Friday, March 27, 2009

Statisculation & Sporting Prejudice In Anti-Helmet Propaganda


This post is In Memory Of Andrew Callighan, who died 21 April (Saturday), two days after he was struck by a pickup truck while riding his bicycle in Michigan. Andrew, who was not wearing a helmet, was thrown several feet from his bike by the impact of the crash and was found on the side of the road when police and other rescue workers arrived. He sustained severe and multiple skull fractures and was pronounced dead Saturday at Helen Devos Children's Hospital in Grand Rapids. Michigan has no state law regarding the use of bicycle helmets.

Get your coffee ready. We're going to explore 2 topics that I feel must be addressed. Each of those 2 topics involves a detailed case study (highlighted in blue font), and my comments are given below a table, or graph. My primary audience are the folks who use mis-information to suggest that helmets cause not only a decrease in cycling, but a host of other problems, some of which we will cover. I do not necessarily support mandatory helmet legislation, and don't give a damn about what is policy and what isn't. But I don't understand the logic of people who will use everything in their arsenal to fight law, if they are given the chance. I reckon at least 90% of these people would shut up if they had no 'mis-information', flawed or half baked research articles and spurious surveys to feed from in the first place. Helmets have their limitations, and I have no assumptions about them having super powers. While I do call for safety, what I'm calling for more is good research, accounting for alternative explanations, and applying caution and critical reading skills before believing in or spreading the material in research papers around.

Example : Mr. Burton, a transport planner, takes it upon himself to inform others that he read 'something' , somewhere that suggests helmets do zilch for safety.


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INTRODUCTION

There's that saying that when your number comes by, its time to go. But the more stubborn of us are bound to challenge that and ask : "Really?"

Leaving out any religious connotations, I'm convinced by the fact that if you hold yours or someone else's life in your hands, and if you choose to rule out common sense and smart thinking in favor of stupidity or negligence, then its more likely that you or the other party is at higher priority on death's list. In this case, the 18 year old driver who handled the pickup probably made some poor driving judgments that took the life of the 12 year old boy, who also decided (or maybe even taught to do) that day that he would avoid wearing a helmet and take some risks.

On a third level are the noble folks who build structurally unsound products that don't function when they are called to do so. I have nothing to say to these people if they don't realize the damage they're doing, but hey...that's for another topic another day.

Over the years, the above 3 elements have finger pointed at each other whenever a traffic related issue came up. Drivers complain about stupid cyclists, cyclists complain about stupid drivers, and both of them complain about stupid cars, stupid bikes, stupid helmets and why, even stupid transportation laws and politicians. I am sorry to say that I'm ashamed of all three parties! Human tendency is to always hold self righteousness high and pass the soup bowl of blame to someone else, or provide an excuse for stupidity. If only one of the three could have done the right thing themselves, and followed the rules, or made life easier for the rest and lived and let lived, or did something like they said they would do, then we could be a more safe and constructive society.

Accidents can be avoided. Injuries can be prevented. Even wearing a helmet may not prevent the accident, but just like entering a lottery increases your odds of winning by a huge margin than your neighbor who didn't (probability of winning by not entering is a big zero), wearing a helmet increases the odds of preventing critical head injuries that could otherwise rob the quality of your life pretty quickly. [See Brain Injury Library, TBI Consulting]



1. STATISCULATION


The cabal of cyclists who don't support the wearing of helmets always have some excuse to make. Fine. If you don't like them, that's your choice. But by choosing to do so, you're agreeing to taking a huge risk with your critical 3 pound brain, your skin, your bones, the value of your life and that of your family's.

But there's one interesting thing here. To make their case loud and clear, they do some sketchy things. Among them is pulling up statistics from heaven knows where that show the growth of some negative events for cycling and attribute those events to some form of helmet law. The event can be anything from the decrease of cyclist numbers on the road to the increase in head injuries.

How they come up with this definitive correlation is not explained to the rest of us. What matters to them is that it correlated, somehow. Finally they come to the wonderful conclusion that helmet laws are indeed responsible for decreasing cycling. Or that helmets actually increase the rate of head injuries.

But for every explanation, there are alternative ways to think. For instance, in the first scenario, did wearing helmets really decrease cycling or did cyclists just stop riding, having found something better to do with their time and money? In the second scenario, did helmets increase the rate of head injury or did cyclists ride more faster (due to the false sense of security) and push the helmet they were wearing beyond design conditions for which it was made?

Oops. Didn't think of those, did you?

Sadly, in the age of the internet, we don't have too much of information anymore. We have too much of mis-information. Mis-information is spread by people who have more time to waste than the person willing to read and agree to them.

Be careful with statistics and spurious looking "graphs". At best, they can help understand a trend and simplify this complex world we live in. At worst, they can be employed by the person creating and using them to deliberately tie in two unrelated events and LIE. When they are presented to the rest of the world, the flu is passed around. Misleading people with the use of statistics is called Statisculation. The people most likely to be misled/awestruck are the ignorant who don't give a damn how statistics work or how the figures presented to them were arrived at. If they have a thought process to begin with that they absolutely stand by, and if they find any 'statistic' that will support that thought process, they will welcome it by all means and pass it onto others. [See How Statistics Can Lie, United States Golf Association]


CASE-STUDY : DID THE HELMET LEGISLATION REALLY DECREASE CYCLING IN AUSTRALIA AND LEAD TO OBESITY?


JACOBSEN'S FIRST FORMAL ANALYSIS OF THE SAFETY PRINCIPLE : In 2003, in a paper written for Injury Prevention, P L Jacobsen famously validated the "Safety In Numbers" principle, a well known concept in transport circles. The paper proved this principle by using census data to show that the likelihood of a collision between motorists and cyclists in many Californian cities decreased as the numbers of cyclists and pedestrians increased (inverse proportionality). This principle was represented by his exponential growth equation relating "relative risk of cycling" with the "amount of cycling". If cycling doubled, he said, the risk per km falls by 34% according to his exponential relationship. You can read the original paper here [Free, PDF].


