The Helmet Thing

So I'm pulling this helmet conversation out of the comments of another post so that it doesn't overwhelm or confuse that issue.

It started when old guy wrote

Not wearing a helmet while riding on that road -- indeed any road -- is pretty dumb. Why don't folks understand this?

Which led me to ask

I wear a helmet. But let me ask this question, why is riding a bike without a helmet dumb?

I asked this because I have a somewhat weak opinion about helmets. About as strong as I can state it is "I think you're probably better off wearing a helmet." I can't really back that up with any hard data. I would probably do better than arguing the opposite, but still not very well. So I wince when people decide to call others stupid for not wearing one or when they freak out about because Ellen Jones is riding a bike on the front page of the Washington Post and she's not wearing a helmet. People react with the same alarm they would if she were teaching a baby to smoke. But no one has ever been able to make a particularly convincing argument that bike helmets save lives or prevent head injuries.

I also wince when Mikael Colville-Andersen of Copenhagenize belittles people who do wear helmets for largely the same reason. He can't really convince me that a helmet is a useless talisman. The helmet most of us use now wasn't invented until 1990, so for the argument that we're becoming wimps and "I didn't wear one when I was a kid" I say, they didn't exist when you were a kid. We used to not use seat belts, but a seat belt has probably saved the life of every member of my family at least once. We're not becoming wimps, we're getting new tools.

old guy replied:

because if you're going to ride a bike, at some point you're going to fall off. And wearing a helmet so increases the probability of surviving such an event, at such small cost, none but a fool would eschew that protection.

So, there are activities for which we wear helmets (football, whitewater rafting, hockey etc...) and those for which we don't (tennis, basketball, reading, etc...). There is some line drawn between activities where a helmet is necessary and those for which we think it is unnecessary. But that line, for most people I've talked to, is arbitrarily drawn. It has much more to do with social norms and gut feelings than it does with facts.

Ideally, helmet wearing activities would have a probability of a head impact above 0 at some number p and there would exist a helmet that would improve the survivability and/or reduce injuries.  The value of p is pretty arbitrary. In fact no one could probably name that value for themselves. And even if you did, it would be difficult to know the probability of head impact for cycling or any other activity. So you've sort of pulled a number p out of thin air and then placed cycling above or below that value again based on numbers you made up (of you're own experience which has some value but is probably not too reliable).

Originally helmet use started with bike racing, which is - from my observation - much more likely to result in a fall than riding around town. Cyclists ride fast, close together, in positions that maximize speed at the expense of visibility and maneuverability and so, wearing a helmet makes more sense. But then helmet use moved into recreational and transportational riding. So the rise of helmets in day-to-day riding may have started as a fashion choice which would have little to do with safety.

Even if it did start as fashion, does wearing a helmet when riding make sense? Not as much sense as when racing (which is what the guy on the cover of the City Paper was probably thinking. Racing is above the line. Riding is below the line), but it still might make sense depending on where your line is. For Barack Obama, riding with his family on closed roads may be below the line.

Oddly, by his statement, old guy hasn't been arbitrary. He has named his p, p>0. People have hit their head while cycling, and if you ride long enough, so will you. Therefore you should wear a helmet. That's actually a very respectable and defensible position.

But if p>0 is your line then you need to make a list of every single activity you do where there is a chance of hitting your head and then wear a helmet - if one exists that works - or else you're "dumb". Which is basically what I wrote back to him.

The National Safety Council estimates that there are 25,000 slip and fall accidents for pedestrians every DAY, and that every year 16,000 people die from such falls. Many of these injuries and fatalities are in the form of head injuries. Do you wear a helmet when walking around? If you walk around, eventually you're going to fall. Do you wear a helmet in a car? If you drive around, eventually you're going to hit something?

old guy modified his position.

25,000/the billions of walking trips is minuscule compared to the proportion of biking trips that end in falls.

So his line is arbitrary. It's above 0 and above whatever he thinks the probability of hitting his head while walking is and below whatever he thinks the probability of hitting his head while cycling is. That's fair. He knows himself better than I do. Maybe he's a safe walker but a reckless cyclist. Whatever. I don't care. And I don't think he's stupid. Because my placement of the line is just as arbitrary as his. But we all need to recognize that we've made this arbitrary and largely indefensible decision and thus no one is dumber than us if they come up with a different decision. And so, if you're going to call people who choose a different helmet choice than you "stupid" or "dumb" I'm going to ask you to defend your position with facts (that don't exist).

guez has also put his line above walking and below cycling, but admits that it comes from his gut.

It's only illogical to wear a helmet while cycling--or playing hockey, or skateboarding, or walking around a construction site--but not while walking if the danger of serious head injury while walking is equal or greater than that of these other activities. While I can't prove it, I suspect that it isn't.

Though I haven't embraced the Copenhagenization "pedestrian/motorist helmet" meme I was using those activities as examples. Still I might wonder about certain types of walking. What if you're drunk? Would your chance of getting serious head injury while walking be greater than cycling sober? What about drunk at night? What about drunk at night and in the snow and ice? I mean, I've seen drunk people walk in the snow and they fall down a lot. So should they wear a helmet?

Somehow old guy thinks this means I'm arguing against helmet use.

You know as I think about it, I really find it reprehensible that some novice reading this thread would see how you, a paragon of bicycling wisdom, are arguing against using a helmet.

I'm not. If you want my opinion, I'll restate it. I think you're probably better off wearing a helmet. I wear a helmet.

I'm confident that you're better off riding a bike. So if a helmet keeps you from riding then don't wear one, you might regret it, but on average the benefits of riding probably outweigh the risks of not wearing a helmet.

