Talk:Bicycle helmet/Archive 1

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Starting the new page

Hi - I have removed a broken link in the 'Reduction in bicycle participation' section. I also re-worded the corresponding sentence, since it originally referred to 'evidence', but no evidence aside from said broken link was provided. If 'evidence' is supposed to mean a published study, shouldn't it be referenced in a non-temporary fashion (e.g. journal, volume, pages - as elsewhere in this artile - or a Pubmed ID) rather than a link to some webpage? Generally, although I found the information on this page informative, I agree with the discussion below (Neutral Point of View) that it seems biased. For reasons stated in this article, it may be difficult to assess the utility of mandatory bike helmet laws and apparently there is conflicting evidence in this field. Near the beginning of 'The helmet debate' section there are strong criticisms of the evidence in favour of helmet use; however, I did not notice a similar discussion of the limitations of the evidence against mandatory helmet laws. I grew up in a city which adopted mandatory helmet usage long ago (Vancouver, BC), which also has quite high participation and am now living in a city with no such law (Montreal) and relatively low participation and have been a cyclist for many years. Personally, I find it very difficult to believe that helmet laws are not effective at preventing some types of serious injury, such as smashing your head on the pavement or another obstacle after getting 'doored', cut off, or simply wiping out. Helmet laws may eventually lead to a culture of helmet usage and possibly to increased awareness of other safe-biking behaviours. I would strongly advise against exaggerating the strength of evidence in support of hypotheses which may dissuade someone from wearing a helmet! --Doug

SF I thnk that while the material is intimately involved with the risk compensation debate, it is just one example of risk compensation. So the risk compensation article maybe wouldn't be the place to go into it in the same detail. Also if the issue of seatbelt laws are going to be discussed, and if NPOV is to be observed, then surely all sides of the debate must be represented in the same article? (This was clearly not the case with the original article.) Perhaps an alternative is to separate the seatbelt law section out into its own article? Separate from seatbelts? --Sf 15:47, 23 Aug 2004 (UTC)

Hi Re: Bicycle helmets Somebody has now added to the related section on risk compensation I have added to the section on seatbelts. Both pages give more information of relevance to the ongoing bike helmet controversy. Shane F.

Hey, I had a look at the seat-belt page. I see what you're saying about it. Personally I think that it might be better to move a lot of this stuff to just the Risk Compensation page. Also, if you register, it makes it a lot easier for people to track your related edits, and easier to sign them. (The edit summary box isn't really the best place to try to squeeze your e-mail address!) Thanks. PMcM 14:50, 23 Aug 2004 (UTC)

I have put in some neutral POV stuff on cycle helmet legislation. If anyone wants background I am happy to provide it --BozMo|talk 11:21, 19 Aug 2004 (UTC)

Wow this is kind of exciting I put up a request for this page!! (ricjl 18:24, 19 Aug 2004 (UTC))

Hey! I Wikified the very interesting controversy section, and took out the references, as they didn't refer to anything! If someone who knows about this (User:BozMo?) has the sources, then they could maybe put the full info in a References section, and re-instate the references in the article. As it was they didn't seem to be much use.

Also NPOV'd the final paragraph; 'would be most unwise' to 'may be unwise'; the rest of it was very well NPOV'd already given that it is (by definition) controversial! Thanks! PMcM 12:43, 20 Aug 2004 (UTC)

surely it is npov to say that it /is/ unwise to /assume/ since the assumption /may/ not be correct?

Fair point. Probably using both may and assume is unnecessary, but at the time I thought that it would be most unwise was unnecessarily strong. It was more the most unwise part I didn't like, and the is/may just got sucked into the editing while I was there. Feel free to change it about if you like. I explained it so I could get opinion on it, rather than meaning to sound like: "Don't do this again!" :) PMcM 12:22, 23 Aug 2004 (UTC)

Anyone else think that the Safe cycling vs Helmet use and Controversy sections could be glued together? They seem to sort of cover the same ground. PMcM 12:30, 23 Aug 2004 (UTC)

History

Skid lid bicycle helmet

Some comment about the skidlid helmet might be good. This helmet was put out of business with the introduction of the Snell standard. Gam3 05:05, 3 January 2006 (UTC)

Add it to the History section by all means, if you can verify the dates and so on. - Just zis  Guy, you know? ^[T]/_[C] 15:42, 1 February 2006 (UTC)

You are in error about the demise of Skid-Lid Manufacturing and the Skid-Lid cycling helmet. I was the President of the company from 1981 to 1985, so have some intimate knowledge. There were no obligatory standards for bicycle helmets at the time the company folded. Skid-Lid became financially overextended in 1985 from redesigning and retooling for a new model. Financing was secured by letters of credit that a major distributor used to secure first shipments of the new model. Those letters of credit required product liability insurance. Such liability insurance became very difficult to purchase and extremely expensive across the sporting goods industry at that time (the "product liability crisis"), and Skid-Lid lost its insurance. That caused the financing to collapse. We did not have the financial reserves to book production of our custom materials, particularly our unusual helmet liner foam (primarily used in football helmets), in advance and quickly ran out of the ability to produce. 129.46.237.199 23:00, 19 April 2007 (UTC)drpaddle

Welcome to Wikipedia "The free encyclopedia that anyone can edit. Could we ask you to put your insights into the article itself? -Dhodges 00:24, 20 April 2007 (UTC)

...I'd like to read more historical helmet-use (or purchase, even) stats here, a bit of background. A line graph would be an ideal start, showing how helmet use has changed in each country since the 60's. How big is the helmet market? How did it develop? What factors influenced it? Are there jumps in the graph? Is it just piggy-backing on mountain bike popularity? There's a lot of content discussing the current polar views on helmets' effectiveness, but not a lot showing how or why lay attitudes have changed (in some countries, anyway) seemingly from a polar opposite position of 20 or 30 years back. [TXB 17/1/07] —Preceding unsigned comment added by 82.41.6.68 (talk) 22:47, 17 January 2008 (UTC)

References

I have full citations for the references, but no links as they are not on the web.

Thompson, R., Rivara, F. and Thompson, D. (1989), 'A Case-Control Study of the Effectiveness of Bicycle Safety Helmets', New England Journal of Medicine, 25 May, 320:21, 1361-67 (the grand-daddy of all helmet studies)

The abstract from the NEJM is online. Alas, the full text is not, at least not for layfolk. RossPatterson 03:58, 26 March 2006 (UTC)

Trends in cycle injury in New Zealand under voluntary helmet use, Scuffham, Langley. Accident Analysis and Prevention, Vol 29:1, 1997 - showed no benefit from lareg-scale increaes in helmet use.

Risk, John Adams, Routledge, 1995, ISBN 1857280687 - authoritative reference on risk compensation theory.

Excellent! That was exactly what I was looking for. I think I managed to put it all in in the right places, but if I messed up anything obviously feel free to move it around. Thanks again! PMcM 13:42, 20 Aug 2004 (UTC)

Cycle helmets are not designed ...

I do not understand the first sentence of the first section:

"Cycle helmets are not designed to provide adequate protection for a collision involving another moving vehicle (e.g. a car)."

Is the point that helmets are only designed for the impact of the cyclist's head against the ground and not for the impact against the car? Does it have something to do with linear versus rotational forces? What are helmets designed for? Thanks for any clarification. -- Jitse Niesen 13:20, 26 Jan 2005 (UTC)

Helmets are essentially designed to withstand the force generated by an object equivalent to the weight of the rider’s head falling several feet to the ground.

Here’s a description of the tests from helmets.org:

…All of the standards discussed here require the helmet to pass a lab test where it is placed on an instrumented headform, turned upside down and dropped for a measured distance onto an anvil. The anvil can be flat, round (hemispheric) or another shape like a curbstone, a skate blade or a horse's hoof. Drop distances vary but are generally between one and two meters (3.3 to 6.6 feet). For the helmet to pass, the instruments inside the headform must register less than 300 g's during the impact, or in some cases less than 250 or even 200 g's. (We have a separate discussion on that.) The standard specifies the coverage required by calling out a test line above which the impacts can be aimed. There is always a strap and buckle strength requirement, and sometimes a "rolloff" test to see if the helmet will stay on the headform when yanked fore or aft. For more, see our quick chart or our detailed comparison.

And here’s a simplified version of the CPSC standard:

simplified version of the CPSC standard

Now, the force generated by a bicycle moving at a fairly typical velocity of say 20 to 30 kph. plus a car moving in the opposite direction at say 50 to 60 kph. is much, much greater than that. In fact, it’s greater than any practical helmet can resist

Why not set a higher standard? There’s no technology known to modern science that could do much better. Until we develop Star Trek type force fields, we just have to do the best we can.

Incidentally, I do wear a helmet Why?…Well aside from disguising the onset of male pattern baldness, I figure it’ll at least protect me in a minor impact

If someone who wasn’t a liberal arts major wants to weigh in, please be my guest.Dhodges 02:55, 27 Jan 2005 (UTC)

Thanks; I changed the article to reflect your answer. Personally, I usually wear a helmet when cycling in the United Kingdom, but not in the Netherlands. Pretty inconsistent, isn't it? And that for a mathematician ... By the way, I think it would be nice if something were added about the use of helmets in cycle races. -- Jitse Niesen 12:57, 27 Jan 2005 (UTC)

RobAnybody 20:13, 7 Apr 2005 (UTC) Link changed:

This: How to Wear A Bicycle Helmet for this: How to Fit a Bicycle Helmet The first page provides only basic advice plus LOTS of unpleasant advertisements. The helmets.org page has much more detailed instructions, an easy to remember "fitting mantra" ("Eye-Ear-Mouth" -- useful when you teach kids how to maintain and check the fit of their helmets.) and additional resources on helmets.

I need to ask where the claim under Research evidence that Thompson, Rivara and Thompson were already committed advocates of helmet legislation before publishing their first study came from.

Should there be a section where the fatal head injury accidents with cars are compared to those fatal accidents that happen due cautiousness?

proposed fixed for NPOV

This is the first article I've read on the wikipedia that I felt really violated the NPOV. I'm a professional statistician, and was a bit shocked by it. (It reminded me of the AIDS denial discussion of a decade ago.) Personally, I have argued that it is much more important to encourage people to ride bikes even if they aren't wearing helmets. But this has nothing to do with the science of whether helmets work. Further it is a personal statement about trade offs between dieing now vs. living longer. That I have a strong point of view (see my web page on those issues: http://gosset.wharton.upenn.edu/~foster/mortality) doesn't change the science or what should be here on the wiki. I'm planning on working on the article, but thought I'd see who was currently maintaining it. I didn't want to get into a POV war since this is so biased as it stands. The above sounds like a start of a flame war. I don't mean it that way. I'm simply trying to say that I view this as a serious issue and plan on putting in some time to fix it.

A big proposal that I think would help alot would be to separate the science into two pieces. First, do helmets save lives. Second do helmet laws save lives. These are two very different scientific claims. The first is best addressed by case-control studies. (I personally hate them--but we aren't going to be doing any controlled experiments anytime soon.) The second is very difficult to study. It takes a Freakinomics kinda perspective to do it right. Further, the fact that you haven't "rejected the null" doesn't show the laws don't work--simply that we don't know.

So this split would allow what I (along with the CDC) believe to be strong science to shine through. Namely, helmets work. But the political science side about the laws is very difficult to prove one way or the other. (Consider the difficulty in proving "carry laws" for fire arms. It is easier there and still books have been written about each side.) Since these are two very different points, I don't believe they should be in the same article. I don't know if there is a principle on the wikipedia of "only one concept per article" but it is a rule that I always try to follow in my personal papers. So hopefully this will help motivate the split.

I figure the above proposal is big enough that it should be discussed before it is done. (As a fairly minor player it probly also should be done by a more senior editor.)

Dean p foster 17:16, 26 July 2007 (UTC)

The very fact that you are proclaiming case control studies over and above the much more robust population data indicates that you yourself are approaching the topic from a political (point scoring) rather than scientific perspective. You might start by demonstrating the applicability of "case control methods" to the study of this field. --Sf 16:16, 10 August 2007 (UTC)

By population studies I'm guessing you mean the ones concerning changes in laws? If so, these are very difficult to do well and are far from considered strong evidence one way or another. Case control has a huge amount moree statistical research behind it. So it is much easier to get closer to right. On the other hand, you might be referring to the statistics that I just inserted in the introduction--namely that the rates are lower for helmet wearers. These are accurate statistics, but don't address causation. So I guess I need to know more about what you are thinking before I understand your critisism. I'll ignore the baiting.  :-) Dean P Foster 19:42, 10 August 2007 (UTC)

194.105.253.6 14:09, 14 August 2005 (UTC)

I think this article is great and I agree with the POV that shines through, but we need some balancing here.

Editors of the article should have a look at Wikipedia:Neutral point of view, which is a bit longish, but it is possible to skim to relevant sections. There I found a reference to an example of a hotly debated issue, namely abortion that is provided as an example of how a NPOV style and structure can be obtained.

Specifically, it is important to say who it is that presents a point of view instead of presenting it as fact, ( I guess ), and I think that the list of references and Further reading should contain sections specifically marked Pro and Contra. The BHRF site is quite clearly contra, but not as blatantly biased as most pro compulsion sites or atricles. Perhaps place BHRF/bicyclehelmets.org both in a category for Science and in a category for anti-compulsion.

194.105.253.6 19:14, 14 August 2005 (UTC)

Could it be helpful to link to debate and controversy and even Benford's law of controversy ? An article about science based controversies, past and present would be nice. Might put in a request. The Global Warming article looks impressive. Anti-helmet arguments sometimes point to the Hormone replacement therapy as an example of Case control studies gone wrong. The wikipedia article on this does not do a good enough job of representing the controversy, unless I'm terribly mistaken.

One possible problem regarding Bicycle Helmets vis-a-vis Wikipedia policy is that very conceivably the apparent scientific majority - that helmets are exceptionally effective in saving lives - is wrong.

