Helmets: discussion in Injury Prevention

Discussion in 'UK and Europe' started by Guy Chapman, Jun 5, 2003.

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  1. Guy Chapman

    Guy Chapman Guest

    The following is a link to an article in Injury Prevention, a learned journal, which is relevant to
    the current discussions on helmets, campaigns and compulsion.

    <http://ip.bmjjournals.com/cgi/content/full/8/2/e1>

    About halfway down is a Dissent written by Mayer Hillman and John Adams which is extremely
    well argued.

    I won't post the whole thing unless someone asks, as it is Very Long Indeed.

    Apologies if this is a repeat posting.

    Guy
     
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  2. "Guy Chapman" <[email protected]> wrote in message
    news:[email protected]...
    > The following is a link to an article in Injury Prevention, a learned journal, which is relevant
    > to the current discussions on helmets, campaigns and compulsion.
    >
    > <http://ip.bmjjournals.com/cgi/content/full/8/2/e1>
    >
    > About halfway down is a Dissent written by Mayer Hillman and John Adams which is extremely
    > well argued.
    >
    > I won't post the whole thing unless someone asks, as it is Very Long Indeed.
    >
    > Apologies if this is a repeat posting.
    >
    > Guy

    Thanks for posting this Guy, interesting reading. When I tried tonight, unfortunately the Mayer
    Hillman link was down. The original article seems to be the normal Rivara-Thompson interpretation of
    the "facts" (facts=whatever Rivara and Thompson say they are).

    Is there anybody who still gives the slightest credibility to what these two jokers propose? They
    have been proven wrong so often, I am surprised that they can get any kind of scientific journal to
    publish their views.

    "Authors of a systematic review would obtain and evaluate all available research before arriving at
    a conclusion." condemned out of their own mouths, perhaps Rivara and Thompson would like to eat
    their own words.

    Cheers

    Rich
     
  3. Fredster

    Fredster Guest

    "Guy Chapman" <[email protected]> wrote in message
    news:[email protected]...
    > The following is a link to an article in Injury Prevention, a learned journal, which is relevant
    > to the current discussions on helmets, campaigns and compulsion.
    >
    > <http://ip.bmjjournals.com/cgi/content/full/8/2/e1>
    >
    > About halfway down is a Dissent written by Mayer Hillman and John Adams which is extremely
    > well argued.
    >
    > I won't post the whole thing unless someone asks, as it is Very Long Indeed.
    >
    > Apologies if this is a repeat posting.
    >
    > Guy

    I was unable to follow the link to the main discussion but it was interesting to note that all
    parties in the discussion refered to above agree that protective helmets offer some benefits in
    reducing the severity of head injuries in the event of an accident. Obviously, the issue of risk
    compensation could utterly negate these benefits for some people but people really have to decide
    this for themselves as it is an entirely personal thing. I'm sure that there is an element of risk
    compensation in my cycling due to wearing a helmet but I'm equally sure that it is less significant
    than the injury prevention aspect of the helmet. I tend to be more concerned with the accident
    itself (or the not having it) than with which bits of me get injured and how badly.

    The dissent mentions ice hockey and american football players and the risk compensation provided by
    body armour. I agree that this probably reflects fairly well onto something like downhill mountain
    biking where you are pushing your limits and are more likely to do so if you feel safer. I'm not so
    sure it reflects that well onto the daily commute though. I'm not likely to risk running a red light
    or try to squeeze through a smaller gap just because I've got a helmet on. I assume that, if I take
    risks, I have a good chance of being injured and, frankly, I'm not prepared to suffer any injury to
    save time getting to work. On the other hand, I might be prepared to risk a mild injury in an ice
    hockey game to prevent the team from losing. Cycling is not a contact sport and a helmet only
    protects from one type of injury in specific circumstances so I would be doubtful that, amongst
    experienced, aware cyclists, risk compensation would have a negative effect on helmet safety,
    especially in non-competitive situations
     
  4. Just Zis Guy

    Just Zis Guy Guest

    "Richard Burton" <[email protected]> wrote in message
    news:[email protected]...

