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10 total messages Started by Avery Burdett Sun, 17 Mar 1996 00:00
More on Helmet Fraud
#86
Author: Avery Burdett
Date: Sun, 17 Mar 1996 00:00
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Notes sent to me by New Zealander Nigel Perry from recent
international conferences at which he presented on injury prevention held in
Melbourne in Feb, 96 provide further insight into the biases of prominent
American helmet zealots Robert and Diane Thompson, and Frederick
Rivara, authors of the widely quoted but flawed Seattle study on the
effectiveness of bike helmets (New England Journal of Medicine, May
25, 1989) and arch-zealot Philip Graitcer of the World Health
Organization's (WHO) Helmet Initiative.

1. Rivara offered up the 5 point plan from Washington State's
children's helmet campaign. The last point was "focus on helmets -
not riding behaviour". In other words, forget CAN-BIKE, Effective
Cycling, or any other cycle skills training, just let child
cyclists get into crashes because helmets will protect them. 

Rivara also argued that helmets provide a 70% decrease in risk of
head injury (his Seattle paper claimed 75%). John Langley from the
Injury Prevention Research Unit (IPRU) at Otago University, NZ,
himself pro-law, questioned this and asked for proof in view of the
NZ results which showed no reduction in head injury rate. He wanted
to know the epidemiologocal evidence for cycle helmets helping in
severe crashes. Prevention of deaths - where is the evidence? The work done in
Seattle and in Oz shows no such evidence.

2. Paul Scuffham, also of IPRU, presented a paper which showed
helmets have not reduced head injury rates in NZ both pre and post
law. The Seattle people attacked the results saying they must be
wrong. Peter Vulcan (Monash Accident Research Centre, Victoria,
Australia), also pro-law, had checked the figures and found the
analysis correct. John Langley thought that helmets were being
oversold, which he considered dangerous and gave the anti-helmet
lobbyists ammunition. (Did he mean anti-law lobbyists?). 

3. Some argued that to promote helmets, real cases should be used
as "this is very persuasive", (certainly more persuasive when there
is no epidemiological evidence to support the effectivenss of
helmets). Diane Thompson stated "negative cases will always occur".

Concerning this selective use of data, Robert Thompson stated it
was his job to provide figures, and society/politicians to make
decisions on laws. When asked shouldn't these figures be in context
Robert Thompson argued that wasn't his job, if society wants them
they should ask!  Curiously, Thompson was also heard to say he
wouldn't want his children walking to school wearing helmets as
some Japanese children do.

4. The Swedes reported on helmet "hangings". They resulted from
helmets getting caught in play equipment, trees, etc. while the
kids were wearing them off-bike. They said that everything was
going fine until 1990 when the tragedies started - "we knew we'd
killed, but didn't know we had saved anybody". 

Philip Gratcier suggested it was badly designed play equipment and
a tree in the wrong place that caused the problems! Just so you
know where Gratcier is coming from, the WHO Helmet Intiative
supports multi-activity helmets so kids can "wear them all the
time". If you thought that the WHO spent money only on worthwhile
causes you'd be wrong. The WHO wastes scarce international resources on helmet
loonies like Graitcer.

An apparent positive aspect of the conference was that it separated
helmet zealots (seemingly all American) from those who value their
integrity. Despite their belief in the efficacy of helmets, many
researchers were prepared to admit that there is still no evidence
that shows helmets reduce serious head injuries or save lives. 

E-mail me if you would like a complete copy of Nigel's notes.
--
Avery Burdett
Ottawa, Ontario
Re: More on Helmet Fraud
#87
Author: Jody Levine
Date: Mon, 18 Mar 1996 00:00
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In article <4ihihp$v37@nuacht.iol.ie> Garry Lee <glee@iol.ie> writes:
>The quoting of opinion from one country which is supposed to supplant
>the evidence from numerous other studies is itself dodgy science.
>
>Sometimes humans have to forget statistics and use their heads.

This is rediculous. If you're going to question statistics, you must
do it intelligently (i.e. use your head).

>Why do motorcyclists wear them?

