published helmet research - not troll

Frank Krygowski wrote:
Steven Bornfeld wrote:



Well, that's the problem, isn't it? Tough to run a controlled
study of this type in real-life conditions.


It would be tough if there weren't such things as mandatory helmet laws
(MHLs). Or even better, _enforced_ MHLs. When you've got a step
increase in the percentage of cyclists in helmets for a whole country,
it's not a bad test of "real-life conditions." All you have to do is
remember to account for the decrease in cycling those laws have caused.
(Pro-helmet papers have been known to ignore a 35% cycling drop, and
count the 30% HI drop as a good sign!)


I don't know how you can call this a real test with any control. In
your response to Jay, you just said:

"Other pro-helmet studies from Australia have done things like ignore
the drop in cycling, ignore the concurrent installation of speed cameras
and stiff drunk driving enforcement, etc. to maximize the supposed
helmet benefit. Still, this is the first time I recall any study but
T&R's coming anywhere close to 85%. Despite the fudging, other
pro-helmet studies come out much lower. I'd like to check the original
paper."


If there were confounding factors in the prior example, you can't come
back and now say these can be ignored.


Why someone would even try to suggest that helmets don't save
lives because there are no controlled studies to prove they do says
more about these people than it does about helmets.


Your statements are too vague to be of use.


I'm not suggesting you use it. I am suggesting that antihelmet
partisans can be depended upon to parse the data out there selectively.


The people I know who say helmets don't save lives are the people who
have spent the largest amount of time examining the actual data. The
people who claim they must are typically people who have read a few
helmet promotion blurbs.

Is that what you meant, exactly?


I've heard the same arguments from people who don't wear seatbelts
in cars. I thought they made what could be valid points--until I
spent a year covering head/neck trauma during my residency.


Let's stick to the issue. Seatbelts are a side point. They're not
really comparable - largely because seat belts are tested and certified
for serious collisions, the ones that cause most serious accidents. Bike
helmets are definitely not.

So tell us about your head trauma experience. Since we're talking about
saving lives, what percentage of the head trauma fatalities you saw were
cyclists?

They don't usually call the dentist on the head trauma fatalities. I
was called on facial injuries. There were a substantial number of
cycling accidents. Most weren't wearing helmets, but then this was 28
years ago.


You probably realize that nationally, cyclists are less than 1% of that
problem, right?


If it's you, you're 100% dead.

Steve


Was your experience different from the national average? I'm quite
curious.

John Forrest Tomlinson wrote:
On Fri, 18 Jun 2004 19:24:50 -0400, Steven Bornfeld
wrote:



But this is like saying that a
seat belt shouldn't be worn because it won't save you from crushing
injury of the thorax in a head-on 60 mph crash.
Safety measures shouldn't be discarded because they are not 100% effective.


I haven't said anyone should wear a seatbelt and I haven't said anyone
shouldn't wear a bicycle helmet. I've asked, repeatedly in this
thread, for some evidence of speculation about overstated dangers. If
helmet proponents want to push for wider helmet use, I think it's only
fair that they be honest about what is known and identify their
speculation as such. That's not a lot to ask -- for honesty.

JT

I spend far too much time over at the dental newsgroup from folks who
still think fluoride is a Communist plot, that fluoride caries data are
false. Likewise, we're assaulted daily by folks who think we're
poisoning our patients with mercury, that vaccines cause autism, etc,
etc. My experience and expertise ain't worth crap.
You want to believe this is a helmet manufacturer conspiracy, go right
ahead. I have no intention of wasting time proving that the earth isn't
flat.

Steve

Steve

Frank Krygowski wrote:
Steven Bornfeld wrote:


There are many studies out there--some designed better, some
worse. There is poor compliance with helmet regulations in the US
where they exist. But certainly Kunich can show studies which cast
doubt on the efficacy of helmets in preventing head injuries. There
is also this:

http://www.cochrane.org/cochrane/revabstr/ab001855.htm

which reaches exactly the opposite conclusion.


It's scary to me that a person can get serious medical training, yet
come away with your attitude. "Some go one way, some go another way. Oh
well, no point examining the methodology. We'll just go by gut feeling."

I don't know what "attitude" you're detecting, other than that I
disagree with you. I fully expect that the studies that support your
position are all well-designed.


Seriously, is that how they select chemotherapy drugs??


In the end, people are going to believe what they want.
Unfortunately, my tax dollars are going to pay the medical expenses of
those who ignore common sense.


Good grief. Sounds like more gut feeling to me!

Why not compute what percentage of your tax dollars to to auto accidents
(40,000 fatalities per year), to pedestrian fatalities (6500 per year),
to drownings (over 4000 per year). Then start thinking about obesity,
smoking, and all the other causes of preventable death.

What is your point?


Given the numbers, the 700 or so bike fatalities per year in the US are
NOT going to keep you from buying your next Mercedes! (As if the others
did...)