    > > <http://ip.bmjjournals.com/cgi/content/full/8/2/e1>

    > The original article seems to be the normal Rivara-Thompson interpretation of the "facts"
    > (facts=whatever Rivara and Thompson say they are).

    > Is there anybody who still gives the slightest credibility to what these
    two
    > jokers propose?

    What you have to remember is that Rivara is a paediatrician. There is little doubt that helmets are
    worthwhile for children, because children tend to have more crashes than adults and they tend to be
    the kind of crashes where helmets work - i.e. low speed loss-of-control.

    Where Rivara goes wrong is to assume that this is in some way relevant to cycling as a whole. He is
    not alone. Angie Lee of BHIT has made the same illogical leap in a recent article in my local paper.
    There are two glaring logical disconnects:

    - you can't use research into child injuries to infer anything meaningful about adults

    - helmet compulsion could only apply to riding on public roads, whereas 90% of the accidents about
    which Rivara and BHIT are concerned happen in play, generally on private land.

    The fundamental problem remains that the two sides of the debate are arguing different motions. The
    compulsionists say helmets may provide protection in a crash, and as a lobby is pretty
    well-organised and homogeneous. Typically they are health professionals, not road safety
    specialists. The anti-compulsionists are diverse, much more likely to be cyclists, and use a much
    larger range of arguments - although they all come back to the fact that around the world injury
    rates are highest where helmet use is highest, and vice versa.

    I think if the compulsionists were in a Scottish court the verdict would be "not proven."

    --
    Guy
    ===
    I wonder if you wouldn't mind piecing out our imperfections with your thoughts; and while you're
    about it perhaps you could think when we talk of bicycles, that you see them printing their proud
    wheels i' the receiving earth; thanks awfully.
     
  5. Paul Kelly

    Paul Kelly Guest

    "Just zis Guy, you know?" <[email protected]> wrote in message
    news:[email protected]...
    >- although they all come back to the fact that around the world injury rates are highest where
    > helmet use is
    highest,
    > and vice versa.

    Can you point me to a specific reference on that?

    pk
     
  6. Just Zis Guy

    Just Zis Guy Guest

    "Paul Kelly" <[email protected]> wrote in message
    news:[email protected]...

    >
    > Can you point me to a specific reference on that?

    There is a well-referenced letter here:
    <http://bmj.com/cgi/content/full/322/7293/1063?ijkey=044838035d6587692d82ad8
    ad92eb0d0faa3f4d5&keytype2=tf_ipsecsha#resp2>

    --
    Guy
    ===
    I wonder if you wouldn't mind piecing out our imperfections with your thoughts; and while you're
    about it perhaps you could think when we talk of bicycles, that you see them printing their proud
    wheels i' the receiving earth; thanks awfully.
     
  7. Tim Woodall

    Tim Woodall Guest

    On Fri, 6 Jun 2003 13:51:05 +0100, Just zis Guy, you know? <[email protected]> wrote:
    > "Paul Kelly" <[email protected]> wrote in message
    > news:[email protected]...
    >
    >>
    >> Can you point me to a specific reference on that?
    >
    > There is a well-referenced letter here:
    > <http://bmj.com/cgi/content/full/322/7293/1063?ijkey=044838035d6587692d82ad8
    > ad92eb0d0faa3f4d5&keytype2=tf_ipsecsha#resp2>
    >
    Why oh why have I never bothered to learn to touch type the numbers :-(

    Bottom of the page. Helmets aren't enough. We should all be wearing body armour as well!

    "Further investigation is clearly indicated into the prevalence and effectiveness of the use of body
    armour (in addition to helmets), amoung both recreational and competitive mountain bikers. This may
    be a valuable step in improving the safety of this sport."

    Surely the easiest way to improve the safety of mountain biking it just to ban it completely.

    Regards,

    Tim.

    --
    God said, "div D = rho, div B = 0, curl E = - @B/@t, curl H = J + @D/@t," and there was light.

    http://tjw.hn.org/ http://www.locofungus.btinternet.co.uk/
     
  8. Just Zis Guy

    Just Zis Guy Guest

    "Tim Woodall" <[email protected]> wrote in message
    news:[email protected]...

    > Surely the easiest way to improve the safety of mountain biking it just to ban it completely.

