In a Twitter-comment to a discussiuon on bike-helmet laws, i wrote:
“More people dies from inactivity than from not using helmets. But the helmet saved my head.”
It sums up my opinion on bike-helmet laws: Use of helmets should not be compulsory, but I recommend the use of helmet. I am using helmet most of the time when I am riding my bike.
To my surpirse I got rather insulting replies from Amsterdamized and Copenhagenize, organisations that support cycling. As a reply to my tweet, Amsterdamized wrote:
“sorry, no it didn’t. Physics make that impossible. Research.”
They are refering to “research”, but they are still able to make a definitive conclusion about my accident, without any knowledge of what happened. One cannot take people who are referring to “research” seriously when they can make unsubstatiated statements like this. My reply was:
“The helmet was damaged, the head inside was not. Enough for me.”
Copenhagenize added insult by writing:
“Did you see the face of jesus in the clouds, too? “
They were referring to the website cyclehelmets.org, run by an organisation called Bike Helmet Research Foundation (BHRF). I know this organisation only from the information provided on their own website. As a professor, I naturally read at least the reports and articles referred to that seemed to be most relevant. At the same time I am sceptic to information provided by only one source that I do not know. There are many out there in cyberspace who claim to be neutral, impartial or objetive, but who have vested interests and hidden agendas. I do not know if BHRF have, I am only saying that I do not know the organisation, hence the source. I can see what they are referring to, but I do not know what they have left out (if anything).
If I should summarise the reports and articles on the subject I have read so far, the main content is this:
A bike helmet may not give as good protection as some will claim. Some studies show good protection against head and face injuries, others not. If you crash with a motor viechle or head on a concrete wall, the helmet may not save you. The helmet will not save your neck and spine, and you may get injuries from rotation of your head (probably neck injuries). If the impact is really hard, the helmet may crack, which may mean it will give no protection in the incident. If a helmet protects, the the expanded polystyrene liner should crush and not break. Once fully compressed, it gives no further protection.
First an answer to Amsterdamized: The expanded polystyrene liner was compressed in my helmet. The helmet was damaged on the surface, but it had not cracked. My head inside the helmet was not damaged. I know much better than Amsterdamized what happened. I am confident that the helmet absorbed a lot of the energy from the impact, and it also saved my head from bruises. I am glad that my head did not look like my leg, which still, more than a year after the accident, has very visible traces from the incident.
Other studies suggest that those who use helmet will cycle with higher risk. It is elementary that a statistical correlation will not say very much about causes and effects. [Edit insert: Where there are more fire fighters, there are more fire => More fire fighters causes more fire.] It may very well be that people who use their bike on flat terrain in cities at fairly low speed do not use helmets and have few head injuries, as long as they are not hit and run over by cars (where a helmet will not give much protection). If you are cycling at higher speed, the situation may be different. The risk of being injuried in an accident will be higher if one ride at higher speed, and it is likely that injuries will be more serious. I guess that the proportion of cyclists using helmets are higher among those who ride at higt speed. Some studies suggest that use of helmet will cause cyclists to take higher risks. But this is pure speculation with no evidence to support such conclusions. I do not think I take higher risks now than I used to do before I started using helmet.
I have not seen any studies even suggesting that use of helmet may increase the risk when cycling. The studies makes Amsteramized’s statement that the helmet cannot have saved my head, downright stupid.
We may remind the people from countries flat as pancakes, such as Denmark and Netherland, that in some countries we have real hills. We do not have to go 20 km out of town to find something with a slight resemblance of a hill, as they had to do when hosting the world championship outside Copenhagen. The gentle, rolling landscapes the danes love to call “alps” can hardly be called hills. In the Oslo-area, where I live, any cyclist can reach a speed of 40-50 km/h without any effort when going downhill. If you do not brake, you will often reach this (and higher) speed.