I've been keeping an eye on this since I started motorcycling about seven
years ago. A motorcycle helmet will reduce your chance of death from head 
injury by %50, resulting in an overall fataity decrease of about 7%, since
most people die from chest wounds, bleeding, etc. Helmet law enactment
generally reduces fatalities by a few percent, usually because usage rates
were high before law enactment. What was surprising was how, in Quebec,
the moto helmet law reduced the accident rate significantly (can't 
remember the number) presumably due to the eye protection that comes with 
many helmets. Yet eye protection is not required on a motorcycle in Canada.
I'm posting this from memory, so some of this could be a bit off.

I wear a helmet because even though I'm less likely to bonk my head than
break a leg, the results of head injury can be more severe. I also find
my helmet comfortable, in that it does a great job at keeping crap out of
my face, it keeps my hair from turning into a tangled mess, and keeps the
wind noise down.

>If you are heading towards the ground in mid-air would you prefer to
>be wearing one?

But how likely are you to be heading towards the ground in mid air? I once 
broke my wrist when I fell on a patch of ice, but I don't walk around with 
wrist protectors. 

If the down-under stats showed a drastic increase in usage but no decrease 
in injuries, we must ask *why*. Either head injuries are so infrequent that
they don't show up in the stats, other factors such as false sense of 
security come into play, or helmets don't work in the real world (most 
people don't wear them properly anyway). What do you think it is?  

>Have a read of this.
>http://www.bhsi.org/webdocs/henderso.htm

Post the relevant bits so that we can discuss it.

Jody
Re: More on Helmet Fraud
#88
Author: Garry Lee
Date: Mon, 18 Mar 1996 00:00
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> >Sometimes humans have to forget statistics and use their heads.
>
Statistical analysis can be so complicated as to be meaningless.
Scientists have apparently proven that a bee cannot fly.

> >If you are heading towards the ground in mid-air would you prefer to
> >be wearing one?
> 
> But how likely are you to be heading towards the ground in mid air? I once 
> broke my wrist when I fell on a patch of ice, but I don't walk around with 
> wrist protectors. 

A broken wrist will not kill or indeed seriously injure you. Head
injuries are a different matter.

 
> If the down-under stats showed a drastic increase in usage but no decrease 
> in injuries, we must ask *why*. Either head injuries are so infrequent that
> they don't show up in the stats
This is not so as head injuries are a major cause of death in bike
fatalities..

, other factors such as false sense of 
> security come into play,

This has NOT been shown in any of the scientific papers.

 or helmets don't work in the real world (most 
> people don't wear them properly anyway)

I agree that many  people do not wear them properly.
They have been shown to work in the real world if properly worn.
There may be other factors at work in this study that no-one has
thought of. Most studies show benefit.




 What do you think it is?  
> 
> >Have a read of this.
> >http://www.bhsi.org/webdocs/henderso.htm
> 
> Post the relevant bits so that we can discuss it.
> 
It's 35 pages long and it is worth reading all of it. It is very fair
and thorough. I've read the whole lot twice.
Re: More on Helmet Fraud
#89
Author: Jo Fay
Date: Mon, 18 Mar 1996 00:00
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Garry Lee <glee@iol.ie> wrote:
>The quoting of opinion from one country which is supposed to supplant
>the evidence from numerous other studies is itself dodgy science.
>
>Sometimes humans have to forget statistics and use their heads.
>
>Why do jockeys wear helmets?
>Why do motorcyclists wear them?
>If you are heading towards the ground in mid-air would you prefer to
>be wearing one?
>
>I would say read the opinions from ALL studies before making up your
>mind.

As a motorcyclist I mainly wear a helmet because the visor keeps grit, dust,
win and rain out of my face.  But in some types of driving the security of a
helmet can make the rider take more chances eg off-roading, and also allows the
rider to drive faster (assuming their bike lets them). I feel that the eye
protection does far more to keep me safe (by keeping me out of accidents) than
the head protection, although that said I've no intention of wearing a helmet
that won't give decent protection in an accident.

When I went horseriding I wore a helmet because the ground is so far away the
impact would be high, and horses can be unpredictable.

As a cyclist I don't wear a helmet because at my level of risk (as I see it - I
don't cycle fast or on busy roads) current helmets don't seem worth the effort
as an adult (they should provide some decent weather protection as well)
although if I was 10 again and learning to cycle I would wear one because
that's a riskier age.