For those who would call a non-helmeted cyclist dumb I'd also ask this: have you taken a confident city cyclist course - which by the way is free? If not, are you dumb? I suspect that getting every cyclist to take that course would save significantly more lives than getting a helmet on them.

And finally, if you suspect that the danger of serious head injury while walking isn't equal to or greater than cycling I'd point you to some study results on cyclehelmets.org

The road users most at risk from head injury are pedestrians and young drivers.

Helmets for motorists are much more effective than those for cyclists and more beneficial than seat belts, interior padding or air bags. Their potential for reducing injury is 17 times greater than that of cycle helmets.

And from statistics here in the states. The ratio of walk commuters to bike commuters is 5.6 to 1 (2.8/0.5) The ratio of pedestrian deaths to cyclist deaths is 6.7 to 1 (4644/698). So you and I may not have our lines in the right place.

Comments

[Lee Watkins IV]

I think people like to pretend that the helmet thing is a rational decision, but really it's a cultural decision. More than anything it's a statement about how we think cycling is viewed in society. It is an image that we have been sold on by bicycle shops run by racers as well as by concerned family memebers.

In Nascar auto racing, the drivers wear helmets, special clothes, shoes, gloves, etc.. However the same drivers do not wear helmets and fancy outfit when they are driving to the supermarket down the street - even if they will be going 70mph on the highway, still no helmet or fancy clothes.

If the Nascar driver wore his helmet when he drove to the supermarket, people would have a different expectation about the way he would be driving, and he would also have a different expectation.

Suppose he also make his daughter wear a helmet when she drove a car to the supermarket. And his perents, etc. His family would then have a different expectation about driving.

Suppose that the only people who have been drivign for the last 50 years or so have mostly been racers from Nascar. And suppose anytime these Nascar people went to the dealer or repair shop for their car, they were sold on racing helmets and racing clothes, shoes, gloves, etc. that you must use anytime you are driving. Everyone who drives would say you are crazy not to wear a helmet. but of course everyone on the highway is driving like a Nascar rally.

It's not a rational decision, it's a cultural cue. you don't need a helmet and fancy clothes to go to the supermarket. It might be safer, but it's not practical and it changes the culture.

[Joe D]

Without bike helmets, I'd have been a widower before my daughter was born (hence, no daughter and no wife). My wife was t-boned by a driver illegally passing stopped traffic on the shoulder. If she hand't been wearing her helmet, the big hole in the car's windshield would have been full of blood, bone, and brain.

I don't call people who don't wear helmets stupid. I ask them what kind of example they're setting for their children. I remind them that it's not because they're bad riders, it's because there are so many more bad drivers (just because there are more drivers) than when we were kids.

[Dan D]

I personally rarely wear a helmet and I think the "arbitrary p" is the reason why. When I do wear a helmet it's because it's dark and/or wet
out and I'm going a longer distance—all factors that increase the unknown p above my arbitrary threshold.

That said, the peds vs bike commuters vs fatalities stats are a bit misleading. I would guess a larger part of pedestrian deaths are non-commuters and the walking part of non-walk-to-work commuting.

[SJE]

I agree that there is a lot of normative judgment in helmet wearing. There are times when wearing a helmet is probably a BAD thing: if its very hot and humid, you need as much airflow as possible to keep the brain cool and not get sweat in your eyes.

From a physics perspective, however, the speed at which you hit the pavement and the control you have in hitting it is likely to be worse on a bike than walking. On a bike you are higher up, moving faster (so can hit things ahead of you), and tend to get thrown through the air if you hit something and so may have less chance to use your body to slow your impact. Happened to me a few times, although some times I got enough momentum to basically roll. With walking, you may be better able to control your fall with your body, and to not have the forward momentum that you have with a bike.

[Gerry]

Urban cycling in D.C. or other U.S. cities is a lot different -- and more dangerous -- than urban cycling in Copenhagen. In Copenhagen, bicyclists and motorists share the road. Here, urban cyclists have to wrest some sliver of the road from often adversarial motorists.

I would ride without a helmet in Copenhagen; I wouldn't in D.C.

[Amy Smith]

Whilst commuting on bike, I wear a helmet. A short trip in hood, no, since I ride on Georgia Avenue I have to ride on the sidewalk anyway due to driver speed and their aggression. I rode my bike all over New Zealand and Scotland in the pre-helmet 80's. When I look back at the pictures and compare riding today with the helmet, I know it felt so good without one and wearing a helmet would have taken away from the fun of wind in hair in mountains/moors feeling. I have never been in a serious bike accident, but have come close to getting killed by speeding cars running red lights and tour busses turning. A helmet would not have saved me in any of the cases.

[freewheel]

There is a group of people out there (I don't know how large, but I've talked to a few) who don't ride their bikes because they think they have to wear a helmet to do so, and they don't want to look funny, so they don't ride their bike. It's as crazy as it sounds. If we have to do away with helmets in order to promote bicycling, I'd be in favor of it.

Instead, we should emphasize that helmets are optional. It's not like a seatbelt, which in a multitude of situtations will save your life. Also, no law requires that you wear a helmet (I think the Park Service tried at one point to come out with a mandatory helmet rule, but it was shot down). I wear a helmet based on my understanding that helmets can prevent or at least lessen the severity of concussions. If I'm wrong about that, let me know and I'll stop wearing the stupid thing (although it is useful for holding a headlight at this time of year).

