J
Just zis Guy, you know?
Guest
Bicycle Helmets: Time for a sense of perspective
================================================
To focus on injury mitigation in cyclists to the exclusion of
addressing the causes of crashes, as is the trend in public debate at
present, risks fundamental errors - not least the apparent post hoc
fallacy of assuming that cycling head injuries are the result of
failure to wear helmets, rather than of the types of crashes cyclists
experience.
I recently analysed Department of Health data on child hospital
admissions for England for the period 1995/96 to 2002/03. From this
analysis it was apparent that:
- the proportion of head injuries in child cyclists on the road is
hardly different from that of child pedestrians;
- the risk of head injury in offroad cycling is an order of magnitude
lower than in road cycling;
- cycling is far from being the leading cause of head injury
admission, being behind trips and falls and even assault.
It is interesting to me, as both a cyclist and a parent, to explore
the reasons that cycling is seen as a uniquely dangerous activity,
when a dispassionate look at these and many other statistics indicates
very clearly that it is not. Some of us will recently have witnessed
"lightbulb moments" in friends and colleagues who we have accompanied
as "bike buddies" in Bike Week. The comment "well, that was less
scary than I thought" will have been uttered many times this past
week!
I have a view that there are a number of factors at work here:
- head injuries raise a spectre of intellectual disablement which
cannot be "fixed" by modern medicine, even though this is very rare -
the fact that such injuries are now thought to be mainly the result of
rotational forces which helmets do not mitigate (and may even
aggravate) adds a touch of irony;
- even trivial head injuries can bleed spectacularly, which combines
with the fear factor above to ensure the maximum likelihood of
attendance at A&E or a minor injuries unit "just in case" - even
though in most cases treatment is limited to dressing or, at worst,
stitches - so that nurses, for example, "see a lot of cycling head
injuries";
- there exists a substantial industry whose expensive product will not
sell unless a culture of fear is maintained, and the protective effect
of its product "sexed up" - few people would spend the price of a
modern helmet if they were told bluntly that they are tested only for
the equivalent of a fall from a stationary riding position, yet this
is the literal truth (and explains the wide disparity between claims
made by manufacturers, whose claims are controlled by advertising
regulations, and by helmet advocacy groups, who still quote the
discredited 1989 Thompson, Rivara and Thompson study);
- the culture of fear extends in particular to the danger of motor
traffic, with some justification as the estimated 10% of child cycling
which is on-road results in half of all cyclist admissions;
- there is a widespread and undoubtedly false belief that, firstly,
there is nothing that can be done about the source of this danger
(i.e. drivers cannot be made to drive more carefully), and secondly,
that no amount of riding skill can reduce the danger;
- fundamentally, most of those campaigning for helmets are not
cyclists and have little understanding of the vast range of different
activities and scales of risk which that term encompasses - it is as
if all outdoor activity from afternoon walks in the park to
free-climbing were considered under a single umbrella.
One thing struck me very forcefully when analysing the admissions
data. Motor vehicles account for around 10% of child hospital
admissions but half of all injury fatalities (Office of National
Statistics). This greatly increased danger is shared by cyclists,
(far more numerous) pedestrians and motor vehicle occupants. The
danger is inherent in the source, not the victims' activities.
A proper study of head injury in cyclists cannot evade these facts.
It is well known that cyclists in particular are generally not to
blame in crashes involving motor traffic; what is less well known is
that riding techniques already exist which dramatically reduce the
chances of some of the more common sorts of crash. It is to be hoped
that public debate on cyclist safety will soon lose its cyclopean
focus on injury mitigation devices which, it has to be said, are not
associated anywhere in the world with improvements in safety, and
shift onto prevention, both by improved driver behaviour and better
riding skills.
Guy
--
May contain traces of irony. Contents liable to settle after posting.
http://www.chapmancentral.co.uk
88% of helmet statistics are made up, 65% of them at Washington University
================================================
To focus on injury mitigation in cyclists to the exclusion of
addressing the causes of crashes, as is the trend in public debate at
present, risks fundamental errors - not least the apparent post hoc
fallacy of assuming that cycling head injuries are the result of
failure to wear helmets, rather than of the types of crashes cyclists
experience.
I recently analysed Department of Health data on child hospital
admissions for England for the period 1995/96 to 2002/03. From this
analysis it was apparent that:
- the proportion of head injuries in child cyclists on the road is
hardly different from that of child pedestrians;
- the risk of head injury in offroad cycling is an order of magnitude
lower than in road cycling;
- cycling is far from being the leading cause of head injury
admission, being behind trips and falls and even assault.
It is interesting to me, as both a cyclist and a parent, to explore
the reasons that cycling is seen as a uniquely dangerous activity,
when a dispassionate look at these and many other statistics indicates
very clearly that it is not. Some of us will recently have witnessed
"lightbulb moments" in friends and colleagues who we have accompanied
as "bike buddies" in Bike Week. The comment "well, that was less
scary than I thought" will have been uttered many times this past
week!
I have a view that there are a number of factors at work here:
- head injuries raise a spectre of intellectual disablement which
cannot be "fixed" by modern medicine, even though this is very rare -
the fact that such injuries are now thought to be mainly the result of
rotational forces which helmets do not mitigate (and may even
aggravate) adds a touch of irony;
- even trivial head injuries can bleed spectacularly, which combines
with the fear factor above to ensure the maximum likelihood of
attendance at A&E or a minor injuries unit "just in case" - even
though in most cases treatment is limited to dressing or, at worst,
stitches - so that nurses, for example, "see a lot of cycling head
injuries";
- there exists a substantial industry whose expensive product will not
sell unless a culture of fear is maintained, and the protective effect
of its product "sexed up" - few people would spend the price of a
modern helmet if they were told bluntly that they are tested only for
the equivalent of a fall from a stationary riding position, yet this
is the literal truth (and explains the wide disparity between claims
made by manufacturers, whose claims are controlled by advertising
regulations, and by helmet advocacy groups, who still quote the
discredited 1989 Thompson, Rivara and Thompson study);
- the culture of fear extends in particular to the danger of motor
traffic, with some justification as the estimated 10% of child cycling
which is on-road results in half of all cyclist admissions;
- there is a widespread and undoubtedly false belief that, firstly,
there is nothing that can be done about the source of this danger
(i.e. drivers cannot be made to drive more carefully), and secondly,
that no amount of riding skill can reduce the danger;
- fundamentally, most of those campaigning for helmets are not
cyclists and have little understanding of the vast range of different
activities and scales of risk which that term encompasses - it is as
if all outdoor activity from afternoon walks in the park to
free-climbing were considered under a single umbrella.
One thing struck me very forcefully when analysing the admissions
data. Motor vehicles account for around 10% of child hospital
admissions but half of all injury fatalities (Office of National
Statistics). This greatly increased danger is shared by cyclists,
(far more numerous) pedestrians and motor vehicle occupants. The
danger is inherent in the source, not the victims' activities.
A proper study of head injury in cyclists cannot evade these facts.
It is well known that cyclists in particular are generally not to
blame in crashes involving motor traffic; what is less well known is
that riding techniques already exist which dramatically reduce the
chances of some of the more common sorts of crash. It is to be hoped
that public debate on cyclist safety will soon lose its cyclopean
focus on injury mitigation devices which, it has to be said, are not
associated anywhere in the world with improvements in safety, and
shift onto prevention, both by improved driver behaviour and better
riding skills.
Guy
--
May contain traces of irony. Contents liable to settle after posting.
http://www.chapmancentral.co.uk
88% of helmet statistics are made up, 65% of them at Washington University
