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#81
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published helmet research - not troll
"Steven Bornfeld" wrote As long as this is not libertarian, and allowing that proper bicycle maintenance and effective cycling are more important to cyclist safety, what would your feelings be about: 1) Mandatory licensing of cyclists (as per motor vehicles) 2) Mandatory minimum age for cyclists on public streets and roads 3) Mandatory registration of bicycles and periodic bicycle inspections This list is a perfectly good way of eliminating cycling injuries completely within one generation. Of course, it would also eliminate cycling in general. If you don't cycle as a kid, it is highly unlikely you would ever do it as an adult. Pete |
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published helmet research - not troll
Mark & Steven Bornfeld DDS writes:
Bill Z. wrote: Steven Bornfeld writes: Steve This was also beaten to death a decade ago, and is being trotted out again. The guy didn't say that helmets were ineffective. He suggested that the health benefits of cycling regularly, even for "commuter" or "utility" cyclists riding short distances at low speeds, exceeded the risks whether helmets were used or not. That has zero to do with whether helmets are effective or not. It may be a good argment against mandatory helmet laws (depending on how much of a disencentive a helmet requirement actually is.) snip As for actually calculating the quantitative saving of lives, this is always more complicated than it seems. snip Except that "saving lives" isn't the issue - the number of accidents per year is low enough that a useful reduction in fatalities (say, 10% or so) would be lost in the noise. The real question is the extent to which helmets reduce injuries. If they reduce them enough to pay for the cost of the helmet through reductions in the cost of treating an injury, the thing will pay for itself. BTW, in terms of mandating them, the real argument against doing that is the wide spread in annual mileage. I know people who ride many thousands of miles each year and others whose yearly mileage rarely exceeds 5 or 10 miles. Do you require a helmet for a person who rides such short distances? We are talking, after all about a factor of a 1000 in annual mileage. In any case, this has all been beaten to death in previous discussions. Nothing new is being brought up. -- My real name backwards: nemuaZ lliB |
#83
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published helmet research - not troll
Pete wrote: "Steven Bornfeld" wrote As long as this is not libertarian, and allowing that proper bicycle maintenance and effective cycling are more important to cyclist safety, what would your feelings be about: 1) Mandatory licensing of cyclists (as per motor vehicles) 2) Mandatory minimum age for cyclists on public streets and roads 3) Mandatory registration of bicycles and periodic bicycle inspections This list is a perfectly good way of eliminating cycling injuries completely within one generation. Of course, it would also eliminate cycling in general. If you don't cycle as a kid, it is highly unlikely you would ever do it as an adult. Pete Maybe. I put up with this for my car. No reason I wouldn't for my bike. Not saying I would advocate any or all of this, but I might on reflection. Mandatory inspection makes a lot more sense to me than mandatory CPSC regs such as reflectorized pedals. Steve |
#84
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published helmet research - not troll
"Steven Bornfeld" wrote in message ... Pete wrote: "Steven Bornfeld" wrote As long as this is not libertarian, and allowing that proper bicycle maintenance and effective cycling are more important to cyclist safety, what would your feelings be about: 1) Mandatory licensing of cyclists (as per motor vehicles) 2) Mandatory minimum age for cyclists on public streets and roads 3) Mandatory registration of bicycles and periodic bicycle inspections This list is a perfectly good way of eliminating cycling injuries completely within one generation. Of course, it would also eliminate cycling in general. If you don't cycle as a kid, it is highly unlikely you would ever do it as an adult. Pete Maybe. I put up with this for my car. No reason I wouldn't for my bike. Not saying I would advocate any or all of this, but I might on reflection. Mandatory inspection makes a lot more sense to me than mandatory CPSC regs such as reflectorized pedals. Item: Brake inspection. Do you mandate two functional brakes? One? I can ride a no-brake fixie very well. Item: Lights. Required? Why? Item Registration. What price would you put on a years bike registration? $1? $5? The same as a car? Either way, its a bad choice. Either not cost effective, or wildly out of proportion. Item: Licensing and minimum age. What age would this be? 16? 14? 12? By age 14 or so...if they haven't ridden yet, they arent likely to. Motor vehicles are thusly regulated because of the enormous potential for damage. Bikes, and other forms of transport have no such potential. I have a house on a very short, 8 house cul-de-sac. Zero traffic, except for residents. Rules such as this would prevent my 8 year old neighbor from riding across the street to her friends house. Do we license pedestrians next? Pete Nice troll, though. |
