On 25/11/04 2:00 pm, in article ,
"John Doe" wrote:

If you want to read about the benefit of wearing a helmet while
riding a bicycle, all you have to do is research the matter.


No. You have to read, understand and critically assess the reports. The
brief summaries you have posted are misleading in the extreme.

When a scientist happens to want to find something, sometimes the data will
be interpreted in misleading or erroneous ways.

rantThe problem with the soundbite internet culture is that people think
that knowledge is empowerment. They are wrong. Knowledge without
understanding is futile. Why do people who have no training in critical
assessment of experimental design think they can do science? Why then do
medical journals publish such stuff?/rant

FWIW I am a trained scientist who is a an active researcher. I have been
following the literature on helmets for some considerable time. I have
actually read many of the papers you list. In all that time I have never
found a paper from a case control study whose conclusions were appropriate
to the data they had collected. And never found one that could explain the
population wide data differences (or lack of) after helmet wearing.
I have added a few comments below. For decent rebuttals of many of these,
visit http://www.cyclehelmets.org

...d

J Clin Neurosci. 2004 Feb;11(2):126-9.

Helmet wearing ... essential for the prevention of head injury.

Why do I need a helmet if I don't hit my head?


Clin Pediatr (Phila). 2003 Oct;42(8):673-7.

Helmet use protects against head injury.


Not if you don't have an accident. Preventing accidents works better than
trying to ameliorate the effects of accidents. H&S 101.

Inj Prev. 2003 Sep;9(3):266-7.

Imperial College of Science, Technology and Medicine, London, UK...
The wearing of a cycle helmet is estimated to prevent 60% of head
injuries.

This paper was roundly criticised (try using a decent literature search
engine and follow the citations. You'd find out that they made a simple
arithemtic error. If their error is corrected then their conclusions are
that every person wearing a helemt protects two people from head injury..

Ugeskr Laeger. 2002 Oct 28;164(44):5115-9.

Helmets offer bicyclists aged 0-15 years protection against head
injury.

How much and is it necessary?

Online J Knowl Synth Nurs. 2002 Mar 25;9:1. Print 2002 Mar 25.

Current research continues to show that bicycle helmets prevent
serious injury and death in cyclists of all ages. Children are at
special risk for head injury.


This is angela Lee's paper that shows no hard numbers, just meaningless
rhetoric.


Arch Pediatr. 2001 Nov;8(11):1246-50.

All five conclude in favor of the effectiveness of the bicycle
helmet even when taking bias into account.

Pick five studies that happen to support your case and claim overwhelming
support in a meta analysis.



Accident Analysis & Prevention. 2001 May;33(3):345-52.

In conclusion, the evidence is clear that bicycle helmets prevent
serious injury and even death.


Tidsskr Nor Laegeforen. 2000 Jun 30;120(17):1955-9.

BACKGROUND: Bicycle helmets prevent head injury in bicycle riders...
RESULTS: ... If every rider used a helmet, about 1,600 head injuries
would be avoided every year, of these, 800 among children aged 0-
14... INTERPRETATIONS: There is a significant health improvement
potential in promoting bicycle helmets in Norway


Semin Neurol. 2000;20(2):247-53.

Helmet usage and common sense would lower the number of serious head
trauma cases by 50%.

A statement I would agree with. I'd even agree with it if the 'Helmets and'
was removed.

Inj Prev. 1998 Jun;4(2):122-5.

More than 70% of injured bicyclists reported no helmet use. The
proportion of admissions of injured bicyclists who did not use
helmets was always higher than the proportion of admissions of those
who used helmets (OR = 2.23, CI = 1.39 to 3.62). Head and face
injuries occurred more often among those who did not use helmets.


Against a background of how many actually wearing helmets in the street?

JAMA. 1996 Dec 25;276(24):1968-73.

CONCLUSIONS: Bicycle helmets, regardless of type, provide
substantial protection against head injuries for cyclists of all
ages involved in crashes, including crashes involving motor
vehicles.


Pediatrics. 1996 Nov;98(5):868-70.

RESULTS: An average of 247 traumatic brain injury deaths and 140,000
head injuries among children and adolescents younger than 20 years
were related to bicycle crashes each year in the United States. As
many as 184 deaths and 116,000 head injuries might have been
prevented annually if these riders had worn helmets.

That isn't data, it is speculation..

Clin J Sport Med. 1996 Apr;6(2):102-7.

RESULTS... The risk of serious head injury was significantly greater
when a helmet was not worn... CONCLUSIONS. Helmets afford a
protective effect with respect to serious head injuries.

