My uneasy relationship with helmets
I am in favor of bicycles, bicycling and bicycle safety. I am opposed to bicyclists sustaining injuries and particularly head injuries that result in traumatic brain injury. More bicycles on streets and roadways make all bicyclists safer. Mandatory helmet
laws increase the rate of helmet use but decrease the number of bicyclists. The
health benefits of riding a bicycle far outweigh the risks of injury or death
(in “life years”). Bicycle helmets represent a design compromise that reduces
effectiveness in a crash in favor of lighter weight, comfort and ventilation.
If you are relying on a helmet to keep you safer while riding a bicycle, you
have skipped a number of important steps that can more effectively keep you “safer.”
I ordinarily keep my opinions about bicycle helmets to myself. I never tell anyone not to wear a helmet, though I sometimes wish the helmet people would reciprocate. The only reason I’m going “public” now is because the Active Transportation Alliance has
adopted a policy of making helmet use mandatory for its various fundraising
and/or sponsored events. The language currently being used is “I agree to wear a helmet suitable for cycling at all times during the bicycle tour. Those who refuse to
wear a helmet will not be permitted to ride and will not receive a
refund.” The attorney side of me suspects this is an insurance underwriting requirement and the ATA needs to include this language to get a break on its liability premium (or possibly, a requirement to get any kind of coverage at all). And lest any of you think that the insurance underwriters are trying to make everyone safer, additional
requirements imposed on the policyholder are typically included in policies to
form a basis for excluding coverage.
The bicyclist side of me is disappointed that an organization which professes
to “advocate for transportation that encourages and promotes safety, physical activity,
health, recreation, social interaction, equity, environmental stewardship and
resource conservation,” has adopted a policy which runs contrary to that
mission statement. (I just became aware that “Bicycle Chicago Meet-up” and
Lee’s Big Shoulders Neighborhood Tours have the same requirement.)
I don’t want this post to be about me, but by way of background, my bicycling “experience” pre-dates the widespread use of helmets
(probably even the old “hairnets”). When I was a kid, you wore a helmet when you played football and when you batted in baseball, but that was pretty much it. In high school
and college, I competed in gymnastics (trampoline, no less), rugby and ski
racing - never wore a helmet, and neither did anyone else. My non-competitive
unhelmeted activities during this period of time included freestyle skiing with
lots of inverted aerials, and lots of vertical mogul runs. Bicycled some in
college, but never wore a helmet. Always wear a helmet snowmobiling, but
seriously, that’s a little like requiring people to wear a helmet when they go
skydiving. How did people survive such ultra-hazardous activities in the
pre-helmet dark ages? We took extra care not to hit our heads when we fell
down. Sometimes the old ways are the best ways.
This is not an academic paper for peer review, so I’m going to omit cites. If you’re really curious about one of them that you can’t find yourself or feel the need to rip on me in general, let me know and I’ll try to find it again. I know there are a lot of engineers and health care professionals on the chainlink, and I hope this post yields some constructive
criticism and feedback.
Bicycle helmets are mostly designed for slow, vertical falls. The testing methodology is to drop the weighted (11 lbs/5 kilos) helmet from a height of 1.2 meters onto a round anvil and/or a curb-shaped anvil and from a height of 2 meters onto a flat anvil. The headform measures the amount of impact attenuation when the helmet comes to rest, expressed in joules. A helmet which “passes the test” can permit a maximum of 98 joules at the headform. Failure threshold is 300 g, which happens to be the level at which you can expect to lose consciousness, and probably suffer some injury which hopefully will not be permanent.
Real world impacts are going to look a lot different from the testing methodology in that they are much more likely to include: multiple impacts, irregularly shaped “anvils,” and rotational forces (think crack the whip or water skiing outside of the wake when the boat turns). Real world impacts are also much more likely to occur with some significant horizontal speed (which has both advantages and disadvantages).
I bought my first helmet in about 1988. It was a thick styrofoam, poorly vented Specialized helmet which had a nylon fabric cover stretched over it and bore certification stickers to the 1984 Snell and ANSI standards. The unfinished styrofoam design was abandoned within five years for the hard shell finish due to the observation of increased neck and brain injury related to rotational forces exerted upon a helmet which was too “grippy” when it contacted pavement.