#85
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published helmet research - not troll
Pete wrote: "Steven Bornfeld" wrote in message ... Pete wrote: "Steven Bornfeld" wrote As long as this is not libertarian, and allowing that proper bicycle maintenance and effective cycling are more important to cyclist safety, what would your feelings be about: 1) Mandatory licensing of cyclists (as per motor vehicles) 2) Mandatory minimum age for cyclists on public streets and roads 3) Mandatory registration of bicycles and periodic bicycle inspections This list is a perfectly good way of eliminating cycling injuries completely within one generation. Of course, it would also eliminate cycling in general. If you don't cycle as a kid, it is highly unlikely you would ever do it as an adult. Pete Maybe. I put up with this for my car. No reason I wouldn't for my bike. Not saying I would advocate any or all of this, but I might on reflection. Mandatory inspection makes a lot more sense to me than mandatory CPSC regs such as reflectorized pedals. Item: Brake inspection. Do you mandate two functional brakes? One? I can ride a no-brake fixie very well. Item: Lights. Required? Why? Item Registration. What price would you put on a years bike registration? $1? $5? The same as a car? Either way, its a bad choice. Either not cost effective, or wildly out of proportion. Item: Licensing and minimum age. What age would this be? 16? 14? 12? By age 14 or so...if they haven't ridden yet, they arent likely to. Motor vehicles are thusly regulated because of the enormous potential for damage. Bikes, and other forms of transport have no such potential. I have a house on a very short, 8 house cul-de-sac. Zero traffic, except for residents. Rules such as this would prevent my 8 year old neighbor from riding across the street to her friends house. Do we license pedestrians next? Pete Nice troll, though. Not at all. You can make the rules as draconian as you wish, or not. One might regulate driving on public roads, or designate certain areas that might be exempt (like snowmobiles, for example). You may set a reasonable age (say 10) but mandate passing a test. One could tax bicycle components and dedicate funds for enforcement. I'm not a legislator, but the choice shouldn't be between no regulation and stupid over-regulation. Of course if you believe there is no safety issue to speak of, there's no reason to speak about this at all. Steve |
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published helmet research - not troll
"Steven Bornfeld" wrote Not at all. You can make the rules as draconian as you wish, or not. One might regulate driving on public roads, or designate certain areas Public roads are public roads. That includes the 6 lane arterial and the 5 house cul-de-sac. Do we exempt certain streets? Or only include certain streets? that might be exempt (like snowmobiles, for example). You may set a reasonable age (say 10) but mandate passing a test. 10 is a reasonable age? So I can't ride with my 9 year old on quiet residential streets? One could tax bicycle components and dedicate funds for enforcement. They already are. Sales tax on bike parts goes into the general fund, like everything else. I'm not a legislator, but the choice shouldn't be between no regulation and stupid over-regulation. The 'regulation' is already there. Pretty much every city and state code says cyclists *must* follow most of the same rules as motorists. Enforce as necessary. Of course if you believe there is no safety issue to speak of, there's no reason to speak about this at all. To be sure, a large number of bike-car crashes are due to the cyclist doing something stupid. Riding at night with no lights, wrong way riding, zooming out of a driveway. Is giving a 10 year old a test and making her parent pay a registration fee the answer? It doesn't seem to have helped in the other large percentage of bike-car crashes that are due to the tested, licensed, and registered motorist doing something stupid. Education and enforcement is the key...not more unenforced rules. Pete |
#87
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published helmet research - not troll
On Sat, 19 Jun 2004 22:31:00 -0400, Steven Bornfeld
wrote: Mandatory inspection makes a lot more sense to me than mandatory CPSC regs such as reflectorized pedals. Who and how many people would this help? In talking about public policy, you've got to ask what is the benefit and what is the cost? I see benefit for an extremely small amount of people and cost for an extremely large number of people. So I don't understand the point of this suggestion. JT |
#88
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published helmet research - not troll
On Sat, 19 Jun 2004 18:38:51 -0400, Steven Bornfeld