I agree that the article needs some organizational and NPOV work. It is fairly slanted against helmet use as it stands now. Feel free to add whatever links you feel are relevant... Peregrine981 07:36, August 15, 2005 (UTC)

If it's slanted against helmet use, it's because so is the scientific evidence. If there are any credible studies in favour of helmet use (that e.g. don't have fatally flawed sample biases) then of course they could be used as support for helmet use, but as far as I know, they don't exist. NPOV isn't a synonym for 'he-said she-said' reporting. Varitek 17:47, 16 August 2005 (UTC)

maybe so. However, I get the distinct impression that no one who is in favour of helmet compulsion has contributed to this article, and I just get that feeling through reading it. Personally I'm against helmet compulsion, and have no problem with most of this article, except for slightly lax crediting and sources citing, but I suspect that a safety campaigner might well object to some of the wording. Peregrine981 05:19, August 17, 2005 (UTC)

If they can come up with any credible source to back up their desire for helmet compulsion, then they're free to add it. If they can't (and I don't believe they can, yet at least) then their POV has no place in the article. Being a "safety campaigner" carries no weight. If they object to the wording, then they'll have to justify their objection, and to the best of my knowledge, they can't do it with anything beyond POV folk wisdom. Varitek 09:34, 17 August 2005 (UTC)

I think editors should strive to balance the presentation here although it is hard. One thing being mentioned in the Wikipedia:NPOV articles is that it matters whether a view is a majority view or not, especially among experts. OK define expert  :-) Many of the people and even scientists campaiging for helmets do not know a lot about cycling and health, and they seem to think that cycling is exceptionally dangerous. Still I think links explicitly to pro-helmet sites are lacking. Many WHO documents talk positively about helmet promotion, and that should be mentioned. ( They do it on the same old mistaken ground of articles in vein with the Thompson, Rivara and Thompson (1989) study, but do not always cite sources ). Perhaps a list of pro et contra arguments being used could be helpful. A report commisioned by the Bristish Department for Transport, Bicycle helmets: review of effectiveness (No.30), counted scientific articles pro et contra helmet compulsion/efficacy and found that: "Overall, 31 papers were in favour of helmet wearing of which 20 advocate legislation. 32 papers were against helmet wearing/legislation. The remaining papers took no position." You will also see, however, that 35 articles are grouped in "A proven case for head injury reduction from scientific studies", while 15 articles say "The scientific methods of many studies are defective" Having read a dozen such critiques, those pro arguments are virtually impossible to mention without informing abot the grave and convincing critique they have received in peer reviewed journals and elsewhere. But in mentioning the pro et con arguments we would at least be presenting both sides of the debate. Editors should also mention who holds those views, which is what NPOV guidelines encourages, I think. Mokgand 22:25, 17 August 2005 (UTC)

When you say WHO, do you mean WHO or the "WHO Helmet Initiative" which has no official backing from the WHO and is the work of Philip Graitcer, a helmet zealot who actively refuses to cite any research or organisation which is not 100% pro helmet? - Just zis Guy, you know? 21:05, 25 October 2005 (UTC)

I have tried to give an overview of the limited, but still wide-ranging, controversy on whether helmet laws work. I hope it has NPOV and good-quality references with additional Web links where available. (Some items are available only in one form or the other.) I agree with others; NPOV is very difficult in this subject, where "common-sense" seems to point in the opposite direction to most of the science. Does anyone have a good form of words for a point of view that probably is a majority and is certainly widely asserted, but doesn't have the evidence? I find it difficult to come up with anything remotely neutral that doesn't came across as derogatory to some people. Even most of the doctors I've discussed this with have no idea that there is any doubt that helmet laws work. Some have taken even a mention of the evidence to be insulting, unprofessional, and "dangerous". Richard Keatinge 22nd June 2006

Changes

I've begun re-arranging the sections to put general information about helmets in the first part of the article, followed by a treatment of the controversies. A lot of pro or anti helmet material was placed in the early paragraphs back when this article was comparatively short. (I knew it back when it was a stub...). I think it's important in terms of NPOV to keep all the arguments together. --Dhodges 06:11, 19 August 2005 (UTC)

I'd also like to get rid of some redundant entries in external links. cyclehelmets.org seems to be listed three times. I'll check that I'm not missing some actual differences between entries first though. --Dhodges 06:34, 19 August 2005 (UTC)

I'd like to agree with above commenters regarding the lack of pro-helmet citations. IMHO, this is not a balanced article. Ronnotel 17:40, 25 October 2005 (UTC)

Removed passage Nov 1 2005

There is a point in there, but also strong POV and tone. Not sure how to refactor it into something that can be included. --Christopherlin 05:13, 2 November 2005 (UTC)

One must wonder if there isn't better use for the energy and enthusiasm consumed by this debate. It certainly diverts energy and unity in the cycling community when it could be placed towards better law enforcement of cyclists' rights, safe cycling education, community outreach encouraging youth to take up cycling, etc.

Perhaps something along the lines of:

Groups working for cycling often consider helmet law campaigns a major problem, diverting attention and resources away from primary safety measures whose results are less equivocal. Few, if any, cyclists' groups campaign for helmet laws.

- Just zis Guy, you know? 09:57, 2 November 2005 (UTC)

Other Ideas

I agree it's POV and not to make it swing too far that way, but from somone against helmet compultion, I would like to ask a question to the editors: I would like to see (only if sources mention):

1) Why the sudden attention to helmets when bike riding has been around for far longer? For example, as far as I remember, measures have been taken to reduce child drownings since heavy pool use, because children have been dying from pools. 2) Comparing this to motorcycle helmet data. 3) The probability of reducing head injuries of wearing a helmet while driving a car. 4) Statistical studies of wearing elbow pads and knee pads in reducing 'minor accidents.'

Safety in numbers hasty generalisation

Due to technical reasons the 'z' in the caption header has been supplanted with 's'. First it is claimed in POV fashion that

Arguably, even helmet promotion or high levels of helmet use by utility cyclists will deter non-cyclists by reinforcing the misconception that road riding is a lot more dangerous than walking or driving, which it is not.

But then this is countermanded:

This reduction of cycle use directly imposes increased risk on cyclists that continue to ride, due to the now well established "safety in numbers" effect.

Sure, it is safe to ride in traffic if almost everyone is a bicyclist. But do you really claim it is safe to ride among holy sheetmetal cows when there's one bicycle for every hundred cars or so? Seems like one is generalising from a populous bicycle-rich area to everywhere. A lone bicyclist is quite vulnerable in a population where almost everyone drives a car.

The former is supported by at least one report from Transport Research Laboratory, number to follow, plus data from Failure Analysis Associates and from Road Casualties Great Britain and other sources. The latter is well documented, the BHRF website has a couple of reports in full text. The two are not inconsistent: one is about risk relative to toher activities, the other about changes in risk as participation changes. In London when the Congestion Charge was introduced levels of cycling were reported to have doubled and casualty numbers remained constant, so the causalty rate halved. And yes it is safe to ride among sheetmetal cows, I do it every day. Just zis Guy you know? 13:48, 4 March 2006 (UTC)

But you ride in the safety of numbers, right? Also, I don't particularly buy the conclusions of all these reports, as they seem to assume some mythical average bicyclist and so on, and do not take into account how different actions alter the people who use bicycles, and where.

Take the sidewalk issue, for example. (I ride on them, no matter what the authoritarian-human-law-fighting-laws-of-physics says, but not much faster than walking.) The research says that most accidents are when crossing sidewalks with a bicycle, not driving among cars. But that's because only experts ride among cars, not your casual bicyclists who most do not even know of the existence of laws equating 100kg bicyclists with 1000kg lumps of metal. If the less careful people that do not _stop_ to check for crossing traffic rode among cars, they'd be just as dead. (Assuming there weren't a considerable number of bicyclist so as to create safety in numbers.) The difference between bicycling on a sidewalk and on the road is that on the sidewalk you can be in control of the situation, on the road you can't. Some people just choose not to be in control. On the sidewalk you can cross the road in the safety of the numbers of the pedestriants if you choose to do so, on the road you can't.

Where I live, there are many _wide_ sidewalks with very little pedestrian traffic, and where bicycling is banned. And to make the situation even more inequitable between bicyclists and motorists, the streets are to uphill.

There is, to my knowledge, no significant informed dissent from the view that cycling gets safer per cyclist, the more people cycle. This has been shown by studies at the local level and by comparison of safety levels in different countries. Lots of people have said the same thing about living in towns where there are wide sidewalks and so on, but that is a misleading idea because not only do these towns also have wide roads (which are easy to share safely), the major point of danger is at junctions, and is increased by a factor of about five if you are riding on the sidewalk, because you are out of the area where motorists are actively scanning, because they are looking for other cars. And although it's been said that riding on the road is banned in many places, I have seen a number of such assertions successfully challenged by reference to the local vehicle code. Very often the police are also in ignorance of the actual law! Where I live riding on the sidewalk is actually illegal. Overall the USA (where I guess you are) has a pretty low level of cycling, so the safety in numbers effect is generally at a low level. British cities like London, Oxford, Cambridge and Edinburgh show the safety in numbers effect pretty clearly despite narrow streets and very limited availablility of space for segregated facilities. Just zis Guy you know? 15:25, 4 March 2006 (UTC)

Crossing roads from sidewalks is only unsafe if you do not exploit the safety of numbers of pedestrians. Or do you claim it is extremely unsafe for pedestrians to cross roads as well? Where I live, Finland (and in a small city where there can not be said to be safety in numbers of bicyclists), bicyclists are infact required by law to cross roads on the right side of the road, between the safe zebra crossing for pedestrians (and bicyclists if laws were sane!), and the car lane, and then return to the car lane after the crossing. What's even more insane, you're assumed to turn left by doing that two times (like pedestrians, but without entering the safety of sidewalks and zebra crossings), not by simply turning left like cars would.

Wide car lanes are not that much safer to share than slightly narrower ones as long as there's still space for the car to overtake the bicycle. They still rather leave 5cm between you and the car than 5cm between the car and the white line. Only separate lanes for bicycles that the cars have hard time entering will make them pass from farther away. Perhaps a narrow road, where there's no space to overtake a bicycle or to even drive more than about 10km/h, would be safe, but a wide road without segregated bike lane isn't. When it's wide enough, there'll just be two car lanes if the other half of it isn't such a bicycle lane, and the bicyclists are no better off.

You are confisuing the general with the specifi here, I think: you can make a specific crossing of a specific road by a specific person at a specific time pretty much totally safe, but in aggregate when pedestrians get injured it's most likely to be when crossing at or near a junction, because that is where you maximise the number of potential conflicts and also you maximise the chance that drivers are looking somewhere else. The same applies for sidewalk cycling: if you stop, look carefuly and wait until there are absolutely no cars before crossing you'll probably be safe enough, but that's not how it works in practice. According to the statistics riding on the sidewalk against the flow of traffic is one of the most dangerous things you can do on a bicycle. The evidence on segregated facilities is far fomr conclusive - although you'd imagine they make things safer, in the end the journey still has to get form A to B and the jurney will involve multiple interactions with roads (unless you're very lucky). So building huge numbers of bike paths in a city will not necessarily make any actual difference to the injury rate. There's some discussion of this at cycle lane. In the end what matters is having a full awareness of what the risks are in the particular cycling activity you are doing, and how to manage them. A graduate of an Effective Cycling program riding mainly on the road will likely be safer than an inexperienced cyclist riding mainly on the sidewalk, and the more experienced cyclists do tend to use the roads more because they involve much less stopping and starting, which is very inefficient. Chris Juden worked out that stopping and starting once requires the same effort as between 100 and 200 yards of riding. Just zis Guy you know? 17:31, 4 March 2006 (UTC)

No, that (stopping and watching) very closely approximates what I do, riding in the city centre, where there's no hurry anywhere, and one might just want to stop in the middle of the block to enter a shop and so on. It is relatively safe, because I'm in control. On the road, I'm not in control, I'm just a bowling pin constantly being bombarded with the bowling balls, trying to not get hit. One could perhaps say the same of pedestrians vs. bicyclists, but the difference is in the numbers again. Most users of roads are motorists, and thus they're the king. Everyone else beware. Likewise, pedestrians are the kings of the sidewalks; other sidewalk users should try to behave almost like one. On the road this is not possible; a bicycle can't even remotely approximate a car. And, you know, we have ice and snow here much of the year. That makes things quite dangerous on the road. (Outside the city centre, where there's any traffic to speak of, there are multi-use paths where bicycles are supposed to be ridden on. They're not ideal because the pedestrians tend to occupy them like they were sidewalks as there are n

Regarding narrow lanes where being overtaken by a car is unsafe (but they try it anyway): My advice is to ride in the middle of the lane, so that overtaking is impossible, and ride quickly so as to minimise the annoyance to the cars behind. I'm not certain how legal this is where you live, and it takes some guts to do, but really you are only preventing the car drivers from doing something unsafe anyway. The exception is if you are on a stretch which is very busy or has a high speed limit, in which case you'd probably cause a large tailback and make the roads less safe!

Another tactic that works well at night is to wear your lights off-centre and to the right (in the UK, to the left in countries that drive on the right). This way you look nearer (from the perspective of the car driver) than you really are and they keep a little more distance WikianJim 14:42, 7 August 2006 (UTC)

Self referencing

Richard Keatinge has added some links. Among these, I removed a site (cyclehelmets.org) that is owned (according to whois) by Keatinge himself. Self-referencing to one's own webpage is evil. —Preceding unsigned comment added by 80.202.223.241 (talk • contribs)

• Richard is the registrar of the domain but has not been active in maintaining the content for at least a year; he was not the author of that page. I am on the editorial board of that site (I didn't write it either). Also, linking ones own site is not evil, although it is generally frowned on. Doing it multiple times, or where the same or better content is available elsewhere, is evil. Just zis Guy you know? 22:39, 11 July 2006 (UTC)

opening sentence- NPOV

The opening sentence has been modified to where it is seriously POV. Now, I agree that a helmet cannot protect a rider from the full impact of hitting an object at full speed (see above). However, the argument put forward by helmet advocates is that even in a serious accident the rider’s head will seldom take the full impact of the speed at which he was travelling. Suggesting that helmets only provide protection in “simple falls" is misleading. -Dhodges 00:55, 24 July 2006 (UTC)

Opening sentence in question has been re-worked, thanks Bwileyr. -Dhodges 18:51, 24 July 2006 (UTC)

The word collision is problematic. The standards describe falls - one version of the standards specifically excluded collisions in its preamble. Collisions are generally interpreted as involving motor vehicles, and no helmet is designed to withstand motor vehicle impact. So I have left it as falls without the word simple. Actually the tests primarily mimic a simple fall onto a flat surface, but we'll leave that for the body of the article. Just zis Guy you know? 20:06, 24 July 2006 (UTC)

Professional cyclists' helmets

Why do professional cyclists wear those funny shaped (tapered) helmets (e.g. in the tour de france)? An example can be found here. Are they more aerodynamic? I swear I'm not being facetious, I really am curious, and think this should be addressed in the article. Alcuin 21:34, 25 July 2006 (UTC)

You've answered your own question. Yes, they're aerodynamic. Wouldn't hurt to put some mention of this in the article (it'd make a nice break from the pro and anti helmet sniping) Incidentally, the really freaky looking helments are intended for time trials -Dhodges 22:32, 25 July 2006 (UTC)

Disputed: The Helmet debate

I added the NPOV tag to this article. If there is a 'helmet debate' section then that section has to capture both sides of the debate in a neutral way. Currently the article advocates strongly which violates WP:NPOV To become more neutral the article should present some referenced arguments for both sides. Prospect77 04:47, 5 August 2006 (UTC)

Sadly your edits took it, in my view, much too far the other way. Just zis Guy you know? 11:27, 7 August 2006 (UTC)

