In
those places with helmet laws, the law says "_Always_ wear a helmet."


I also suspect that the majority, faced with a "ride without or walk"
scenario would ride, in most cases. The helmet is protection from a
low-probability occurrence in most forms of cycling;

That, I agree with. I'll go further, to say a helmet is protection
from an event so rare that it was never remarked on in safety
literature before Bell had a consumer product to push.

Seriously - can anyone find any bike safety literature from before 1975
saying "Bicycling is a source of serious head injuries, so protect your
head if you fall"? I don't recall ever hearing that. I've got cycling
books - some original, some reprints - dating back into the 1800s.
Head injuries are never mentioned, including in kids' safety
instruction. Except for track and criterium racers, helmets are never
considered.

The product came first, from a helmet company looking for new markets.
The hype came later. (And I'd _love_ to see Bell's corporate meeting
minutes!)


Many anti-helmet types seem to make the unwarranted assumption that
all or most helmet wearers are inherently as rabidly pro-helmet as
they are against them, when the reality is that this is not the case.

You make two mistakes there. First, to you, the term "anti-helmet
types" may seem like useful shorthand, but the term "helmet skeptics"
is _much_ more accurate. In this thread, there have been helmet
skeptics who say they normally wear one voluntarily. "Anti-helmet"
certainly doesn't fit.

Second (and far worse) is to paint the helmet skeptics as the "rabid"
ones. I've never, ever met a person wanting to make helmet use
illegal. Most helmet skeptics simply want to allow personal choice,
and they want the choices to be based on accurate information.

OTOH, there are MANY helmet promoters who actively lobby to make
freedom of choice illegal. Bell Sports does so through Safe Kids -
I've come up against their lobbying efforts in our state legislature.
The "Bicycle Helmet Safety Institute," the web's most pro-helmet site,
makes no bones about wanting all-ages helmet laws. And of course,
there are the countries of Australia and New Zealand where all-ages
MHLs already exist. There are many states in America where parents are
not allowed to make that choice regarding their own children, and some
locations where even adults are forbidden to ride without special hats.

The intolerant side is clearly the pro-helmet side. When a person
feels his own judgement should trump the knowledge, judgement or
freedom of another person, that is clearly intolerant.

And when a major corporation uses deception and politicking to get its
product _mandated_, there are serious problems with government.

- Frank Krygowski

On 18 Jul 2005 07:45:40 -0700, wrote:

And when a major corporation uses deception and politicking to get its
product _mandated_, there are serious problems with government.

You wouldn't be alluding to the "Bell Legislative Assistance Program"
there would you, Frank?


Guy
--
http://www.chapmancentral.co.uk

"Let’s have a moment of silence for all those Americans who are stuck
in traffic on their way to the gym to ride the stationary bicycle."
- Earl Blumenauer

Werehatrack wrote:
On 17 Jul 2005 20:17:41 -0700, wrote:

I invite you to extend your
logic beyond cycling! After all, when _do_ you "know what's going to
happen"? Surely you realize that cycling is not even on the map for
causing serious head injuries, right? Why not wear a helmet for all
activities that cause head injuries?

Perhaps my habits have nothing to do with statistics or publicity.
Perhaps they were formed long ago because the only four people I've
known who had head injuries got them either on bikes or motorcycles.

And your anecdotes (trimmed) might be used to argue for motorcycle
helmets. I'll add that the per-hour fatality and head injury data I've
seen show motorcycles at least ten times as dangerous as motoring,
cycling or walking - all three of which are about equal, BTW.


The fourth was the only bicyclist. He was one of a pair struck by a
drunk driving a small pickup. Did the helmet save his life? That's
arguable. He went over the cab and landed in the bed of the truck;
the helmet was bashed, but it's hard to say if it was an impact that
would have been potentially fatal.

And if you haven't seen it, I'd be happy to post my counterexample.
But I've done that before. I'll repeat only on request.

Still, what you've given is four examples of people in crashes on two
wheels. Personally, I know far more people who were head injured,
several fatally, while riding in motor vehicles. Those head-injured
include two siblings, one grandmother, and one colleague at work. I
can quickly recall three friends who died in car crashes. One I know
died solely due to head injury; I suspect the others did as well,
because although it's never mentioned (there are no car helmets to
promote, after all) most car fatalities are due to head injury. And I
suspect there are more car head injuries among my acquaintances. In
America, these things are the most common source of head injury, but
are given very little attention and almost no publicity.

When was the last time you saw a motorist described this way?
"Officers said the motorist died of a head injury, like most fatally
injured motorists. He was not wearing a helmet."


Incorrect. My *personal* experience has been that *automobiles* pose
a significant risk to me when I'm on a bike out there in their path.

Ah well. I'm sure I've encountered many millions of automobiles in my
cycling life. My impression is much different than yours. If they
posed a significant risk, I'd have been significantly injured
_sometime_ in the past 50 years!

- Frank Krygowski

On Mon, 18 Jul 2005 09:30:34 -0500, catzz66
wrote:


[re risk compensation]

To use it as a generalization is the leap. People are so complex that
anything "may" be true for some people, as your quote suggests. I don't
have any problem with that.

Actually I cannot think of a single area of life where risk
compensation does not happen. Seriously. The truly bizarre position
to my mind is to deny it applies to specific activities.

The only question, for me, is the extent to which we compensate. And
that is going to be a function of perceived risk and perceived levels
of protection. The extent of balancing behaviour may be very small,
or it may be very large. The tests for the likelihood of measurable
balancing behaviour include how noticeable the intervention is, how
conscious a person is of it, and so on. Helmets score high on these
scales. Adverts for mountain biking helmets play on this: "courage
for your head"; MTB mags discuss protective equipment as allowing you
to push the envelope.

Against that we have a small number of those who are strongly
pro-helmet who assert that risk compensation (uniquely) doesn't happen
in the case of cycle helmets. But as I said, when they set out to
prove it at least one of these types found the opposite...


Guy
--
http://www.chapmancentral.co.uk

"Let’s have a moment of silence for all those Americans who are stuck
in traffic on their way to the gym to ride the stationary bicycle."
- Earl Blumenauer

The Wogster wrote:
I can be funny, in cars, I
believe in seat-belt laws but only for the driver, because a seat-belt,
can keep the driver in his/her seat and able to possibly regain control
after a crash.

I tend to go the other way. I think we'd be better off by forbidding
driver seat belts, and attaching a 6" steel spike to the center of each
steering wheel, pointed at the driver's chest.

The last thing we need, IMO, is to make drivers feel even more
invulnerable.

- Frank Krygowski

wrote:

I tend to go the other way. I think we'd be better off by forbidding
driver seat belts, and attaching a 6" steel spike to the center of each
steering wheel, pointed at the driver's chest.

The last thing we need, IMO, is to make drivers feel even more
invulnerable.

- Frank Krygowski

And it is insightful comments like this that add so much to the helmet
debate. And some wonder why your "investigations" are not universally
accepted as the gospel.