Cycling the single biggest sporting activity for referrals to brain unit in Beaumont

Brendan Burgess

Brendan Burgess

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Cycling the single biggest activity for referrals to brain unit

Of contact sports, Gaelic football accounts for most referrals to Beaumont Hospital centre
www.irishtimes.com www.irishtimes.com

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Of 26 patients with cycling-related head injuries who were transferred to the unit, [as distinct from referred?] only two were recorded as wearing a helmet at the time of injury. Eighteen did not have helmets and no information about helmet status was available for the other six cases.

The two patients with helmets suffered minor injuries while two-thirds (67 per cent) of those not wearing a helmet suffered intercranial haemorrhage, with five requiring surgical intervention.

The four patients who died were all cyclists, two of whom were involved in collisions with cars.

I find this confusing, but this is what I think they are saying:

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To put this in perspective: 56,000 people reported commuting by bicycle in Census 2016, up from 39,000 in 2011. It is almost certainly higher now.

If you add in leisure cyclists you will get maybe 65,000 regular cyclists. The number of regular rugby players and horse riders is probably an order of magnitude lower.

The academic literature certainly shows much less head injury in helmeted cyclists. But there could be confounding factors such as more risky behaviour, non-functional brakes, no lights, etc.

Data on cycle helmet use were available for 6621 of the 11 192 cycle-related injuries entered onto the TARN Database in the 66 months of this study (93 excluded as not pedal cyclists). 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).
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I wear a helmet but I wouldn't make it compulsory. There are other health benefits to cycling and compulsory helmets will just put some potential cyclists off cycling at all.
 
So 86 head injuries per annum out of 65,000 cyclists

About 18 serious injuries per annum.

4 died, but all were in collision with cars - so their injuries were probably catastrophic anyway. The helmet does protect the head when going through a windscreen but doesn't do much for the rest of the body.

Overall, cycling is very safe and as it's very good for the health, the benefits far outweigh the risks.

I would also imagine that with the development of cycle lanes, it's getting safer. The increase in the numbers cycling also make drivers more aware of cyclists.

Brendan
 
As some of you know I cycle a lot but up until 2017 I never wore a helmet, never saw the need, didn't like the feel or look of a helmet
That all change in 2017 when I went to Spain to cycle, In Spain it is mandatory that you wear a helmet when out cycling except when in a city
So I had no choice and now I don't even think twice about putting it on when going out for a spin

But it was this year when I actually saw and realised the benefit of wearing a helmet after having four crashes
one was hitting a pedestrian on Vico road, two were hitting kerb stones that I should have seen but didn't and the fourth was a front tyre blow out
Those were the first accidents that I've had in at least a decade but in each of them my head or at least my helmet hit the ground
And in those moments of contact there were lightbulb moments where helmets made complete and utter sense to me
But I wouldn't have known this only for, Spain has a mandatory policy on helmet wearing when cycling in the country side

So you can thank Spain that I'm still able to post here, you lucky dogs!!!
 
Brendan Burgess said:
Hi Cervelo

I wear a helmet when going on a long cycle up the hills, but not around town.


Brendan
Click to expand...

same here - it's really down to relative risk. Helmet will protect you in some circumstances, but the main risk on the roads is bad drivers (or worse aggressive drivers who want to "teach you a lesson"). Countries introduce mandatory helmet laws because they can't be bothered to make the necessary infrastructural changes to make cycling safer - hardly anyone wears a helmet in the Netherlands...
 
Brendan Burgess said:
I wear a helmet when going on a long cycle up the hills, but not around town.
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I can't believe I'm doing this after all my years of refusing to wear a helmet :rolleyes:

But I find this statement a little ironic and a wee bit discombobulating and similar to a car driver saying
"I only wear my seatbelt on long journeys but don't bother on shorter journeys like popping down to the shops"
An accident can happen anywhere but I'd hazard a guess and say that you're more likely to have one in the city than the countryside
and if your going to wear a helmet then you should wear it all the time or none of the time
 
Brendan Burgess said:
www.irishtimes.com

Cycling the single biggest activity for referrals to brain unit

Of contact sports, Gaelic football accounts for most referrals to Beaumont Hospital centre
www.irishtimes.com www.irishtimes.com

View attachment 5208

Of 26 patients with cycling-related head injuries who were transferred to the unit, [as distinct from referred?] only two were recorded as wearing a helmet at the time of injury. Eighteen did not have helmets and no information about helmet status was available for the other six cases.

The two patients with helmets suffered minor injuries while two-thirds (67 per cent) of those not wearing a helmet suffered intercranial haemorrhage, with five requiring surgical intervention.

The four patients who died were all cyclists, two of whom were involved in collisions with cars.