wrote in message : Let me see if I get this straight. All the studies showing a benefit have fatal flaws; all the studies that show no benefit are well-designed. Not necessarily. There are, as I said, essentially two sorts of study. Small-scale prospective studies, of which the 1989 Thompson, Rivara and Thompson is the best-known; these show unequivocal benefit and large scale savings in injuries. Then there are population-level studies, which are equivocal. They show no measurable bnefit. They show lots of confounding factors. I have seen rebuttals of all the major pro-helmet papers. Most of these rebuttals are valid, like the criticism of the control group in TR&T which effectively makes the whole thing worthless. I have yet to see any rebuttal of a population-level study. I do read everything I can find, and I was originally strongly pro-helmet and in favour of compulsion for children. One of the key factors in changing my view was the fact that I had no idea the population level studies even existed. Helmet promoters were telling me that helmets save 85% of head injuries and 88% of brain injuries, stated as fact, but then I found that even the original authors had revised these estimates downwards, and that the figures were well known to be unreliable. It's like the business of WMD: as the lies start to be exposed, you have to question whether there is any basis of truth at all. Actually the real position is probably that helmets prevent most trivial injuries and very few serious ones. There is a probably narrow band of cases where helmets may turn a serious injury ionto a minor injury, but risk compensation also means that there is another band of cases where the crash would not have happened in the first place had the rider not been wearing a helmet. So overall there are solid reasons why, at the population level, where only serious and fatal injuries are counted, there would be no visible effect; while at the detail level, where all injuries are counted, some effect may be seen. All that, I have no problem with. I do have a problem with helmet promotion which igniores the distinction between different kinds of crash and different kinds of injury. The idea that because a helmet saves a cut head it will necessarily prevent massive brain trauma when hit by a pseeding truck is laughable, but by using a single figure for injury reductions that is exactly what the promoters are trying to imply. I also have a problem with the excessive focus on helmets. In the minds of the medical and legislative communities, wearing a helmet seems to be viewed as the first, best thing a cyclist can do to ensure their safety. There is no credible evidence to support that prioritisation. The only thing which I can think of which has been proved everywhere to omprove safety, is more people cycling. So if you want cycling to be safer, you have to promote cycling (and good cycling skills, obviously). Promoting helmets requires that you build the perception of cycling as a hazardous activity, which works against that goal. The studies I saw cited are all retrospective studies. I believe it is possible that somewhere a paper may have been published that confuses percentages for percentage points. It is hard to believe this happened multiple times in referreed journals. There are recognisable flaws with many of the key papers. You can find some good critiques at http://www.cyclehelmets.org and http://www.cycle-helmets.com and other places too. Let me be clear--I am not an expert in safety data nor in epidemiology. But I am up to my eyeballs in newsgroup pundits (in unrelated fields) making patently ridiculous claims about the body of evidence in fields in which I do have expertise. It is impossible for me to evaluate helmet data for myself, nor have I found it prudent to believe folks such as yourself who may very well have that expertise. OK, but some of us are not your garden-variety newsgroup pundits. Some of those who post have actually done research. I have analysed UK child hospital admissions returns and found that there is no significant difference in the proportion of head injuries suffered by road cyclists and pedestrians, despite helemt wearing rates only around 15%. That doesn't suggest to me that cycling is especially dangerous. I work with John Franklin, probably the UK's leading cycle safety expert, and I've talked to the people who test helemts against the standards. It was they who told me that modern helmets are far weaker than those in the TR&T study, and that many helmets fil the tests anyway. These guys have shown me that scepticism is not a contrarian view. That's the point. We are no anti-helemt, we are anti-FUD. Someone is trying to sell you an expensive product; the manyufacturers can't say it will save you if you are hit by a car because they know damn well it won't, so they fund studies and they fund groups like Safe Kids and they get someone else who won't get sued when you die to tell you that helmets are a magic panacea to all cycling injuries. One hopes that people in position of authority choose carefully in whom they listen to when policy is made. If only. The UK's Department of Transport currently bases its policy on an "independent review" written by a team of people all of whom work together, and several of whom have published papers calling for helmet compulsion. No sceptic was included in the review body. Some factual errors have since been removed, but it remains a dogma-driven document written by those promoting helmets. There are three sides, you see: pro-helmet, anti-helmet and sceptic. Most cyclists who have read all the facts become sceptics: they make up their own minds and think others should also be allowed to do so. Newbies tend to be pro-helmet, until they realise that their pro-helmet view is largely the result