D. ROBINSON'S RESEARCH TO VALIDATE JACOBSEN : On the other end of the globe in Australia, D. Robinson, a researcher from University of New England in New South Wales, tried to replicate and validate Jacobsen's safety principle. In 1990, a mandatory helmet law was passed in Australia, making it the first in the world to do so. Robinson sought to also find out if there was any correlation between the injury rates as reported by hospitals prior to and after 1990 (year of helmet law), compared with the number of cyclists on the road in the same time periods. She chose localized areas in Australia for this reporting, as opposed to several cities and communities that would make up the continent. You can read the original paper here [Free, PDF]


BEFORE THE HELMET LAW WAS PASSED : Robinson reported that cycling dramatically gained popularity in WA in the 1980's and as a result, cycling became more safer because the number of cyclists being admitted to hospitals decreased as per information from WA Health Department! Between 1982 and 1989, number of regular cyclists on the roads doubled. Take note that Robinson defines a "regular" cyclist as anyone who cycled at least once every week. The number of injuries and deaths per 10,000 cyclists decreased from 5.6 in 1982 to 3.8 in 1989, a 32.14% decrease. She rounded that to 33%, and finally concluded that it is consistent with Jacobsen's growth rule which states that if cycling ever doubles, the risk per km falls by 34%.

ESTIMATIONS WERE USED : Australia did not have data on bicycle use for these years. So Robinson used "estimates" that she borrowed from the Australian Bureau of Statistics for 1982, 1986 and 1989. The amount of error in these estimations are unknown and how they were estimated is also largely upto the guessing of the reader of the paper. If the estimations had error in them, we might as well find that the number of cyclists didn't increase, but they fluctuated or stayed somewhat constant in that time frame. In that case, the data wouldn't really validate the Jacobsen's growth principle for Australia or the rest of her theory that is to follow.

ROAD VEHICLE TREND? What gets cloudy here is that she does not show how the trend of motor vehicles on the road varied in this time frame. Suppose the number of motor vehicles decreased (due to population migration, motorists choosing biking instead of driving, or other reasons) then logically, that reason could also be attributed to the lesser number of fatal injuries in cyclists. No data of number of vehicles and the trends in their use during these years in WA has been provided to us.


AFTER THE HELMET LAW WAS PASSED : Robinson reported that certain "surveys" showed cycling had decreased in the years following the legislation year of 1990. The graph on the right side is extremely unreadable, as obtained from the original paper, so I've obtained a better one from a primary source that Robinson cited in her references. This primary source happens to be a 1995 paper from Monash University by Carr et. al which I will discuss a little below. You can access the paper here here [Free, PDF].

WHAT SURVEYS? : What the source "surveys" were, we not told explicitly. It is often assumed by many people that somehow surveys provide accurate information. But are they really scientific? How can you remove biases and the tendency to report wrong beliefs like we often see in surveys? What is the amount of error in these surveys? What is its confidence rate in %? Afterall, robots aren't behind surveys. Humans are. Also, if census data was used to distill the details of how much people were using their bicycle, the amount and frequency of data collection always has limitations. A census may take place infrequently (every 5 or 10 years) and it also may not yield comprehensive data about bicycle use by the population.

SMALL DATA SAMPLES : Even if the surveys were well documented and have 90% confidence , they reported on a small sample set for Melbourne, Victoria for the years 1987 to 1992. The number of years in that sample after the legislation was passed is a mere 2. It is not for the whole of Australia either. It is for Melbourne, Victoria. More importantly, the counting of cyclists was done in the same month (May) between 1990-92. What about the rest of months? Did the count decrease or increase? People may have different agendas from the May of one year compared to the May of the other year. Some may just be late to get on the bike due to being busy with other engagements. Robinson's data does not explore the cycling trend in those other months.

THE CYCLING TRENDS BETWEEN 1990-92: Now for years 1990-92, for the month of May, the decrease is not so dramatic as shown by Table 2. More cyclists were wearing helmets and the number of cyclists counted decreased in the first year and then rose again in the next if you check the numbers. Going by Robinson's numbers for adult cyclists, there was a 29% decrease change in cycling counts in 1991 from 1990, after the helmet legislation. However, in 1992, there was a 34% increase change in adult cycling counts from 1991. The levels had almost returned back to 1990 levels. Robinson doesn't delve into this too much, but still diverts the reader's attention to decrease in child cyclists and injuries.

DEDICATION OF CHILD CYCLISTS VS ADULT CYCLISTS : We all know that children are fickle minded. As they grow up, or due to some form or another of peer or parental pressure, their interests and hobbies and life goals change. Pretty darn quick. Children also could have been discouraged of cycling not because of helmet laws, but due to the fact that the helmets they were now required to wear by law were DORKY LOOKING, uncool, user unfriendly, or plain ugly to show around in public. I'm very much interested to see a sample helmet from 1990 in Australia and what kids thought about it THEN. Was there a survey of that?? Robinson does not go deep into this very important issue at all. But she's quick to take the naked numbers of decrease in child cyclists and point fingers at helmet laws. It is adult cyclists who are the dedicated ones. They have to go to work, and if that is to be done by riding a bike, they'll do it because they're the ones to put food on the table, not their kids. In the year following helmet law in 1990, according to table 2, the decrease in adult cyclists was lesser than the decrease in number of child cyclists compared to 1990 (-461 adult to -649 child, 1991) . In 1992, the increase in number of adult cyclists from 1991 was more than those of child cyclists (+378 adult to +89 child, 1992). As one can see, child cycling never recovered properly in that year compared to adult cycling. Robinson really didn't question this and find out WHY? She just quickly moves on to prove her big theory.