[mike]

"And from statistics here in the states. The ratio of walk commuters to bike commuters is 5.6 to 1 (2.8/0.5) The ratio of pedestrian deaths to cyclist deaths is 6.7 to 1 (4644/698). So you and I may not have our lines in the right place."

Love your blog, and examining the value of wearing a helmet is important. However, the logic of this last paragraph is like comparing apples to oranges. You state the ratio of walk to bike commuting and then the ratio of walk to bike deaths but you don't explain how the two relate.

Virtually everyone spends some time walking every day, but only 2.8% of workers walk to work. So only a small percentage of total miles walked are commuting miles.

.5% of people bike to work. Everyone does not ride a bike, but many riders do ride to work.

I'm guessing the ratio of total miles walked vs. total miles commuted by foot is far more than the ratio of total miles ridden vs. total miles ridden to work. So comparing the ratios of walking commuters with biking commuters, without correcting for total miles traveled in each category, and then comparing them with death rates produces a misleading conclusion.

[Joe V]

Folks have sort of touched on this, but I don't wear a helmet because I'm worried about falling, but because I'm worried about drivers hitting me (again). Most everyone I know that's gotten hit by a car has banged their head on the ground, and luckily they were all wearing helmets. Given the delicacy of the brain, I'd rather have as much padding between it and pavement as possible.

I'm most confused by the people who are strenuously against wearing helmets, or even make arguments like saying it's "inconvenient" or "uncomfortable." Or it impedes airflow to the brain. Come on. And I'm not at all convinced that folks are not riding bikes because of it; if it wasn't that, they'd make some other excuse.

In 50 years we'll look back on this discussion, the way we do seatbelts now, and puzzle over how people used to complain about something so innocuous as bike helmets.

[Washcycle]

Yeah I totally admit that the stats in the last paragraph are deeply flawed if you're using them to determine the relative safety of walking and biking. Ideally, you'd want "miles biked:miles walked" and "head injuries for cyclists:head injuries for pedestrians" but those numbers are much harder (impossible?) to find. My point was only that it may not be as clear cut as one thinks.

To what SJE wrote about the difference of falling while walking and falling while biking I'll add that we've been walking for several thousand years and biking for a few dozen. I remember reading about a study at U of Minnesota about people falling on ice and they determined that when people slip their brain goes into maximum overdrive and makes thousands of calculations to "right the ship" and that they can't even make computer programs that can do this kind of work. Walking is terribly complex, but our brains were made to do it and do it very well - biking is a new skill.

[think a little]

TBIs are bad news period.

One of the most heartbreaking things Ive seen in my life was at a reception where they had some vets who were at Walter Reed, and there was this one nice open faced sergeant who was explaining to someone "They tell me I used to be very smart, but I dont remember...."
You could see where they had put the back of his head together after and IED strike.

I wear a helmet.

[ridethewomble]

Great post. You sum up my feelings perfectly.

It's a personal choice. I wear a helmet 99% of the time. More than once, I have avoided serious head injury by wearing a helmet. I would never go helmetless riding the rocks at Gambrill St. Park, or riding on busy streets downtown. I don't think I'm being foolish when I decide to go without when taking a leisurely pedal on a beach cruiser, or making a sort run to the store, though. ...and yes, I know the risk of hitting my head during such activities in non-zero. I'm a rational, intelligent adult, however, and I have the right to weigh risks and decide to accept them.

I think it's smarter to wear a helmet than not. I don't call people fools for not making the same choice I do, though.

[Carla]

I didn't use to wear a helmet for years. I knew that if I fell, I'd be more at risk for injuries, but the helmet also took away one of the best part of biking for me: the wind through my hair.

When I started commuting to work, I knew that my odds of falling was higher, and I'd be riding more through traffic, and since then I've been wearing a helmet.

I still don't like it, and no longer bike for fun (I really do miss the wind...). I have fallen a couple of times, but have not hit my head anywhere yet.

Helmets are like car insurance -- you have it, hoping you'll never need it, but they don't actually prevent any accidents.

[Matt]

You're right, helmets do not prevent accidents. They are not designed to do so - they are only designed to protect you if you have one.

That's why I wear a helmet - because it might happen. I haven't had an accident in a while but I have had them, and they have all been from hitting something on the pavement - a hole I didn't see, a chunk of asphalt, etc. As others have said, the only real "reason" not to is "it doesn't look cool," which isn't a reason at all.

Also, as others have said pretty much all the statistics you cited above are used in a horrible manner. Your slip-and-fall stats make no mention of the types of people who have these accidents (AGE), what kind of injuries they sustain, or what the results of those injuries are other than # of deaths.

Many of us have pointed out the rational argument for wearing a helmet - if you fall/crash, you will have a better chance of avoiding serious head injury with a helmet than without. Nobody has presented a rational argument for not wearing a helmet. I wouldn't make it mandatory, but I think people should just make the logical choice.

[Contrarian]

Wash, excellent posting, again you've taken a complex subject and distilled it to its essence.

First, the obligatory: I wear a helmet.

The one thing you don't touch on is the effectiveness of helmets. Like so many topics in cycling safety, actual reliable data is quite rare -- and much of what is put out there is of dubious validity. If helmets were truly effective, we would expect to see dramatic drops in injury and death rates over the past few decades, as helmets have have become more popular. But nothing of the kind has happened. A study of Canadian provinces that adopted mandatory helmet laws found that accident rates actually increased after the laws were enacted -- the number of accidents decreased, but the amount of cycling dropped even more, causing the accident rate to climb. (The Canadian studies have been widely offered as proof of the effectiveness of helmets, which offers a window into the world of bicycle safety science.)

