Re: Helmet efficacy test

On 3/26/2025 10:31 AM, Zen Cycle wrote:

On 3/25/2025 10:09 PM, Frank Krygowski wrote:

On 3/25/2025 11:11 AM, Zen Cycle wrote:

>

On 3/25/2025 4:19 AM, floriduh dumbass wrote:

On Mon, 24 Mar 2025 21:20:38 -0400, Frank Krygowski
<frkrygow@sbcglobal.net> wrote:
>

Bicycling has never been a major source of serious traumatic brain
injury (TBI). On a nationwide basis, bicycling's contribution to TBI
counts is low enough to be off most "causes" charts. Bicycling causes
fewer then 1% of U.S. TBI deaths, far fewer than pedestrian travel, and
far fewer on a "per mile" basis. And historic data over the years shows
quite clearly that bicycle helmets are not preventing either fatalities
or concussions.

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Impossible to document that.

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Wrong, as usual.
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https://pmc.ncbi.nlm.nih.gov/articles/PMC7025438/
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https://www.nature.com/articles/s41598-023-35728-x
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https://www.cpsc.gov/Newsroom/News-Releases/2021/New-CDC-Report- Finds- More-Adults-Are-Dying-from-Bicycle-Related-Accidents-CPSC- Says-it- Highlights-the-Importance-of-Helmets
>
https://www.nsc.org/safety-first/bicycle-safety-statistics-may- surprise- you?srsltid=AfmBOoq4LC_IGLItTnDBXBm4Yu6K20nqSHjsZbqpkk- jQ2y4Y1J7hfbf
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https://biausa.org/public-affairs/media/keep-your-brain-safe-while- biking
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https://publications.aap.org/pediatrics/article/150/3/ e2022058878/188764/Helmet-Use-in-Preventing-Head-Injuries-in? autologincheck=redirected
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These all contradict Frank, but that isn't the point of this message.

>
I'm willing to discuss any of those. A couple quick points: Several discuss "head injury" not "brain injury." Bike helmet promoters bank heavily on conflating the two in order to scare the public. The most notorious example I'm aware of was the notorious Thompson & Rivara 1989 paper that generated the false claim of "85% benefit." T&R actually counted abrasions of the ears as "head injuries" when computing benefit. Yes, technically, it's part of the head - but it's not what people have been led to think about.

 Your entire argument seems to center around "what people have been told/ led to believe" rather than the actual data.
 

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Second quick point: That T&R study has been thoroughly discredited. One issue which should make it obviously invalid to anyone with scientific knowledge is that its levels of protection have _never_ been corroborated by subsequent studies.
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There's much more I could say, but those are quick and easy points.
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As to documentation of my points above: Yes, you can find enthusiastic propaganda making it sound like bicycling is a major source of brain injury.

 Not relevant to whether or not helmets are effective.

Please understand: While I believe the protective value of bike helmets is _greatly_ exaggerated, I'm not claiming they have zero protective value. Had I worn one the day I bumped my head on the canoe hanging in my garage, it would have hurt a lot less. And I'll repeat that the almost miraculous "85% benefit!!!" has never been corroborated in over 35 years of trying. A court actually ruled its claim should be removed from U.S. government documents - but it's still widely quoted as fact by helmet promoters.
  >> But if it doesn't give numbers for other sources, the claim has not

been demonstrated. You'd have to compare with other activities - for example, descending stairs; or walking in a city; or riding in a car. Or heck, just look up the total numbers for brain injuries in America and compare with bicycling.

 Not relevant to whether of not helmets are effective.

It _is_ relevant to whether we should be discouraging cycling by claiming it's safe only if you wear a weird oddball hat! "Dangerizing" bicycling that way does no good for bicycling or for society.

The easiest data to find, in my experience, is brain injury fatality data. What I've found is over 55,000 TBI fatalities per year in the U.S. In that time period there were about 500 bicycle TBI fatalities, so significantly less than 1% of the total.
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Will we ever get helmets on the other 99%?

 So now your adopting Johns argument against assault weapons bans? "far more people die of cancer than are killed in mass shootings with assault weapons, don't you care about people with cancer?"
 In other words, the number of TBIs from bike accidents isn't relevant to the discussion on whether helmets are effective or not.

Regarding relevance: What are you trying to achieve? Do you promote helmets in hopes of lowering society's overall medical expenses? If so, it's probably a losing proposition. The only study I know of on the cost effectiveness of helmet use (in Australia) found it to be a net loss.
Are you saying "Forget the monetary cost. Brain injuries are so terrible we need to prevent them any way possible."? If so, you're ignoring much bigger sources of brain injury. Why would you do that?
Are you focused ONLY on calling attention to bicycling's dangers? Then I submit you're causing more harm than good. Bicycling is NOT very dangerous, especially ordinary bicycling, as opposed to gonzo mountain biking or road racing - which is what I suspect was related to your crashes. By emphasizing your crashes and pretending they are normal and demand protection, you're dissuading people from riding. That means they miss the health benefits of riding, and society misses the benefits of more people on bikes.

Have they reduced bicycling concussions, the most common (albeit mild) brain injury?

 Yes
 

I've found no evidence.

 You're ignoring it.
 https://pmc.ncbi.nlm.nih.gov/articles/PMC6747631/
"Evaluating the impact of cycle helmet use on severe traumatic brain injury and death in a national cohort of over 11000 pedal cyclists: a retrospective study from the NHS England Trauma Audit and Research Network dataset".
 "There was a significantly higher crude 30-day mortality in un-helmeted cyclists 5.6% (4.8%–6.6%) versus helmeted cyclists 1.8% (1.4%–2.2%) (p<0.001)."
 "Cycle helmet use was also associated with a reduction in severe traumatic brain injury (TBI) 19.1% (780, 18.0%–20.4%) versus 47.6% (1211, 45.6%–49.5%) (p<0.001), intensive care unit requirement 19.6% (797, 18.4%–20.8%) versus 27.1% (691, 25.4%–28.9%) (p<0.001) and neurosurgical intervention 2.5% (103, 2.1%–3.1%) versus 8.5% (217, 7.5%– 9.7%) (p<0.001)."
 

In the years that helmets suddenly went from rare to common, there was no corresponding drop in bike fatalities.

  "There was a significantly higher crude 30-day mortality in un-helmeted cyclists 5.6% (4.8%–6.6%) versus helmeted cyclists 1.8% (1.4%–2.2%) (p<0.001)."
 

Pedestrian fatalities actually dropped more during that time. And recorded bike concussions have actually risen.

 More people are riding. This gives a better data set to show results such as "Cycle helmet use was also associated with a reduction in severe traumatic brain injury (TBI) 19.1% (780, 18.0%–20.4%) versus 47.6% (1211, 45.6%–49.5%)"

Maybe I should have said "I found no good evidence." National counts show no drop in either fatalities or concussions that are attributable to helmet uptake. And again, the trouble with such "case-control" studies is the assumption that those presenting to ER are adequately representative of all people riding bikes. I submit they are not.
To put it in blunter terms: If you're riding badly enough that you're going to crash hard enough to go to ER, you may be better off wearing a helmet. But most people _never_ crash that hard, in part because they are more sensible about risks. Most people still do not wear helmets even here in the U.S., let alone worldwide; and only a tiny percentage of unlucky or unskilled or gonzo riders ever end up in ER.
Bicycling is NOT very dangerous. It does us no good to pretend it is.
--
- Frank Krygowski