Significantly in the statistical sense does not indicate that it is
worthwhile for an individual.



Unfallchirurg. 1996 Mar;99(3):202-6.

It is remarkable that more serious head injuries did not occur in
the helmet group... In our opinion the bicycle helmet can reduce the
incidence and the grade severity of head injuries significantly...


South Med J. 1996 Feb;89(2):218-20.

This study indicates that when safety measures such as restraint
systems, helmets, or proper supervision are ignored, children may
die as a result of trauma.


Sports Med. 1995 Nov;20(5):348-62.

It is estimated that up to 85% of all cycling fatalities caused by
head injuries could be prevented by the use of an appropriate
cycling helmet.


J Trauma. 1995 Jun;38(6):871-5.

Although it is urgent to increase helmet use substantially by child
bicyclists, special attention should be paid to high-risk groups,
such as children with mental disorders and children who are likely
to ride in traffic.


Conn Med. 1995 Jan;59(1):3-9.

Bicycle-related head injury is an important cause of mortality and
morbidity of Connecticut children and youth and is largely
preventable through the use of bicycle helmets.


CMAJ. 1995 Jan 1;152(1):45-53.

CONCLUSIONS: Bicycle-related deaths result from factors that are
generally avoidable. Identifiable risk factors other than lack of
helmet use...


BMJ. 1994 Jun 11;308(6943):1537-40.

CONCLUSION--The findings...confirm protective effect of helmet
wearing for any bicycle accident.

This was the cambridge study where the data do not support the conclusions
claimed.

Pediatrics. 1994 Apr;93(4):567-9.

Helmet use among school-aged children increased from 5.5% in 1987 to
40.2% in 1992. Bicycle-related head injuries decreased by 66.6% in
5- to 9-year-old and 67.6% in 10- to 14-year-old members of an
health maintenance organization.


Public Health Rep. 1994 Mar-Apr;109(2):296-301.

Bicycle helmet use in the United States has remained low despite
clear demonstration of its beneficial effect on reducing the
incidence of serious head injury.


BMJ. 1994 Jan 15;308(6922):173-6.

The risk of head injury in bicycle accidents is reduced among
children wearing a helmet.


J Pediatr Surg. 1993 Feb;28(2):214-6.

These findings suggest that more emphasis should be placed on
primary and secondary injury prevention by such methods as bicycle
safety education for children and the promotion of bike helmet use.


Bol Asoc Med P R. 1992 Nov;84(11):305-8.

A case control study of accidents among bicycle riders experiencing
a crash demonstrates that safety helmets reduce the risk of head
injury by 85% and brain injury by 88%.


Pediatrics. 1992 Jan;89(1):78-80.

Research has demonstrated that helmets protect against head injury
during bicycle crashes.


JAMA. 1991 Dec 4;266(21):3032-3.

SETTING--Entire United States... MAIN RESULTS--...Forty-one percent
of head injury deaths and 76% of head injuries occurred among
children less than 15 years of age. Universal use of helmets by all
bicyclists could have prevented as many as 2500 deaths and 757,000
head injuries, ie, one death every day and one head injury every 4
minutes.


Pediatrics. 1991 Jul;88(1):43-7.

There is good evidence to recommend helmets, yet few children wear
them.


Indiana Med. 1991 Apr;84(4):264-6.

Suggestions are given on how physicians can help educate, distribute
information and encourage bicycle helmet use through their contact
with families... Ultimately, we hope such a program will increase
helmet use and consequently reduce morbidity and mortality from head
injury in Indiana's children.


J Emerg Nurs. 1990 Jan-Feb;16(1):36-40.

Wearing a properly fitted and maintained helmet that has been
certified is the best method for reducing a tragic injury. Choosing
to have a child wear a helmet may cause adjustments, but it hardly
compares to those imposed by any type of head injury.


N Engl J Med. 1989 May 25;320(21):1361-7.

We conclude that bicycle safety helmets are highly effective in
preventing head injury. Helmets are particularly important for
children, since they suffer the majority of serious head injuries
from bicycling accidents.


T&R. The infamous 'helmets prevent 85% of leg injuries' paper.


Am J Prev Med. 1986 Nov-Dec;2(6):330-3.

The failure of bicyclists, particularly children, to use bicycle
helmets presents an opportunity for prevention of thousands of the
traumatic head injuries that occur annually in the United States.


Aust Fam Physician. 1984 Apr;13(4):284-5.

Bicyclists have been relatively ignored, which is especially
regrettable when two thirds of bicycle casualties are school
children.