Well, that's very nice.

Steve ('89 Honda)



--
--------------------+
Frank Krygowski [To reply, remove rodent and vegetable dot com,
replace with cc.ysu dot edu]

Frank Krygowski wrote:
Steven Bornfeld wrote:



John Forrest Tomlinson wrote:

And when you consider that riding a
bike w/o a helmet is probably better for your health than not riding
at all,


Pure speculation, JT, pure speculation.


Meyer Hillman, a rather famous researcher for the British Medical
Association, has computed that the years of life gained due to cycling
outnumber the years of life lost by a 20 to 1 ratio.

From what I've seen, the speculation in this discussion has come from
you! "Common sense" indeed!

Yeah, yeah. I'll bet he hates helmets too.

Steve

Frank Krygowski wrote:
Steven Bornfeld wrote:


Safety measures shouldn't be discarded because they are not 100%
effective.


Perhaps that's true.

But safety measures shouldn't be strongly promoted unless their benefits
are proven in large populations.

They shouldn't even be considered for mandating unless it's proven that
the resulting benefits outweigh the detriments - including the important
benefit of personal freedom, for one's self and one's family.

And they shouldn't receive the lion's share of promotion unless other
measures are much less effective.


Unfortunately, bike helmets seem to look relatively useless in large
population studies (as opposed to limited case-control studies with
self-selected subjects).

Mandating, and perhaps even strong promotion, of bike helmets tends to
drive people away from cycling, by making it seem extraordinarily
dangerous. And promoters have successfully convinced the public that
cycling is, indeed, dangerous - despite data to the contrary.

And it's still true that often, the ONLY thing people hear about bike
safety is "Always wear a helmet!!!!" Nothing about rules of the road,
lights at night, maintaining the machine, etc.

I've seen enough helmeted families riding facing traffic, or riding at
night without lights, to know that the emphasis needs to be changed.


Recently, a member of my extended family was in for some minor medical
care - interestingly, related to being hit by a car while walking. The
physician heard mention of bicycling, and asked "Do you always wear a
helmet?" When the answer was "No," there was some scolding.

Think about that. Nothing about "Do you follow the rules of the road?
do you ride on the right? Do you use lights at night? Is your bike
mechanically sound?" And of course, nothing about "Do you wear a helmet
when crossing the street?" _despite_ the recent car impact!

Clearly, the emphasis is mistaken.

Feel free to start another thread. My advocacy of helmets does not in
any way make me irresponsible regarding these other issues. Do you
believe it does?

Steve

Erik Freitag writes:

On Sat, 19 Jun 2004 00:21:50 +0000, Bill Z. wrote:

This is not true. Children do not ride less due to helmet laws,
particularly in California, where the helmet laws are not enforced (or
rarely enforced.) If you tell a young teen to start using a helmet when
he previously didn't want to, you can expect a negative reaction (natural
rebelliousness.) Kids who started using helmets when they started riding
bicycles don't have that reaction.

I think this is another evidence-free (in the statistical sense)
assertion. I offer a counter-anecdote - my kids, 11 & 13 won't ride to
school because they don't want to wear their helmets because helmets make
them look like geeks, like their dad. Dad won't let them ride without one
because there's a law ...

See if you can prove otherwise. I've seen the police drive by an
unhelmeted kid riding a bicycle numerous times. I've never seen
an officer stop a child.

If they don't cite anyone, the law won't have any effect. In fact,
I doubt if most parents are even aware of the law.

BTW, your kids may be just using that as an excuse. If you told them
they couldn't use a helmet, they might insist on using one, just to
be rebellious. You konw, 13 years old ...


--
My real name backwards: nemuaZ lliB

Frank Krygowski wrote:
Steven Bornfeld wrote:



Frank Krygowski wrote:

Meyer Hillman, a rather famous researcher for the British Medical
Association, has computed that the years of life gained due to
cycling outnumber the years of life lost by a 20 to 1 ratio.

From what I've seen, the speculation in this discussion has come
from you! "Common sense" indeed!



Yeah, yeah. I'll bet he hates helmets too.


:-) The intellectual level of the discussion seems to be falling like a
stone.

He did study the issue of benefits versus detriments of cycling when he
was researching the helmet issue, true. And it's partly for that reason
that he is strongly against mandating helmets, and very cautious about
even promoting them.

Give the guy credit for doing study and research before forming his
opinion, please.

Like I said. I'd be happy to seek out the study. Can you post a
reference?

Steve

Steven Bornfeld wrote:


Frank Krygowski wrote:

Meyer Hillman, a rather famous researcher for the British Medical
Association, has computed that the years of life gained due to cycling
outnumber the years of life lost by a 20 to 1 ratio.

From what I've seen, the speculation in this discussion has come from
you! "Common sense" indeed!


Yeah, yeah. I'll bet he hates helmets too.

:-) The intellectual level of the discussion seems to be falling like a
stone.