We shouldn't be surprised that bicycle helmets aren't terribly effective at preventing serious accidents and deaths, because they were never designed to be -- in fact, it would be surprising if they were. The bicycle helmet standards were designed to protect one type of rider -- children -- from one type of accident -- falls. Basically, they went after the low-hanging fruit. There is nowhere near enough protection in a bike helmet to offer meaningful protection to an adult who has a fall at a typical adult speed, let alone a collision.

One poster commented that if you really care about safety you should wear a skateboard helmet, because they offer more protection. I disagree -- you should wear a motorcycle helmet. With full face shield. Then at least you'll be wearing something designed for the speeds that bicyclists travel.

Finally, it's apt that several posters have drawn analogies between helmet use and seatbelt use. However, the effectiveness of seatbelts has been proven beyond reasonable debate.

Again, I wear a helmet, and I make my kids wear helmets.

[Washcycle]

Matt, I know the stats are lacking and I could poke holes in them right there with you. But if your standard is "if you fall/crash, you will have a better chance of avoiding serious head injury with a helmet than without" and therefore you should wear a helmet; then that could also apply to walking and motoring. At the very least, it sounds like you should put a helmet on grandma.

In your opinion, at what rate of head injuries per mile (or minute or whatever) does helmet use become a good idea?

[Kristen]

I wear a helmet. And I don't care whether other riders where a helmet or not, so long as they are obeying the laws while riding.

I paid a lot of money for the knowledge in my head, and I think of a helmet as insurance for that investments.

If other riders don't care enough about their brains, that's not my problem. I can't take care of everyone else, I can only take care of me and, to a lesser extent, my loved ones.

Motorcycle and car helmets are designed for that specific usage and are inappropriate to use for cycling.

Motorcycles can travel at speeds way faster than any unassisted bicycle, and have safety equipment rated for that speed requirement.

I would expect that when a cyclist can routinely travel at speeds exceeding 35mph on flat ground with no tail wind, safety gear will change to match the new speed requirements.

[Rich Wilson]

I think you get more bang for your buck (chance of use times severity of injury prevented) with gloves. I wear both.

What bugs me is parents who don't wear helmets but make their kids wear them. I wonder if those are the same parents who teach their kids to ride facing traffic.

[Catherine]

Ah, helmets. I hate them. But I wear them. Most of the time.

The only time I don't wear a helmet is when I'm riding around Old Town during daylight hours. Then, I stick to the side streets and stop at every stop sign, and take the lane. I'm fairly well convinced that those behaviors bring my chance of being hit by a car down to about that of walking around town, and I'm comfortable with that.

The rest of the time (generally my commute up the MVT to Capitol Hill, but also around Old Town and beyond after dark), I wear a helmet. I actually think that if I'm going to be in a bike accident at all, it'll be on the MVT. The sheer volume of trail users during the peak times, the wildly varying speeds/attentiveness of the trail users, the silence of bicycles, the hyperactivity of dogs, the narrowness of the trail.....it's really a disaster waiting to happen. (Oh, and an aside--PLEASE get bells, folks! Or say "on your left". It's actually the rules, but it's also polite and safe).

The ride through DC is a helmeted ride because (a) kind of silly to take the thing off once you've got it on--imagine getting hit by a car with your helmet in your basket, not on your head (b) unlike Old Town, my ride through DC is mainly traffic light-intersections (not stop signs) which drivers are more likely to run (either run right through or the more common right-on-red-without-stopping-or-looking) and which allows them to pick up some serious speed (creates an incentive for speed in some cases) and generally gives the feeling of "street as highway" over "street as part of the neighborhood"--even though the speed limits are the same as in Old Town.

My general feeling about helmets is like yours, Wash--I think you're generally better off wearing one. I cannot imagine the regret I or my family would feel if I were injured as a result of not wearing one (something that is so easily avoided). I do question my decision to not wear one around Old Town from time to time (I mean it's not like it hurts to wear one) and may change my mind one of these days.

[Josh G.]

Ah, I think it's perfectly normal for parents not to wear helmets while working with their kids- it falls to to variability of danger that comes with novice riders. My personal theory with teaching my wife to ride is that even if you take naturally to biking, everyone still has three bad crashes where they learn what a bike can do on wet gravel, etc. and I'd much prefer my theoretical children's soft little skulls had a helmet on while they work out the physics of falling at speed.

The counterargument that by not wearing a helmet, you'll be killed and leave your helmeted children fatherless seems shrill and doesn't give an adult the credit of their experience towards the dangers.

I wear a helmet if I'll spend the majority of the ride in the streets (especially streets without bike lanes) but I tend to go without if I'll be on the W&OD. Deep down I know I'm rationalizing because I just prefer the way riding without a helmet feels, but the joggers on the W&OD are just as likely to be hit by cars as I am (I don't blow through the crosswalks at speed) but for some reason no one has ever yelled at them for not wearing a helmet. Granted, there's the extra danger of my going at a much higher speed and not seeing the deer in time... or that poor squirrel. RIP, little guy.

I feel that there would be a much larger increase in safety if cyclists increased in numbers, but I feel that the perception that wearing a helmet gives is that what we do is intrinsically unsafe, thus keeping more people from biking and thereby making it less safe to do so. It's just so hard to justify sacrificing a potential head injury for what is basically a philosophical/political stand.

Thank you for bringing this topic up again!

[Bob]

I appreciate the civil tone of the essay and of the comments that follow it. Well done, folks.

