Monday, November 15, 2010

EDs add to danger-mongering of cycling

OMG! here we go again - nothing in this letter published in today's MJA (Medical Journal of Australia), should convince politicians NOT to repeal bicycle helmet laws.

After all if "bakers" were to tell us that people buy bread everyday and that some of "bakers" actually sell out of bread everyday, it wouldn't necessarily mean that everybody is buying bread everyday, and that everybody is eating masses of it too everyday!

The collection of figures and stats always contains many variables and invariably is 'cherry-picked' to bolster the finder's fixed beliefs. It's common knowledge that we seek information to prove categorically our 'point-of-view'.

ED doctors are no exception - they believe in helmets... me, I'm (married to) a doctor!

Joking aside, given the current academic debate on the issue of mandatory helmet laws within our community, it is a great shame that the RPA survey adds nothing of any substance to it.

Oh the drama & the spin! - but what I want to know is:

..."apart from Big Helma, who stands to gain?"...

Certainly not the Australian public.

Due to a tricky little issue called ethics, testing for helmets remains loose and sieve-like - always will.

As Dr Ian Walker, the eminent British scientist and researcher, explains in Tom Vanderbuilt's 'How We Drive' blog, no-one in the world knows whether bicycle helmets save lives or not for certain because:

"...only one method exists for us to get a definitive answer: the experiment. If we took a large number of bicyclists and randomly made one-third ride with helmets, one-third ride with fake helmets (the placebo) and one-third ride with no helmets (the control), then after a couple of years we could count the dead and get the answer we are hoping for. Sadly, however, there are some fairly obvious ethical difficulties with this."

Dr Walker goes on to succinctly point out, that the only evidence that will ever be available is indirect:

"...casualty figures, surveys and observational studies, all of which are riddled with biases...and for every piece of evidence we can find in one direction, there is another telling us the opposite..."

...hence the RPA study and it's findings, so opposite to the most recent peer-reviewed academic study. How does a government ever choose which study it will use to influence policy?...1 potato, 2 potato, 3 potato, 4...?!

In fact I would like to ask Dr Dinh to explain why, if helmets have done all they were cracked up to do over the past 20 years, this has proved so difficult to actually see here in Australia and why other countries around the world use us as the example for not introducing mandatory helmet laws?

But I digress - let's get back to Dr Walker who has more to say (do read his complete 'guest appearance' in Tom's blog):

" countries where helmets have been made mandatory, and where usage went from low to high levels almost overnight, there is just no real evidence of a concomitant drop in injuries. Indeed, what we see instead is a big drop in the number of people cycling, which is a disaster – far worse for public health than the few head injuries the helmet laws tried to prevent. Whenever a person gives up cycling, they get far less day-to-day exercise. This means they trade a very small risk of dying from a head injury (almost certainly smaller than you think – I can almost guarantee it won’t be a bicycling head injury that sees you off) for a greatly increased risk of dying early from heart disease or cancer (almost certainly larger than you think – I’d lay good odds that one of these two will get you)."

When will Australia cease vilifying 'road-users-who-use-bicycles', and attribute blame to the actual injury perpetrators - 'road-users-who-use-motor-vehicles'?

By refusing to relinquish our faith in helmets & helmet laws, we exhibit wilful blindness in our duty of care to vulnerable road users - what a pity we are such a negligent nation!


Quick little PS:

For the record, Sydney Morning Herald, in para 11 it's 'diffuse axonal injury' NOT 'diffuse external injury' which you persist in (mis)quoting!

...and also, I didn't think I'd ever be saying this, but I agree (!) with Minister Borger's insightful labelling of NSW Labour's 'dead & lifeless'...'urban failures' - WOW! what an admission on his part! way to go, Minister!

Notwithstanding, I'm somewhat confused where he was going with this admission though - was it an indirect attack on Clover's wonderful plans for George Street which are anything but 'urban failures'? - surely not!!!!

"...anyhoo! 'policy-advice-from-me' concerning emergency resuscitation of 'failed-urban-bits':

* prepare a little bicycle-love x x

* by making sure you IGNORE the RPA ED spin x x

* & drafting REPEAL provisions for mandatory helmet laws today (ok tomorrow, it's late I know!) x x"


  1. The biggest problem with the letter is that the statistics are not presented in their proper context. For instance, how many of the patients who fell in the 'fall off bike without collision' category were travelling at high speeds? What percentage of the patients were road cyclists in lycra? How many of these patients were taking unnecessary risks or disobeying road rules on streets with a high volume of traffic? Perhaps the study should have compared the slow and upright style of cycling in European cities (where cycling is not considered to be a fitness activity or sport, but an everyday way of getting from A to B) to the fast and hunched-over style that seems to be so prevalent in this country.