The subject of this debate is generally a physical question involving energy absorption, so the scientific consensus should be represented. If there are credable studies that show pro-helmet conclusions, their work should be added to counter the studies that came out against helmets. However, if there aren't any such studies we can't just fill the article up with politically funded psudoscience to make it more "balanced". Probably where there is less consensus is the social aspects. For example, does wearing a helmet encourage a feeling of safety which would encourage more people to cycle (thus making it safer)? AFAIK, no reasearch has really looked at these questions, but it would be interesting to read if they had. FWIW, I road cycle and always wear a helmet. WikianJim 14:34, 7 August 2006 (UTC)

I disagree that the subject of the debate is a physical question: it is a question of whether helmets are an effective response to the risks of cycling. Also, there is no scientific consensus. Doctors working in trauma medicine often (though by no means always) promote helemts; doctors working in public health are far more likely to be concerned about deterrent effect on a beneficial activity. There are a lot of case-control studies, but there were a lot of case-control studies showing that HRT prevents coronary heart disease and they were wrong. An analysis of highly cited observational studies showed that most of them are either greatly overoptimistic or flat wrong. In this case despite predictions of up to 85% reductions in head injuries, not one population has shown a measurable reduction in head injury rates consequent on increases in helmet use - I think this is telling. Overall, having spent a lot of time analysing this issue, it seems to me that cycling is not especially dangerous, that promoting helmets has as a pre-requisite building the perception of cycling as a dangeorus activity, and overall there is more benefit to be had from promoting cycling than promoting helmets. I know of several cycling organisations which regard the promotion of cycling and the promotion of helemts as mutually exclusive, and I suspect they are right. Just zis Guy you know? 14:58, 7 August 2006 (UTC)

Currently the article reads like a blog. It gives undue weight to a minority anti-helmet point of view. In fact that is the only POV represented in this article. The purpose of the helmet debate section is to capture accurately both sides of the debate, not evaluate the question of 'who is right'Prospect77 15:31, 7 August 2006 (UTC)

The minority view is wearing helmets. Most cyclists worldwide do not. It is easy to forget this from our perspective as Western Anglophone contributors; the loudest voices all yell in English. The Dutch think the idea of wearing helmets for everyday cycling is absurd, the wearing rate there is around one in a thousand. If anything the move is away from uncritical acceptance of helmets, as there is increasing awareness that large scale increases in use have failed to deliver anythign like the claimed benefits. I used to be a helemt promoter myself, until I read the underlying research; the original TR&T paper appears to me to ba an example of working back from the desired conclusions and then increasing the figures when they don't seem good enough (hance 85% not the 75% which the data tables actually show). I'm somewhat disappointed that you state "nothing" was done to fix the problems; I spent some time referencing individual statements. Just zis Guy you know? 15:46, 7 August 2006 (UTC)

The fact that a section is title 'Helmet Debate' is a good start. That means there is a debate. But I don't really see the debate fairly captured here, see? I think the section needs to be fleshed out more, so that the medical establishment and governmental agencies that advocate helmet use are accurately and fairly represented. It isn't Wikipedia's job to resolve controversial subjects, only document them accurately.Prospect77 16:03, 7 August 2006 (UTC)

There's a problem with the claim that 85% of cycling fatalities are due to head injury. It's discussed elsewhere. I don't know of a reliable source for that claim, although if it were true it would not be markedly different than for other sources of traumatic death. Do you have any evidence that cyclists are more likely to suffer injury and death epr mile than users of other modes? The last set of figures I saw showed that in the US there was a slightly higher per-mile risk for car occupants, and that car occupants were at greater risk of traumatic brain injury, especially DAI. It's funny how whatever question you ask a helmet advocate the answer is 85% :-)

While it might be Wikipedia's job to document the views of those who advocate helmets, it is undoubtedly not our job to help them out by repeating false claims (85% of injuries is the litmus test for bullshit here). Nor is "the medical establishment" a single cohesive whole; there is, as I said above, an apparent majority among trauma doctors but much more ambivalence among public health doctors and epidemiologists, because they recognise that promoting helmets menas promoting the danger of cycling, which is incompatible with promoting cycling itself.

This para is problematic: The United States Centers for Disease Control recommend the use of cycling helmets. A 1995 CDC injury control recommendation concluded that cycling helmets are effective at reducing head injury among bicycle riders. Based on 1984-1988 statistics, a 100% helmet use rate would have prevented 500 deaths and 151,000 head injuries, annually. The CDC recommend mandatory helmet laws as well as education campaigns. - the figure is arrived at by assuming that the predictions of the pro-helmet studies are right. They aren't, not by any verifiable test. When New Zealand and Australia went to 94% and 85% helmet use respectively, more or less doubling in a single year, there was no measurable change in injury rates. Any epidemiologist wil tell you that case-control studies are not predictive in this way. Apart form anythign else pretty close to 100% of all cyclist fatalities are due to impacts with motor vehicles, and there is no known cycle helemt which can provide adequate protection in these cases.

The "research evidence" section is not Research evidence (contra helmet) - it discusses pro and contra evidence. It points out weknesses in both types of evidence. Feel free to discuss the evidence in detail, but it may be wise to discuss it here first since several editors have worked on that section who, to my personal knowledge, have extensive libraries of helmet studies, probably more extensive than my helmet library which is less than a thousand documents. Just zis Guy you know? 19:42, 7 August 2006 (UTC)

JzG, this article is still in gross violation of the mandatory NPOV policy due to its tone and selection of sources. See previous comments from other users including the recent failed Good Article Nomination. The problem is not that there are missing references. The problem with this article is that it:

1. presents the minority POV of that debate with undue weight. Anti helmet groups are the minority POV in this debate. (by the article's own references have failed to influence either governments or organizations like the CDC, etc.)

2. The article gives virtually no weight to the (legal and medical) majority POV in this debate. Where majority POV sources are cited they are immediately countered or disparaged.

"The policy requires that, where there are or have been conflicting views, these should be presented fairly, but not asserted. All significant published points of view are presented, not just the most popular one. It should not be asserted that the most popular view or some sort of intermediate view among the different views is the correct one. Readers are left to form their own opinions." See http://en.wikipedia.org/wiki/Wikipedia:Neutral_point_of_view#Undue_weight

Minority POV? First, governments and the CDC don't necessarily reflect common or informed sentiment about this issue. Try conducting a small poll among bicyclists, for instance. Second, many jurisdictions have *not* passed helmet laws because of public resistance. Is this failure to influence government? Perhaps what is needed to "balance" this debate is to accurately document the disconnect between perception of the balance of the debate and the balance of the debate. :) -- Anonymous Campus Cyclist

How about you conduct a poll with anybody who has ever ridden a bike? Why are we restricting this to a very specific group of bicycle enthusiasts? Won't that already qualify their answer?--24.22.147.202 01:51, 12 March 2007 (UTC)

Anti helmet is a minority POV within the scientific community as well. Go and check google scholar with the keywords helmet bicycle and count how many studies are pro helmet and how many anti helmet.

Feel free - but be careful to distinguish between the small number of studies that report research which could tell us whether helmets work, and the large amount which assumes that they do.

There are several issues in this section that worry me. 1. The Rotational Injury Section

There is a link to a study (reference 65) from 1987 (!) about rotational energy and efficacy of helmets that were in use at that time. The report is also giving some advice how to improve the helmet design - which hopefully were implemented by now? Since the report is now over 20 years old, I would suggest to either select a study conducted more recently, to actually point out that the study is about helmets in use 20 years ago or to discard the study as outdated. —Preceding unsigned comment added by 134.95.38.9 (talk) 14:16, 20 February 2008 (UTC)

As far as I can tell the only actions that have been taken are those described, the cone-head and Phillips helmets, and there is no prospect of providing them in forms suitable for cycle helmets. The quotations are not out of date; to put it bluntly, the Australians had a study that showed that helmets didn't work, and they went ahead and made them compulsory anyway. I'm not trying to put original research in, but I've never ever been shown any helmet that shows any sign of crushing as intended. Nor, as the second quotation makes clear, had the senior engineer of Bell Helmets in 1998. All quality corrections gratefully received, of course.Richard Keatinge (talk) 14:44, 21 February 2008 (UTC)

2. Time-trend-analysis

Pro helmet studies are identified are rated as 2 or 3 which gives weaker evidence than those with rank 1. So, are there anti helmet studies rated as 1 based on the Oxford Centre for Evidence-based Medicine's standard scale and therefor giving stronger evidence?

No, though there is a grade 1 trial of walking helmets.Richard Keatinge (talk) 14:44, 21 February 2008 (UTC)

If pro helmet studies are rated, anti helmet studies have to be rated as well in order to maintain neutrality. Actually the next study by D. Robinson (reference 29) is not rated at all, altough here study should be rated as 2 since it is also a time series analysis.

It's all under the same heading/section, all rated as grade 2, and mention of Robinson's study immediately follows the account of possible weaknesses. Is it not clear to anyone else? If so, please rewrite for greater clarity.Richard Keatinge (talk) 14:44, 21 February 2008 (UTC)

It appears to me that a double standard is appllied here. Being extremly critical to pro helmet studies and at the same time being less critical toward anti helmet studies.

Actually the reverse is the case. I have worked hard on NPOV for this. Richard Keatinge (talk) 14:44, 21 February 2008 (UTC)

3. The section above: "Most of the literature that mentions helmets refers back to a small number of these studies, rather than itself providing evidence."

Where is the proof to this claim? How many studies where indentified and how many of those are selfreferential. In the same context Robinson's study from the year 2006 (reference 29) is highly selfreferential to a previous study done by her from the year 1996 (refrence 49). Why is this not mentioned here if self referentiality is regarded as a sign of weak evidence? Doesn't this show a lack in neutrality? Sign of double standard again?

Your Google Scholar search will easily verify the small proportion of studies with original data addressing the issue of whether helmets work or not. This is not a controversial claim. The two Cochrane reviews and Robinson pretty well cover the best-quality work, though there are a few more studies of lesser quality. All three refer extensively to previous work done by the same authors in the same field; in the case of these pieces of work, which are intended to be definitive reviews, this merely indicates that they have spent significant chunks of their careers on the issue and are summarizing their previous evidence. The point is that they present and analyze data intended to test a hypothesis. Most of the papers will not do so; they will refer (if at all) to analyses reviewed in the three main references. Richard Keatinge (talk) 14:44, 21 February 2008 (UTC)

4. Anecdotal evidence

This section should be deleted. It is not backed up by scientific data and really serves only one purpose, to show that at least one "believer in helmets" is silly.

In the same context "anecdotal evidence" should be regarded with suspicion and should not be cited in the same context with scientific evidence. Therefore in the section "Risc compensation" the sentence "Anecdotally, many riders report feeling safer with a helmet: "When I wear it, I feel safe..."[59]" should be deleted. The reference that "backs up" this claim is a Blog. This not a sound and reliable source.

Again, not a controversial claim, and a blog is a fairly good reference for the author's state of mind. The anecdotal evidence does need to be mentioned, because it's so important to so many people; as you say it's not the same as scientific evidence. But you're right, a survey showing what lots of people think would be better. I can't think of any offhand. Can you find one?Richard Keatinge (talk) 14:44, 21 February 2008 (UTC)

Failed GA nom

This article is promising, but has not yet reached the Good Article standard. My major issues with the article as of 8 Aug 2006:

• Lack of appropriate images. Diagrams of the parts of a helmet and proper helmet usage, pictures of several types of helmet, and shots of helmets in use (or not). The two images in "The helmet debate" do little to illustrate their subject.
• "The helmet debate" is rather long, and should probably be forked to a new article, with a summary of the key points in its place. It also suffers from statistics overload (for instance, the discussion of ISS without context) and clunky prose in parts.
• There is little hard data on helmet use by country, which seems a natural inclusion in discussion of helmet laws and injury rates.
• Despite the compendious references, the article has POV problems. I noticed suspicious claims ("according to research up to 96% of helmets have been found to be incorrectly fitted") and irrelevant, argumentative passages ("Overall, cycling is beneficial to health - the benefits outweigh the risks by up to 20:1.")

• Both those claims are actually correct and I can reference them. Just zis Guy you know? 08:47, 10 August 2006 (UTC)

Please do Mathijs Romans 08:57, 11 August 2006 (UTC)

Lead

At present the lead includes this statement: Bicycle helmets are intended for use by pedal cyclists on ordinary roads, to give protection in the kind of accident in which the rider falls onto the road without other vehicles being involved (ref)BS6863:1989, Pedal Cyclists' Helmets, British Standards Institution.

This is in there and referenced as-is for the following reasons:

• I believe it's important to clarify precisely what helmets are designed for, since there seems to be a widespread lack of knowledge on this.
• Although all the standards are broadly similar, the BSI one was the only one of which I'm aware to say explicitly what they are designed for.
• Brian Walker of Head Protection Evaluations, Britain's leading helmet tester, supports this being the design criterion (at least one of his documents is cited later, there are others).
• The tests typically involve a 1.5m drop onto a flat surface with a lightweight headform, so the statement in the BSI intro is entirely plausible.

If it's absolutely necessary I will dig around and see what other sources support this statement, but as far as I'm aware it's not considered controversial, being a simple statement of the capabilites per the standards. Just zis Guy you know? 09:54, 10 August 2006 (UTC)

Please provide the direct quote(s) from BS6863 that support that lead statement. -- de Facto (talk). 11:49, 10 August 2006 (UTC)

This British Standard has been prepared under the direction
of the Personal Safety Equipment Standards Policy Committee.
It specifies requirements for helmets intended for
use by pedal cyclists on ordinary roads, particularly by
young riders in the 5 years to 14 years age group, but which
may also be suitable for use off the road. It is not intended
for high-speed or long-distance cycling, or for riders taking
part in competitive events. The level of protection offered
is less than that given by helmets for motor-cycle riders
and is intended to give protection in the kind of accident
in which the rider falls onto the road without other vehicles
being involved.

This edition introduces technical changes to bring the
standard up-to-date but it does not reflect a full review of
the standard, which will be undertaken in due course.
The protection given by a helmet depends on the circum-
stances of the accident, and wearing a helmet cannot always
prevent death or long-term disability.

A proportion of the energy of an impact is absorbed by the
helmet, thereby reducing the force of the blow sustained by
the head. The structure of the helmet may be damaged in
absorbing this energy and any helmet that sustains a severe
blow needs to be replaced even if damage is not apparent.
To achieve the performance of which it is capable, and to
ensure stability on the head, a helmet should be as closely
fitting as possible consistent with comfort; in use it is
essential that the helmet is securely fastened, with any chin
strap under tension at all times.

The Technical Committee responsible for this standard
recognized that ventilation is important to pedal cyclists
but were unable to devise a satisfactory performance test
without delaying the standard. It is intended to include
performance requirements for ventilation in a future
edition, and designers of helmets are advised to encourage
a flow of air over the wearer's head.

This edition of the standard differs from the previous
edition mainly by permitting a helmet to comply with the
requirement concerning restriction of hearing either by a
construction requirement or by a new performance test.