He did study the issue of benefits versus detriments of cycling when he
was researching the helmet issue, true. And it's partly for that reason
that he is strongly against mandating helmets, and very cautious about
even promoting them.

Give the guy credit for doing study and research before forming his
opinion, please.


--
--------------------+
Frank Krygowski [To reply, remove rodent and vegetable dot com,
replace with cc.ysu dot edu]

Bill Z. wrote:

Erik Freitag writes:


On Sat, 19 Jun 2004 00:21:50 +0000, Bill Z. wrote:


This is not true. Children do not ride less due to helmet laws,
particularly in California, where the helmet laws are not enforced (or
rarely enforced.) If you tell a young teen to start using a helmet when
he previously didn't want to, you can expect a negative reaction (natural
rebelliousness.) Kids who started using helmets when they started riding
bicycles don't have that reaction.

I think this is another evidence-free (in the statistical sense)
assertion. I offer a counter-anecdote - my kids, 11 & 13 won't ride to
school because they don't want to wear their helmets because helmets make
them look like geeks, like their dad. Dad won't let them ride without one
because there's a law ...


See if you can prove otherwise. I've seen the police drive by an
unhelmeted kid riding a bicycle numerous times. I've never seen
an officer stop a child.

If they don't cite anyone, the law won't have any effect. In fact,
I doubt if most parents are even aware of the law.

There are other ways in which laws can be enforced and have effects.

My bike commute in the SF East Bay area took me past an elementary
school, a middle school, and a high school. Although there are far
fewer kids cycling to school now than before the helmet law, I still see
a reasonable number. Almost all of them have a helmet, but about 80% of
those helmets are hanging from their handlebars. Maybe this is just a
new fashion statement, but I think there's another reason - the kids
really don't want to wear the helmets but the law is enforced at the
schoolyard (and possibly at home). As soon as they are off the school
property the helmets come off their heads and get tied to the bars.

When my daughter was starting high school I asked her why none of her
friends rode their bikes anymore. She asked them and the main reason
given was the 'helmet hair' issue. Now we may not think that's a very
good reason, but it really doesn't matter if it keeps kids from riding.
Fewer kids riding is likely to mean fewer adults riding later.

Steven Bornfeld wrote:



Frank Krygowski wrote:

Steven Bornfeld wrote:



Well, that's the problem, isn't it? Tough to run a controlled
study of this type in real-life conditions.



It would be tough if there weren't such things as mandatory helmet
laws (MHLs). Or even better, _enforced_ MHLs. When you've got a step
increase in the percentage of cyclists in helmets for a whole country,
it's not a bad test of "real-life conditions." All you have to do is
remember to account for the decrease in cycling those laws have
caused. (Pro-helmet papers have been known to ignore a 35% cycling
drop, and count the 30% HI drop as a good sign!)



I don't know how you can call this a real test with any control.
In your response to Jay, you just said:

"Other pro-helmet studies from Australia have done things like ignore
the drop in cycling, ignore the concurrent installation of speed cameras
and stiff drunk driving enforcement, etc. to maximize the supposed
helmet benefit. Still, this is the first time I recall any study but
T&R's coming anywhere close to 85%. Despite the fudging, other
pro-helmet studies come out much lower. I'd like to check the original
paper."


If there were confounding factors in the prior example, you can't
come back and now say these can be ignored.

Do you understand that we're talking about multiple papers?

And do you understand that if the confounding factors all would tend to
decrease cyclist injuries, it's disingenuous to attribute all reduced
injuries to just one factor, the helmets?


I am suggesting that antihelmet
partisans can be depended upon to parse the data out there selectively.

.... whereas pro-helmet partisans ...???

Incidentally, the word "antihelmet" is rather imprecise.
"Anticompulsion" would be more accurate for many. "Anti-over-promotion"
would fit others. "Anti-fearmongering" still others. But I must say, I
can't recall anyone ever wanting to make helmets illegal.

Of course, it may be that the Church of the Helmet requires absolute
belief in _all_ pro-helmet dogma. If so, then there really are lots of
anti-helmet people.


I've heard the same arguments from people who don't wear
seatbelts in cars. I thought they made what could be valid
points--until I spent a year covering head/neck trauma during my
residency.


So tell us about your head trauma experience. Since we're talking
about saving lives, what percentage of the head trauma fatalities you
saw were cyclists?


They don't usually call the dentist on the head trauma fatalities.
I was called on facial injuries. There were a substantial number of
cycling accidents. Most weren't wearing helmets, but then this was 28
years ago.

Oh, a dentist.

IOW, you know something about teeth. You know relatively little about
head trauma. I should have guessed.



You probably realize that nationally, cyclists are less than 1% of
that problem, right?

If it's you, you're 100% dead.

.... and, apparently, you know relatively little about evaluating
relative risk.



--
--------------------+
Frank Krygowski [To reply, remove rodent and vegetable dot com,
replace with cc.ysu dot edu]