[ksay]

I always wear a helmet. Even on those leisurely jaunts around the neighborhood - you always put your seat belt on, even for short trips, right? There are of course certain types of accidents that a helmet or a seatbelt won't protect you from. But there are plenty that they WILL protect you from.

I've never been in an accident, and I don't want my first one to be the one time I decide to leave the helmet at home.

You can be the most capable cyclist in town, but drivers can be unpredictable, distracted, and reckless. Plus there are a ton of potholes and other dangerous road conditions. But still, I wouldn't necessarily call someone riding without a helmet dumb.

Texting while driving? Dumb.

[Jonathan Krall]

Obligatory data: I wear a helmet when I spandex-up and don't when I don't.

Culture: I absolutely agree that helmet use is a cultural thing. I skip the helmet for near-home transport because I want to help build a culture in which near-home slowriding doesn't demand a raft of safety equipment. When someone asks about my lack of a helmet I reply that it is "at home with my racing bike, where it belongs."

Stats: I have a problem with injury rates expressed "per mile." Recreational riding/walking/driving involves having fun during the time available, so comparing injuries "per hour" makes sense. For transport, a cyclist will likely shop closer to home than a motorist, so comparing injuries "per trip" makes sense (similarly, people who live closer to their workplaces are more likely to walk or ride). However well-intentioned, quoting injury rates "per mile" is misleading; it tends to equate "faster" with "safer."

Anecdotes: I have a serious issue with people who post heart-wrenching anecdotal stories. Those stories are worse than useless. For example, the USA is hip deep in obese children whose parents are "protecting" them from kidnappers, child-molesters, and countless other phantoms. According to the book Pedaling Revolution, half of the children struck by cars while walking to school are struck by parents driving their children to school!

I won't say we have nothing to fear but fear itself, but it is very close to the top of my list.

[Eric]

For me the choice is simple; broken bones heal head injuries are be permanent. I’d rather have to deal with a permanent limp than head injury which will prevent me from taking care of myself. A friend of mine is a Neuropsychologist part of her job involves teaching people who have had head injuries to do something as simple as eat with a fork.

I wear a helmet when I bike for the same reason I wear my seat belt in a car. It reduces the level of injury in the event of an accident. It is not designed to prevent an accident. Accident reduction only occurs when cyclists and drivers follow the law and share the road.

[Washcycle]

Seat belts don't prevent an accident, but they can mitigate it. A seat belt keeps people from becoming projectiles and they keep the driver in front of the steering wheel where they can - and do sometimes - regain control of the car.

[W. K. Lis]

Yet in Europe, where there are more bicyclists, helmets are rare.

http://www.youtube.com/watch?v=2n_znwWroGM

http://www.youtube.com/watch?v=jUaTETIJkIQ

[Beaker]

I hate my helmet, but I always wear it. I've only had one serious crash, and it was when I hit a patch of oil, while turning on low-traffic paved road at night. My helmet hit the pavement hard, and protected my head nicely. I wouldn't have died if I had been helmet-free, but TBI is not something my already-addled brain needs.

[Deb]

Have you read this article by Ian Walker? http://www.howwedrive.com/2008/10/01/to-wear-or-not-to-wear-and-is-that-even-the-right-question-ian-walker-on-cycle-helmets/

I found it to be one of the most logical looks at helmet use I've ever read. One of the points that is really important imo is that all of the evidence we have in either direction is indirect. Also that we're hoping for a little padding to protect against a 2ton car. In the end, his conclusion is that no one knows for certain if helmets work to protect bicyclists. (And I should mention, this is something he researched more extensively than any of us commenting here have ever thought to.)

I wear a helmet, partially because I don't want to hear it from everyone who will insist that I'd be stupid not to. In this society, wearing a helmet saves us a lot of grief from other people, regardless of whether it protects us from falls.

Also, it is a handy place for my mirror.

[Contrarian]

Before you complete your cost-benefit analysis you need to read this blog post about a benefit of not wearing a helmet that you may not have thought of:
http://www.marginalrevolution.com/marginalrevolution/2009/10/motorcycle-externality-fact-of-the-day.html

[Washcycle]

I know my helmet saves my life because Mrs. Washcycle would kill me if I didn't wear it. (though she sometimes goes without if we're going to dinner because she doesn't want to look like she just wore a bike helmet).

[Tom]

Heck of a post Wash. I'm glad you mentioned the risks of walking drunk at night.

I had one such incident where I fell and fractured my skull and had a wicked concussion. If I had worn a helmet, I probably wouldn't have fractured my skull but I still would have had a wicked concussion. I recovered and went on to achieve great cognitive heights (I submit this post as evidence).

I never thought of wearing a helmet while on subsequent pub-crawls. I've learned from my "accident" and now avoid certain situations.

I have fallen off a bicycle on many occasions. I’ve cracked ribs, broke a collarbone and lost a lot of skin. I did bump my head on the ground once or twice but never really had even a headache.

BTW, I only have worn a bicycle helmet once. I was forced to wear it by a bicycle “salesman” in order to test ride a bike. I felt that people were laughing at me. Didn’t buy the bike. Not there anyway.

I have one nagging question about the effectiveness of helmets in general. Football helmets are massive. They appear to provide way more protection than a bicycle helmet. Yet many if not most NFL players have suffered concussions during their careers. Many end up with severe damage after a career. Why is that?

Likewise, wouldn’t your bicycle helmeted head bouncing off the pavement with great force also cause your brain to bash into the inside of your skull just like a football player? Or, are cyclists different?

I know I am. To paraphrase T.S. Garp, “My head has been pre-disastered”.