    If motoring safety concentrates on preventing speeding and reckless driving, why is this rarely ever discussed when it comes to preventing cycling accidents? Instead we have this false perception that the simple act of wearing a helmet is all we need to keep us safe. I remember the last time I got caught by the bike police for not wearing a helmet: a few seconds before they pulled me over in the city I witnessed two seemingly respectable and helmeted men perform illegal right hand turns on a red light during rush hour, darting through cars and pedestrians in the process. As soon as the light turned green and I crossed the intersection the cops nabbed me. Unfortunately the irony of the situation seemed to be lost on them completely.

  2. The biggest problem with the letter is that it insists in on blaming the victims, it fails to address the central issue of road safety. 95% of motor crashes are caused by driver error. If these medical men really want to reduce the rate of head injury they would concentrate on this issue.

  3. The biggest problem with the letter is that it insists in on blaming the victims, it fails to address the central issue of road safety. 95% of motor crashes are caused by driver error. If these medical men really want to reduce the rate of head injury they would concentrate on this issue. (with link)

  4. That 'study' by Dinh, et al. is complete rubbish.

    From the outset one of their objectives was to:

    'demonstrate the safety benefits of helmet use'

    Now, that's not very scientific, is it?

    ...they then make conclusions on mandatory helmet legislation and yet this had nothing to do with the study!

    Newspapers & journalists are rapidly turning into photocopying services, publishing dross that has been served up to them by some business or 'vested interest' of some sort - negating to hear from 'the other side' of the argument. The few quality journalists left are finding it harder to compete. You only have to watch one episode of 'Media Watch' to know that this is the case.

    This sort of rubbish happens a lot in the USA too, and the public just swallows it and asks for more! We are not only all obese from too much junk food, but our minds are obese from all this junk knowledge.

    Can we turn this mess around? I hope so.

    Dr Paul Martin
    Brisbane, Australia

  5. Etienne, Kim, & Paul: why don't politicians use us as their political advisors? - we've got it covered! - and if our suggestions for political reform were employed, all our circumstances would be very much improved for the better.

    Thanks for taking the time to share your insight

  6. Reading that study demonstrated one key point for me: the pro-helmet and anti-helmet-law camps are debating 2 different issues.

    The data showed that:
    1) IN the event of a collision, helmet usage increases survival rates, and
    2) Mandatory helmet laws make it more likely you WILL have an accident.

    The graph shows that there has been no net change in AIS3 (severe head injuries) since 1990 yet a massive increase in hospital admissions while cycling numbers have decreased.

    Sue, I know you are on the DAS bandwagen but I don't think that helps the cause. Most people still think this debate is pro vs anti helmet (just look at the medicos who wrote that paper) but it shouldn't be. It is about getting rid of laws that don't work. The safest places in the world to ride are those without helmet laws, and motorists face an equal head injury risk as cyclists. I don't wear a helmet in my car so I shouldn't have to on my bike.

    Anyway, rant over, keep on riding free!

  7. Hey Dave! Thanks for your great comment, & I totally agree with you that 'it is about getting rid of laws that don't work' - I really want to see that happen and I hope that I'm adding something useful to that end.

    This is going to sound ignorant on my part but does the 'DAS' in your 'DAS bandwagen' quote mean 'Distributed antenna systems' (I googled those letters and that's what they came up with) and if so does that mean that you think I rabbit on (dal!) - just curious - I'm feeling somewhat dense - but I really want to know what you mean!

    ...and thank you for your 'riding free' encouragement - music to my ears!!!

  8. I use a bicycle at work it's my only means of transport at the moment to get between jobs.

    I use the sun hat outdoors as recomended by the woekplace health and safety act. It has a 7 to 10 CM sun rim all the way arpund.

    If you are forced by law to use an outdoor headware at work that is less that the recomendation in the law, your employer can be fined. that's me in the case of a self employed person.
    Read about my run in with police, not reported by the media???

  9. @sue - Sorry my typo there - meant to be DAI as in diffuse axonal injury! Just as bad as the SMH eh?

  10. Dave - ha! ha! - you are!!!!

    ...& back to your sentiments that it has become a pros & cons helmet debate, I'm really with you in the anti-helmet law stance and not actually anti-helmets per se...

    ...after all just because I think they're dangerous & don't wear them myself doesn't mean I would deny someone the choice to helmet-up - just like I wouldn't deny someone the choice to climb ridiculously high skinny trees or stay on the ground & smoke nicotine - matters for choice!!

    ...& phew! it's a relief that I don't rabbit on though!