ROBINSON'S LOGIC : From the data in the table above, Robinson's logic is that the increases in numbers wearing helmets were "generally" less than decreases in numbers counted...which led her to write that this proves non-helmeted cyclists are more likely to be discouraged to wear helmets and continue cycling.

Wow. Wait a minute.

How can she relate 'discouragement' in Australian cycling with numbers for a small sample set of 30 days for 2 years for Melbourne, Victoria?? I can't understand that logic. Also, the more dedicated of cyclists are in the adult population, not in children. The decrease in child cyclists was more than that of adults.

SEASONAL VARIATIONS UNACCOUNTED FOR : The data also doesn't account for seasonal variations in cycling precisely because it investigated only the month of May. We all know that cycling is a seasonal activity. Only few are brave to venture out in winter in the elements. Victoria has a winter season. People ski there on its slopes, among other activities. Melbourne is colder than other mainland Australian state capital cities in the winter. More commonly, Melbourne experiences frost and fog in winter. Also looking at a climate chart from the Bureau of Meteorology, the month of May is one of the coldest in Melbourne, with temperatures ranging between a low of 9 deg C to a high of 17 deg C.


PRE-MODIFIED 8 YEAR HOSPITAL ADMISSIONS DATA (June, 1986 - June, 1994) : This comes from the Monash University citation that Robinson provided in her paper. The original data from hospitals for cyclist head injuries showed a decrease after 1990 but a sudden increase in 1993 and it was determined by "examiners" that this apparent increase was due to some "Casemix" anomaly in the Victorian Hospital System (increased admissions from hospitals because of the promise of more hospital funding from the government that year). So anyway, the original Hospital Admissions data for head injuries for cyclists was then modified through some sophisticated "multi-variate time-series modeling techniques" that even I have a hard time researching what they exactly did to the data. Anyone who didn't complete a sophisticated course in statistics can really bite the dust here.


MODIFIED 8 YEAR HOSPITAL ADMISSIONS DATA WITH MULTI-VARIATE TIME SERIES ANALYSIS : The modified graph after they applied their time-model to it just surprised me. Observe the lessened curve in helmeted cyclist head injuries after 1990 as shown by dotted line, compared to the solid lines that show the same before the model was applied. Again, the original data was modified through sophisticated statistical methods that only the researchers know exactly. Anyone has to seriously question the validity of these 'intervention analysis' techniques employed by different groups of researchers and understand it thoroughly before taking it, misplacing it and chanting slogans with it. At this point, I challenge all the people who decry the use of helmets : Do you fully understand these type of sophisticated statistical tools that researchers use to modify and play around with data? Do you understand the complex decisions that are behind these actions? Can you blindly say yes, before you've done your research and link to these articles to support your cause? A course in Time Series Analysis to fully understand what the Monash researchers have done in this paper requires atleast a semester or two of university-level study. This isn't the introductory level statistics that you do in your biology class.

The modified hospital data looked encouraging for cycling than the original. It was estimated from these modified data that in the first four years of helmet legislation, a 39.5% reduction in the number of head injuries was observed in Victoria(level shift). I presume that is what this graph shows. However, in comes at group of Australian researchers - Cameron et al, Mead et. al etc - who suggests that hey, the decrease in head injuries is dramatic compared to pre-law levels and then declare that this decrease MAY have been due an overall decrease in bicycle use, and not helmet use at all. Infact this has been suggested in Page 1 of the Monash report.


CONFLICTING RESEARCH CONCLUSIONS/SUGGESTIONS : Interestingly, in page 21 of the Monash report, there's evidence of some conflicting statements. They say their analysis is insufficient in distinguishing between reductions due to helmet wearing and reductions solely due to the possible reductions in exposure, and then boldly go on to say a little later that they think "its fair to assume" from their analysis that helmet legislation and the subsequent discouragement in cycling caused the decrease in head injuries that they "modeled" all this time. So what's the correct and final story on this one?

If you also didn't read between the lines of the report, page 15 says that the researchers didn't even investigate other measures of road safety in their models which may explain what happened to the decrease in head injuries to cyclists. How safe is this ignorance?


The rest of the paper from Robinson, which referenced the Monash paper for food, delves into injury rates for Victoria and finally concludes that : "Thus, as predicted by the growth rule, the risk of injury per cyclist increased when cycling decreased because of helmet laws in Australia."

Robinson's paper provides an inadequate picture of what really happened to cycling in the months after the helmet legislation in Australia. More so, one of the prominent references from Monash University she's given in her citation (Carr et al) use murky modeling techniques to modify original data, (which needs deep and further study). They also seem to be inadequate in their research as reported by themselves and make conflicting statements in several pages of their report, yet they say its "fair to assume" that helmet legislation decreased cycling numbers and hence cycling head injuries.

Robinson uses all this to do too much generalizing. She uses small sample sets, and data for localized regions in Australia (possibly from other researchers) to arrive at the grand conclusion that because the helmet law was passed in 1990, cycling collectively decreased in Australia in years thereafter! I may agree with the fact that there is safety in numbers but I cannot validate this paper to make a conclusion that helmet laws decreased cycling in Australia and dramatically increased the risk of injury just due to it. The trends for cycling that Robinson has reported is episodic and localized, and I would encourage her to investigate the effects of cycling over a long period of time and in many different places, at the same time, also delving into some of the other causes, apart from helmet law, that affected the numbers. I highlighted some of these possible causes in the writeup. It doesn't hurt to sometimes ask "WHY", even more than once.

