This was a British study
> and found that cars tend to be more dangerous with cyclists if the cyclists are wearing a helmet
Re-analysis showed that there actually was no significant effect. Source: https://swov.nl/en/fact-sheet/bicycle-helmets (under: "Do bicycle helmets also have adverse effects?")
> which is why there are no mandatory bicycle helmet laws in the Netherlands
We (the Netherlands) don't have helmet laws because we hate helmets, not because we did research and concluded they'd have significant adverse effects.
I know that when I'm driving a car, I specifically behave differently when I see a bicyclist with a helmet vs without. /s
This just sounds so preposterous. First off, I doubt the average driver notices bicyclists at all. Of those that do, I'd seriously doubt if they even consider that they are wearing a helmet or not and just express frustration at the bicycle being there in the first place. The suggestion that a driver notices a helmet and acts more aggressively towards the rider or that they give a wider berth to the rider when not wearing a helmet is just "trying too hard" for lack of better words to describe my incredulity.
This seems like an issue. The average driver should absolutely notice the environment they're operating in.
This includes noticing those around them. This should be especially true for the more vulnerable road users.
If you are riding a bicycle in an area (like mine) where biking is just not at all that common in the majority of areas, then the drivers of motor vehicles are just out of practice of noticing bicycles. It is not in their muscle memory of needing to look out for them. Other cars, sure. Pedestrians, maybe (but that's probably pretty low as well).
If I see a bicyclist that looks like a bicyclist I tend to drive closer to them because I expect they are going to stay in their lane. Conversely, people who look like they aren't regular bike riders or teenagers just screwing around -- I will give a much wider berth... in some cases even going a completely different route to avoid them.
I recall a coworker explaining the duality of cycling in full kit vs. cycling in "street" clothes with his children. In the former case, he appears as a pro or semi-pro cyclist and in the latter, as a dad spending time with his children.
It's not hard to guess which get-up gets him honked at, coal rolled[0], etc. It's also not hard speculate that a driver is more likely to give the dad spending time with his children more room on the road. (Of course, in either case the cyclists should all be wearing helmets, but we're only even having this discussion because not all are so responsible.)
I mean yeah helmets for commuting at a snail's pace in areas without cars are an annoyance at best.
Actually, we did. From [0] (the link to the study itself is on that page too):
> A recent Dutch study (2021) concludes that many people expect to make fewer bike rides when mandatory helmet laws are introduced. These findings suggest that such a law would have a negative effect both on bike usage and on public health in general.
In addition to the standard arguments already posted here about safety in numbers, efficacy of a helmet, and infrastructure design, they also mention a few practical problems with helmets:
- What to do with the helmet when you're not wearing it? A good helmet is too big to just store in a coat pocket or a handbag.
- What to do if you lose your helmet or it gets stolen? How will you make it home then?
[0] https://www.fietsersbond.nl/de-fiets/accessoires/fietshelmen...
That said, it's notoriously under-studied. If you look into "best helmet" in terms of safety you'll see a lot of marketing speak and not a lot of science. The way that helmets are tested tend to 1) not be reflective of actual use of the helmet in a conflict scenario and 2) tend to make pretty broad assumptions about the largest danger factor on the roads.
The thing is that you would /think/ that there's a lot of evidence out there for helmet use. The most compelling evidence for helmet use is for drivers in cars / automobiles, and we wouldn't dare mandate that into existence.
Helmet laws always seem to get people ruffled up but at the end of the day the number of bike fatalities is already low, and skewing that in terms of helmet use somewhat misses the point - dedicated and separated bicycle infrastructure will have a vastly larger impact compared to any mandate on using a helmet. It seems like arguing about adding a mandate on helmets is just an easy way for the system to wash its hands of responsibility for not regulating vehicle and street design more thoroughly.
Yes, actually, really!