    Did I just hear Mike Vandemann enter the room?

    Another factor to consider: what proportion of the head injuries supposedly to be saved by
    compulsory helmet wearing are sustained in offorad cycling? And how do the lidmongers expect
    comulsory helmet wearing to be applied to situations on private land?

    Competitive offroad driving is dangerous as well, so all car drivers should be forced to use
    five-point harnesses, roll cages, fireproof suits and crash helmets. And have their blood group
    painted on the outside of their cars.

    --
    Guy
    ===
    I wonder if you wouldn't mind piecing out our imperfections with your thoughts; and while you're
    about it perhaps you could think when we talk of bicycles, that you see them printing their proud
    wheels i' the receiving earth; thanks awfully.
     
  9. "Fredster" <[email protected]> writes:

    >"Guy Chapman" <[email protected]> wrote in message
    >news:[email protected]...

    >> The following is a link to an article in Injury Prevention, a learned journal, which is relevant
    >> to the current discussions on helmets, campaigns and compulsion.
    >>
    >> <http://ip.bmjjournals.com/cgi/content/full/8/2/e1>
    >>
    >> About halfway down is a Dissent written by Mayer Hillman and John Adams which is extremely well
    >> argued.

    >I was unable to follow the link to the main discussion but it was interesting to note that all
    >parties in the discussion refered to above agree that protective helmets offer some benefits in
    >reducing the severity of head injuries in the event of an accident. Obviously, the issue of risk
    >compensation could utterly negate these benefits for some people but people really have to decide
    >this for themselves as it is an entirely personal thing. I'm sure that there is an element of risk
    >compensation in my cycling due to wearing a helmet but I'm equally sure that it is less significant
    >than the injury prevention aspect of the helmet.

    Risk compensation has to do with intuitive feelings of how safe you feel. The idea is that in any
    activity where there is motivation to take risks, e.g., cycling, when going faster saves time but is
    sometimes more dangerous, you will speed up to the point where going any faster would start to feel
    uncomfortably risky.

    So it seems to me that if a safety device makes doesn't make you feel as much more safe as it really
    is, then although you will take more risks with it, you won't take enough risks to negate its
    effect, therefore it will improve your safety.

    If on the other hand, it makes you feel safer than it really is, the effect of risk compensation
    will be that you take *more* risks than are warranted, and so you will end up being *more* at risks
    by using the device.

    Applying this reasoning to helmets, reading this newsgroup makes it quite clear that at least some
    cyclists who wear helmets have very exaggerated beliefs about their efficiency. Of course these
    beliefs are those they express consciously and verbally in newsgroup arguments, and may not bear a
    fixed simple relationship to how much safer the helmet actually makes them feel on a bike. To
    discover that we'd have to time them in various conditions with and without a helmet.

    This is what worries me about the helmet marketing propaganda. Is it affecting the behaviour of
    helmet purchasers in such a way as to put them more at risk?

    I know for a fact, for example, that my fear of skinning my hands in a fall to the road
    significantly reduces my maximum speed if I'm not wearing gloves. It may be silly, but intuitively
    I'm far more scared of skinning my hands in a simple fall than hitting my head, perhaps because as a
    child cyclist I did sometimes skin my hands painfully, but never hit my head.

    >Cycling is not a contact sport and a helmet only protects from one type of injury in specific
    >circumstances so I would be doubtful that, amongst experienced, aware cyclists, risk compensation
    >would have a negative effect on helmet safety, especially in non-competitive situations

    But what effect do you think it might have on children, and on older inexperienced cyclists taking
    it up for health reasons, etc?
    --
    Chris Malcolm [email protected] +44 (0)131 650 3085 School of Artificial Intelligence, Division of
    Informatics Edinburgh University, 5 Forrest Hill, Edinburgh, EH1 2QL, UK
    [http://www.dai.ed.ac.uk/daidb/people/homes/cam/ ] DoD #205
     
  10. Just zis Guy, you know? wrote:
    > Competitive offroad driving is dangerous as well, so all car drivers should be forced to use
    > five-point harnesses, roll cages, fireproof suits and crash helmets. And have their blood group
    > painted on the outside of their cars.

    6-point please - I value me jewels :)

    w
     
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