[Stuart]

Living in the city I know that the odds of being shot or stabbed are statistically higher than if I lived in the country. So given this elevated risk, it only makes sense that I should wear a flak vest everyday. Because at some point, there is a small but distinct possibility that I will be shot or stabbed in my neighborhood and having that flak vest on will save my life.

Similarly, the risk of sustaining a critical head injury in a car wreck is likely in certain types of collisions. Knowing how likely it is that I will sustain a head injury while driving my car, I wear a helmet every time I drive.

[Contrarian]

Living in the city I know that the odds of being shot or stabbed are statistically higher than if I lived in the country.
If you were to actually look at the statistics of urban vs. rural violence you might be surprised.

Which ties into the whole point of this post: we do a poor job of quantifying risk, in general.

[Brendan]

If you get killed by a driver in a car while not wearing a helmet, some smart defense lawyer is going to say the lack of a helmet contributed to your own death. Contributory negligence. Your family loses its wrongful death suit.

That scenario isn't based on autopsies and precise scientific determinations of cause of death, but on what I'd expect from a jury.

[Bob Steinbach]

In all this talk about bike safety, why do we only focus on helmets? I personally think skinny tires are more dangerous than fat tires. I think toe clips or more dangerous than no clips. I think 20+ miles an hour is usually more dangerous than 15- miles per hour, at least in regards to falls. I think heavily traveled roads are more dangerous than lightly travelled roads/ bike paths. And I definitely think that reckless riding is the most dangerous bike-related behavior. I also think that expecting that anonymous drivers will behave safely in my vicinity is asking for trouble.

So, I ride a fat tired, no clip bike, obey traffic laws and always pay more attention to drivers behavior than I should have to in an ideal world. I take paths and back streets, even if adds a little time to my commute. And when I can't avoid busy streets, I make sure drivers will see me (yellow jacket and lights. I make eye contact as often as possible if I see a potential conflict with a car. And I sometimes wear a helmet; in the dark, when it is wet, when mountain biking or when participating in group rides where the sponsor encourages it. But most of the time, on paths and quiet streets, or on the way to the grocery store, I think it is extremely unlikely that I will fall off my fat tired, clipless bike, being ridden at a moderate speed. And, if i do, I will likely contact the pavement with my hand, knee or shoulder, not my head.

I will ride more if I don't always have to strap on my helmet and riding more is what I'm interested in, and what I think what will be best for me in the long run. Judging intelligence or common sense on the single variable of helmet use is very selective thinking. If you want to wear your helmet all the time, I won't judge you for your skinny tires; don't judge me for my bare head.

Bob S.

[Washcycle]

@Tom, I think a big difference between football and cycling is that if you play a football game, your probability of hitting your head is probably 100% (unless you're a punter or kicker), if your ride a bike for your whole life I'm not sure it gets that high.

@Brendan, in DC that isn't true. I'm not sure about VA or MD.

§ 50-1606. Contributory negligence. Failure to wear a helmet as described in this subchapter shall not be considered as evidence of either negligence per se, contributory negligence, or assumption of the risk in any civil suit arising out of any accident in which a person under 16 years of age is injured. Failure to wear a helmet shall not be a admissible as evidence in the trial of any civil action, nor in any way diminish or reduce the damages recoverable in such action.

[BeyondDC]

Why is Copenhagen safer to cycle in than DC? Because there are so many more cyclists.

Helmets are a barrier to entry. Telling people they should never ride a bike unless they have a helmet reduces the number of cylcists on the road, which makes the road more dangerous for everyone, including the people who wear helmets.

I'm all for using a helmet if you have one handy and want to wear it. At the individual level it generally makes sense. What doesn't make sense is making people feel like they have to, or belitting anyone who doesn't. That causes fewer people to ride, which is worse than riding without a helmet.

So yeah, wear a helmet if you want, but being a jerk about it is utterly counterproductive.

[Erin]

Like many of the posters above, I wear a helmet (now). When I was young, there were few or no helmets available. When I moved overseas (to Germany), I didn't wear one, and neither did anyone else. When I returned to the US, all my friends wore them and knew people who were hit by cars and would have been severely injured had they not had helmets, and they encouraged me to wear one. Now it's no big deal: I wear it daily, and I don't mind it at all. I live in New York City and the drivers here are nuts. Almost every day, I suffer very-near-misses. People think that helmets are dorky or uncomfortable... but I don't think either is really true. Even with my glasses and long hair, I can find helmets to fit. And I and my friends actually look cute in helmets. We're not worried about it, we just encourage each other to be as safe as possible. We want each other alive.

[Tom]

Wash,

I know, I know, I've played and watched millions of football games. I know how it's played.

But why don't those massive helmets prevent head injuries?

[Washcycle]

I think they do. They just don't prevent 100% of head injuries. Imagine how many concussions there would be if they didn't wear helmets? (of course the game would slow down and there would be fewer of the kinds of big hits you have now if they didn't wear helmets - it would be more akin to rugby or footie).

[Doug]

I do care about my brain. I think it is a bit overzealous to assume that if I don't wear a helmet it is because I don't care. In fact, I do care and I would start wearing a helmet the second someone designs one that I believe will protect my head from something greater than a bruise, scrape or minor cut.
Unless any of the posters here who had their "life saved" by wearing a helmet are accident reconstruction experts they should retract their statements or rephrase them as statements of faith - which is what they are.
I am not stating that helmets do not work, I am stating that I have yet to see any evidence that they do anything to reduce the number of severe head injuries sustained by cyclists. I believe that helmet manufacturers should rely less on helmet laws and more on building a compelling product.