of not being given all the facts. The number of anti-helemt people is very small. And I'n not one of them. See my website if you are in any doubt of that. That, of course, is a fundamental problem. Any agnostic who argues with a True Believer will end up sounding like an atheist, even though they are not. See, I'm going to have to look up that paper. It is very, very difficult for me to believe that NEJM would publish a paper with a flaw that blatant. Sure. Just as it is hard to believe that the percentage points problem would have got past the peer review process. But what you have to remember is that these guys are looking for helmets to work. When I was training as an engineer i was told to guard against that. The idea of an experiment is to test a hypothesis, not to find data to support it. You're supposed to try to disprove, not prove, your initial premise. In this case the researchers (funded, unless I've been misinformed, by the Snell Insititue) had already decided on the outcome before they started. Anyway, if you have trouble getting a copy, let me known and I'll send you a PDF. I can also give you John Franklin's comments on it. The fact that head injury rates have risen by 40% in the USA in a period when helmet use rose from 18% to 50% surely tells us something. Are we talking about cycling head injuries, or total head injuries? Cycling. As does the fact that the pro-helmet British government has admitted that it knows of no case where cyclist safety has improved with increasing helmet use. I'd love to hear some context. It was a letter from the road safety minister to an MP, in response to a question about whether the Government would be supporting a bill to compel children to wear cycle helmets, which had been introduced as a Private Member's Bill. There's a commentary on the process he url:http://www.chapmancentral.co.uk/web/public.nsf/Documents/martlew_bill In order to get the Member concerned to move the Bill, the propsers (a singl;e-issue pressure group) provided a lot of statistics like "28,000 cycling-related head injuries annually" (which turned out to be 1,200), and compulsion representing "20,000 tragedies saved every year" (which turned out to be 500 known serious injuries, almost all sustained in crashes with motor vehicles). I return to my earlier point: if the case were that clear-cut, why is it necessary to exaggerate the figures? The pressure group also got one grieving mother to travel to London to promote the Bill, having told her that her child would have lived had he been forced to wear a helmet (which, of course, you can't prove; his injury sounds as if it could have been caused by rotational forces which helmets can't mitigate). So I read the Coroner's report. He had ridden off the footway into the path of a car because his bike had defective brakes. Footway riding and riding a bike with defective brakes are already offences. So why is this a case for comlsory helemt use, rather than enforcement of existing regulations? And why should we believe that a teenage boy already breaking two laws would obey a third? And in any case, telling the mother that if only there had been a law to compel helmet use her child would be alive today is a heartless and cynical piece of manipulation. It is certainly understandable to me that racers who'd become accustomed to the wind in their hair would object to the "intrusion" of the insurance companies. Certainly there had been no studies back then demonstrating the uselessness of helmets in preventing serious injuries, but those I spoke to (some of whom you undoubtedly know personally) were just as opposed to mandated helmets as you are now. That was not, in my opinion, an actuarial judgement; there was not enough data to go on at the time. Quite why a device designed for a crash at around 12mph should be mandated for racing is an interesting philosophical question. Actually in this area you have a point. It was a decision made for the USCF by whichever insurance carrier was willing to write the liability policy. Far be it from me to tell you their decisions are made on the basis of good, rational data. ;-) Just so. Actuarial data relies on long-term trends and large data sets. In this case it looks more like a kneejerk reaction to asingle incident. As those who follow pro racing know only too well, the mandatory use of helmets has not stopped racing cyclists from dying of head injuries. The numbers are in any case too small for robust statistical comparisons to be made. Only about 10% of cyclist injuries are to the area covered by the helmet and many (possibly most) cyclists who die of head injury also have other mortal injuries. Most fatal cyclist injuries are of course sustained in crashes involving motor vehicles: it is motor traffic, not cycling, which is dangerous. Statistically you are right of course. But we are talking about cycling; we might have much more to talk about were this a political or automotive ng. But I know of several folks who have suffered head injury, a couple of which were life-threatening (prolonged coma and permanent neurological damage) without the benefit of motor vehicles. Sure, but the fact remains that the risk of serious head injury is (roughly an order of magnitude, according to my figures) higher where a motor vehicle is involved. Although there