Without giving a picture of all the factors mentioned above and their relative contributions to Australian cycling, no intelligent person reading Robinson's paper can accurately put faith in the fact that helmet law was the prime motivator for a long term, permanent, and nation wide cycling decrease in Australia. I urge her and the umpteen groups of researchers who have all fed on each other's research material to give these old papers a good second look. Continue to explore alternative explanations for a decrease in cycling levels. See if they are accurate, and still really relevant for 2009.

These are the papers that are being used to bring down safety laws in several countries of the world. I'm not even sure that the people who reference this material fully understand the use of your sophisticated statistical analysis techniques, and data manipulation tools and the implications of these actions.


PASS IT ON, BUDDY!


Many different websites, bloggers, forum participators and "medical experts" link directly to cycle-helmets.com, a website which makes it own interpretations based on Robinson and other Australian papers. Then they twist it to their liking and start throwing the bombs. Like this misinformation, portraying helmet laws as fighting with public health :

Most people who read this would not have read the original research papers but will assimilate other people's wrong interpretations of it and finally, what they'll receive, believe in and spread out to others are false assertions such as "helmets decrease cycling", or "helmets cause more injuries" or "helmets decrease public health" and so on and so forth.


If Australia has an obesity problem, does it really have to do a lot with "punishing" helmet laws or more to do with laziness of people (an age old problem, even before helmet laws), personality and psychological issues, and the human desire to put in more calories into the body than what is burnt. There is a definite science behind obesity and understanding it will help solve problems. Does the author of cycle-helmets really believe that there is some sort of major underworld partnership going on between obesity in Australia and bicycle helmet legislation?

Many other sections of cycle-helmets.com contain mis-information through videos. My favorite one was the following below, a link to a video showing a car running over a helmet, as if suggesting to the reader that a helmet should be somehow designed with super powers to withstand the weight and force of a car over your head.

Oh, and if it breaks, it must be a worthless piece of junk right?

Websites like cycle-helmets.com are easily visited by people because of its suggestive URL. Any one trying to do an internet search for cycle helmets will be caught unwary and visit the link. Then they'll be pulled into reading some fantastic BS on the drawbacks of helmets, helmet laws and how it brought down the entire continent of Australia and continues to do so.

Choose wisely what you read. Scrutinize everything, especially research papers. Case in point : After multiple peer reviews, Ed Coyle's research study on Lance Armstrong (Improved muscular efficiency displayed as Tour de France champion matures, 2005) which tried to show how Armstrong's body became more efficient between 1993 and 1999, was found to have some glaring calculation errors in the delta efficiency. [See Coyle Study on Armstrong : A Minor Error Or Scientific Hoax?] Ofcourse, Lance will not talk about this on his Twitter page. He may not even understand how the numbers were arrived at.



2. SPORTING PREJUDICE


Taking the example above of the "helmet laws & decreasing cyclists" correlation, it could very well be that the number of people cycling decreased because some of them discovered another sport and chose to commit to that over biking. I'm not saying that's exactly true, but what if it were? The question to ask then is : Is cycling the only way to keep fit?

If a person wants to be healthy and lead a better life, cycling is not the only avenue. If he got discouraged in cycling because of the need to wear helmets, he may not necessarily have gone back to drinking and smoking and sitting on the couch watching football all day. Unless you can prove that, this argument has no weight in it.

As cyclists, we all love to support our cause and make ridership grow. No harm in that. But healthy living comes in many forms. Bicycling is a solution. But its not THE solution. You can walk to work, golf, or play tennis on weekends, or even chill out in the swimming pool. Why the heck do you have to ride a bike to remain fit? Is it the only sport around? Please stop the desire to homogenize sporting and let people be themselves. Embrace your hobby and talk about it, but learn to shut up and let people do their own thing. Simple. Lately, pushing has come to shoving to make people ride more. I do not approve of this behavior, either from cyclists, advocates, or public health politicians. Promote all healthy ways of living, don't bias yourself to one.


CASE-STUDY : DOES LACK OF CYCLING SUDDENLY CAUSE DISEASE?


In a letter to the editor of the Canadian Family Physician, Thomas DeMarco MD argues that helmet legislation could decrease cycling. In his writeup, he references an Australian experiment with helmet law and connects it to the falling in ridership. We already covered the Australian Helmet Law crisis above and the flaws in a prominent research paper. But the citation given here is some 'C. Komanoff' who read 'some data' from a so-called 'Monash University' at some 'pro bike conference' in Ore, 1994. Great. What the heck is that 'data'? We won't know.

NO CYCLING = DISEASE ARGUMENT : In the following lines, he emphasizes that "most importantly, less cycling means less physical activity which translates to more atherosclerosis, obesity, non-insulin dependent diabetes mellitus and osteoporosis." Wow! Thats a big bunch of disease. How did Mr. DeMarco arrive exactly at the definitive correlation? No cycling = disease? And did he begin with the false thinking that cycling is the only sport, past time or recreation around, or that people who don't commit to cycling suddenly commit to physical inactivity in an instant, which inturn gets them sick and about to die? Can you please prove that?

IS CYCLING THE ONLY WAY TO STAY HEALTHY? What gives Thomas DeMarco the monopoly to generalize the human mind and the complex wants and desires of people? Or ignore other sports that can help one stay healthy? Most importantly, what gives cycling the monopoly to make people healthy? If this was the only way to be fit, we'd imagine a health fanatic world full of cyclists. That's not the case.

I, for one, am thankful that cycling is not the only sport/recreation around. I'd go beserk, otherwise.



