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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 ...

Charles Tator: Dear Jeremy, you have been lucky so far. Please don't continue to press your luck. Someday you will thank me. Cars and trucks deliver more punch than the ground ususally.

Cliff Lee - The Globe and Mail: Dr. Tator, I must ask - is there really no strong evidence, from what you've seen, to support risk compensation theory?

Anne McIlroy: I find it worrying when I see cyclists with their helmets half hanging off their head. They may think they are protected, and perhaps are more aggressive as a result, but they aren't.

Gerry Wilde: Yes, Jeff, this brings up the political dimension. I lived more that 30 years in the Netherlands (much of the time on my bike), and I know the political resistance of bicyclists against mandatory helmet use. They feel that it moves the responsibility for accident avoidance from motorists to biclyclists, and that they don' want.

Guest: My children and other youth that I have listened to on this subject inform me that they want to wear only one helmet for all activities and that the helmet must have a cool appearance. Is their request possible and would it ensure safety?

Charles Tator: I have read many unconvincing papers purporting to prove the risk compensation theory. I remain unconvinced. I have read more papers debunking the risk compensation theory, and I have found them much more convincing.

Jeremy: I agree Dr T. However I do believe that cars and trucks are merely one factor in what are never simple or happy situations. When there are collisions I think that its important to consider behaviour as much as safety gear. My helmet stays rooted to my head, but if I swerve in front of a sedan with a false sense of entitlement to a lane then I'm as much at fault as the car that runs me down.

Jeremy: @guest. Check out Bern helmets. Many of them are certified for several activities and they also have a nice aesthetic.

Guest: Military studies have clearly shown that helmets decrease an individual's ability to perceive their environment, most especially with regards to hearing- that's why special forces usually don't wear helmets in many situations.

Charles Tator: Unfortunately, there is no single helmet that will be appropriate for all sports. We are encouraging the engineers and helmet makers to try and make helmets more multi-purpose, and there is some headway (pardon the pun). Yes, cool is highly desirable, too.

Jeff: Unfortunately, most helmets are not designed to protect against concussions. I've done accelerometer drop testing of bike helmets, and have found that they are only effective at reducing the HIC levels to that 'typically' below the threshold for concussion at impact speeds under about 20 km/h. So, they are effective if you fall off your bike, but not if you are struck by a motorist.

Neil FitzGerald: Can you comment on any observed differences in the rate and/or severity of head injuries in rugby versus football. It seems the helmets in football do provide a new means of attacking/tackling that rugby players do not tend to engage in. Thoughts?

Guest: I think comparing riding a bike to the special forces is like comparing apples to oranges. The needs of soldiers compared to cyclists cannot reasonably be offered as grounds for eliminating helmet laws.

Charles Tator: It is true that helmets reduce the ability to hear sounds, especially in the range of the human voice. This is a definite shortcoming with helmets such as ski helmets when you might not hear someone overtaking you from behind. However, skiers should be aware of this shortcoming, and does not count very much in terms of the helmet's value in preventing death (Natasha Richardson should have worn a helmet).

Gerry Wilde: Comment on Neil FitzGerald: Could I extend that question to comparsions between soccer and other contact (i.e. colision, concusion) sports?

Charles Tator: Injury prevention in sports such as football and hockey require a large range of injury prevention measures including respect, education, and rules enforcement, and no one ever said that helmets can do the job alone.

Jeff: Sorry, to continue, also, hockey and football helmets are not designed to protect against concussions. Dr. Tator knows this, as does Hockey Canada. Fortunately, there is a helmet technology in development that dissipates impact energy when the impact is severe enough. This might be something that will give parents more 'peace of mind' since this actually attempts to prevent concussions, and not just stop skull fractures. You have to a a sacrificial component to the helmet, just like airbags in cars are sacrificial.

Charles Tator: Rugby has its own specific measures for injury prevention. Rules against the collapse of the scrum have been very important for preventing broken necks and other injuries.

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