[guez]

WC,

In answer to your question, I think that people who are severely impaired by alcohol should probably avoid walking at all. And sure, if you insist on wobbling around drunk on the ice, it might make sense to wear a helmet.

[Eric_W.]

This is a rather silly debate. Has anyone of you fallen off your bike and hit your head? I have. And I am really glad that I could review the scratches on my helmet and my glasses while not having any injury to my head (my leg, not so lucky...)

This whole debate about helmets not offering enough protection is not even academic.

So, let's conduct an empirical study of washcycle contributors who think helmets are not effective: Go outside right now and kneel on the sidewalk. Now bang your head against the pavement as hard as you can. Then, (provided you can still do it), do the same thing wearing your bicycle helmet.

Let us know how it went and whether the helmet was of any use..

Oh, and parents who make their kids wear helmets while they do not wear one... What are they called again? Oh yes: hypocrites.

[patrick]

Bicycling is NOT dangerous. You are no more likely to be hurt or injured biking than you are walking or driving on a per trip basis.

There are only about 750 deaths per year in the US while cycling, versus about 42,000 auto deaths per year. I know there are many more drivers than cyclists, but the numbers work out to be the same on a per trip basis. If you don't feel the need to wear a helmet when driving then you shouldn't feel a need to wear a helmet while cycling. You can look up the numbers. They are publicly available at the bureau of transportation statistics (bts.gov)

I don't have any issue with helmet wearing, but I do have an issue with people who suggest that everybody should wear a helmet, and that anybody that doesn't is dumb/stupid/reckless. It only serves to reinforce the myth that cycling is dangerous.

Helmets are not designed or tested to save a life, they are designed to reduce impacts to the head for the average cycling accident, but the average cycling accident results in no injury worth going to the hospital over. They are less rigorously tested than football, hockey, or baseball helmets. If you are looking to protect yourself from a life threatening injury while cycling, you need to wear a motorcycle helmet, which are tested for the types of impacts that might threaten a cyclist's life (collisions with automobiles). Have you noticed that BMX cyclists wear full head helmets? It is because the standard helmets do not provide sufficient protection against the type of injuries they receive, and they don't even have to worry about being hit by a car.

There are much better ways to protect your safety than wearing a helmet. Biking on the sidewalk is twice as likely to result in an accident. Biking in the wrong direction is 6 times as likely to result in an accident. Biking while inebriated is about 10 times more likely to result in an accident. Knowing and practicing cycling best practices is far more likely to improve your safety than wearing a helmet.

The best way to improve overall safety is to increase the number of people cycling, and anything that makes cycling seem dangerous or life threatening (such as suggesting that it is so dangerous that you should wear a helmet every time you get on a bike does).

Again, I'm not against anybody wearing a helmet, they do provide some protection, just not the amount that people believe, and not for the type of injuries that people are most concerned about. Just don't try to bully other people into wearing them.

[Washcycle]

Eric_W, there is something to the idea of requiring kids to wear more safety devices than adults. They're more likely to fall. They aren't licensed drivers like most adults. And most important children may be "more susceptible than adults to permanent brain damage even when the forces involved are equivalent." These are some of the reason there are child helmet laws even when there aren't ones for adults. [It's kind of like they're the drunk pedestrians walking around in the dark on a snowy evening, though maybe not that bad].

As for your experiment - you should read what Ian Walker writes about the common sense argument (in his, he's getting hit in the head with a hammer).

[vdub3315]

Better safe than sorry. - my wise mother

[patrick]

There's a difference between being safe and having a false sense of security.

[Tom]

@eric W.

You go first. I'll watch.

[Tom]

I don't wear a helmet but my kids wear helmets. Not because I make them, the government makes them. In Virginia you have to wear a helmet until your 15 birthday. If I do my job correctly they will be skilled cyclists by then.

My kids somehow understand that adults and children live by different sets of standards. I can drive car. They can't. I can drink alcohol. They can't. I can vote. They can't. The list goes on an on.

For all those parents that wear helmets only because they don't want to be seen as hypocrites, I have a short message that you can deliver to your kids. It is: "I don't need to wear a helmet because I know how to ride a bike. The government would like you to wear a helmet until you are 15. That is when the government thinks that you have the skills and judgment s to ride a bike safely". My kids get it. If your kids don’t then you’re stuck.

[Eric_W.]

"@eric W.

You go first. I'll watch."

@tom

I don't have to, I am wearing a helmet because I know that it allowed me to go to work with only a nice bleeding leg injury instead of adding a nice bleeding head injury.

And please stop the "wear a motorcycle helmet" stuff. That's a great idea if you want to die of a heat stroke. And BMXers obviously wear the gear and the full face helmet during their performances which is hardly comparable to a daily commute.

I have to say that I am amazed at the "arguments" you guys are dragging out to not having to wear helmets. I guess thatn is how motorcyclists argued when they successfully repealed or avoided helmet laws in some states.

@washcycle: I assume you do not have children. My argument was not about the higher vulnerability of children v. adults but regarding the role model aspect of parents.

[Washcycle]

I think Tom makes a good point. If you don't care for helmets, but you do respect the law, then you'll ride without one and make your kids wear one and that isn't hypocritical. Kids are required to wear life jackets when on a boat but adults are not. Many adults don't. That's not hypocritical it's a recognition of the law and that kids aren't as strong at swimming.

@Eric. It's only a role model issue if you think everyone should wear a helmet. But if one isn't wearing a helmet they probably don't think everyone should. They think kids should.