CONCLUSION


The more I think about people complaining over helmets or helmet laws, the more I feel that they just care about the advance of their dogmas to others. They don't really care for their safety first and foremost. They don't think about the situation and environment they're cycling in (Europe is very different from America, where the status quo is motorship), and for them, the sport of cycling is the only salvation to a better life. If helmet laws are passed, they say that it will quickly bring down the numbers of cyclists on the road by quoting and data mining from questionable research articles and surveys done in other countries in different time periods. Then they argue that if ridership decreases, the number of people with AIDS, malaria, obesity, osteopororis, diabetes, blood pressure, cancer and any other ailment that you can think of will INCREASE. And we are to believe that.

False interpretations of statistics, or statisculation, and making absolutely baseless correlations between two unrelated events have been the defacto tools for these groups of people to fight helmet laws.

Yet, given all this, you oddballs may still opt to rule out helmets and decry the need for safety to ride the way you feel is best. Which is absolutely fine, as long as you don't mis-inform others, while forgetting the personal risks of going riding without a helmet.

But there could be a point when you arrive at the cross-roads. Say it was a Monday morning and you see your 12 year old kid, your own life and blood, walk out of the house with a bicycle. He's going to ride beside the road to get to school, which is about a mile away. He's not wearing a helmet. (At least that's what he learnt from the family growing up).

In a chilling moment a few hours later, the telephone rings at your house and the local cops have some life changing news for you and your wife. Its very distressing and there are no words to describe that sinking feeling. They happened to bring some really bad news about your son. He was riding his bike to school but apparently... he never made it there. They are requesting you at the scene immediately. Suddenly when your world was going all smoothly, someone in your family has become a statistic.

What will your line of thinking be then? I'm just curious.



ADDITIONAL/RELATED RESOURCES :


How A Bicycle Helmet Works

How Bicycle Helmets Are Made

Helmets : How They Work And What They Do

The Effectiveness Of Bicycle Helmets : A Review by Dr. Michael Henderson, who is a physician who has spent most of his professional life in highway safety research and administration. He established and ran Australia's first government crash research group and test lab, and he chaired the Standards Australia committee that wrote the first standard covering bicycle helmets.

How Helmets Are Tested In Snell Labs

Damned Lies And Statistics : Untangling Numbers From The Media, Politicians And Activists

Brain Injury Resource Center

What's Your Excuse, Washington City Paper (March 11, 2009)

Bicycle Accident Victim, 12, loved the outdoors

Current U.S Bicycle Helmet Laws

Continuing Misinformation About Declining Hunter Numbers


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45 comments:

Marvinthefish said...

The graph in Dorothy L Robinson's paper you describe as "unreadable" comes from this report (Aug 1995) by Carr, Skalova and Cameron, which is referred to by Robinson -- http://www.monash.edu.au/muarc/reports/muarc076.pdf , where it is in a better resolution (page 21). You may be able to validate it and decide whether Robinson tampered with it.

ksteinhoff said...

I hate helmet wars. I used to wear a helmet on the road so that no scum-sucking bottom dweller lawyer could argue that "yes, my client's Hummer flattened your client like a bug, but your guy wasn't wearing a helmet."

When I was on a safe bike trail in the middle of nowhere, I'd skip the magic foam hat.

My riding partner did an endo on one of those rides on a perfectly clear stretch of blacktop trail on a perfectly clear day while not wearing a helmet.

She fractured her skull in five places and hasn't ridden a bike or been able to work for two years.

The situation you describe at the end isn't about statistics: it's about how a life can change in milliseconds.

Do I like wearing a helmet? No. But I do like increasing the odds that I won't have brain damage from a minor little accident.

Anonymous said...

My heart just melts to see such an innocent looking kid die. Hopefully the folks behind the helmet flame wars will be ashamed of themselves and put emotions in front of their dogmas.

Phil said...

You've brought some hard, and excellent questions to light. It has got me thinking a lot. In this age of the internet and other popular types of media, other folks do our thinking for us, while we sit like zombies and assimilate all this information without any critical thinking on our part. Both the people who are behind spreading lies, and those who find it okay to believe in it are treading the wrong path. Sadly this isn't going to help cycling at all.

Anonymous said...

A saying heard in the bike circles I travel: If I have an accident today, I'd rather be riding my bike tomorrow than re-learning the alphabet.

John, Texas said...

You forgot some more issue, which I thought may be helpful. Most of this data is outdated for our times. I'm not sure if a national helmet law still exists in Australia, but I'm very much interested to see the trend in cycling numbers since 1990-2008.

Anonymous said...

Right on target!

Just plain fu****g excuses.

Chris Pikulski said...

One of the big issues I have heard is that helmets decrease youth cycling because kids don't think they're cool.

My answer to that is that our industry has a huge number of talented and innovative people who can make kid's helmets look cool and hip. If they don't exists today in the market, they will tomorrow due to that need.

If kids were only educated enough and shown the consequences of head injuries and the life thereafter, they would equate a disabled life with UNCOOL and value safety more than 'looks'.

Anonymous said...

this is great. at long last we have all the ridiculous drivel from the helmet industry and their spokespeople gathered in one convenient place for perusal when we need a giggle.

i realise that your shares in car companies are doing rather badly and you're probably keen to make some extra cash on your shares in helmet companies but this is hardly a respectable way to do it.

anyway, i'm always up for a laugh so feel free to tackle the other 40-50 odd helmet-sceptic papers when you're ready.

Jens

Bleemeister said...

Interesting post. I find it hard to suffer fools gladly, both those who believe everything without question all that is on the 'net or elsewhere, and those who think rding without a helmet is OK. Helmets are cheap insurance for the umpredictable. I can tell you from experience, personal and otherwise that helmets work. As for believing all one is fed in *data*, there is plenty of evidence that bad data = bad results.