With any helmet however there is going to be a compromise between full head
protection and keeping it light enought and allowing proper hearing/sight/head
movement. And in some accidents the weight of the helmet might contribute to
the injuries.

I think really we need to have some sensible helmets available that provide
some benefit besides impact-protection.  And some _real_ cycle training and
education for vehicle drivers. I do think children should wear helmets while
cycling on the road, for a variety of reasons.

Jo

-- 
 __________________________________________________
|                            |                     |
|   Hug a furry animal       | jmf@sanger.ac.uk    |
|         today              |                     |
|____________________________|_____________________|
Re: More on Helmet Fraud
#90
Author: Jo Fay
Date: Tue, 19 Mar 1996 00:00
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dlinford@dogmatix.helix.net (D.Linford) wrote:
>>>Why do motorcyclists wear them?
>
>>I've been keeping an eye on this since I started motorcycling about seven
>>years ago. A motorcycle helmet will reduce your chance of death from head 
>>injury by %50, resulting in an overall fataity decrease of about 7%, since
>>most people die from chest wounds, bleeding, etc. Helmet law enactment
>
>	You should keep in mind that their real (though not stated)
>concern with motorcycles is money. If you wear a helmet, you will
>likely die, or get better. Without one, you could be in a coma for a
>long time at government expense... Related to the the major reason for
>sliding the lower speed limits in during the oil crisis too.

The cost to the government isn't that high. Helmets are an easy 'fix' for a
problem caused by all-round bad driving and poor roads (have you seen those
yellow ridges on the roads before roundabouts? They are dangerous to a
motorcyclist).  Introducing a mandatory helmet law lets the government be seen
as 'caring and doing something'.

But, even though they've been around for so long the design still leaves a lot
to be desired. At the moment they  transfer some of the risk from your head to
your neck, because of the extra weight of the helmet but lack of neck
protection. Also if you're knocked unconcious there are an awful lot of
'helpful' twits who promptly try to remove the helmet. I think I'd prefer a
coma to being paralysed from the neck down, although I'd much prefer not to
have an accident at all. On the other hand I wouldn't ride my motorbike without
a helmet because of the speed (and also the essential eye protection).

I think it's interesting that many of the major motorcycle campaign groups want
voluntary helmet use. (including MAG).

Jo
-- 
 __________________________________________________
|                            |                     |
|   Hug a furry animal       | jmf@sanger.ac.uk    |
|         today              |                     |
|____________________________|_____________________|
Re: More on Helmet Fraud
#91
Author: Ray Auchterlounie
Date: Tue, 19 Mar 1996 00:00
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Garry Lee <glee@iol.ie> wrote:
>The quoting of opinion from one country which is supposed to supplant
>the evidence from numerous other studies is itself dodgy science.

Which _one_ country - Austraila, New Zealand, and Sweden were 
all quoted. In the UK, British Medical Assn. research has also
come out _against_ helmet laws.

>Sometimes humans have to forget statistics and use their heads.

How do you propose to assess risk objectively without statistics ?

>Why do jockeys wear helmets?

Because they're required to. In some disciplines body armour is
also required. When they arent required not all jockeys wear them.
Falls from horses are a lot different to falls from bikes.
Where I ride horses I regularly encounter overhanging tree 
branches at (or below) head height. Where I ride bikes, I dont.

>Why do motorcyclists wear them?

Because they're required to. Some also wear full leathers and body
armour. 
It is of course perfectly possible to cycle whilst wearing a motorbike
helmet and full leathers - it is however hot, uncomfortable and you 
look a prat.... now where have I seen that before :)

Q. Why _dont_ motorists wear them ?

A. In motor racing they do of course - but on the public roads
   in most countries they dont, because its usually _illegal_.
   'tis a crazy world.

>If you are heading towards the ground in mid-air would you prefer to
>be wearing one?

I can categorically state that in this situation I would NOT
want a cycle helmet on my head. Clear enough ?

I would also like to be drunk - less bits of me would break on
impact. Now, what did your question have to do with road safety ?

>I would say read the opinions from ALL studies before making up your
>mind.