Also the hitting the head on the ground thing. I think if the probability of being hit on the head were 1 (as you've described), everyone would choose to wear a helmet - even if they think they're ineffective. If the probability of being hit on the head were 0, everyone would choose not to wear a helmet - even if they think they're very effective.

But the probability is somewhere between 1 and 0 and the effectiveness is unknown - this is no different than walking or driving. So some people choose not to wear a helmet when biking just as almost everyone does for walking and driving. If drivers knew they were going to hit their head they'd surely want a NASCAR helmet, but they probably won't hit their head so they don't.

Finally, I bought a snowboarding helmet yesterday to wear when winter biking. It's going to be much warmer. Looking forward to it.

[Cycler]

Nicely put article. It summarized a lot of my feelings of ambivalence about helmets.
As a poster above said, If I rode in Copenhagen I probably wouldn't wear one. I think that riding without any traffic or parked cars my p for falling off my bike would be about the same as falling walking (frequency of hitting a pothole= frequency of stepping in a hole)

And as everyone on either side of the helmet debate would attest, if you get run over by the wheels of a motor vehicle, the plastic helmet is unlikely to save you.
However in an urban environment where people constantly fling their doors open, turn in front of me unexpectedly, step out in front of me, or otherwise cause me to stop abruptly, I think wearing head protection in case I am flung to the pavement is a good idea.
I think that one solution to the issue is cultural- it would be great to see more helmets that don't look like you just fell off the back of the peleton.

[MM]

Bicycle helmet use has been estimated to reduce head injury risk by 85 percent.

Ninety-one percent of bicyclists killed in 2008 reportedly weren't wearing helmets.

For more information: http://www.iihs.org/research/fatality_facts_2008/bicycles.html

[Washcycle]

A lot has been done since that 1989 study. From Wikipedia.

"The most widely quoted case-control study, by Thompson, Rivara, and Thompson, reported an 85 % reduction in the risk of head injury by using a helmet. There are many criticisms of this study,[48] including use of a control group with very different risks. Re-analysis of the Thompson, Rivara and Thompson data, substituting helmet wearing rates from co-author Rivara's contemporaneous street counts[49], reduces the calculated benefit to below the level of statistical significance."

[patrick]

I would like to re-iterate that cycling is not dangerous. If you feel safe walking or driving, you are just as safe cycling. If you don't feel you need to wear a helmet while walking or driving, then you shouldn't feel you need to wear one for cycling.

But if you are still concerned, the best you can do for yourself is to learn some basic cycling techniques:

Don't ride without a light at night without a light (cars can't see you)

Don't ride the wrong way on the street (cars aren't expecting you)

Don't ride on the sidewalk (cars are not looking for fast moving objects there)

Don't ride in the "door zone" (drivers don't look to see if anybody is coming before opening their door)

Look behind you before turning.

Those basic techniques will go a long way to make sure you are not hurt, with or without a helmet.

[Alex]

At low speeds an inadvertent fall where you hit your head, a helmet is the difference between getting up and back on the bike versus a trip to the hospital with a concussion. THAT'S when you need it most contrary to most people's opinion. In a head on collision with DC garbage truck, a styrofoam lined helmet probably won't do much for you.

It's like seat belts, get over it and wear a helmet. You'll get used to it soon enough and eventually, will feel "naked" without it.

Sure, it's a personal choice, but if that is your choice, you have to live with the consequences.

[Contrarian]

In the current New Yorker Malcom Gladwell has an article about the long-term impact of head trauma in football players. Researchers put sensors in players helmets and can actually measure the force of impacts, in g's. Gladwell writes: "If you drove your car into a wall at twenty-five miles per hour and you weren’t wearing your seat belt, the force of your head hitting the windshield would be around 100 gs" and tells the story of a player who received a concussion from a hit that registered 63 g's.

Interestingly, the same technology is used to test and certify bicycle helmets. In the US, the Consumer Product Safety Commission requires that all bicycle helmets sold pass an impact test. The test is to take a 5kg weight, representing a typical head, and strap it in the helmet. The helmet and weight are then dropped three times and the impact force is measured. They are dropped from a height of 2 meters onto a flat surface, and 1.2 meters onto rounded and curbstone-shaped surfaces. In order to pass the test the sensor has to register less than 300 g's.

So the test essentially simulates an adult falling off a stationary bike and landing on his head. The standard of protection is an impact force five times that required to cause a concussion, and three times that of an unbelted 20 MPH car crash. There's just not a lot of protection there.

[Contrarian]

Interesting story from the NY Times about helmet efficacy at http://bicycleuniverse.info/eqp/helmets-nyt.html. Money quote:

"The number of head injuries sustained in bicycle accidents has increased 10 percent since 1991, even as helmet use has risen sharply, according to figures compiled by the Consumer Product Safety Commission. With ridership declining over the same period, the rate of head injuries among bicyclists has increased 51 percent even as the use of bicycle helmets has become widespread. "

[Washcycle]

Here's an article on the comparative danger of biking and walking (biking is safer by two studies)

"The company looked at a variety of activities and determined that the number of fatalities per million hours of exposure was 0.26 for biking, 0.47 for driving, 1.53 for living (all causes of death), and 8.80 for motorcycling."

And

"The Rutgers University researchers who completed this study concluded that, per kilometer traveled, bicycling fatalities are 11 times as high as car occupant fatalities. Seems pretty grim for biking until you look at what the same study found about walking. Pedestrian fatalities per kilometer traveled were 36 times as high as driving fatalities, suggesting that walking is more than three times as dangerous as biking."