I find this confusing, but this is what I think they are saying:

View attachment 5209
Click to expand...
Seems like it's anti cycling click bait from IT.



"The @IrishTimes has just published a rehashed version of an article from September 2019.
It's the same study, from the same author, using the same data set."
 
Cervelo said:
"I only wear my seatbelt on long journeys but don't bother on shorter journeys like popping down to the shops"
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Hi Cervelo

It's completely different.

If I am coming down a mountain at speed and come off the bike, I would have serious injuries.

Around the city, I don't go fast at all. I have come off the bike but the injuries are minor.


As you point out:

Cervelo said:
Spain has a mandatory policy on helmet wearing when cycling in the country side
Click to expand...

That seems to make sense to me.

Brendan
 
Brendan Burgess said:
Hi Cervelo

It's completely different.

If I am coming down a mountain at speed and come off the bike, I would have serious injuries.

Around the city, I don't go fast at all. I have come off the bike but the injuries are minor.


As you point out:



That seems to make sense to me.

Brendan
Click to expand...

i dont cycle, personally i value my life too much... but isnt the risk in the city being hit by a car or bus or crashing into a jay walker, surely the relative impacts would be similar.
 
Brendan Burgess said:
Around the city, I don't go fast at all. I have come off the bike but the injuries are minor.
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Yes but you're not likely to get pulled under a truck turning left at the Sally Gap.

Likewise in the city there are more hard vertical surfaces to the thrown against like cars, the sides of trucks, and walls.
 
PGF2016 said:
Seems like it's anti cycling click bait from IT.



"The @IrishTimes has just published a rehashed version of an article from September 2019.
It's the same study, from the same author, using the same data set."
Click to expand...
It's sadly not surprising from the IT, they've been on this for quite some time. Also the study is referencing sporting injuries rather than transport injuries, the data set will show cycling as a very low percentage of transport head-related injuries, yet no-one is suggesting car drivers or passengers wear helmets.
 
67% of those not wearing helmets (12 individuals) had Intracranial haemorrhage, with 5 requiring surgical intervention.

So that is 5 per annum.

4 cyclists died - 2 were involved with cars and 2 were on their own.

Brendan
 
Last edited:
Brendan,
I don't wish to turn this into a debate about how and when you should or should not wear a helmet
but in my opinion there are many types of accidents that you can have on a bicycle
they really all fall into two main types ones that you cause and ones that happen to you
and its the latter where the real issue lies, it doesn't matter what speed your cycling at in the city
It's the speed of the car that hits you is the major concern here
 
This is an extract from the Conclusions

In 2017, traumatic brain injuries accounted for 18% (n = 1357)
of all major trauma injuries in Ireland, of which 20% (n = 175) of
road trauma patients were cyclists [9]. Despite cycling being considered
the healthiest and most environmentally sustainable
means of transport in urban area [10] as well as having significant
health benefits [11–13], a cyclist is one of the most vulnerable road
user in Ireland. Recently, Dublin’s cycling infrastructure was
demonstrated to be inferior to that of its European counterparts,
leading to an increased risk of injury [14,15]. At present, there is
no legal requirement enforcing the mandatory use of cycling helmets
in Ireland. Strong evidence exists illustrating the protective
nature of helmets on brain injuries internationally [16–19] and
within an Irish cohort [20]. Our study demonstrated that 69% of
cyclists transferred to our service were not wearing a helmet and
all 4 mortalities were associated with cycling. A recent metaanalysis
demonstrated that the positive effects of helmets are
greater in single bicycle crashes compared to collisions with motor
vehicles [19]. However, making helmet use mandatory maybe
associated with high risk behaviour [21] as well as reducing
the overall number of cyclists thereby increasing the risk to the
remaining cyclists [22]. The current debate regarding helmet
legislation should not be used in isolation but in conjunction with
a concerted effort to significantly improved the cycling
infrastructure.
 
Cervelo said:
It's the speed of the car that hits you is the major concern here
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Yes, and when you are hit by a car at speed, you get some protection for your head from wearing a helmet, but none for the other parts.

Two of the 4 deaths were caused by being knocked off the bike by a car. Here is the description :

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I don't understand all those words, but the helmet wouldn't have been much good.

I am guessing that the helmet would have saved the lives of the two people whose accident did not involve anyone else.

Brendan
 
Brendan Burgess said:
I am guessing that the helmet would have saved the lives of the two people whose accident did not involve anyone else.
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Hmmm.... if an accident is bad enough to kill someone then would a helmet have saved them? Are helmets that good?

Like yourself I wear one when outside urban areas but I don't think they are of much use for anything over relatively slow speeds.
 
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