Any typos are due to OCR errors. Just zis Guy you know? 12:28, 10 August 2006 (UTC)

Thanks for that. It confirms what I thought and raises a couple more questions.

1. This is from the, now withdrawn, BS 6863:1989 standard. Do you know if this, or similar, or contradictory, or no information is present about the use of helmets in the current British Standard (BS EN 1078:1997)?
2. It excludes use for high-speed, long-distance and competitive cycling. Are the bicycle helmets that they use not included in the scope of this article?

-- de Facto (talk). 13:12, 10 August 2006 (UTC)

As I said above, this is the only standard I can think of offhand which spells it out in these terms. Applicability is backed by the test (1.75m drop, sorry, 1.5m is for a different test) and by authorities such as John Franklin and Brian Walker. Other standards do not go into this detail, EN.1078 removes the second half of para 1 and I think all of para 2 and 4. It restricts itself in the main to discussing the tests themselves, rather than how the standard relates to actual cycling. The tests, though, are fundamentally similar. Over the years the main difference has been to change details like the testing of retention systems and add shaped anvils (with lower drops).

Brian Walker says that the standards have become less rigorous over time which is certainly true of the Snell standards since the first Snell test would require something like one of those lightweight open-face motorcycle helmets that scooter and moped riders used to wear. Most helmets in the USA are now tested to CPSC, not Snell, and CPSC is self-certified. Brian says that he's had a lot more failures against the EN tests since that happened. Specialized are I think the only major US manufacturer still to use independently verified lot-traceable testing. They are also, according to Brian, the least likely to fail on test.

As to high-speed cycling, the helmets racers wear are not tested to any different standard. In fact, time trial shells used until comparatively recently to be simple fairings with no impact absorption at all. Given that a proportion fail on test in a 1.75m drop onto a flat surface, it always amuses me that some in the racing fraternity expect them to work in 50km/h downhill crashes. Someone (I think it might be Davis) has been compiling some stats on racing fatalities; the rate this decade is said to be somewhat over double the rate in any previous decade. But we don't have much data since racing fatalities are incredibly rare. As are all cycling fatalities, of course. Just zis Guy you know? 13:35, 10 August 2006 (UTC)

EN.1078:

The protection given by a helmet depends on the
circumstances of the accident and wearing a helmet
cannot always prevent death or long term disability.
A proportion of the energy of an impact is absorbed by
the helmet, thereby reducing the force of the blow
sustained by the head. The structure of the helmet may
be damaged in absorbing this energy and any helmet
that sustains a severe blow needs to be replaced even
if damage is not apparent.

The technical committee which has prepared this
standard realizes that it is of importance for the
wearer's comfort and psychrometric performance that
a helmet is ventilated. At the time the standard was
prepared no method for measuring the ventilating
capacity of a helmet was recognized. For that reason
no requirements concerning ventilation or heat
transmission have been introduced. Manufacturers of
helmets are urged to design their helmets to encourage
a flow of air over the wearer's head.

Pedal cyclists' helmets and helmets for users of
skateboards and roller skates are fitted with a
retention system to retain the helmet on the head.
However, there may be a foreseeable risk that helmets
of young children could become trapped and thereby
cause a risk of strangulation of the child. In such cases
an impact protection helmet for young children (see
EN 1080) should be used.

Actually most authorities I've seen recommend a hard-shell helmet and not one of the current brand of bicycle helmets (which have little or no protection to the occiputal region) for roller skating, stunts, unicycling and skateboarding. The new bred of adjustable head cradle was not realy established when EN.1078 was drawn up. I don't think I have a copy of EN.1080 to hand, but I know that following incidents in Sweden and the USA childrens helmet buckles are now designed to release if the helmet becomes trapped. Just zis Guy you know? 14:01, 10 August 2006 (UTC)

Another photo

I'm going to try to take a photo of two helmets for comparision. There's my "many-vent" type helmet that I use for road riding, and a friend's "hard-lid" type that he uses for mountain bike stunts. Should be a good basis for a comparison of the various kinds.

Cycling is a factor in head injuries, ergo helmets are good

The following quote is from http: secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=media_30aug2006_e .

"Cycling as a factor in head injuries

Traumatic head injuries were sustained during sports and recreational activities in 28% of children and youth admitted to hospital for traumatic injury, and 8% of adults. Cycling is one of the leading causes of sports and recreation–related head injury. Of the 4,605 cycling injury hospitalizations in 2003–2004, 18% were due to head injuries. The highest proportion of hospitalizations due to cycling-related head injuries was seen in children and youth (60%).

The number of cycling-related head-injury admissions dropped between 1994–1995 and 2003–2004, particularly among children and youth (under age 20), who experienced a 55% decrease (from 1,085 to 494), with the largest decrease experienced by those aged 5 to 9 years (64%). Adults aged 20 years and older also saw a decrease in cycling-related head-injury hospital admissions, with a 24% decline (from 422 to 321 cases) during the same time period. "

If this is the study I was looking at recently there are at least four problems: first, attributing the change to helmet use is implausible given that a stated 2% of total injuries were due to bicycling and there is no evidence of helmet use in the higher-risk activities of walking and car use; second, the trends for adult and child cyclists are similar but there was no observed change in helmet use rates for adults; third, the severity actually increased, with average hospital stay for cycling head injury going up from 4.3 to 6.9 days whereas stay for general cycling injuries went down from 4.6 to 4.2 days; fourth, the decrease for cycling (55%) was lower than that for falls (58%). So any rational analysis of this data would indicate that helmets are at best irrelevant, both in addressing an insignificant cause, and in failing to differentially impact that cause to any significant extent. Guy 14:28, 5 September 2006 (UTC)

A personal comment from a cyclist

A lot of contributors, pro and con, are clearly more interested in proving themselves right than in the actual issue (remember what it is? "Do bicycle helmets prevent injury?" in case you missed it). Put me down for the pro-helmet camp - I have an old helmet which has a large hole in it, and a head which doesn't. Cite all the studies you want, my helmet cost me GBP10 and as far as I am concerned has no other downside. "If you have a brain, get a helmet".

Ah, proof by assertion. So much for WP:NPOV. Guy 14:15, 5 September 2006 (UTC)

Hear Hear! Safety at any cost! He must be that safety-conscious guy we all see wearing a helmet while driving around in his sedan. --Glippy00 05:35, 11 April 2007 (UTC)

For the record, I (the helmet wearer above) am a fairly dangerous individual with some reputation as an adrenaline junkie. That's why I wear a helmet. As for NPOV, I thought this was a discussion page?

Risk compensation --motorists

(sigh) I guess I might as well bring this up before the anti-helmet brigade jumps on it. It seems a recent U.K. study suggests that motorists give helmet wearing cyclists less space when passing then non helmet wearers [1].

Actually I've always been sceptical of risk compensation theory. The idea that, as a cyclist, I'm literally going to risk my neck because I have something protecting my cranium doesn't appeal to me.

That said, it may make some sense that motorists see helmeted cyclists as more predictable.

The study also suggests that motorists give women more space. Apparently the researcher put on a long wig for this part of the study. I don't think they avoided him because they thought he was a woman; I think they thought he was a really ugly woman (nice whiskers). -Dhodges 14:45, 12 September 2006 (UTC)

...Helemt wearing cyclist inevitably claim they do not take any greater risks because of their helmet use. However, ask them what they'd do if their helmet was lost/stolen half way through a ride, and chances are they state how they'd change their routine: different route home, choose co-riders cerefully, be "extra careful", etc. Almost certainly such extra precautions, normally forgone because of the helmet use, result in significantly greater head-injury protection than the helmet would have, and infinitely greater protection to other types of injury (spinal cord etc). [SPW 10/10/2006]

On the other hand, you could then claim that helmet use provides other benefits than safety - the trade off for not increasing safety is increased speed, personal satisfaction, etc. I get to work quicker because I am willing to take the downhill sections of my route at 45mph; that is a (more or less) rational judgement balancing safety and the "need for speed".

...I believe SPW's argument is to show risk compensation exists. The replier suggests this behaviour may be a good thing but this suggestion is not contentious. Rather, the question is whether people over-compensate, having over-estimated any safety gains they may enjoy from wearing their helmet. [TXB 17/1/07]

What to do with busted helmets

The article states: "Bicycle helmets should always be discarded after any accident."

I have heard that helmet manufacturers would study busted helmets in order to make better ones. Are there currently any organizations that accept used-up helmets for research?

Trek has (or had) a policy by which you could return your damaged helmet to the manufacturer, along with a description of what happened, and they would send you a new one free. I don't know if this is for research purposes, though. GregorB 23:31, 13 November 2006 (UTC)

WHO

I think we should at least mention that the WHO is in favour of helmet compulsion, as they are a fairly important actor in the field. If there's evidence this is a one man crusade put that in to balance it. Peregrine981 16:30, 11 October 2006 (UTC)

Agreed The WHO is putting this material out. They must exercise some control over what goes out with their name on it. -Dhodges 16:44, 11 October 2006 (UTC)

WHO Helmet Initiative is a one-man crusade by Philip Graitcer. He believes as Received Truth the Thompson, Rivara and Thompson 88% figures. There has been communication between CTC, BHRF and WHO, it is pretty plain that WHO have not investigated the situation at all and are just parrotting the usual claptrap. They are not even aware that there is a conflict between promoting "BIKE DANGER!!!!" WEAR A PLASTIC HAT OR YOU'LL DIE!!!!" and promoting cycling. The WHO's figures for injury reduction are the usual extrapolation from very small case-control studies, and as usual take absolutely no account whatsoever of the observed changes where helmet use has changed over time, which flatly contradict the conclusions of the report. Guy 09:22, 13 October 2006 (UTC)

They do seem to use a Thompson, Rivara, and Thompson study, although I'm not sure if its the 1989 study, as they cite a report from 2005. Is this just the same old one but repackaged? I'm very sympathetic to what you're saying, but from the standpoint of NPOV, it would be very useful if you could find a credible reference for what you're saying so that we can include it to counter the WHO study. Peregrine981 15:48, 13 October 2006 (UTC)

TR&T have reworked their data a number of times, but all their reworkings share the same fundamental flaw: they attribute all differences in injury rates between helmet and non-helmet populations to the helmets. This is easily exposed as false by comparing the non-head injury rates. TR&T use exclusively case-control methodologies, and these are simply not predictive. Any prediction of injury reductions based on any figures from case-control studies is wrong. We know it's wrong because there is no known population where an increase in helmet wearing has led to a provable reduction in head injury rates, even where the helmet wearing rate has doubled in a very short period. None of the papers making extravagant claims of injury savings based on extrapolation of case-control data has ever, to my knowledge, accounted for this: they all start from the assumption that the case-control data is accurately predictive, despite the mass of evidence that it isn't. Guy 10:16, 18 October 2006 (UTC)

This is good to know. Do you have a reference that we can include so that no pro-helmet zealots can reinsert the report? As it stands now we have a usually reputable source saying that helmets reduce injuries significantly, but not report refuting that claim. It seems like we're introducing our own POV/original research without proper sources. Peregrine981 16:19, 18 October 2006 (UTC)

I think we should wait, since my information is that WHO are now waiting for the Cochrane report on helmet legislation before forming a view. Of course this might, like the Cochrane review of helmet research, be a farce, but I hope not since at least some clueful people are involved and are talking to those who do not approach this as a religious issue. Guy 13:02, 14 November 2006 (UTC)

Closing Speed

Having stewed over this for some time, I really think we need to look at the whole question of closing speed. That is, the speed the cyclist’s head is going at impact. This is when an injury is going to take place. A brief survey of the ‘Net reveals the combatants in the helmet debate do indeed bandy this term about often postulating closing speeds vastly in excess of what a helmet can absorb.

But, let’s consider the possibility that a person’s head is not going to be going at high speed at impact. Whatever high speed the head was going at prior to impact is irrelevant.

Personal example from when I was young and stupid:

• Little old lady comes out of a side street without seeing me.
• I manage to swerve and avoid her.
• Unfortunately, I plow into the back of a station wagon sitting in traffic.

Impact to head? None actually. The fork and frame of my lovely Motobecane Nomade are thoroughly bent out of shape but my head had decelerated to zero kph well short of the car. Yes, contrary to popular belief, Derek has never sustained a serious head injury .

Another factor I’ve encountered is terminal velocity, the velocity imparted to the head by gravity. I can just about imagine an accident in which the final impact is caused by gravity as gravity takes over from forward momentum. I’d probably have a better time imagining it if I had studied Physics instead of Shakespeare. at university.

I really think we need to get working on the P.O.V issues this article has , perhaps bringing in pro cycling organizations such as BHSI [2][3]. I’ve hesitated to get heavily involved in the physics of the issue since I have no physics past high school. -Dhodges 18:15, 11 October 2006 (UTC)

BHSI is not a "pro cycling organisation", it's Randy Swart's one man helmet crusade. CTC is a pro-cycling organisation, their stance on helmets is far more cautious. BHSI is absolutely not in any way neutral. The article is, in my view, only biased when viewed from the perspective that helmets are good (or indeed that they are evil). There is a lot of science in there.

The problem here is that there is a quasi-religious movement which believes in helemts, and a sceptical movement which is portrayed as the opposite extreme (often described by the likes of Barry Pless, editor of Injury Prveention, as "anti-helmet zealots"). This is the logocal fallacy of the false middle. I have met a very very small number of people who are actively opposed to helmets, almost exclusively in reaction to the damage caused by helmet promotion to the cause of cycling, helmet promotion and promotion of cycling as a safe mode of transport are generally recognised by all but the single-issue campaigners as being mutually exclusive. Scepticism is the default position ion the scientific method, and the major fault of the likes of Randy Swart is that they require the sceptics to prove the negative while accepting as an article of faith that helmets are unequivocally good. Robinson's recent paper in the BMJ reviewed the measured (as opposed to speculated) effects of increases in helmet use on cyclist head injury rates and found, as others have before and since, no measurable effect. The largest study ever, Rodgers, shows a small but significant increase in risk. So any site that starts from the base premise of benefit, and dismisses contradictory evidence on the basis that it conflicts with this premise, should be treated with caution. It would be a bit like citing Kent Hovind as an authority in an article on evolution :-)

The point about speed is that helmet promoters have in the past said that a helmet which will absorb a 12mph impact will reduce the force of a 30mph impact to 18mph. This is simply false. Energy = 1/2 mv^2 as any fule kno, which means that the effect on an impact significantly above 12mph will be negligible. This is probably one of the many reasons why no real population has ever shown a measurable effect on serious head injuries from increases in helmet use: the collisions which cause serious injury are far beyond the capabilities of helmets. Guy 10:04, 18 October 2006 (UTC)

I meant to say pro helmet organization, Derek shoots himself in the foot again. -Dhodges 23:23, 18 October 2006 (UTC)

archiving?