In my case there is no doubt that wearing a helmet covered my ass plenty when I crashed a few years ago. And this accident was on a well known bike path. Short story: Was riding along, minding my own line, when an idiot who was passing crashed into me. His flat h-bars went into my front wheel and my head into the ground. I had multiple broken bones, collapsed lung, etc (Was in the hospital for 6 days. The guy that caused this got back on his bike and rode off w/o so much as a "Oops - sorry!"). Other than a slight concusion my head was OK. After looking at the remains of the helmet the doctor stated that I would have suffered a fractured skull at the least, or death at the worst.

I *get* the whole "ride without a helmet" mistique. I must have trained 10k or more back in the day without a helmet and raced with a hairnet helmet. Hell, everyone did back then. And when the Fed made the use of hardshell helmets for racing the rule I was just as loud as anyone else in bitching over the change. I look back and laugh at how ignorant we were then. Now that helmets are light and well vented, one would be a fool to not wear a helmet, just as much as to beleive all the crap data on can easily mine on the internet.

Adrian said...

@ John in Texas @ 11:21

Australian State of Victoria made cycle helmets compulsory in 1990 and the following year the number of cyclists was apparently reduced. Nine years on, however, cycling is more popular in Victoria than it was before 1990. Cycle helmets have been accepted as a sensible safety measure much the same as motorcycle helmets and car seat belts.

For those concerned about the price: the price goes down dramatically after introduction. In Victoria a standard helmet now costs less than twenty Australian dollars (around eight pounds) and they come with several different thicknesses of exchangeable internal pads to accommodate growing heads and ensure an accurate fit.

They keep the rain off too which, as I recall, would be a useful attribute in the UK.

Just like the introduction of seat belts and motorcycle helmets, it started off feeling like just another piece of irrelevant bureaucratic madness. But nowadays as I flush out the coronaries up the hill to work, I feel naked without it.

Rod Diaz said...

Thanks for sharing, Ron. I like my brain, and though I don´t think a helmet would save my a$$ if I get crushed by a car, there´s a chance it´ll help me avoid catastrophic brain damage. I ride a lot, and experienced two head blows. None had major consequences, both times I was wearing a helmet.

On a similar vein, there are some ¨statisticulations¨ that claim that breast examination does not reduce mortality from mamary cancer. Maybe not in a ¨population¨, but effing A it make a lot of difference to the woman who managed to detect her tumors early.

It is hard to equate something that is in the population of hundreds of thousands (i.e. cyclists) with personal experiences. Undoubtedly many don´t like wearing helmets, and for some of them mandatory helmet laws will be a final disincentive to cycling. What can I say? Many people still refuse to wear seatbelts or keep using their communication devices to ¨text¨while driving. Laws have been put in place to protect them (and others), and reduce the cost to society of the risks they take.

I think Farrar and Raisin were happy to be wearing a helmet, and it wouldn´t have made it worse on Casartelli. But hey, it´s your head; if you don´t think it´s worth protecting who am I to convince you?

R. Ekman, MD said...

There is strong international evidence that the wearing of a bicycle helmet reduces the risk of being seriously injured in an accident by 60- 80%.

There is no empirical justification for saying that a compulsory helmet-wearing law reduces bicycling as a means of transportation. Experiences from Australia and New Zealand show that most people continue to cycle, using a helmet as protection, after legislation comes into force.

During a short period following legislation in Australia a slight decrease in bicycling among groups of teenagers and adults was detected, but there is no scientific evidence that this is a lasting effect.

This is a very good post. I pass on my condolences to the family of this boy. Even if a few lives can be saved with helmets, its a worth.

Anonymous said...

Anon said : The fallacy into which you have fallen (perhaps with the best intentions) is called "misleading vividness".

I have another one for you, which I heard many times.

1. I, John Doe, rode my bike for 100,000 miles without a helmet.

2. I never had a crash that a helmet would save me from.

3. Hence, I don't need a helmet.

dan said...

Wearing a helmet saved me from serious head injuries twice. That's all I need to know to believe it's a good idea.

I think a lot of people don't realize it has nothing to do with how good or careful a rider you are. It's the other guy, the one not paying attention while driving his 2-ton bullet, who's going to make you land on your head.

Anonymous said...

I've become more skeptical of helmet effectiveness because of the injuries and deaths that have occurred to cyclists who were wearing helmets, rather than statistical arguments when entire populations have switched to helmet use.

At it's base, a helmet is made to absorb a certain amount of energy, but when there is death and serious injury to cyclists, collisions with motor vehicles are almost always involved and these collisions are far in excess of the amount of energy a helmet was made to absorb.

Even if there were such a thing as a helmet that was 100% effective, most cyclists would still die in collisions with motor vehicles because these collisions often damage other systems of the body to such a degree that death soon follows.

A helmet can provide a certain level of protection, but they usually can only offer protection from minor injury, rarely major injury. That people believe a simple helmet can save a life in a collision with a motor vehicle is sad because we owe others more consideration of what happens in the circumstances of such an incident and not rely on such a simplistic solution that no helmet manufacturer has ever been claimed to be within the protective qualities of their product.

Anonymous said...

As someone who has been closely affected by a loved one who died from a head injury I have to ask, what is it about riding a bicycle that brings up this issue? Does this happen to people on bicycles more than others, because I don't think it does.

The loved one I knew that died did so from falling down the stairs, not riding a bicycle. In my long life, i have also known others that have been hospitalized with head injuries from falls off ladders and automobile accidents as well. I paid attention when Dr. Atkins died from a head injury while walking on an icy sidewalk because I was on his diet at the time.

I don't understand why these head injuries seem to be getting ignored yet bicycle injuries get attention. I'm no scientist but I don't think it takes one to see there are far fewer of these injuries happening to people riding bikes than all those others.