Bicycle helmet design must strike a balance between fashion and function. As the pressure has built for manufacturers to design “cooler” helmets (both from an aesthetic and ventilation standpoint), more and larger vents have been cut into the helmet surface. This has resulted in helmets which are indeed cooler and lighter, but which lack the structural integrity of my ugly old Specialized helmet. And penetration risk from rocks and tree branches when mountain biking?: Forget it; not even tested anymore; too many vents. Snell standards are gone, the certifying bodies in the U.S. are now CPSC and ASTM both of which require less energy attenuation than the Snell 95 standards
did. If you’re really serious about wearing a helmet to protect yourself from
traumatic brain injury, buy yourself a good, full-faced Arai, Bell or Shoei
motorcycle helmet-much better energy attenuation, and you also get the added
benefit of protection from facial injuries.
I wear a helmet approximately 25% of the time I ride a bike. My decision to wear a helmet is usually based on: a) likelihood of sustained speeds in excess of 18 mph; b) exceedingly long rides (>6 hours); and/or c) riding with a lot of strangers. I ALWAYS wear a helmet when I ride a mountain bike on trails. The only time I have ever hit my head when bicycling was when I was wearing a helmet. It’s not that I’m such a genius at predicting crashes, it’s simply because a helmet adds an additional 2-3 inches to the
radius of my head and that confuses my muscles and my sensory nervous system. I
have spent a lifetime “learning” where the perimeter of my head ends and I
can’t rewire my perceptual system to account for that extra 2-3 inches. I have
never been hit by a car, but I’m not counting being doored three times over the
years.
Fear is a very effective marketing tool. Whether you’re Rahm Emanuel not wanting to let a good crisis go to waste, or you’re the Bush administration trying to head off the impending invasion of the U.S. by Islamic extremists, a lot of things get “sold” in this country based on an inflated perception of danger. Bike accidents result in approximately 540,000 emergency room visits in the U.S. every year. Of those, 67,000 (12.4%) involve head injuries, and 8375 involve brain injuries [TBI] (1.5%). I can’t find the exact cite for this one folks, but it’s fairly representative of any given year in
the U.S. I’m going to make a pure guess that emergency room visits as an
accident index result in underreporting the total number of bicycle accidents
by a minimum of a factor of three; i.e. there are 3 times as many bicycle
accidents in the U.S. each year and that for every one that sends someone to
the emergency room, another two go unreported or at least don’t result in a
trip to the hospital. I’m also going to guess that an accident serious enough
to result in a TBI is unlikely to result in no hospital visit, so the 8375 TBI
number is probably pretty close to accurate. If this data and these guesses are
true, your risk of TBI is about 0.5% for any given accident, and probably even
lower than that.
Riding a bicycle can improve cardiovascular fitness and improve Body Mass Index, but it doesn’t change certain hard-wired physiological traits or cognitive functions that assist in making you a “safer” bicyclist. We all have differences in strength (including the composition of slow-twitch vs. fast-twitch muscles), balance, visual acuity, (including depth perception and ability to detect motion), hearing, proprioception, and judgment, to name just a few. I have seen at least a half a dozen bicyclists in the past week, after dark, wearing a helmet, with no lights on the front or the back of their bicycle. I have told two of them they’re going to need a bigger helmet.
As stated, I am opposed to head injuries and particularly traumatic brain injuries. My brain has remained a solid second on my list of favorite organs since adolescence. If I’m ever in a bicycle accident with a car, I want to be dressed like the guy in “The Hurt Locker.” Most studies of the efficacy of bicycle helmets have found them to be effective at reducing the risk of head injury. In my estimation, that takes the risk down from remote to infinitesimal.
Mandatory helmet laws increase the rate of helmet use, but reduce the number of cyclists on the road (Australia, New Zealand, Canada - British Columbia and Nova Scotia).