BTW, Should we start archiving the discussions on this page? It's getting pretty long. -Dhodges 18:17, 11 October 2006 (UTC)

Sure. Also, an anon added the "accuracy" tag to the lead, but I think we've established that it is accurate from good quality sources above. Guy 09:41, 18 October 2006 (UTC)

Page split; separate page for The Controversy, short summary here?

The main page is getting pretty long too. Any opinions on the idea of putting the uncontroversial facts on this page - should keep it very short :_), down as far as the end of section 1.4 I suggest. We would keep only a small summary of the Controversy here and put up another page for the Controversy? I'll check back on comments here, or feel free to email me, but unless I get strong disagreement I'll put up a trial Controversy page in a week or two, other commitments permitting. Richard Keatinge 16:49, 18 October 2006 (UTC)

• I still think it's better in one article. Guy 12:59, 14 November 2006 (UTC)

- thanks Guy and also for those who emailed me; I'll drop the idea for the moment. Richard Keatinge 10:44, 16 November 2006 (UTC)

Citation cleanup

The citations in this article need serious work. First off; citations go after the punctuation. Next, please use an appropriate citation template when adding a reference. I've done a bit of cleanup, but more needs to be done. Kellen ^T 15:17, 7 March 2007 (UTC)

Helmet regulations in cycling sport

I've just added the section with the above title. Could still be expanded a bit. Also, I'm not sure that its current placing within the article is ideal, so feel free to move it if necessary. GregorB 17:50, 13 May 2007 (UTC)

Research evidence

I could find no source for the claim that Thompson, Rivara and Thompson were already committed advocates of helmet legislation before publishing their first study.

Would you have an idea how to find out more about this? I think it is important, as it shows bias. Something that would discredit something as not being an objective and balanced viewpoint.

Cochrane Review

A "Cochrane review" is discussed, but not defined. What is it? Jim.henderson 03:52, 19 July 2007 (UTC)

See [4] and Cochrane Collaboration Richard Keatinge 11:59, 19 July 2007 (UTC)

Thanks. I know nothing of medical statistics (except, as with the definition of pornography, I know what I like) but between seeing your answer and reacting I went for a 65 km ride with my helmet on. Anyway, if my insertion of the link in the article is incorrect or misleading, kindly handle it in a more appropriate way, but do link it somehow for the benefit of my fellow curious outsiders. Jim.henderson 02:02, 20 July 2007 (UTC)

Over 90% of helmets incorrectly fitted

This statement (over 90% of helmets are incorrectly fitted) in the article has been flagged as "citation needed". I have sought a reference and I can't find one. I can find many, many statements similar to this one by doing a web search (in fact, the figure of 96% turns up again and again), but no reference to an original study that might be the source. Anyone else have any ideas? 213.131.238.25 17:47, 15 August 2007 (UTC)Dermot

Got it; it's in. 213.131.238.25 09:39, 16 August 2007 (UTC)Dermot

Inappropriate headlining of data, original research

>> Over the past 10 years, about 90% of the 7290 bicyclists who died in the US were not wearing a helmet. [4] Though impressive, without knowing the base rate of bikers who actually wear helmets, this number tells us nothing about the effectiveness of helmets. If the fraction of helmet wearers is greater than 10%, it is safer to be in the population of helmet wears than not. Though statistics on the fraction of bikers who actual wear helmets are less accurate than death statistics, a variety of studies all have put it over this threshold of 10%. [5] [6] [7] [8]. This doesn't prove that helmets themselves save lives, but it may provide comfort to 15 million people in the US who have purchased helmets in a typical year.[9] <<

This does not belong at the start of the introduction. Also, it's oddly written. What is "impressive" about the number of dead cyclists? What are "helmet wears"? Who cares whether statistics which, it is conceded, prove nothing "give comfort" to people who have spent 30 dollars?

I don't know where this should go, but if anyone who understands this topic better than I do could move it, it would improve the article a great deal.

15:50, 10 August 2007 (UTC)Dermot

Apologies to Dean p Foster, but I just deleted that paragraph. Perhaps someone else could put the statistics in where they belong in the article, but they're not so special that they deserve to take up half the introduction. As for the reasoning in that paragraph (whatever about the statistical data themselves), it's not a clear argument to me. It's another confusion of correlation with cause. Even if voluntary helmet-wearing IS associated with lower fatality levels, it could be because voluntary helmet-wearers are more cautious than average cyclists. This is already dealt with in the article.213.131.238.25 17:44, 10 August 2007 (UTC)Dermot

Wallak immediately undid my revision. Someone else look at this, please. This paragraph in the introduction is sloppy and unbalanced.213.131.238.25 17:45, 10 August 2007 (UTC)Dermot

No need to apologize--just rewrite it! I admit I'm not a good writer--but I did work hard putting the statistics together. I do feel it is important to be in the introduction since it address the primary purpose of a helmet. The rest of the article has a bit of NPOV problem (see my suggestion above) which these statistics point out. Dean P Foster 19:49, 10 August 2007 (UTC)

Hi Dean. Thanks for taking criticism in good spirit. I'll have a shot at re-writing it over the weekend or early next week. However, I have to repeat: unless other contributors object strongly, I think your statistics have to go somewhere else besides the introduction; not because of any bias I have or because the statistics are invalid (I take my hat off to you for compiling the evidence, including the references), but because they color a reader's impression of the entire subject before the discussion has even begun. There are detailed discussion of the statistical evidence elsewhere in the article and your statistics belong with them, it is my strong feeling. They also contain a potential confusion of correlation and cause, which I'll try to address in a re-write. Thanks again!194.165.181.135 21:46, 10 August 2007 (UTC)Dermot

I'd suggest not bothering. Sorry, Dean, but the FARS database, which the statistics were based on, do not accurately count helmet use. In particular, when helmet use is not known, and it usually isn't because the policepeople and so on who have to enter the information do not see this data field as a priority, it's then normally interpreted as helmet not used. That's why you got the results you did. I hate to have to say it after your hard work, but this data simply cannot support any conclusion about the effectiveness of helmets. Your work is also original research under the Wikipedia definition. I have deleted it and suggest it should stay deleted. Richard Keatinge 22:49, 10 August 2007 (UTC)

Saying the FARS gets it wrong based much more on orginal research than my adding 10 numbers together and then dividing. We could remove the orginal research by just using the most recent year for which data is collected. But as a statistician, I like the accuracy of using more data. But the statements would all be supported with this change. I'm willing to have it moved to the statistics section. But I felt that a helmets primary function is safety, and these are the best numbers I've found on safety. They are numbers that will be the same next year and the year after. So they are worth of memorizing. Dean p foster 12:28, 11 August 2007 (UTC)

I really am sorry about your hard work, but the point is that the FARS data cannot support your point. Most crashes recorded there as "no helmet" are in fact crashes where helmet use was not recorded. A large, but unknown proportion will in fact have been wearing helmets. The result of your work is not numbers on safety; it is invalid - rubbish. If it's any consolation you are not the first to be misled by this presentation of this data. Richard Keatinge 07:10, 13 August 2007 (UTC)

Citation? What numbers are better? If these are the best there are, they should be used with a disclaimer. If you know of better, then we have a point of comparison. They do list "unknown" as one category. So I'm not sure what you are basing your facts on. So, let me reiterate--I think a version of this material is relavent for the article. I'm happy (even moree than happy) to have my submission edited and improved. But reverting to a delete doesn't seem to be moving the conversation forward. Why don't you take a stab at rewriting it so it would pass your "rubish" filter. Dean P Foster 17:03, 13 August 2007 (UTC)

I was unaware of the "No Original Research" restriction on article entries in Wikipedia until Richard pointed it out. Looking at it now, Dean, your contribution can't go in in any shape or form. The link Richard provided above makes it clear that "Synthesis of published material serving to advance a position" is not allowed. "Editors often make the mistake of thinking that if A is published by a reliable source, and B is published by a reliable source, then A and B can be joined together in an article to advance position C." That's exactly what you're doing here. Your analysis whould have to have been published by a reliable source in relation to this topic before it could be published in Wikipedia. I urge you to read the link carefully: original research 213.131.238.25 18:41, 13 August 2007 (UTC)Dermot

Good point. This article in generally has lots of issues with both NPOV and No Orginal Research. I was trying to fix that by adding some actual citations and statistics (which happen to run against the general flow of the article). I don't think that the right response is to kill all the statements that contain orginal research or are uncited. There would be very little left of the article as it stands. Further, that certainly would end up in a revert war. What is the best way to move forward on improving this article? Dean P Foster 19:55, 13 August 2007 (UTC)

Now there's a really good question. As you'll see from the article and the above discussion, the effectiveness and desirability of helmets, and of compulsion, are areas where opinion is polarized. The experts often can't even seem to agree on what is evidence. This has tended to put me off trying to tidy it up; almost anything that anyone writes will be contentious. However, quite a lot of good work has been done on this article; there are plenty of well-referenced comments which cover most of the main issues. I agree, there are some unreferenced statements which need citations (or deletion), and work on those would be good. The issue that you mention, of whether helmet wearing makes you more or less likely to have an accident, is a good one, without any really definitive evidence either way as far as I know. If you can get your own work published somewhere independent, that would be good and would make it legitimately citable. But, as I've mentioned before, it is not possible to obtain valid conclusions from invalid data. Richard Keatinge 09:57, 14 August 2007 (UTC)

That seems a good summing up of the situation. I personally think that the article is actually rather good, and I think, as Richard says, that it sums up the current state of knowledge on the subject. Nevertheless, given how very polarizing the subject it, it needs every statement to be backed up. Also there are "original research" markers sprinkled throughout the text now, and really they mostly should be "citation needed". For example, in the Research Evidence section, it is claimed that helmet-wearing is low down in the list of top-priortiy interventions for cyclists' road saftey. This has been marked "original research", whereas we should be asking for a citation. As a matter of fact, I have seen this statement quite a few times outside this article. I'll look for a citation for it. I'll also set up a user id for myself. I've been meaning to do it for about a year!213.131.238.25 12:16, 14 August 2007 (UTC)Dermot

Apologies if this was already posted - am just passing through at the mo: Faulty FARS bicycle helmet use data & implications for effectiveness. --Sf 13:06, 14 August 2007 (UTC)

I'm not familar with the journal "Injury Prevention". Is it peer reviewed? Are the comments on the page peer reviewed? If the articles are peer reviewed but not the comments, then the distinction is between "science" and "slashdot discussion". Now I often side with the line noise on slashdot, but it really isn't what we are looking for a wikipedia. If we take the comment at face value though, let's focus on the numbers. They are claiming FL has 13% helmet at death rate. The number I added to the article is 10%. Yes these differ. But not enough to change the conclusions. I'm happy with any government statistics--they are in the business of reporting them. But if there are better numbers around, we should us them. But to put our head in the sand and pretend no numbers exist is not the right solution. Possibly puting in the FARS numbers with a discussion is right. Dean p foster 14:06, 14 August 2007 (UTC)

I just took the time to read about the "injury prevention" journal. Looks like a good journal. Peer reviewed and all. So we should cite the article. But the comments should be treated as lower quality--they are not peer reviewed. Dean p foster 14:11, 14 August 2007 (UTC)

I don't know what Wikipedia policy is on letters to the online versions of journals, but I assume it would be simliar to any policy relating to letters written to the paper version of Nature, or Scientific American. Those letters, I assume, are treated as informed comment. An experienced Wikipedia editor might be able to clarify whether that is the case. But it seems to me that those "comments" linked to by Sf are not "slashdot discussion", which are informal, instantaneous comments by a user group, not written in a scientific style, and frequently glib. The BMJ eLetters are serious contributions by people working in the same or a relevant field, written in a formal, scientific style, with supporting references to scientific studies. They are also read and considered by the editor before publication, a process that can take a few weeks.213.131.238.25 15:19, 14 August 2007 (UTC)Dermot

I think this is the relevant guideline: Reliable Sources "Reliable sources are authors or publications regarded as trustworthy or authoritative in relation to the subject at hand. Reliable publications are those with an established structure for fact-checking and editorial oversight." Since each eLetter is passed by the editor, it seems to me that BMJ eLetters are a reliable source. 213.131.238.25 16:39, 14 August 2007 (UTC)Dermot

________________________________

I think your entry on cycle helmets is very biased against the use of cycle helmets and needs to be re-balanced. For instance it refers to an 'upcoming' Cochrane Review on cycle helmet legislation. This is now available at: 'Bicycle helmet legislation for the uptake of helmet use and prevention of head injuries'- Authors' conclusions "Bicycle helmet legislation appears to be effective in increasing helmet use and decreasing head injury rates in the populations for which it is implemented." http://www.cochrane.org/reviews/en/ab005401.html

The Cochrane Reviews are widely regarded as 'gold-standard' evidence-based science and while this item (below) appears in the entry bibliography, it is not referred to in the text or footnoted: 'Helmets for preventing head and facial injuries in bicyclists' "Wearing a helmet dramatically reduces the risk of head and facial injuries for bicyclists involved in a crash, even if it involves a motor vehicle Cycling is a healthy and popular activity for people of all ages. Crashes involving bicyclists are, however, common and often involve motor vehicles. Head injuries are responsible for around three-quarters of deaths among bicyclists involved in crashes. Facial injuries are also common. The review found that wearing a helmet reduced the risk of head or brain injury by approximately two-thirds or more, regardless of whether the crash involved a motor vehicle. Injuries to the mid and upper face were also markedly reduced, although helmets did not prevent lower facial injuries." http://www.cochrane.org/reviews/en/ab001855.html

And nowhere is the main point it makes, that: "The review found that wearing a helmet reduced the risk of head or brain injury by approximately two-thirds or more, regardless of whether the crash involved a motor vehicle", mentioned or acknowledged. _____________________________________

I notice that you didn't include the entirety of the Authors' conclusions: "However, there are very few high quality evaluative studies that measure these outcomes, and none that reported data on an [sic] possible declines in bicycle use." This probably should be the impression that a reader should come away with after reading the Wikipedia article: the evidence is poor, and many of the claims made in favor of helmets are inflated, given the paucity of quality evidence.213.131.238.25 10:01, 15 August 2007 (UTC)Dermot

Also, the second paper you cite is by Thompson, Rivara and Thompson from 1999, and they, once again, are dealing exclusively with case-cotrol studies, with all their attendant weaknesses as predictive studies (as dealt with in the article already). I assume that some of the five "well-conducted case-control studies" they mention are their own, since the famous number 88% makes an appearance. 213.131.238.25 10:20, 15 August 2007 (UTC)Dermot

BTW, I forgot to say thanks for pointing out that the Cochrane Review of legislation is now available. It should go into the article now. I'll do it later, if no-one else does it.213.131.238.25 10:22, 15 August 2007 (UTC)Dermot

Ok, it's in.213.131.238.25 10:28, 15 August 2007 (UTC)Dermot

Good. I have another reference to it. The section on "research evidence" originally gave an account of just why there is so much scientific controversy. I have rewritten it to reinstate that, and also to give a very brief account of the main arguments and references. I hope that others find this useful. Richard Keatinge 11:41, 15 August 2007 (UTC)

I agree that the Cochrane Report is the gold standard in medical research. They do very good work. Going against their opinion puts us close to "fringe" science. But, their report isn't addressing safety of helmets, but effectiveness of helmet laws. The artlce starts out with the paragraph,

"Bicycle helmets have been shown to be effective in preventing head, brain, and facial injuries to cyclists (Rivara 1998, Thompson 1996). A Cochrane systematic review reports that helmets reduce the risk of head injury by up to 88%, and reduce the risk of facial injury by 65% for cyclists of all ages (Thompson 2001)."