In the memory of the one I loved, I would ask everybody to put this into perspective and not ignore the many and focus on a few. From the way I see this being played out around the neighborhood, no one seems to have any sense of perspective anymore. When I grew up, riding a bicycle was a good healthy thing to do and the only ones that ran into problems doing it were the ones who lacked a lick of common sense and probably would have had a similar problem doing something else because they lacked the common sense to behave safely in the first place.

Kevin said...

Dr DL said And remember that cycling without a helmet is far better for both health and our environment than not cycling at all.

Yeah ok. Thanks for that divine wisdom, 'Dr'!

Anonymous said...

I'll speak up here and say I ride a bike without a helmet. Am I taking a risk? I suppose so but I think I'm not taking any greater risk than anyone else. I know who is taking a bigger risk than a cyclist who doesn't wear a helmet. Someone who isn't getting the exercise that a cyclist gets from riding a bike.

I'm at that age where health problems are getting bigger than problems arising from accidents. If someone is going to suggest a 50 year old man is running the same risk as a 12 year old boy, they might want to get their own head examined.

I know of too many people close to my age that have had a stroke or other malady that had the person been riding a bike, they may have avoided. Sometimes people can't see the forest for the trees.

Jill said...

Utopian worlds not exist Ron. :)

Ravi Chopra said...

yes. think outside the box! don't believe the interpretations people set on a bunch of numbers.

Anonymous said...

Boy. I've read some bafflegab in my day, but I think this takes the cake.

It seems to all boil down to the author believing that a helmet will save a life in a collision with a truck.

Well, if he believes that, I think someone's been had by the helmet lobby.

Phil said...

Bafflegag = Confusing or generally unintelligible language or jargon

@ Anon 7:57pm : I take it that you can understand plain simple English. If yes, please bring something of value to this discussion. If not, feel free NOT to comment.

Anonymous said...

apparently, you don't need common sense

Richard said...

The bullshit contained in research studies can only be extracted by someone who wants to take the trouble to. I'm sick and tired of research studies coming in the way of my life. All fucking research studies aim to do one thing - to cause depression and make you do stupid things. Research studies say I can't drink too much coffee, that I can't drink too much water, that I can't bike without hurting my sperm count (remember that one) that I can't swim without causing hair LOSS and baldness, that I can't eat fish because it will cause memory loss and stroke in old age.

The latest "research" scare comes with some Iranian fellow having found that drinking hot tea causes cancer! http://uk.reuters.com/article/healthNews/idUKTRE52Q01620090327?pageNumber=1&virtualBrandChannel=0 Me and me extended family members have been drinking tea for several years, yet we have no damn cancer sticking out of our mouths.

I am done with reading research studies!! They cause depression and sink the value and variety of life. The people behind research are nothing but fat assed lab rats. Get out of the lab and enjoy the world, people.

Anonymous said...

Just reading the leadin to the blog, I have to assume Ron must know something about the tragic incident that Andrew died from.

From Google, I found a story about this and understand Andrew was turning into his driveway and was hit from behind by the truck.

How could this have happened? Did Andrew turn left and ride across the roadway or was Andrew riding on the left side of the road and turn right across the roadway into his driveway?

I want to know because I don't want something like this to happen again.

A Passionate Biker said...

Well written and it brings food for thought. Real science is not inventing a theory, putting some numbers together that will support it and then shove it down people's throats.

Real science is looking if your theory works, trying to invalidate it through alternative explanations and scenarios that will make it unshakable.

I quote Richard Feyman who said something elegant in this regard :

It's a kind of scientific integrity, a principle of scientific thought that corresponds to a kind of
utter honesty--a kind of leaning over backwards. For example, if
you're doing an experiment, you should report everything that you
think might make it invalid--not only what you think is right about
it: other causes that could possibly explain your results; and
things you thought of that you've eliminated by some other
experiment, and how they worked--to make sure the other fellow can tell they have been eliminated.

Details that could throw doubt on your interpretation must be
given, if you know them. You must do the best you can--if you know
anything at all wrong, or possibly wrong--to explain it. If you
make a theory, for example, and advertise it, or put it out, then
you must also put down all the facts that disagree with it, as well as those that agree with it. There is also a more subtle problem. When you have put a lot of ideas together to make an elaborate theory, you want to make sure, when explaining what it fits, that those things it fits are not just the things that gave you the idea for the theory; but that the finished theory makes something else come out right, in addition.

In summary, the idea is to try to give all of the information to
help others to judge the value of your contribution; not just the
information that leads to judgment in one particular direction or
another."

Just a cyclist said...

Ron, I really like your blog, more specifically, the technical posts.

This blogpost, however, with its analysis and its conclusions does not really come as a surprise; considering your inclination to proudly declare cycling to rate among 'the most dangerous sports in the world' (actually, seven times, doing a google search for "most dangerous" on your blog).

No offence, but I cannot call you a good advocate for cycling.

BTW, just a thought; what if you began your post with an emotionally loaded article about a helmeted rider who suffered a fatal accident? Answer: the focus would have had to be on the cause of the accident, possible traffic insfrastructural analyses and or more stringent regulations for motor traffic. Now, wouldn't that kind of efforts be better both for cyclist safety and the number of cyclists? ...But then, safety in numbers also ranks as "statisulation" for you, your favourite statisticians and for Bell.

Have to mention though, that for the sake of cycling safety, your technical analyses of broken bicycles are just great.

(Don't make the mistake of replying by wishing me death and destruction by head injuries. Remember that your main focus was to tackle such things. Please.)

brad said...

Ron, after reading Robinson's research, your commentary and Robinson's response, it's my personal opinion that you're the one who is on the short side of the "numbers game" with Robinson.

Not that my opinion matters anymore than yours, but I really can't say yours is more valid than mine either.