Helmets provide a 63 to 88% reduction in the risk of head, brain and severe brain injury for all ages of bicyclists
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7025438/
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).
https://bmjopen.bmj.com/content/9/9/e027845
“The evidence is clear: helmets save lives and significantly reduce the risks of severe injury,” said Lois K. Lee, MD, MPH, FAAP, lead author of the statement, written by the AAP Council on Injury, Violence, and Poison Prevention. “And yet sports-related injuries make up a substantial proportion of all traumatic brain injuries. As a pediatric emergency medicine physician, I advise all my patients – and their parents-- to wear helmets.”
https://www.aap.org/en/news-room/news-releases/aap/2022/amer...
My problem is that helmet use isn't exactly "well-studied." All these studies look at existing reports from medical centres on injuries & deaths. This doesn't actually account for the broader behavioural changes in the system, or look at causes outside of "injured while wearing a helmet vs. not."
In any other industry this kind of reporting (while factual) is absolutely ignoring everything else. A short list of what isn't being considered:
- Which road and behaviour led to incident?
- Which kinds of road conflicts can be addressed by helmets?
- How did road design lead to the incident?
- Were environmental factors a concern (winter, ice, rain, etc.)?
- How does behaviour for the cyclist change as a result of not wearing a helmet?
- How does behaviour for other road users change as a result of a cyclist not wearing a helmet?
- What kinds of helmets are more viable for protection in the case of the most extreme (and most common) conflict scenarios? How do we then test these helmets to ensure compliance in manufacturing?
These are all questions you'd expect to be answered here, and then you'd do the cost-benefit analysis on whether a mandate is necessary or not. A "well-studied" field would have discussed these effects in broader detail, not just short-cut to "fewer people who already had huge injuries while cycling died when using a helmet." That is not the entire problem, because it leaves out a huge sampling of people who do not wear helmets and do not make it to the hospital in the first place.
The numbers are under reported. Every cyclist I know that uses a bike for transport has been hit by a car. Myself thrice, never reported. Crashes involving myself, never reported. Hence, there is a bias in the data for the really traumatic injuries
A very good example of what "selection bias" means.
Cyclists who are hit by traffic are likely to be hit much, much harder than that. Therefore the effect of the helmet is more or less entirely untested, and manufacturers have no incentive to design helmets for that scenario.
They did not.
But it's true that "Dutch neurologists and surgeons call on people to wear helmets while cycling"
https://road.cc/content/news/dutch-neurologists-call-cyclist...
Because, you know, politicians would do anything to keep people voting for them, including putting people lives at risk to please them (COVID just proved it, if there was some doubt left), but doctors opinions are a bit more of a reliable source to understand what could potentially kill you and what could save your life.
Now, get me a statistician and we can talk.
Which is a very silly argument.
A surgeon is one among the few that can see a spike in brain traumas cases and can investigate the causes, it's totally more reliable than you or me, because he has the data and the knowledge, we don't.
I don't know about you, but I would ask a veteran about the horrors of war, not to 4 years kids, who, having seen none of it, are, by your reasoning, less biased.
> A surgeon is not going to see the vast majority of people who don't suffer head trauma
Because surgeons are notoriously not people too and live in a closet in the hospital.
> Now, get me a statistician and we can talk.
first of all, medical professionals typically study statistics, epidemiology doesn't really figure out itself on its own.
Secondly, I work with statisticians to assess the risks for insurance companies (not in the US). I work with that kind of data everyday and, guess what, MDs reports are highly predictive of risks, the average Joe with a laptop opinions, are discarded because, after examination, have been found "completely non-predictive".
Having tutored medical professionals trying to pass their epidemiology classes, I would not make that claim. From my observations, epidemiology and statistical literacy is treated as a "check this box" effort, the least important of their courses.
This sounds absurd ofcourse, and it is. But from the point of the surgeons it is not absurd, as it reduces trauma significantly. So any decisions should be taken by taking into account socio-economic effects as well. Cycling is a part of Dutch culture and compared to other countries we are doing very well. Mandatory helmets are a big deal (where do you keep the helmets?) and will definitely move people from bikes to cars.