So they consider it common scientific knowledge that helmets are effective. That is what should be reflected in this article. Being invited to write a Cochrane allows the authors to claim to be experts, and hence they should cite their own work. After all, they were asked in their role as expert. (The Cochrane clearly is different than the Wikipedia on this score.) I think we should be starting with a quote something like the above, rather than a quote about how inconclusive the evidence is. This report only claims a grey area for helmet laws, NOT helmet use.

I again propose that we split this article into two by splitting off the helmet law's discussion. That is the right place to discuss wiether LAB kinda stuff is more effective than helmet laws. It really isn't right to be in the helmet article since it is more about all of biking than about helmets themselves. If no one objects, I think I'll start the new article and copy over the stuff from this article that fits there. I've never started a new page, so I'm hoping someone would be willing to help me with such a large undertaking. Dean P Foster 18:15, 16 August 2007 (UTC)

Dean P Foster 18:15, 16 August 2007 (UTC)

Strong object: The relevance of the laws is that they provide a strong body of robust population level data that directly undermines and refutes the claims (and claimed expertise) of Thompson, Rivara et al. It is the data the laws have provided not the laws themselves that are essential to unbiased discussion of the topic. Attempts to remove reference to this data suggests an objective of presenting a biased view of the field. As to the Cochrane Foundation's reputation within the medical profession - it is arguable that by giving Thompson and Rivara a platform, the Cochrane foundation puts their own reputation at risk. --Sf 21:45, 16 August 2007 (UTC)

Disagree even though I suggested splitting the article myself last autumn, see above. After seeing my epidemiology students using Wikipedia it became clear that they, as casual users, expected to find any controversy under the main heading. One spent ages looking for stuff on the effects of seat belts without realizing that what he was looking for was in a separate article, Seat belt legislation.

Dean, you also seem to be trying to introduce a strong POV here. As Shane says, the importance of the laws is that they provide good evidence that helmets don't have any useful effect. And, on the subject of the Cochrane Collaboration, they depend on volunteers, as Wikipedia does. Most of what they produce has been based on randomized trials, and some of their recent forays into areas without that sort of top-quality evidence are highly controversial. Richard Keatinge 08:38, 17 August 2007 (UTC)

I'm trying to reflect what is considered good science. There are two different questions, are helmets useful to people (science says yes, or at least all mainstream science says yes). The other question is, are helmet laws useful (this one is less clear). So by having both in the same article, we incorrectly give the impression that helmets aren't effective safety devices. So, yes I do have a point of view. It is called, "main stream science." For example, Dyson recently wrote a piece arguing that maybe oil comes from non-biological sources. This is the non-standard view. It is handled very well on the Petroleum page. Minority positions need to be attributed carefully--the majority doesn't need names. My understanding of NPOV is that we aren't being journalist (who often feel they need to give 1/2 time to scientific experts and 1/2 time to fringe scientist to be far). But we should present the minority position in a unbiased fashion. This I'm confortable with. But presenting the fringe position as the one true answer (as this article currently does) gives me the willies. Sorry for getting a bit emotional. I've impressed many people who were amazed at the NPOV of articles like evolution, and israel, and made wiki converts of them. So I was bothered when I was pointed to this page by a biker who wanted to know what I thought the state of the research was on helmets. That this page disagrees with CDC, Cocharane, many governments, and the best science I've been able to find was shocking. So yes I have taken on a crusade to try to fix it. If it were the evolution page that were biased, I'd give up (and give up on the wikipedia all together). But since pages that have much more built in biases come out reading like NPOV, I felt this page could be fixed also. Sorry for the tirade. I haven't joined a flame fest in almost 25 years now. (I recall my last one was over using too much CPU as a PhD student in computer science...) Dean p foster 13:21, 17 August 2007 (UTC)

With respect, you are asking the wrong questions and working from questionable assumptions. The essence of the debate is that much/most of what has been published cannot be represented as "good science". Much of the material published comes from US medical practitioners using the US medical literature to publish their opinions. By definition most medics recieve little or no training in traffic accident analysis, causes or distributions. Similarly, they recieve little or no training in materials science. Thus the competence of medical "experts" to make claims regarding usefulness of polystyrene foam in preventing traffic injuries is entirely open to question. The same issue applies to peer review panels composed of such individuals. As to as to what you refer to as "mainstream science" by which I assume you mean the "mainstream medical literature in the US" - much of what has been published there starts from a working hypothesis that has been repeatedly challenged and refuted. The fact that similar material continues to get published reinforces the view that those involved are interfering in matters where they have no competence. Furthermore it is arguable that publications working from these assumptions should be excluded from any source that wishes to remain reputable - such as Wikipedia --Sf 14:08, 17 August 2007 (UTC)

This is extreme original research (and a bit of conspricy theory thrown in). US science is considered reputable in most of the world. Peer review is considered the best way of evaluating science. Taking these on is the route to total fringe science: AIDS being caused by HIV, young earth, etc. The mainstream can be wrong. That is definitely NOT our job to determine. That is extreme POV and extreme original research. Your view summaries the article perfectly. Your defense of the article is admirable. But, I feel it is crippling any chance of it achieving the NPOV that wikipedia aspires to for this article. Dean p foster 15:27, 17 August 2007 (UTC)

That's it. There doesn't seem to be a scientific consensus on how beneficial helmets are (even considered apart from helmet laws). Published case-controls studies suggest one thing; populations studies of jurisdictions where helmet use has gone markedly up suggest another. I must say though, that the fact you can "prove" that helmets prevent most *lower-body* injuies using the case-control data is a major black mark against them. That strongly suggests confounding. I would have assumed anyway that the null hypothesis should be that helmet-wearers are no safer then bare-headed cyclists, and research would seek to disprove the null hypothesis. Most of the case-controls studies seem to take the benefits as a given. 213.131.238.25 14:53, 17 August 2007 (UTC)Dermot

There is no contradiction here. they are asking two different questions. Hence the need for splitting the page. You are correct--the null should be "helmets are no different." The only scientifically strong statements, are rejecting this null--either helmets are good or helmets are bad. The vast majority of studies on individuals I've seen either show helmets are good, or no difference. If in fact there wasn't any difference, we would expect about 1/2 of them to reject positive and 1/2 to reject negative. This doesn't seem to be the state of the liturature. The population studies aren't answering the same question. So they can not be used as evidence either for helmet safety or against helmet safety. (If laws lead to fewer deaths, it could just be a change in social goals. So nothing to do with the helmets themselves.) So having these two very different questions in the same article seems to be confusing some of the people who write discussion here--and I assume it is confusing aome of the readers. THis seems silly to do. Dean p foster 15:27, 17 August 2007 (UTC)

"The vast majority of studies on individuals I've seen either show helmets are good, or no difference." But most of these studies (at least the ones I've seen) are case-control studies. Over and over again.

The Wikipedia page on Case-control Studies says: >> As a result the following guidelines have been proposed when assessing case-control evidence [Hormone replacement therapy and coronary heart disease: four lessons. Petitti D, International Journal of Epidemiology, 2004;33:461-463]):

Do not turn a blind eye to contradiction. Do not ignore contradictory evidence but try to understand the reasons behind the contradictions.

Do not be seduced by mechanism. Even where a plausible mechanism exists, do not assume that we know everything about that mechanism and how it might interact with other factors.

Suspend belief. Of the researchers defending observational studies, Pettiti says this: "belief caused them to be unstrenuous in considering confounding as an explanation for the studies". Do not be seduced by your desire to prove your case.

Maintain scepticism. Question whether the factor under investigation can really be that important; consider what other differences might characterise the case and control groups. Do not extrapolate results beyond the limits of reasonable certainty (e.g. with grandiose forecasts of "lives saved").

Case-control studies are a valuable investigative tool, providing rapid results at low cost, but caution should be exercised unless results are confirmed by other, more robust evidence.

Where is the "other" confirmation of the case-control studies? You can't back up case-control studies with more case-control studies. If they prevented 88% of head injuries (or whatever high number is usually put forward), you'd have to expect that fact to be detectable in population studies. And it hasn't. When case-control studies suggested a link between smoking and lung cancer, other studies consequently backed it up. This hasn't happened in the case of helmets.213.131.238.25 15:38, 17 August 2007 (UTC)Dermot

Reorganization under appropriate headings

I have pulled the debate section together under some slightly changed headings:

2 The helmet debate; contested evidence, contested values

2.1 Do helmets work? Contradictory research evidence 2.2 Groups and attitudes 2.3 Safety in numbers; reduction in bicycle participation after helmet laws 2.4 Helmets and increased risk of injury 2.5 Promotion and compulsion; situation and arguments 2.6 Cycling as a dangerous activity

I really hope that this gives a more coherent story, even though I think there is more work to be done. I have tried to keep the rewriting to a minimum so as to make this edit mainly about rearrangement. I have also, I think, addressed some of Dean's worries about POV. Richard Keatinge 15:44, 20 August 2007 (UTC)

Nice work, Richard. I think that the subsection beginning "Some studies suggesting increased risk from helmet use may give spurious results, as mentioned for case-control studies above" is a good thing to highlight. What's sauce for the goose ... 213.131.238.25 16:13, 20 August 2007 (UTC)Dermot

I think we should divide up the evidence section into two pieces--do helmets work? Do helmet laws work? These are very different questions and have very different scientific issues. Mixing them together I think is part of the confusion in the whole issue. For example, the science of material failures only addresses the first question. Where as the issue of economics only is related to the second question. So I think 2.1 really needs to be split. Dean P Foster 22:00, 20 August 2007 (UTC)

For the average reader the more fundamental question is "Do helmets prevent or reduce injuries in populations of persons who wear them?" The treatment of article that you suggest might be taken as an attempt to downplay or dilute the issues of risk compensation and/or the risk taking characteristics of the population of voluntary helmet users. --Sf 07:29, 21 August 2007 (UTC)

I agree with Sf; I suggest that if and only if mass helmet use has a useful effect, then economics becomes relevant and legislation becomes rationally supportable. Materials science would fit better in 1.1, if you want to put any more in - like economics, it's only really relevant if mass helmet use works. I see legislation as being scientifically relevant mainly because in some areas it has led to a rapid shift to mass helmet use. Richard Keatinge 07:55, 21 August 2007 (UTC) —The preceding unsigned comment was added by Richard Keatinge (talk • contribs).

I've re-organised the "The helmet debate' section (again). I hope I've contributed to making it more logical, and more useful for readers. My goal was to bring together logically linked statements into a well structured sections, each with concise and clear titles. -- de Facto (talk). 20:55, 3 September 2007 (UTC)

It looks good to me. Richard Keatinge 08:24, 4 September 2007 (UTC)

Yes, I've only skimmed it, but it seems a very good template: more ordered, more concise. 213.131.238.25 09:50, 4 September 2007 (UTC)Dermot

Unattributed quotation

At the end of the case-controls section of "Do helmets work? Contradictory research evidence", there's a confusing quotation: >> "We conclude that helmet non-use is strongly associated with severe injuries in this study population. This is true even when the patients without major head injuries are analyzed as a group.[15] This is taken as evidence that the cases and controls in this study have very different types of injury even if there is no actual effect of helmets, and therefore that conclusions about the protective effect of helmets are unlikely to be accurate. << There's an opening quote but no closing quote. Is this a quotation from a publication? If so, which one?194.165.183.1 15:35, 25 August 2007 (UTC)Dermot

Now corrected, the second sentence is not a quotation, at any rate not from the summary which is all I can bring up online right now, but is a summary of their conclusions. Richard Keatinge 19:01, 26 August 2007 (UTC) —Preceding unsigned comment added by Richard Keatinge (talk • contribs)

Thanks! 213.131.238.25 17:48, 27 August 2007 (UTC)Dermot

Good article?

I have done quite a lot of work on this article in the last few days. I suggest that it is approaching good article status, possibly even featured article, if we can do a bit more.

In particular the first section needs references, and some of the existing references need tidying up. I propose to get the separate reference sections on Case studies/risk, Helmet Fit, Compulsion Laws, and Bicycling as traffic books either integrated into the main list, or removed. For example, although I have and admire both the books in this section, I really don't think that "Bicycling as traffic books" belongs in this article at all. Richard Keatinge 10:36, 24 August 2007 (UTC)

I think you've done some terrific work the last few days. I wish I could help with the references in the first sections, but I don't have any literature on those history/design/materials/etc. I agree about the "Bicycling as Traffic" books; they're not directly relevant to the subject in hand. I suppose, though, they could be included in this sense: they're both books widely respected by cyclists and cycling groups, but Franklin's book regards helmets as a relatively unimportant precaution, while Forester's book advocates helmet use quite strongly (albeit as less important than roadcraft and maintenance). I'm not sure if this would allay some of the NPOV concerns some readers have had.213.131.238.25 12:14, 24 August 2007 (UTC)Dermot

I'll just clarify what I meant there -- that the two books could go into the general references section (Franklin's in there already), and the Bicycle as Traffic reference section could go. I think Forester's attitude to helmet-use maybe should go in somewhere (probably the first paragraph of Groups and Attitudes, where attitudes in the US are mentioned), just to show that some experienced cyclists do advocate helmets. I'll do this now. As always, feel free to amend and undo. 213.131.238.25 12:35, 24 August 2007 (UTC)Dermot

Agree on the books an on the recent reworking. I have copy of "Death on the Streets" that might provide a scource for some of the helmet history material. Unfortunately, I am away for the weekend and quite busy next week so I might not get time to dig it out for a while. --Sf 14:17, 24 August 2007 (UTC)

Many thanks to DeFacto for recent hard work. I have tried to build on that, including digging around in the CTC and WHO websites. Has anyone got a really good answer to the problems of referencing the Dutch, and other, lack of interest in helmets, preferably without doing original research? I can't speak Dutch, Danish, and whatnot, and the whole point is that their literature scarcely mentions helmets at all. The forum link I posted was about the only thing I found. Richard Keatinge 11:06, 25 August 2007 (UTC) —Preceding unsigned comment added by Richard Keatinge (talk • contribs)

Yes, I wondered about that too. How do you provide a citation to show that a country *isn't* interested in something?

