How Much Do Helmets Help? Ctd

A reader writes:

Re: your post on bicycle helmets, it’s much worse than you think. See this article, which pretty conclusively proves that helmets don’t do a damn thing for many kinds of head injuries and the government isn’t doing a damn thing to enact better standards. People are being lulled into a sense of safety with helmets that they just don’t have.

Another differs:

I hate when people cite small studies that do not jibe with meta analyses. Here’s one on bike helmets from NIH. I work in public health, so I obviously have a stake in the game. But even further, my daughter fell off a skateboard two years ago and was med-flighted to Boston Children’s Hospital.  The hospital asked us to bring her helmet, which was completely shattered.  Needless to say, she is completely fine now but would not have been without the helmet, according to hospital physicians.

Wear a helmet; don’t wear a helmet.  I don’t care.  But don’t be so arrogant as to tell others not to by hiding behind one small study.


As someone whose life was saved by his bicycle helmet four years ago, I must object to your post.  The benefits of using a helmet are quite clear, and the study you link to doesn’t change that conclusion. It addresses a narrower question: the benefits of mandatory helmet laws.

Its conclusions are intriguing, but mainly because it sees helmeting laws as introducing factors that nullify the benefits of helmet use, such as discouraging bicycle use, improper use of helmets, or (that handy all-purpose explanation) moral hazard – which I frankly find nonsensical (my head came out OK, but I still had serious leg and neck injuries; why would anyone increase their risk of those just because they’re wearing ahelmet?).

I might add that helmet use doesn’t appear to be associated with riskier behavior – indeed the contrary, since helmeted cyclists tend to engage in prudent cycling practices generally, like obeying traffic laws, using lights at night, etc.  The big problem (certainly it was mine) isn’t risky cyclist behavior so much as risky motorist behavior (after all, they ride around wrapped in a two-ton, full-body helmet).

Finally, as Eric Jaffe points out in The Atlantic, while the Canadian study makes a good point about helmet laws, it doesn’t make any sort of case against actually using a helmet.  Rather, it makes a case that other measures to improve bike safety are more important, because they reduce the likelihood of accidents in the first place.  A post like this that discourages helmet use is actually a disservice to cyclists, including yourself.

Another helmet booster tells his horror story:

I can’t and won’t question the mentality of those who do or do not wear helmets while riding a bicycle, but I will say for those concerned with protecting their noggin, helmets do help. Back in the ’80s I rode bicycles competitively and while out on a training ride one February day in Boulder, Colorado, and started to climb a hill in the Rocky Flats area known as The Wall. It was a chilly day and I had chosen to wear a hardshell helmet instead of the old style leather-bound “hair net” because it provided some level of warmth. I had just gotten up off the saddle and started to crank up this ridiculously steep hill when my front wheel came off, my mistake for not checking the wheels before I set out.

I crashed and was lucky someone saw it happen who then drove home and called 911 and returned and waited. I had a flight-for-life to a local emergency hospital and was out cold for 20 hours. I awoke to learn I had 450 stitches with 7-layer closures on the right side of my face done by a masterful plastic surgeon on duty. The helmet saved my ear, part of my scalp, and more than likely prevented my skull from cracking. If you could have seen the scrapes on the side of that helmet, you’d wear a helmet too.

Update from the first reader, who elaborates on his point:

The three anecdotes after the quip you posted from me entirely miss the point. The article from Bicycling magazine shows that bike helmets do exactly what your other readers say they did for them – keep your skull from splitting open in a catastrophic crash, and maybe reduce some scrapes and bleeding in a minor one. What they don’t do is prevent concussions, because the hard material does transmit force to your skull – it absorbs enough so that it breaks instead of your head but not enough to keep your brain from getting rattled. The government could set standards for safer helmets – the technology is being developed – but it hasn’t, so nobody has an economic incentive to sell a new kind of helmet that it can’t say is government or privately “safety certified.” But those certifications are hardly based on the latest science.