As for Andrew, there's no argument about helmet use lain, just showing your use of Andrews case to elicit sympathy and emotion to futher your point. This is a poor use of argument because for as many Andrews as there are in the world, there are those who meet the same fate wearing a helmet. If we focuse n a red herring, the solution will not appear.

I wonder where you stand on the opinions of the other experts I've mentioned but I'm not sure it matters because you've shown your view point is not to be swayed from it's current position no matter what the evidence.

Brad said...

all due respect Ron, but I think you're out to lunch on just how dangerous cycling is.

You're entitled to your opinion of course, but it contradicts tons of research on the topic.

Ride a bike, you live longer. Even considering cases like Andrews.

With "advocates" like you, who needs enemies?

Just a cyclist said...

Bike_Boy, I guess that what you are aiming at is pretty much the same as some of Ron's arguments in his post. Which also is exactly along the same line as some of the latest publications from the "pro-helmet" scientists; to attack the questions raised by "helmet-sceptic" scientists, head on:

-Health benefits lost by less cycling
-Safety in numbers
-Risk compensation

It appears that the will of proving the effectiveness of the "panacea" appears to be really strong, for some reason. Seem to be somewhat unusual for scientific publications anyways.

Just a cyclist said...

I didn't know that you were a vehicular cyclist Ron. I guess we could go on quarreling about that as well but suffice to say that I think vehicular cycling has got its merits as well as helmets do.

Obviously there is a difference in our perceptions of cycling safety and safety priorities. Perhaps this can, in part, be attributed to your inclination towards racing. Not sure though.

The CPSC-link was too much filled with exclamation marks to be taken seriously.

I still remember your posting from last year about the "odds of dying in a bicycle crash"... while you seem not. :)

Let's just be friends, I like most of your blog anyways. Good riding.

Just a cyclist said...

Cycling is not leisure time sport. Cycling is a means of transport.

Brad said...

Ron, your response is somewhat ironic. Your claim that cycling is dangerous is the scare tactic and to show the mortality of all of those who do cycle is lengthened over those who do not is the exact opposite of what you write. Cycling is in itself inherently healthy and to bury your head in the sand on the issue does no one any favors. That you do so is no surprise. It's clear you're buried neck deep already and have no inclination to dig yourself out anytime soon.

Brad said...

actually, that we're even spending time responding to this blog shows we can be a bit wasteful at times.

Still, a bit of time I can spare, a lot I won't.

Just a cyclist said...

Ron, if you could come up with a pro-helmet study that is not outdated, that uses unpecable statistical models and - last but not least - contains unbiased correlations and causations... well, then you'd have a case.
As it is now you just sound angry.

Brad said...

... the irony runs deep when Ron complains about Statisculation and engages in it.

Even in the related blog, Latest Research : Bicycles Second To Automobiles In Child Injuries, he engages in some pretty shoddy research that doesn't distinguish between minor or severe injuries.

I know there will be those who will side with Ron, but I think any reasonably intelligent person with a modicom of common sense and maybe a bit of experience can see Ron hasn't backed his opinions up very well and can pass over this blog without missing much of any value.

Just a cyclist said...

True, thus he would proably not be able to objectively judge the qualities of any pro-helmet paper either.
Which I guess also would apply for myself (prolly also for Brad or for any other sceptic bastard).
So at least, he could be consistent and strap on a high quality helmet on every car-trip (while remembering the oil-refinery simile).

Brad said...

but you see, I would say I'm only a helmet skeptic when someone claims they can provide protection beyond what they're capable of.

I wore a helmet for over 20 years, far before it was the popular thing to do. I campaigned for their use and ran instruction courses for children where I would explain why it is they should wear them.

The trouble is that too many people are claiming an effectiveness that is far beyond a helmets capacity to provide.

This problem becomes even more exaggerated when helmet promoters spread misinformation about the proportion and severity of head injuries cyclists receive.

There's nothing at all wrong with wearing a helmet, but spreading misinformation like Ron has here, runs counter to anything resembling the advocacy cycling deserves.

Phil said...

Here's a study linking alcohol use and bicycle deaths.

http://cityroom.blogs.nytimes.com/2009/04/09/study-links-alcohol-and-bike-deaths/


Of the 220 or so plus fatalities in NYC during a 10 year study, only 3% of those who died wore helmets. The rest didn't wear them and head injuries contributed to three quarters of bicycle deaths.
The NYC Department of Health and Hygiene has advised that the takeaway from this is that helmets save lives. I don't doubt it. Great job on this blog Ron.

Anonymous said...

'cmon Phil. Use your noggin. How many people in NYC wear a helmet? Is it surprising to find out in places where everybody wears helmets, those who die are wearing helmets and in places where they don't, they aren't?

Byron said...

wow. after reading through this, I find the baseless arrogance outstanding.

one day Ron (and others) you'll learn, but I hope it's not the hard way. Until then, try to be more humble and try not to display your contradictory ignorance to openly

Byron said...

an expected response. Those who are arrogant rarely engage in self reflection. They're so wrapped up in themselves that they can't understand a different point of view.

you should try a little humility. It's a wonderful quality.

Phil said...

Anon @ 5:27pm : Not surprising at all. Actually, not only do they NOT favor helmets, a majority of them are also not in favor of the rules of traffic.

http://cityroom.blogs.nytimes.com/2008/11/19/study-finds-cyclists-disobey-traffic-laws/

Not even helmets can protect for plain stupidity.

Brad said...

I'd imagine they'd do just as well as they had for all those years they didn't have them.

I think it's a fine thing Ron is giving up because as I have seen, there's no disuading him from his opinion.

That's as it will be, there are always going to be disagreements but after the issue has been kicked around for over 20 years one would think that if there was a definitive benefit to wearing helmets while riding bicycles, most people would wear them. That there are still only a minority of people who choose to wear helmets speaks volumes about what people think of them