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The Netherlands did a study on bike helmets and found that cars tend to be more dangerous with cyclists if the cyclists are wearing a helmet, which is why there

by JohnGB 4y ago

The Netherlands did a study on bike helmets and found that cars tend to be more dangerous with cyclists if the cyclists are wearing a helmet, which is why there are no mandatory bicycle helmet laws in the Netherlands. However, it's worth noting that the cycling infrastructure in the Netherlands also for the most part separates bikes and cars with more than just a line of paint, so their experience may not translate well to other countries with poor cycling infrastructure.

Fiahil 4y ago
that study comes out a lot, but, AFAIK was poorly challenged. It would be nice to get a second opinion on this topic before jumping to conclusions.
- lukas099 4y ago
  It may not be perfect, but if it's the best study we have on the matter I think we should tentatively and judiciously accept it.
  - snakeboy 4y ago
    I would assume there is quite a lot of evidence for the efficacy of helmets in the event of a crash, no? I think in general it makes more sense to give credence to studies that give intuitive results that are explainable by sound first principles modeling, rather than one study that gives an unintuitive result based on human behavior.
    - ThatGeoGuy 4y ago
      Not really? There may be slight reductions in some injuries as a result of helmet use, but for most cyclists this isn't really what you'd call definitive data. At the end of the day, a few inches of foam isn't going to protect you from a few tonnes of steel. 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.
      - peoplefromibiza 4y ago
        > Not really? There may be slight reductions in some injuries as a result of helmet use, 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/ 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 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/american-academy-of-pediatrics-helmets-significantly-reduce-risks-of-traumatic-brain-injury-while-bike-riding-or-participating-in-other-sports/ https://www.aap.org/en/news-room/news-releases/aap/2022/amer...
        ThatGeoGuy 4y ago
        I don't think I'm necessarily disagreeing that in the worst-case scenario that helmets do the job of reducing brain and skull trauma. Doing something is the alternative to doing nothing, you'd expect some difference here. 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.
    - cryptonector 4y ago
      I got to witness an accident where a helmet would have made a huge difference for the cyclist. A lady was cycling at fairly low speed on a street that had old rails, then her front wheel apparently got stuck in a rail and she fell over and got a pretty serious looking head injury. Several of us in cars pulled over, called 911, and waited till the ambulance arrived and told them what happened. I have no idea what happened to her in the end, but she was unconscious and bleeding profusely from her her. She was not wearing a helmet, as you might surmise.
    - banannaise 4y ago
      Bicycle helmets are designed to protect riders from collisions with terrain at normal cycling speeds (in fact, less than that; helmet tests are done with a speed of about 14 miles per hour [0]). 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. [0] https://helmets.org/limits.htm https://helmets.org/limits.htm
    - lukas099 4y ago
      I intentionally said IF it's the best research we should listen to it. I'm agnostic on whether or not it is the best research.
  - cryptonector 4y ago
    Why not attempt to reproduce it?
    - lukas099 4y ago
      We should attempt to reproduce it, but that will take time and until that happens, we should go with the best information we have.
float4 4y ago
> The Netherlands did a study on bike helmets 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 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.
- dylan604 4y ago
  > and found that cars tend to be more dangerous with cyclists if the cyclists are wearing a helmet 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.
  - paddez 4y ago
    > I doubt the average driver notices bicyclists at all. 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.
    - dylan604 4y ago
      Um, that's the point of it being THE issue. 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).
deleted 4y ago
[deleted]
peoplefromibiza 4y ago
> The Netherlands did a study on bike helmets 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-cyclists-wear-helmets-286871 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.
- kqr 4y ago
  I don't agree. A surgeon is not going to see the vast majority of people who don't suffer head trauma, so they are not any more reliable than anyone else. If anything, they are likely to be more biased than the average person. Now, get me a statistician and we can talk.
  - peoplefromibiza 4y ago
    > A surgeon is not going to see the vast majority of people who don't suffer head trauma 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".
    - 4y ago

by JohnGB 4y ago

Fiahil 4y ago

that study comes out a lot, but, AFAIK was poorly challenged. It would be nice to get a second opinion on this topic before jumping to conclusions.

lukas099 4y ago
It may not be perfect, but if it's the best study we have on the matter I think we should tentatively and judiciously accept it.
- snakeboy 4y ago
  I would assume there is quite a lot of evidence for the efficacy of helmets in the event of a crash, no? I think in general it makes more sense to give credence to studies that give intuitive results that are explainable by sound first principles modeling, rather than one study that gives an unintuitive result based on human behavior.
  - ThatGeoGuy 4y ago
    Not really? There may be slight reductions in some injuries as a result of helmet use, but for most cyclists this isn't really what you'd call definitive data. At the end of the day, a few inches of foam isn't going to protect you from a few tonnes of steel. 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.
    - peoplefromibiza 4y ago
      > Not really? There may be slight reductions in some injuries as a result of helmet use, 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/ 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 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/american-academy-of-pediatrics-helmets-significantly-reduce-risks-of-traumatic-brain-injury-while-bike-riding-or-participating-in-other-sports/ https://www.aap.org/en/news-room/news-releases/aap/2022/amer...
      - ThatGeoGuy 4y ago
        I don't think I'm necessarily disagreeing that in the worst-case scenario that helmets do the job of reducing brain and skull trauma. Doing something is the alternative to doing nothing, you'd expect some difference here. 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.
  - cryptonector 4y ago
    I got to witness an accident where a helmet would have made a huge difference for the cyclist. A lady was cycling at fairly low speed on a street that had old rails, then her front wheel apparently got stuck in a rail and she fell over and got a pretty serious looking head injury. Several of us in cars pulled over, called 911, and waited till the ambulance arrived and told them what happened. I have no idea what happened to her in the end, but she was unconscious and bleeding profusely from her her. She was not wearing a helmet, as you might surmise.
  - banannaise 4y ago
    Bicycle helmets are designed to protect riders from collisions with terrain at normal cycling speeds (in fact, less than that; helmet tests are done with a speed of about 14 miles per hour [0]). 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. [0] https://helmets.org/limits.htm https://helmets.org/limits.htm
  - lukas099 4y ago
    I intentionally said IF it's the best research we should listen to it. I'm agnostic on whether or not it is the best research.
- cryptonector 4y ago
  Why not attempt to reproduce it?
  - lukas099 4y ago
    We should attempt to reproduce it, but that will take time and until that happens, we should go with the best information we have.

float4 4y ago

> The Netherlands did a study on bike helmets 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 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.

dylan604 4y ago
> and found that cars tend to be more dangerous with cyclists if the cyclists are wearing a helmet 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.
- paddez 4y ago
  > I doubt the average driver notices bicyclists at all. 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.
  - dylan604 4y ago
    Um, that's the point of it being THE issue. 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).

deleted 4y ago

[deleted]

peoplefromibiza 4y ago

> The Netherlands did a study on bike helmets 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-cyclists-wear-helmets-286871 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.

kqr 4y ago
I don't agree. A surgeon is not going to see the vast majority of people who don't suffer head trauma, so they are not any more reliable than anyone else. If anything, they are likely to be more biased than the average person. Now, get me a statistician and we can talk.
- peoplefromibiza 4y ago
  > A surgeon is not going to see the vast majority of people who don't suffer head trauma 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".
  - 4y ago