is a risk there of falling into the trap of the compulsion zealots (most of whom seem not to be cyclists) and bundling all cycling together under a single heading. That would be like considering a walk in the park and free-climbing under a single heading. I know one guy who will never walk again following a bike crash, it was probably caused by wheel ejection due to his disc brakes. Some people do mad downhilling. Others ride along traffic-free bike trails. Cycling is a broad church. I have crashed my bike and hit my head, and I've crashed and not hit my head. I know two veterans who had similar crashes, the one wearing the helmet died and the other survived, both the result of hitting potholes in the road, no car involved. Life is one giant crapshoot, after all. In the end, though, the evidence suggests that cycling is not an unusually dangerous activity. The biggest problem with helmet promotion is that it reinforces the perception of cycling as dangeorus without teaching any of the techniques which reduce the danger. In doing so, it actively deters cycling, which paradoxically /increases/ risk. Clarification please: are you talking about relative risk to the rider, or total risk to the population? Sound question. An individual cyclist can reduce the risk to themselves by using good riding techniques (e.g. Effective Cycling). "Cyclist hit by turnign goods vehicle" is nasty, often leading to fatal crushing injuries of the torso. The solutionis simple and obvious: don't ride up the inside of trucks and buses. If you are going to pass in a traffic line, do so on the outside, ensure that the driver is not signalling before you start, be aware that they swing round corners and that the trailer of a semi cuts in, make sure the driver can see you (if yo can't see his mirrors, he can't see you). All of which sounds blindingly obvious, but you'd be amazed at how many cyclists have a lightbulb moment when you tell them this. There are lots of other simple techniques and bits of knowledge which help cyclists coexist more safely with motor traffic. So, the general answer is: for the individual. Also, risk to the individual rider is lower where more people cycle. Cycling also brings health benefits which offset some of the external risks imposed on the cyclist by motorists, so a regular utility cyclist will enjoy a lifespan two years or more longer than average (Mayer Hillman puts the benefits as outweighing the risks by 20:1). In terms of the general population, mode switching to cycling has huge potential benefits. Crashes involving cyclist v cyclist or cyclist v pedestrian are very rarely fatal or even serious. My objections to helmet compulsion are not libertarian, but evidence-based. We have the experience of laws in Australia, New Zealand and Canada to draw on. In no case did injury rates reduce. In every case cycling was deterred. As long as this is not libertarian, and allowing that proper bicycle maintenance and effective cycling are more important to cyclist safety, what would your feelings be about: 1) Mandatory licensing of cyclists (as per motor vehicles) 2) Mandatory minimum age for cyclists on public streets and roads 3) Mandatory registration of bicycles and periodic bicycle inspections All of these have been suggested at various times. They all share one of the fundamental weaknesses of helmet compulsion, in that they deter cycling. Almost no restriction is going to affect me, riding 5,000 miles per year or more and with an investment of around $10,000 in bikes. The rider who has an x-Mart bike and is prompted by a "get off your ass!" promotion to try riding to the corner shop for his newspaper will be faced with either going out and getitng a whole load of expensive training and licenses; breaking the law; or driving (again). You can guess which is going to win. There are other reasons, too. For example: most adults already have a car driver's license. For example: we don't require pedestrians or horse-riders to be licensed. Licensing is a requirement which applies to motor vehicles as a response to the extraordinary levels of danger they impose on others. They have the potential to go very fast, and they weigh a lot. In an exchange of knietic energy, the final velocity of pedestrian plus car is indistinguishable form the velocity of the car beforehand. Massive accelerations cause massive damage. Bikes are small, light, and relatively slow. So there is not sufficient concern to justify a licensing scheme. I am absolutely in favour of voluntary schemes, and schemes run by schools and councils. Minimum age? Well, where would you put that? My ten-year-old can ride safely on the roads here, he has already passed Cycling Proficiency and he's ridden day rides of 50 miles or more with groups. He doesn't get to ride on some roads because they might require evasive techniques he's not learned yet, and because they require too much concentration. His friend of the same age is not allowed on the road on his own because he has no road sense yet. Most parents should be smart enough to realise when their child will be safe on the road, and those who aren't will be placing their child in danger in other ways too. Registration and inspection? The deterrent effect, of course, plus the fact that it would be virtually unenforceable. I would make bike repairs