This was what happened to me. I was riding dowhill, not pedaling to gain speed. But as usual I did not brake just to reduce speed, I just let go. Then a dog run across the lane right in front of me. I braked hard, and was probably thrown over the handlebar (and the dog), and hit the tarmac. I do not remember the seconds from when I hit the brakes till I was laying on the ground. As I had a GPS, I could see afterwards that my speed when it happened was 48,5 km/h. The helmet did its job. And of course when the cushion was crushed, it would not give much more protection. I had to get a new helmet.
The studies referred to may indicate that helmets do not give as good protection as some will claim, and it will not save your head (and life) in all accidents. But it gives some protection and will save you from serious injuries in some accidents. I am still happy that it was my helmet and not my head that took the main impact when I hit the tarmac in 48,5 km/h.
I cannot give any evidence of what kind of injuries I whould have had, had I not used helmet. And I cannot give any evidence on what would have happened with the two persons I happen to know who got serious head injuries when they crashed riding bicycles to work, not using helmets. One of them has never fully recovered years after the accident. Maybe a helmet would have saved their heads, or at least not made the injuries less serious. At least it would not have made the situation worse. It is worth a try.
The same day as I had my accident, the vice rector at one of the Norwegian univeristies was killed in a cycling accident. He lost control, maybe because of some loose gravel on the tarmac, fell and hit the railing. He did not wear a helmet. We will never know if the helmet would have saved his life, but it could have done. I am convinced that my injuries would have been much worse had I not used the helmet. I ended with a fractured thumb, a bruised leg and beaten (but not broken) shoulder, but with no head injuries.
The statement from Amsterdamized that the helmet could not have protected my head means that they are saying that a helmet cannot give any protection in any situation. And they are referring to research! I have not found any reports even suggesting anything that could support this statement. They disqualify themselves from any serious discussions on the subject by statements like this. And Copenhagenize is not far behind.
Bike helmet laws that makes the use of helmet compulsory, is a very different matter. There are many reasons to oppose such laws, which I do. If you are riding at a relaxed speed of 10-15 km/h, which I think is rather common in city traffic, helmet is not necessary. It is not faster than the speed of a fairly well trained jogger. When I am riding my bike to the local bakery in France to get fresh bread for breakfast, I may drop the helmet. But using helmet is a habit, just as using seat belt when driving a car. I sometimes fasten the seat belt even when moving a car in the garage just because it feels natural to use seat belt when driving, and I use helmet when riding a bike even when it is not necessary.
Many politicians are media driven. They are triggered by sensations and drama, not by knowledge. One dramatic accident, and it will be a cry for laws making protection equipment mandatory, and to forbid anything that might carry some risk. It is those people who are likely to order any tree to be cut down because a child could climb it and maybe fall down. It is these politicians that will prevent children from learning to use a knife or an axe, because it is dangerous. And of course, if you never learn how to use it, it will be dangerous. Some suggest that the increase in extreme sports with very high risks may be a kind of compensation for an overprotected childhood.
Those who will make the use of helmet mandatory also tend to overlook that many more people die from inactivity than from biking accidents. If laws that requires bike helmets cause people to park their bikes and go back to cars, it may cause more permature deaths than those prevented by helmets — even if helmets work as good as some claims. But premature death caused by an inactive lifestyle will not make headlines, thus not trigger the politicians who will pretend that they are doing something.
I am not among those who says it is a liberty and a right for anyone to take high risks in all situations (and send the bill to the health care system). I support mandatory use of seat belts when driving, helmets when riding a motorcycle, etc. If anyone should claim that seat belt laws keep people from driving cars, it is no problem. There will be no positive effect if people should be driving more. But cycling has a very positive effect. The cynical, but realistic view is that we may have to sacrifice some who may be injuried or killed in accidents without using helmets, to save those who would have died from inactivitiy had they not been cycling (without helmet).
I stick my initial comment: More people die from inactivity than from not using helmets when cycling. But I am still convinced that I would have had more serious injuries had I not used helment when I crashed.