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A cyclist is silhouetted while passing underneath West Georgia St. near Stanley Park in Vancouver, B.C., on Monday September 13, 2010. DARRYL DYCK FOR THE GLOBE AND MAIL (DARRYL DYCK/DARRYL DYCK/The Globe and Mail)
A cyclist is silhouetted while passing underneath West Georgia St. near Stanley Park in Vancouver, B.C., on Monday September 13, 2010. DARRYL DYCK FOR THE GLOBE AND MAIL (DARRYL DYCK/DARRYL DYCK/The Globe and Mail)

Concussion experts took your questions: Do helmets keep you safe? Add to ...

Anne McIlroy: Can you think of any examples, Dr. Tator, of where people should not wear a helmet because doing so makes them less safe?

Gerry Wilde: Are bike helmets OK if they have not been dropped on the ground a few times? What doe we mean by "OK?" Years ago I looked into the research evidence on bicyicle helmet wearing and effect on safety. Few good quality data seem to exist. This in conctrast with motorcycle helmets. Mandating the use of these does not seem to have reduced the motorcycle fatality rate per 100, 000 registered motorcycle licences in the US.

Charles Tator: A car striking a biker at 30kph is not low velocity. You only get one brain!

Marc: I am under the impression that bike helmets provide less protection than we think. In my estimation (please correct me if I am wrong) the helmet only serves to lessen the impact of the head itself but does nothing to protect the onslaught of havoc that will be unleashed on the brain itself if the head hits a hard surface at a great speed. Do helmets really do their jobs?

Sidney: What exactly do helmets protect our heads from?

Charles Tator: Helmets do a wonderful job of preventing MOST brain injuries, but not all. At 150 kph, the current bike helmets will not be completely protective. Motorcycle helmets will do a better job at this speed. Also, no helmet prevents all concussions.

Anne McIlroy: I'm wondering if perhaps people need to consider they may take more risks when they are wearing one?

Charles Tator: Helmets protect the head from skull fractures, brain lacerations, and contusions and blood clots in the brain or around the brain.

Chris: The data I saw a couple years stated that wearing a helmet during a bike crash will reduce the risk of serious injury by up to 80%.(Sorry I can't remember where I saw that data) So if that is even remotely true just wear the helmut. Think of your head as an egg with a yoke inside. If there is a fast decelration the yolk will smash against the inside of the shell. Your helmut absorbs some of the shock which as a result will slow down the acceleration of the "yolk." I always wear my helmet and the risks I take are the same.

Charles Tator: In my view there is little evidence to prove that helmets make people take more risks. This question has been in the minds of some people, and I do not feel that the evidence is there. We call this the risk compensation theory.

Christopher Miller: My question from a different angle: why would this not justify insisting on pedestrian helmets as well for those crossing the street? And how your answer w.r.t the Netherlands applies to segregated cycling infrastructure like the bike paths we have both there and here, where cars are not a factor? And again, the high risk of head trauma to car occupants in crashes?

Gerry Wilde: Anne, you hit the nail on the head! (pun intended). If the "behavioural factor" is not considered, ti is impossible to decide whether soms se-lf-proctive equipment is helpful to safety or not. Consider ABS, airbags, seatbelts, etc. Yes they could be helpful if people did not alter their driver behaviour when feeling better protected, but they do, as worldwide research (with proper controls) demonstrates.

Charles Tator: We always get questions from helmet haters and bicycle freedom folk about why motorists and pedestrians do not have to wear helmets. The answer lies in the attempt to advocate risk reduction for those most at risk.

Guest: I've been in the cycle industry for a number of years, and I've been a cyclist even longer. Helmets are worth their weight in gold the first time our skull bounces off the curb. I've had accidents in both cases and my recovery time personally from helmeted crashes has always been less. Thats not to say that the crash wasn't damaging because I was wearing a helmet, but the effects were far less serious.

Jeremy: I've only ever had a few run ins with cars whilst on my bike. The odds of a head injury (which I have sustained) while riding on paths, or car free zones is as high as when cars are involved. The car is usually merely a cause of the accident, and usually the results are the same if your head hits a bike path or a sidewalk.

Jeff: While there may be some debate about risk compensation, a 2006 study by Ian Walker, from the UK, found motorists passed closer to cyclists who were wearing bike helmets compared to cyclists who did not have a helmet. So... this is some evidence that helmets increase the risk of a collision, and therefore an injury. I still wear a bike helmet, but it may be causing me more risk than if I was bare-headed.

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