I agree entirely....

>Have a read of this.
>http://www.bhsi.org/webdocs/henderso.htm

...Unless this is your idea of "ALL studies"

--
Ray Auchterlounie                Research Student (still) at:
<rda@kythera.demon.co.uk>            Signal Processing Group
<rda@eng.cam.ac.uk>                  Cambridge University Engineering Dept.
Re: More on Helmet Fraud
#92
Author: D.Linford
Date: Tue, 19 Mar 1996 00:00
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jlevine@rd.hydro.on.ca (Jody Levine) writes:
>In article <4ihihp$v37@nuacht.iol.ie> Garry Lee <glee@iol.ie> writes:
>>The quoting of opinion from one country which is supposed to supplant
>>the evidence from numerous other studies is itself dodgy science.
>>
>>Sometimes humans have to forget statistics and use their heads.

>This is rediculous. If you're going to question statistics, you must
>do it intelligently (i.e. use your head).

>>Why do motorcyclists wear them?

>I've been keeping an eye on this since I started motorcycling about seven
>years ago. A motorcycle helmet will reduce your chance of death from head 
>injury by %50, resulting in an overall fataity decrease of about 7%, since
>most people die from chest wounds, bleeding, etc. Helmet law enactment

	You should keep in mind that their real (though not stated)
concern with motorcycles is money. If you wear a helmet, you will
likely die, or get better. Without one, you could be in a coma for a
long time at government expense... Related to the the major reason for
sliding the lower speed limits in during the oil crisis too.

	There are those bean counters to keep happy!

d
-- 
---- D.Linford ----- Van.BC ----     If you meet the buddha on usenet,
---- dlinford@helix.net --------           ...killfile him.
Re: More on Helmet Fraud
#93
Author: Garry Lee
Date: Tue, 19 Mar 1996 00:00
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Everybody on the internet always jumps to the conclusion that anyone
who promotes the wearing of bicycle helmets 
1. Favours pro-helmet legislation.
2. Thinks that helmet wearing is the ONLY safety procedure you should 
adopt.

I, plainly, from what I have written earlier, think neither.

Firstly, I think that visibility is THE most important factor in 
safety.
Secondly, cycling as much as possible on traffic-free roads.
Thirdly. Anticipation and knowledge of causes of accidents.
Fourthly. Well maintained bike with good brakes, alloy rims etc.
Fifthly. Helmet.

I cycle with other people. There is no doubt whatever that helmets
are very sensible in such circumstance. Ask Peter van Schaik, who is
the most anti-helmet person on the internet. Look at statistics on
head-injuries in American racers, pre and post helmet.

Finally: They afford NO protection unlesss worn properly.

I have only once banged my head in 10 years riding with a helmet.
I was standing on the pedals and my bottom bracket axle snapped.
Fell heavily, broke two ribs and whacked my head.
I would certainly have been concussed as I was on-road.
I'm glad I was wearing it.

The only scientific way this can be decided (who is going to do this?)
is to take 10000 cyclists. Instruct them all in proper helmet wearing 
warn them to not become careless because of it. Then ask half to 
wear and the other half not to. They should be matched for age,
experience, type of cycling, town and country etc.
Then you would get an answer.

This is as complex as trying to sort out the aetiology of heart
disease, there are so many factors involved.

Henderson discusses most of the publications I've seen on bike
helmets.
Re: More on Helmet Fraud
#94
Author: Frank Visser
Date: Tue, 19 Mar 1996 00:00
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Garry Lee (glee@iol.ie) wrote:
>: If cycle helmets are so useful, why is it so hard to distinguish their
>: effect in accident statistics?

: Not is some studies it isn't. Everybody quote the New Zealand and 
: Queensland statistics but none other.



>: Why is the cycle death rate in the UK seven times that of the
>: Netherlands, a country where cycle helmets are virtually unknown?

: Holland has (I'm told) a vast number of cycling roads. It also has 
: no hills so speeds are less. Dutch bikes are mostly clunkers so less
: speed still.

I have to take issue with this remark. I am Dutch, have cycled 15 miles 
every day to school, and cycled through Amsterdam when I was a student. 
Yes, we have a lot of cycle-paths, and yes, speeds are generally not 
high, but there is a lot of interaction with other traffic, i.e. cars, 
especially in Amsterdam. 