194.165.183.1 15:35, 25 August 2007 (UTC)Dermot

I can get one or two but will take me a few days - very busy at work. --Sf 07:19, 27 August 2007 (UTC)

"New government helmet promotion could sound the death knell for the future of cycling. Cyclists Touring Club. Retrieved on 2007-08-24." mentions the lack of interest in helmets in the Netherlands and Denmark, so I've used that as a citation for now. But the way I've edited it in, it appears in the references twice. The usual ref name=*.../ref trick doesn't get rid of it. I'll have to leave it to someone more knowledgeable.213.131.238.25 15:12, 27 August 2007 (UTC)Dermot

Actually, that link was to a document called "Cycle helmet promotion: a dangerous distraction", which I've now used as a supporting citation to the attitude of the Dutch and Danish to cycle helmets. I've found a Cycling North Wales reference to the skull imagery, so I'll leave that in place of the CTC link until someone finds a relevant link to the CTC site. 213.131.238.25 17:48, 27 August 2007 (UTC)Dermot

Good to see all the changes! I've re-ordered a couple of sections and hope to do a little re-writing - mainly, removing approximate duplications. The second half still lacks real clarity, I feel. Any comments? Richard Keatinge 12:17, 28 August 2007 (UTC)

Maybe 'Positions and Arguments' and 'Attitudes' could be merged? They seem to overlap. 213.131.238.25 12:27, 29 August 2007 (UTC)Dermot

On the subject of 'Attitudes', that section does seem incomplete. It says "Much of the debate is partisan in one way or another", which seems to me to mean that researchers are often pro-helmet or anti-helmet, and that this colours their research. However, the only example of anti-helmet bias is Curnow, tucked in at the end, and "publish[ing] criticism of pro-helmet research" doesn't seem very partisan to me, per se. Maybe more referenced examples of anti-helmet bias could be found, or else most of the referenced points in this paragraph could be moved in some form towards the end of the "Do helmets work? Contradictory research evidence" section? 213.131.238.25 16:32, 29 August 2007 (UTC)Dermot

Difficult. I can't really think of any researcher who started out with an obvious anti-helmet bias, though I do know some people who started as pro-helmet and are now definitely sceptics. The section really refers not to discussion of good research (if people are doing good science it doesn't matter what their attitudes are), but to the attitudes underlying much of the poorer research, and I'd suggest that it should probably remain separate.

I have eliminated one whole section. It seemed to me that everything in it was minor or repetitive, and as DeFacto pointed out rather ill-referenced. This article is already rather long. Richard Keatinge 16:36, 30 August 2007 (UTC)

And I have, perhaps cruelly, axed some details about the SWOV - I suggest that all we really need is what I've left. Richard Keatinge 21:28, 30 August 2007 (UTC)

I have removed one fact tag and moved the sentence to make clear, I hope, that the sentence states a theme for the rest of the paragraph.

I also removed the OR tag in the same section. The sentence is rewritten for brevity from a large number of papers on the subject. If we want a large and rather dull paragraph with multiple references for fairly un-controversial ideas, it could be supplied. But it does not strike me as good encyclopaedic style. Comments? Richard Keatinge 08:33, 4 September 2007 (UTC)

Dorre has redrawn the data used for her BMJ review, and some more, and uploaded the resulting artwork and so on to Wikimedia at [[5]]. I have, tentatively, put in a link. Is this appropriate? Apart from any OR issues, it's a pdf file. I await guidance. Richard Keatinge 11:53, 5 September 2007 (UTC)

There are unresolved issues around the use of graphs derived from Scientific publications/published data on Wikipedia. The powers that be are claimed to insist that any graphic material used on Wiki must be licensed for "anyone to use it for any purpose". Similarly it is asserted that uploaders of graphs may not seek to prevent derivative work. I had intended to file a request for comment on this but have been distracted by all kinds of other things. --Sf 23:44, 8 September 2007 (UTC)

For the record I don't think there are any OR issues as such. The graphs are representations of published material. --Sf 10:52, 9 September 2007 (UTC)

Dorre's data has been deleted. I don't see a reason given for deleting it on the user page of the deleter. Anyone know whether it was inappropriate to have posted it? Should it be put back?Tomasrojo (talk) 18:51, 23 March 2008 (UTC)

I have integrated a standard scale of the quality of evidence into the article. Marginally interesting I think. Richard Keatinge 21:02, 8 September 2007 (UTC)

OK, section 2 now has a brief lead, an analysis of whether helmets do what is desired, now immediately followed by an analysis of whether they do anything undesirable. I suggest that these two belong together. Then there is the account of promoters and opponents, and finally the section on promotion and legislation. I made a couple of other minor changes while I was there. Hope this helps. Richard Keatinge 12:06, 9 September 2007 (UTC)

I think this is good the quality of evidence issue is key in my view, also under undesirable effects of helmets we should put something about the incidents where childrn were strangled by the straps after getting helmets caught in playground equipment etc. --Sf 06:14, 10 September 2007 (UTC)

I have chased up some references and puit in a brief section. Richard Keatinge (talk) 15:28, 7 February 2008 (UTC)

With apologies to 80.7.148.117, I have removed: "As mentioned earlier 90% of helmets are incorrectly fitted. Women commonly wear them loosely on the back of the head like a kippah where they can only provide minimal protection."

I didn't think that added much, as noted there was (referenced) comment already.

And: "Wearing of a helmet is apparently seen as a panacea, so reducing the perceived requirement for good riding practices: e.g. observation, prediction etc. They act as though their "magic helmet" will protect them from 4x4s, trucks etc.."

Such comments have been made, but they are theoretical, and these are not referenced. There are other explanations for why helmeted riding might be more dangerous, and these are referenced elsewhere already. Richard Keatinge 09:01, 18 October 2007 (UTC)

Colour as safety issue

I see that the article currently features a picture of a *dark* helmet. At Motorcycle Safety there is a claim that white helmets are around 25 % better in avoiding collisions ie they make the biker more visible to motorists, thus less likely to be hit.If this is the case, it would be good to include mention of such a factor, as it suggests a "behavioural" reason why helmets might "work" in overall injury reduction.Feroshki (talk) 06:17, 29 November 2007 (UTC)

Peaks, sunshades etc

Peaks seem to be nearly universal now. But as they are so short, I wonder if they really have any shading effect? At the least, they might reduce the considerable number of cyclists wearing baseball caps under their helmets, which is contrary to manufacturers' recommendation , specification etc.Feroshki (talk) 06:18, 29 November 2007 (UTC)

Australian office of road safety study

An interesting reference is DEPARTMENT OF TRANSPORT, FEDERAL OFFICE OF ROAD SAFETY. Report No. CR 55 Date May, 1987 Pages 160 f xi ISBN 0 642 510 431 ISSN CR = 0810-770 Title: Motorcycle and bicycle protective helmets requirements resulting from a post crash study and experimental research. Authors: J.P. Corner, C.W. Whitney, N. O'Rourke, D.E. Morgan. [6] Briefly, they studied helmets in real accidents, motorbike helmets for adults and bike helmets for children. The liners did not crush as they are tested to do, because the headforms used for testing are much better at crushing foam than are real heads. And they mention more evidence for rotational injury.

I have done some extensive rewriting of the designs and standards section, and a fair bit of complementary rearranging, as a result.

I have also done a little supplementary rearrangement of sections, headings, and so on, and deleted some duplications. Richard Keatinge (talk) 15:28, 7 February 2008 (UTC)

Dubious assertion removed

Said assertion:

Some officials within UCI had been trying to re-establish a helmet rule, and used this incident to push through the change, initially claiming that it was for insurance reasons although the insurers subsequently denied this.

I did a bit of research on the subject, but I never came across this insurance argument. The official UCI press release gives other reasons. As I said in the edit summary: feel free to reintroduce the above sentence if you can back it with a citation.

Another not quite unrelated matter: the section I am talking about was originally titled "Helmet regulations in cycling sport" (title supplied by yours truly), but was since renamed "Helmet compulsion in cycling sport". Now, excuse my irony, but was there something in the original title that was unclear? Or even POV?

Generally speaking, the article has a bad POV smell, and I'm obviously not the first to notice it. GregorB (talk) 18:05, 16 April 2008 (UTC)

Trials

There are several practical reasons why no trial of the effectiveness of bicycle helmets has ever been done. The main one is that cycling is so safe that the trial would need to be done on an unreasonably large scale. From [7] I find the sample size calculations under "When your primary comparison is a proportion (or a percentage) Intervention trial example Your research question is “does a new treatment work better than the existing one?”." (Using the figure elsewhere in the article for one serious injury per 8,000 years of average cycling, and assuming that cycle helmets are 80% effective in preventing any serious injuries, p1=0.000125, p2=0.000025, p1-p2=0.00001, mean p =0.000075, sqrt mean p is 0.00866, delta is 0.011547, delta squared is 0.000133, number required in each group is 117,750, total for intervention and control groups 235,500. Feel free to check my arithmetic!) I calculate that we would need 235,500 cyclists to take part in a trial for one year in order to have an 80% chance of showing a statistically significant difference. There aren't many trials on that scale, and I can't see this one getting going. Also, "blinded" trials would be very difficult; anyone will know whether they are wearing a helmet or not, and arranging for those assessing the outcomes to be ignorant of helmet use would be tricky.

Legal obstacles? Only where unhelmeted cycling is illegal, true for only a tiny proportion of the world's population. Ethical obstacles? Well, the effectiveness if any of helmets is uncertain, except in the fortunately rare cases of strangulation, and if we can do trials on children with deadly cancers (as is routine, see for example [8]) I can't see much objection to doing it with helmets. Richard Keatinge (talk) 12:01, 12 August 2008 (UTC)

Intense debate

The existence of an intense debate seems to be amply described and referenced in the body of the article. Richard Keatinge (talk) 15:48, 20 October 2008 (UTC)

Original research?

It is useful that Richard Keatinge brought up the concept of original research. A major reason that this article lacks neutrality is that it is in fact loaded with original research, even though it may have been written with the opposite goal. The chart from the Oxford Centre is a case in point. This is an example of argument by cryptic reference, in fact a misinterpretation of a cryptic reference. No, a time-trend analysis (if a simple comparison can even be called an "analysis") is not an "ecological" cohort study. It's not a cohort study at all, because there is no cohort. Rather, a time-trend comparison is essentially an uncontrolled trial.

The central claim of the overgrown section on the helmet debate is that the evidence against helmets is better than the evidence in favor helmets. The article says that the evidence against is class 2, but the evidence in favor is class 3. This is both a misreading and a misuse of the standards of evidence-based medicine --- which first off should cite the much clearer Wikipedia page on evidence-based medicine rather than a cryptic PDF chart from a medical center. It's a misreading because a time trend is an uncontrolled national trial and not an ecological cohort study. It's a misuse because ultimately the grades of evidence-based medicine are guidelines of scientific common sense and not usually legalistic rules. A legalistic interpretation of such grades is only appropriate for evaluating potentially dangerous medical treatments. Bicycle helmets may be a bother, but they are not dangerous in the same sense that surgery is dangerous.

So yes, original research is the existing problem with this article.

Greg Kuperberg (talk) 17:58, 8 December 2008 (UTC)

The ecological comparisons are not cohort studies, they are ecological studies, time-trend analyses. Some do use appropriate control groups, but again it would be original research if I were to point out which ones. On looking through more modern grading systems, most seem to have fewer gradations, they generally put case-control studies and time-trend analyses together, and I've just rewritten the paragraphs, removing mention of grading systems. As you say, these things are guidelines not laws.

Not dangerous? Check the paragraph on strangulation by helmet straps. Fortunately the numbers are small. The number of my patients dying of inactivity-related causes is much larger, and if helmet promotion is indeed putting any of them off cycling, this is bad news for their health. Richard Keatinge (talk) 20:00, 8 December 2008 (UTC)

The fact remains that this article is tendentious and lop-sided against the use of bicycle helmets, when to the contrary the prevailing medical opinion is that bicycle helmets are important. You're clearly one of the skeptics and most of the article was clearly written by skeptics. Now, you guys may be right, but you're giving your dissent more space than the main recommendation of the medical community.

You deserve credit for paying some lip service to prevailing medical opinion. Just not as much as you devote to your own view. For instance, the section "position and arguments" devotes 150 words to the supporters --- like the American Medical Association and the American National Safety Countil --- but 400 words to opponents, which are described vaguely as "many notable academics" and so on.

You really haven't earned the right to the larger soapbox on this issue. The article smacks of original research even though you think that it doesn't. A paragraph that you just edited is still highly tendentious, for instance the quote "the evidence currently available is complex and full of contradictions, providing at least as much support for those who are sceptical as for those who swear by them". This is a fatuous description: research on bicycle helmets isn't any more complicated or contradictory than any other kind of scientific research. It is also an inappropriate citation, because it is a lay organization's assessment of scientific research. Given the length and structure of this article, it would be a Sisyphean effort to settle all of its bias on a point-by-point basis.

Greg Kuperberg (talk) 21:27, 8 December 2008 (UTC)

The article strikes me as painstaking in its NPOV, but nothing is perfect, feel free to improve it if you can. The relevant experts here are transport professionals (including the organization quoted), engineers, certainly not only doctors and certainly not doctors who haven't read the primary literature. It's said that my profession may occasionally have a slight tendency to pontificate without doing the homework... And the quotation is very much to the point, though without inserting OR it's difficult to point out just how complex and contradictory current research actually is. It seems fairly clear to me that a lot of the problems with the literature stem from well-meaning people trying to find figures that prove that helmets work, and producing some very poor studies as a result. How sure are you that you are starting from a neutral point of view? Richard Keatinge (talk) 22:49, 8 December 2008 (UTC)

The article certainly is painstaking, but in a way that undermines NPOV instead of supporting it. Again, there is no basis for labeling helmet research as contradictory compared to any other scientific research, for instance research that chemotherapy can alleviate cancer. Yes, sure, chemotherapy research is full of well-meaning people who pontificate --- what else is new? And the CTC is not an organization of "transport professionals" in the UK, although it may well have some as members. As the name says, it's the national bicycle club.

I know that I personally do not start from a neutral point of view, but that's not the right question. This article does not arrive at one, no matter what pains were taken to get there. For instance, no one took the trouble to place bicycle helmets in the context of helmets in general: Motorcycle helmets, American football helmets, etc. The article demands experiment without theory; it does not address the totality of the evidence of head protection in general. Greg Kuperberg (talk) 22:58, 8 December 2008 (UTC)

I think you'll find that the CTC's comment is well-founded on a careful appreciation of the literature, and that their paid staff as well as their members do indeed include transport professionals; they are a national association and rather more than a simple club. Like me,(a humble ordinary member, definitely not a transport professional) they don't normally take much interest in other designs of helmet intended to protect other people against other sorts of insult. I don't see why they should, nor why other sorts of helmet are particularly relevant to this article. And the relevant engineering theory is fairly well-described here already, using quotations from the relevant expert engineers.

