Jess Mace

Michael-
I work in the public health and epidemiology realm and this is the main
problem with helmet advocacy...there is NO real data concerning head
trauma in the ED and helmet usage...
this is because it is extremely unethical to establish a well powered
epidemiologic study as it would require slamming people's head into the
ground with and without helmets in a prospective
cohort study or double blind randomized control study at various rates
of speed...would you sign up to be in it?

This fact is what opponents of helmet legislation use on a regular
basis, without recognizing the fact such data is impossible to collect
or accurately measure. all we have in anecdotal accounts and some
times in public health policy, that is enough to swing the tide.

There are a few studies out there regarding decreased traumatic brain
injuries in children after helmet laws are enacted, but they're not
widely referenced due to measurement errors and biased selection
criteria if I remember correctly...the authors recognize that it is a
VERY difficult thing to measure (too many variable to enact a TBI).

Jess C. Mace
Clinical Outcomes Research Coordinator
for Timothy Smith, MD, MPH
Otolaryngology - Head and Neck Surgery
Oregon Health & Science University
503.494.5886

>>> "Michael O'Hair" 2/26/2008 6:37 PM >>>
I'll add my two cents to this.

I have seen many, many "family groups" where the kids are wearing
helments and one or more adults are not. I believe this sets up an
image problem: helmets are for kids. I have told a couple of grown ups
that it's hard to be a parent when you've taken a serious hit in the
head.

On the other hand, I have seen far too many people who have donned
their helmet and obviously equated it with some sort of magic armor that
allowed them to ride between traffic and parked cars at 4 MPH, blithely
unaware of their surroundings and the physics behind getting run down by
a 4000 pound car.

It is my opinion that the term "skid lid" definitely applies to bicycle
helmets. They are good for minor accidents, but when the plastic hits
the asphalt at speed (30 MPH or more), not even a Snell Approved
motorcycle helmet can guarantee much beyond "..Well, it would have been
worse without a helmet."

The problem is simply one of common sense: riding in traffic raises
the risk of wrecks, therefore wearing a helmet helps shave the odds a
bit. Unfortunately, legislatures do no deal in common sense. Case in
point, Hawaii was going to outlaw 2-piece wheels on cars until someone
pointed out that almost all cars came equipped with 2-piece wheels.

Who out in OBRA-land has the actual data? How many people on bicycles
suffer non-superficial head injuries (defined as requiring admission to
a hospital) with and without helmets?

----- Original Message -----
From: john
To: obra@list.obra.org
Sent: Tuesday, February 26, 2008 5:03 PM
Subject: Re: [OBRA Chat] Helmets will be mandatory in Vancouver, WA

I know this is just a sliver of arguments for and against but
personally i think we should require helmet use for any sort of vehicle
because most auto accidents involve head injury to the occupants. Plus I
know when i slap on a helmet and drive, I feel more secure and safe
(subconsciously or not) and so i drive a little more
reckless(subconsciously or not).