More cyclists on the road make all cyclists safer. In 1994, 796 bicyclists were killed in crashes with motor vehicles; in 2009, 630 bicyclists were killed in crashes with motor vehicles (-21%). Trips by bicycle have increased from 0.7% in 1990 to 1.0% in 2009 (+43%).
Portland reported this year that their rate of helmet wearing has increased to 80%, all through promotions and peer pressure. I have no problem with encouraging people
to wear helmets, strongly recommending that people wear helmets, but REQUIRING,
and EXCLUDING? Can’t we all just get along?
Views: 600
Replies to This Discussion
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Permalink Reply by Lee Diamond on
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There are several places one can get insurance to do bike events. All of them that I am aware of require the use of helmets as part of their policy. Speaking personally, without insurance, I can't do my rides hence the requirement. If someone gets injured on a ride and they aren't wearing one, well....you're the lawyer.
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Permalink Reply by Kevin C Dormant on
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Almost anything I have to say as lawyer isn't going to get posted on the chainlink. The fact that available insurers are taking steps to exclude coverage of events such as yours' on the basis of helmet usage is wrong. I guess I'm limited to the planning rides.
Lee Diamond said:There are several places one can get insurance to do bike events. All of them that I am aware of require the use of helmets as part of their policy. Speaking personally, without insurance, I can't do my rides hence the requirement. If someone gets injured on a ride and they aren't wearing one, well....you're the lawyer.
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What if I make you a helmet that looks exactly like your existing head?
I know if won't solve the added weight, or larger size and such, but from a distance, you would look the same, if not somewhat...swolen.
Kevin Conway said:Almost anything I have to say as lawyer isn't going to get posted on the chainlink. The fact that available insurers are taking steps to exclude coverage of events such as yours' on the basis of helmet usage is wrong. I guess I'm limited to the planning rides.
Lee Diamond said:There are several places one can get insurance to do bike events. All of them that I am aware of require the use of helmets as part of their policy. Speaking personally, without insurance, I can't do my rides hence the requirement. If someone gets injured on a ride and they aren't wearing one, well....you're the lawyer.
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You both understand I have a head that's pretty difficult to replicate?
H3N3 said:That would be great . . . we could have a lot of fun by swapping helmets and confusing our friends and coworkers.
Lee Diamond said:What if I make you a helmet that looks exactly like your existing head?
I know if won't solve the added weight, or larger size and such, but from a distance, you would look the same, if not somewhat...swolen.
Kevin Conway said:Almost anything I have to say as lawyer isn't going to get posted on the chainlink. The fact that available insurers are taking steps to exclude coverage of events such as yours' on the basis of helmet usage is wrong. I guess I'm limited to the planning rides.
Lee Diamond said:There are several places one can get insurance to do bike events. All of them that I am aware of require the use of helmets as part of their policy. Speaking personally, without insurance, I can't do my rides hence the requirement. If someone gets injured on a ride and they aren't wearing one, well....you're the lawyer.
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What? Are you not aware of my incredible skillz?
Kevin Conway said:You both understand I have a head that's pretty difficult to replicate?
H3N3 said:That would be great . . . we could have a lot of fun by swapping helmets and confusing our friends and coworkers.
Lee Diamond said:What if I make you a helmet that looks exactly like your existing head?
I know if won't solve the added weight, or larger size and such, but from a distance, you would look the same, if not somewhat...swolen.
Kevin Conway said:Almost anything I have to say as lawyer isn't going to get posted on the chainlink. The fact that available insurers are taking steps to exclude coverage of events such as yours' on the basis of helmet usage is wrong. I guess I'm limited to the planning rides.
Lee Diamond said:There are several places one can get insurance to do bike events. All of them that I am aware of require the use of helmets as part of their policy. Speaking personally, without insurance, I can't do my rides hence the requirement. If someone gets injured on a ride and they aren't wearing one, well....you're the lawyer.
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Permalink Reply by Vilda on
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We should all wear Mardi Gras heads. ;-)
I thought my helmet experience was only limited to my own interest. I rode my BMX from wee lad to about 26 and then for whatever dumb reason i graduated to a big boys bike. I NEVER wore a helmet on my BMX, not once. Never doored, never in a car accident. With the big boy bike i bought a helmet. What happens then?