free fo any local sales taxes, encourage "Dr. Bike" schemes with free inspections at schools and community centres. I'd even have beat cops tag bikes which are obviously unsafe. But the danger is principally to the rider. The danger of a defective car is to those around the driver. It's a bit like Russian roulette. With cycling you have five empty chambers and the gun is pointing at your head. With driving you have six loaded guns, only one of which is pointed at you, and pull one trigger at random. But of course, these are unwelcome messages. When you compare child head injury rates for road crashes you find that pedestrians and cyclists have around the same proportion of head injuries, and pedestrian injuries are much more numerous (the risk levels in off-road cycling for children are an order of magnitude lower). Any justification of cycle helmet promotion applies to a much greater extent to walking helmets. And even more so for car occupants, whose fatality rate from head injuries is much greater. Another clarification please: The head injury rates for cyclists vs. pedestrians vs. auto passengers are for 1) Mile traveled 2)total number in population 3) hour spent in activity These are the proportions of all admissions which are due to head injury. So, if you have a bike crash, you are not markedly more likely to suffer head injury than if you are hit as a pedestrian. The risk levels comparison: 10% of cycling is on road, 90% off road. Slightly over 50% of admissions are due to road traffic crashes, slightly under half due to crashes with no motor vehicle involved. Allowing for a small number of simple falls in road riding, the risks are, to a first approximation, an order of magnitude higher for road riding. I think that making the auto industry the focus in this discussion in very much the same way makes it too easy to absolve ourselves of responsibility in this issue. The thing is, though, at the moment the entire focus is on us. Looking at the figures, that's not going to work. Apart from anything else, the same motor risks affect pedestrians, and the number of pedestrians killed and injured is very much higher than the number of cyclists (5-10 times in the UK). Of course motor drivers should not be the sole focus of attention. But right now they are not the focus of /any/ attention in the cycle safety debate. That is what needs ot change. if we wish to appear to be "doing something", it is not enough to fault those who think helmet laws will save us; we must have the courage (and the political clout) to do something that WILL be meaningful. Trust me, I am doing far more than bashing the Liddites. My point is, really, that it is not sufficient for motorists to come along and say it's all my own fault for not wearing a helmet when they knock me off my bike. It's been tried by several insurers in the UK, and in each case thus far they have failed, but that is in part due to work done by our CTC (largest cycling club) who have set up a Cyclists' Defence Fund to fight such cases. There is a debate to be had on cycle safety, and the helemt issue is merely drawing attention away from it. Actually I'm composing a letter on that issue at present: url:http://www.chapmancentral.co.uk/web/public.nsf/Documents/IP Anyway, I can see that you have started to question the orthodox view on helmets, wich is a good thing. Whether you conclude that you personally should or should not wear a helemt, I can't say; and actually I think that's up to you anyway. I think you will probably come to agree (if you don't already) that helmet compulsion is an essentially facile solution, an experiment which has failed wherever it's been tried. It is time to move on to the real issues, as discussed above. Guy -- May contain traces of irony. Contents liable to settle after posting. http://www.chapmancentral.co.uk 88% of helmet statistics are made up, 65% of them at Washington University |
#89
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published helmet research - not troll
On Sat, 19 Jun 2004 23:34:30 GMT, "Shayne Wissler"
wrote in message 944Bc.71708$eu.12036@attbi_s02: Casual observation would imply the opposite. Helmets are more slippery than skin, Er, not quite. That only really applies to hard shell helmets. and they have a larger radius than the skull. Correct. This amplifies rotational forces. Also, the helmet is not as tightly coupled to the head as the skin is Incorrect. A correctly fitted helmet will not rotate on the head. Guy -- May contain traces of irony. Contents liable to settle after posting. http://www.chapmancentral.co.uk 88% of helmet statistics are made up, 65% of them at Washington University |
#90
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published helmet research - not troll
On Sat, 19 Jun 2004 23:43:18 GMT, "Shayne Wissler"
wrote in message qc4Bc.71740$eu.47441@attbi_s02: Dayum, Shane! No one ever thought of this clever insult before! Gee, I guess when someone had thought of something before, then it must not be worth saying, eh? In this case it wasn't worth saying in the first place, of course... Guy -- May contain traces of irony. Contents liable to settle after posting. http://www.chapmancentral.co.uk 88% of helmet statistics are made up, 65% of them at Washington University |
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