I am living now in Cambridge, which is supposed to have some of the
best(!) cycle facilities in England/UK, and in my honest opinion it is
cr*p. Cycle paths, if they are there at all, are *badly* maintained, 
disappear at the places one really needs them, etc., forcing you to cycle on
the road. The sides of the road are full of potholes and badly fixed 
repair-work, forcing me to cycle halfway on the lane. This causes cars to 
overtake me with inches to spair, honk, or otherwise do stupid things. 
Car drivers behave often like maniacs, and after reading some of the 
highway code here, I am starting to realize that it is more geared to get 
cars faster along than to help cyclists or other road users (the rules on 
turning left still boggle me..)

All this has nothing to do with hills or speed, only by designing roads 
etc. without taking bikes or other road users in account (lots of roads 
are virtually uncrossable on foot, you have to walk half a mile to the 
nearest ped. crossing).

So I get really angry when I see a huge billboard, erected I assume by the
Council or something, telling me to wear a helmet, leaving the distinct
impression that if I have an accident, it is my own bloody fault for not
wearing a helmet. Let them first provide adequate & safe cycling
facilities, and then they can come talk to me about wearing helmets. 

I am not wearing helmets, because I *never* needed them in 20 years
cycling in the Netherlands, and am not going to be forced into having one,
because the English are to cheap to get some good cycle facilities. 

How to reduce cycling accidents in England fast:

1: An accident between a car and a cyclist is *always* the fault of a car,
no matter what the cyclist was doing. In a recent court-case in the
Netherlands, a car hit a cyclist (or moped), who was drunk, cycling on the
wrong side of the road without lights in the dark, and the car-driver's
insurance still had to pay. Yes, it is unfair for car-drivers, I know, but
at least they know that any accident will cost them a lot of money, so
they will be very careful

2: well maintained roads. Swerving out of the way for potholes etc. is 
the most dangerous thing I have to do often.

3: consistent cycle paths: If you are going to have a cycle path, make it 
*only* for cyclist, or otherwise wide enough to have room for 
pedestrains; make them continous, don't make them disapear in front of 
traffic lights, roundabouts etc.

However the best way is to have a lot of cyclists, so that cars always 
take them in account, but sadly, there is not much that a governemnt can 
do about that.

Frank 'Ranting? me, of course not' Visser
--
=========================================================================
Frank Visser              |e-mail: fvisser@hgmp.mrc.ac.uk
UK HGMP Resource Centre   |Tel: +44 (0)1223 494526  
Hinxton, Cambridge        ------------------------------------------------
CB10 1SB                  |De wereld gaat aan vlijt ten onder. 
			  |				(Max Dendermonde)  
======================================================================
Re: More on Helmet Fraud
#97
Author: Paul Thomas
Date: Tue, 19 Mar 1996 00:00
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In article <4ik597$amm@nuacht.iol.ie> glee@iol.ie "Garry Lee" writes:

> Why is the cycle death rate in the UK seven times that of the
> Netherlands, a country where cycle helmets are virtually unknown?
> 
> Holland has (I'm told) a vast number of cycling roads. It also has 
> no hills so speeds are less. Dutch bikes are mostly clunkers so less
> speed still.

I have friends who have been to Holland. You'd be suprised how fast
the Dutch can cycle on their clunkers when the fancy takes them.

> 85% of cyclists who are killed by a car (most are) were not seen
> by the motorist. 

But only because motorists can't be bothered to look.

> If you don't cycle in car traffic you greatly
> reduce your chances of being killed. Main roads are statistically
> much more dangerous than minor roads,

Let's look at it another way. Roads are not dangerous, cars are not
dangerous. It is the motorists who are dangerous. Cyclists are killed
by motorists. The road and car merely provide the place and
instrument of execution. Once you realise this, you will see that
even with your head surrounded by polystyrene, you are still no
match for the motorist surrounded by a ton of steel.


-- 
Paul

/*------------------------------------------------------*/
/* Paul Thomas  ********  email : Paul@tmsl.demon.co.uk */
/*------------------------------------------------------*/
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