If you are planning to take a long-term interest in this subject, may I ask you to have a look at some of the key papers? They certainly upset my original assumption that helmets must be good. I suggest again that this article is notable for careful NPOV in a difficult area where uninformed emotion runs high, and that if NPOV upsets the initial assumptions of many people, this is a problem for the assumptions and not the article.Richard Keatinge (talk) 23:44, 8 December 2008 (UTC)

Since the link to the CTC reference is broken, I cannot evaluate who at the CTC declared that scientific research on bicycle helmets was "complex and contradictory". I am a research mathematician and I have had a lot of practice reading scientific research papers. I can imagine that someone who doesn't have that practice could call the research complex and contradictory, but the fact is that it's an entirely standard state as far as research literature goes. Besides, no matter how knowledgeable some of the consultants for CTC are, the fact is that CTC's mission is bicycle enjoyment in general, NOT specifically medical science or bicycle safety. Why does this Wikipedia page trust the Cyclists' Touring Club more than it trusts the American Medical Association?

I did already look at one paper that the article cites in a pivotal way, by Dorothy Robinson, and that has extensive comments from you in the comments section. It's fine that BMJ published this paper, but the fact is that this is a lightweight paper that doesn't sway understanding very much at all. As I said, it's experiment without theory. There is a well-developed science of what helmets do in general. It makes no sense to just scrap all that knowledge and read time trends as if bicycle helmets were an isolated topic. If you want to call it irrelevant, then you are speaking in favor of experiment without theory, and the simple truth is that's a standard form of bad science.

I can see that this article is notable for an eager attempt at NPOV. But careful effort is not by itself enough; the attempt does not succeed. Greg Kuperberg (talk) 02:18, 9 December 2008 (UTC)

If you'd like to write a suitably encyclopedic section on relevant helmet theory, I'd be interested to read it. The relevant bits seem quite well covered already.

I presume you're well able to read a scientific paper, and simply haven't taken in Robinson's comprehensive analysis. It is brief, but comprehensive, because it uses all the available data and control groups from an admirably neutral point of view. In a complicated area, it is occasionally charming to meet a straightforward conclusion, that large changes in helmet use have no apparent effect on the proportion of head injuries. Macpherson and Spinks, leading the opposite point of view, is far weaker, notably because their data omits helmet use and relevant control groups. Do have another look. The coherence and NPOV of this article have been the subject of a lot of hard work and the results are limited - this is an encyclopedia not a research journal - but good. Richard Keatinge (talk) 08:12, 9 December 2008 (UTC)

Both of these references, and several other things that you have said, made it clear that your real concern is research on bicycle helmet laws rather than research on bicycle helmets. If a separate page were made to discuss bicycle helmet laws --- as well as research as to whether they work --- that could do a lot of good to restore intellectual standards on this page.

You can't get me to say that the research on bicycle helmet laws is complex, because the truth is that it's as shallow as a plate. But I totally agree that the research on helmet laws is contradictory and inconclusive. What's irresponsible is to spread a message that bicycle helmets don't work --- or that no one knows whether they work --- just because you don't want your government to make you wear one. I'm an American, so I can understand the libertarian argument against bicycle helmet laws just like I can understand the libertarian argument against motorcycle helmet laws. (I don't entirely agree, but I can respect the viewpoint.) If adult motorcyclists or adult bicyclists don't want to wear helmets, then maybe that's just their business. If nothing else, they make excellent organ donors. Greg Kuperberg (talk) 16:14, 9 December 2008 (UTC)

Actually I have an academic and practical interest in cycling and in cycle helmets; the various legal attempts are interesting because of their potential threat to cycling, and because they have provided data for most of the relevant literature. The entire issue belongs firmly in one article. And I stopped wearing my helmet some time before I became aware of any drive for compulsory helmets, not on any libertarian argument but because it was uncomfortable and some of the early evidence had begun to appear. The fact is that on one reasonable reading of the literature and of informed opinion, cycle helmets don't appear to work. I realize that, as the article points out, helmets are a "motherhood and apple pie" issue in the States, but it's important not to let that strong POV influence what may yet be a good or even featured article. Richard Keatinge (talk) 17:40, 9 December 2008 (UTC)

Well, yes, bicycle helmet laws for children have become a motherhood-and-apple-pie issue in the United States in the past 10 years. Compulsory education is also a motherhood-and-apple-pie issue. Adults can do whatever they want in both cases. I live in Davis, which has the highest bicycle use of any city in the United States. Children here use helmets above 90%, because it's the law. Adult usage is maybe 20%. Greg Kuperberg (talk) 18:15, 9 December 2008 (UTC)

The CTC is Britain's leading cycling advocacy group, and they do a lot of campaigning for cycling safety in the UK. Notable recently was their input into the revised highway code. They will have people who understand this subject, and plenty of people with a scientific background who can advise them, e.g. the work of John Franklin, and http://www.cyclehelmets.org/

It seems to me that you have stumbled upon this article, and decided that it has a POV, without really researching the subject itself. It really is very complicated, e.g. risk compensation, and Dr Ian Walkers (questionable) research that shows motorists pass closer to helmeted cyclists.

You also talk about bad science, well there is a notorious paper on cycle helmets that claimed that they prevent 85% of head injuries, using the same methodology and data set, helmet wearers are something like 7 times more likely to have an accident, and there helmets will also prevent leg injuries. Yet despite the poor science, this paper is still cited by many of the pro-helmet camp. Martin451 (talk) 02:50, 9 December 2008 (UTC)

I've made a few very small contributions to this article, and I've been following its evolution. I think its contributors have striven admirably for neutrality in an area that is rather emotional. The take-away impression one would get from reading this article is that there is a genuine dispute over how effective helmets are and whether they're effective enough to justify promoting them or imposing them. These doubts arise especially from very disappointing results in jurisdictions that have successfully raised the proportion of helmet-wearing cyclists. Most features I've read in the English-language newspapers lately describe the issues in these terms; though, of course, some features still say that helmets prevent 85-88% of head injuries (based on the notorious paper mentioned above) and urge readers to wear them. The second type of feature might present the issue as most people would see it, but this article would be very incomplete if it left it at that, since that paper has been subjected to very detailed criticism over twenty years, and since the paper's predictions fall so very far short of the experience of jurisdictions with active helmet promotion or compulsion. So, in short, I do think the article does present the issues fairly and completely, though it is possible that there are biases I'm blind to, due to subjectivity. Though that's true of any article and any reader.Tomasrojo (talk) 13:47, 12 December 2008 (UTC)

That already is a major distortion of the truth. It is true that a study by Thompson, Rivera, and Thompson is widely cited in the bicycle safety literature. It is not true that this is "the notorious paper" that persuades people that bicycle helmets are a good idea. It is also bogus that bicycle helmets are any more emotional, or complex, or contradictory than any other significant area of research. In every area of research, there is a faction that cares more about debate than science. A large fraction of the attention that they get is irritation, so naturally they say, oh my, this topic is really emotional. Pancreatic cancer, for instance, truly is a deeply emotional research area. Bicycle helmet research is about as emotional as your average bicycle shop.

You are absolutely right though about the take-away impression. Convincing people that there is a debate is most of what this article accomplishes. And that's one of the big diseases of Wikipedia. Instead of learning about Shakespeare or about quantum mechanics, you can learn about the debate about Shakespeare or the debate about quantum mechanics. This page is very long, but it teaches fairly little. Greg Kuperberg (talk) 16:32, 12 December 2008 (UTC)

What the page should be

I should have put "notorious" in quotes. However, any small case-control study that ascribes ALL of the differences between its two populations to one factor and attempts to scale up that effect to larger populations is skating on thin ice. That's basic statistics. With the benefit of time, and very large increases in helmet-wearing, it becomes clear that some serious confounding must have taken place in that study. The paper is very widely criticized. I have read many such criticism, peer-reviewed. It also provides the 85-88% figure for head-injury protection that I read in the mass media, over and over again, so it is a major part of the rationale for promoting bicycle helmets.

Perhaps "a topic prone to entrenched and very strongly expressed positions on both sides" is better than saying an "emotional topic". Forgive me if I expressed myself clumsily. There is a debate; this article is not attempting to make one up. If you think there isn't, might I ask, without wishing to appear slighting, whether you have read much about this topic?

Finally, what impression would you like the reader to be left with after reading the article? Knowing this might help to clear up shortcomings the article has.Tomasrojo (talk) 17:29, 12 December 2008 (UTC)

Bicycle helmets are not any more prone to entrenched opinions than any other area of medical research. It's a fatuous and misleading description.

What impression should the reader get from the article? The current impression is that the main thing that people do with bicycle helmets is quarrel over them. Ideally the reader could learn about all sides of the topic of bicycle helmets. This would include the history of bicycle helmets (this one is well-covered), some description of helmet laws, the ergonomic theory of bicycle helmets, the relation of bicycle helmets to other helmets, and scientific findings about helmets.

And yes, it should say something about "the debate" over bicycle helmets. But (1) characterizing scientific research on bike helmets as one big quarrel is not accurate. Neither is pointing fingers at one widely cited study when in fact there have been dozens of research papers. (2) The debate should be discussed in maybe 5k of text, not 44k plus spillover as in the current version. Greg Kuperberg (talk) 18:34, 12 December 2008 (UTC)

Actually the history of bike helmets is not well-referenced so far; definite room for improvement. If you think you can get all the important elements of the debate into less space, do feel free to try. Even the present form is heavily-abbreviated for encyclopedic style, though I'll have another go at squeezing it a bit more. I suppose it's always possible to put in more research papers, though I think we refer to most of the leading work and opinions.

Greg, is it possible that you are starting with a strong POV, shared possibly by most of your acquaintance and are projecting this experience? (There's the LAW comment from 1991 about helmets being a mother and apple pie issue in the States as early as 1991, and I've heard and read much more to the effect of helmets being thought desirable in the US; the disagreements are mainly on libertarian grounds, which come to think of it could probably do with a reference and wikilink in the article.) The rest of the world (or that tiny bit of it that cares) is not in universal agreement, and has the references to show it. This debate is reflected in the academic literature, and again we have a careful encyclopedic selection of leading references to summarize the main arguments.

I can sympathize with the initial POV as I was an early adopter of a bike helmet here in the UK - it was years before I saw another one on the road and of course years before any evidence came out. But there is an intense debate, possibly not in UC Davis but definitely widespread, a debate that often becomes heated - to look no further, see your words "fatuous and misleading" above, but there is plenty more. I'm grateful for your constructive comments and I'll try to work on some of your good points, but the idea that the debate does not exist or is unimportant is simply not tenable. It is the main issue with cycle helmets at present, and will continue so for the immediate future. Richard Keatinge (talk) 11:37, 13 December 2008 (UTC)

No you're not getting it. Yes there is some sort of debate, but it's actually rather languid. It's fatuous to call the debate intense, because its intensity is actually much lower than in other fields of medicine.

You've put me (or anyone who might disagree with you) in a trap. If you say that there is an intense debate and I say that no, you're exaggerating, then I have added to its intensity. But if I agreed with you that the debate is intense, then we'd be unanimous. This is a way to manufacture intensity in any debate. Suppose that I said that there is an intense debate over the number of bicycles in London, and you said "That's complete rubbish! People would like to know how many bicycles there are in London, but of course there isn't any heated quarrel." Then I could say, "See, that proves it! Don't get too emotional!"

Let's say hypothetically that it really were entirely up in the air whether bicycle helmets save lives. Then yes there would be a debate, even an important debate. But it still wouldn't be an intense or emotional debate. And certainly not one that deserves to be more than half of this wiki page. Whether you realize it or not, you've come to see bicycle helmets as something that people quarrel over, more than something that people wear. Greg Kuperberg (talk) 16:36, 13 December 2008 (UTC)

Round here, that's the way things are. Helmets are worn by a minority and a lot know about the debate. The debate gets quite heated. In many countries, the debate is the only thing (and is pretty quiet and one-sided) and nobody wears them. In many parts of the USA, I'm told, they're universally considered to be not only a Good Thing but the major sign of a responsible cyclist. (See http://bikesnobnyc.blogspot.com/2007/10/cycle-killer-quest-ce-que-cest.html: "Gehl off-handedly mentioned that because Copenhagen has no helmet laws people don't need to bother wearing them. Suddenly the audience was silent and you could hear people shifting in their seats uncomfortably.") Fortunately most of us around here have more important things to do with our lives and matters stay fairly civilised.

You're not trying to suggest there's any good evidence that helmets save lives, are you? Apparently it's received wisdom in some parts. Let's have a reference. Richard Keatinge (talk) 20:51, 13 December 2008 (UTC)

Well that's not the way things are "round here". Only a minority of bicyclists wear helmets in the United States, and only a small minority of safety researchers conducts studies on bicycle helmets, but a much smaller minority than either quarrels over them. When I said that bicycle helmets laws for children are a mom-and-apple-pie issue in the United States, I did not mean that there was any prominent campaign for them. I meant that there has been a legal trend without much public discussion at all. It hasn't been a highly emotional issue, nor an intense issue in any sense, along the lines of "Mothers Against Drunk Driving".

You really need a separate page for the debate over bicycle helmets. You know as well as I do that there are studies that claim that helmets save lives, and of course you're eager to debate with me as to whether it's good evidence or lousy evidence. So I want to be clear that I throw in the towel; I am absent from the rostrum. This Wikipedia page should, in a SHORT section, clearly explain the evidence and clearly explain who supports it and opposes it. Instead, in a VERY LONG section, it vaguely mumbles who has endorsed bicycle helmets, gives a wordy but narrow summary of existing research, and instead carefully explains every reason to discount the evidence in favor. Even if you're right, this kind of summary is out of place. Greg Kuperberg (talk) 21:26, 13 December 2008 (UTC)

OK, this is a point of view. I would suggest that the page has a limited coverage of helmet history and needs more references on the subject, if not more words. And that the debate section, while doubtless improvable, is pretty good, giving a clear account of a serious and sometimes intense issue.

As far as I know, no good research claims that helmets have ever saved a life, and the reports of strangulation are fairly convincing that they have killed. Richard Keatinge (talk) 21:50, 13 December 2008 (UTC)

I agree with you that as far as you know, none of the research that helmets save lives is any good. That's why you should let someone explain why authorities such as the American Medical Association do feel persuaded, instead of using debate as a filibuster. The debate section is too long, and it should not repeat the canard that the debate is intense. Greg Kuperberg (talk) 22:23, 13 December 2008 (UTC)

OK, I don't think we're going to agree on this, unless you take a hard look at the literature. Arguing in the abstract certainly isn't going to get us far. Anyway, thanks for your contributions, and I will have another go at abbreviating. Richard Keatinge (talk) 23:49, 13 December 2008 (UTC)

Greg, the debate is intense. It might not be intense ins some small parts of the US, but it is intense nonetheless, with people like Philip Graitcer trying to get international bodies to promote helmet laws (not just helmets) despite the fact that no helmet law anywhere in the world has ever delivered a measurable reduction in cyclist head injury rates. Guy (Help!) 16:10, 20 December 2008 (UTC)