A major car accident and several doorings. All whilst wearing a helmet.
What does it all mean? It means i should dump the helmet, and big boys bike, and ride my BMX forever. Sadly it gets difficult in the winter.
Isn't the helmet lady around here somewhere to get VERY VERY angry about this whole thread? ;-)
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As I expected when I started the discussion, individual results may vary.
Gabe said:We should all wear Mardi Gras heads. ;-)
I thought my helmet experience was only limited to my own interest. I rode my BMX from wee lad to about 26 and then for whatever dumb reason i graduated to a big boys bike. I NEVER wore a helmet on my BMX, not once. Never doored, never in a car accident. With the big boy bike i bought a helmet. What happens then?
A major car accident and several doorings. All whilst wearing a helmet.
What does it all mean? It means i should dump the helmet, and big boys bike, and ride my BMX forever. Sadly it gets difficult in the winter.
Isn't the helmet lady around here somewhere to get VERY VERY angry about this whole thread? ;-)
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Permalink Reply by igz on
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like seat belts on an air plane.
tho today, i rode finally for the first time from wood dale all the way home on the near west side due to my train being cancelled. today was the first time i wish i did have my helmet with me. the route includes some of the most bike-unfriendly streets in chicago (irving park, franklin blvd, grand ave). it was one of those few times i really wanted a false sense of security. now i know if i get hit by one of the trucks or any other suburban, non-bike aware, speading drivers, im pretty much done for...a helmet is not going to do much for such an impact.
however, there was this one time when i was riding with a friend on armitage getting ready to cross humboldt blvd...right near the ghost bikes actually...she was t-boned by a turning car right in front of me. she was hit by the car doing probably just under 10 miles an hour, maybe even closer to 5 mph...
i imagine there could have been a bit more blood and brain splatter were she not wearing the helmet. im glad it was a perfect indentation of a helmet instead.
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p.s. the only reason i have a helmet is due to a requirement for the M.S. Tour de Farms ride.
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Permalink Reply by Ryan L on
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I had never worn a helmet in my life, I used to be a trail rider, until an old roommate in chicago got hit by a car and I had to go to the emergency room and identify him; I bought a helmet the next day. I had previously been riding in this city for 4 years without one.
I absolutely HATE wearing a helmet but ever since I saw my friend on that cot I just can't turn back.
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Permalink Reply by Bill the Cat on
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Sorry folks, but I am a helmet Nazi. I gracefully flew over a hood of a car several years ago. Earlier this year. my brother was hit by a car. There are no lingering injuries after his accident, but suffice it to say, when he woke up in the ER several hours later he couldn't remember anything. We are both savvy riders & don't partake of a lot a risky behavior when biking, especially on the streets of this city. He credits his helmet with saving his life. I have seen WAY too many cyclists riding with no hands, playing with a phone or ?, basically riding distracted. Also of course cars throw open doors indiscriminately, run stop signs & lights, to say nothing of all of the drivers & bikers who drive drunk. Considering how many folks I have met with traumatic brain injuries, I personally err on the side of helmet enforcers. I agree with the groups that will exclude you from their events if you refuse to wear a helmet. It's their event, & on the rare occasion an accident happens, it can make things a little better for everyone involved. I'm sorry, but as one gets older & I see more of the world, one feels a bit less superior to their surroundings. Is it someone else telling me what to do or is it just a wise decision on my own behalf. It's not a big deal. If a truck crushes my leg, I'll survive. If my head bounces on the pavement a few times in the fall, well maybe I won't. Maybe t 30 some y.o. you still feel pretty invincible & still can't get over someone else "telling you what to do". Well, get over yourself, buy a helmet, & remember the wisdom of The Tick. "Gravity is a harsh mistress". Also, this is NOT Holland. We don't get any respect on these streets in case you hadn't noticed. Oh, & keep those cards & letters coming...
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Permalink Reply by Doug Haynes on
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I think you can help the case against helmets most by not talking anymore...
Such eloquence.
jake said:fuck helmits u die u die and theres no one to blame but ur self fro not wearing one
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