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The Helmet Update

Volume 14, Issue 1 - September, 1996
BHSIDOC#588
Previous Issue: December, 1996




First Results of the Harborview Study !

Drs. Rivara and Thompson, who published landmark helmet research in 1989, have released a first summary of the results of a new study on the protective effect of helmets. They studied 3,390 injured cyclists and concluded that:

  • Helmets reduced the risk of brain injury by 65 percent, and severe brain injury by 74 percent (85% if adjusted as in the 1989 study).
  • Helmets worked equally well for all age groups examined and there was no evidence that a child helmet standard is needed.
  • Helmets worked well in crashes involving motor vehicles.
  • Helmets with hard shells, thin shells or no shell offer similar protection, but hard shell helmets may offer greater protection against severe brain injury. There was no effect on neck injuries.
  • Helmet damage was more often to the edge of the front portion of the helmet than any other site. Helmets did offer some facial protection.

    About 30% of the cyclists with severe brain injury were helmeted. The authors offer possible explanations, including poor fit (which they found to increase the risk of head injury by a factor of two), impacts outside of the protected zone and energy exceeding the design threshold of protection. About half of the helmets were damaged at the edge, indicating some need for protecting a greater area of the head, and possibly explaining why a hard shell helmet may offer more protection.

    The study's authors recommend that all cyclists wear helmets, that the addition of facial protection be considered, that additional coverage be provided, that fast cyclists consider protective clothing similar to that used by motorcyclists or ski racers, that educational campaigns and laws be used to increase helmet use and that environmental changes such as safer roads and separate bike lanes should be explored to reduce the frequency of crashes and the involvement of motor vehicles.

    While it is useful to confirm the results of the 1989 study, this research can provide additional results not yet covered in this initial summary. Seniors, who may need less dense foam in their helmets, are lumped in the "over 40 group" for this first writeup. While the summary indicates that there was no evidence based on severe brain injuries to support a separate child standard, it does not establish whether or not current child helmets are optimal. The fact that there was little helmet damage associated with some of the brain injuries may indicate that helmet foam is too stiff in addition to the fit problems the study mentions. There were only 15 helmeted cyclists with severe brain injuries, too few to determine with statistical significance if hard shells are really superior. The finding that neck injuries were not affected by wearing a helmet, or by what type of helmet it was, should lay that question to rest. There is clearly more to come from this important and well-done research project.

    The Snell Foundation, who funded the research, has the full study up on their server.


    Helmet Resource Center to Open

    This July note from Phil Graitcer of the World Health Organization's Helmet Initiative:

    Emory Injury Prevention Center, Atlanta GA: Emory in partnership with Egleston Children's Health Care System is establishing a program of the WHO Helmet Initiative. We will establish at Emory's Injury Center a resource center for questions and information about helmets - promotion, standards, types, laws, etc. Won't be limited to bicycle helmets. Plan to have a manned phone system, initially on a part time basis, with telephone answering and fax back services. We'll open in the fall, after the Olympics.

    Sound familiar? About time we had some competition! We'll be referring callers to them when the subject is non-bicycling helmets.


    Great Ideas: Oregon Video for Police Officers

    Oregon's police have been reluctant to enforce the state's 1994 helmet law. To help them understand its importance, a video was created as a joint venture between the Health Division's Bicycle Helmet Coordinator, the Oregon Department of Transportation and the Oregon Bicycle Helmet Coalition. Claudia Black, who was then Helmet Coordinator, served as producer, and generally made the project happen. The video includes interviews with the Governor and his wife, the Superintendent of State Police, the President of the State Sheriff's Association and the President of the Association of Chiefs of Police. The camera spends time with a head-injured child, and notes that post-law helmet use increased dramatically but not enough. Injuries have been reduced from 95 in 1993 to 70 in 1994, when the trendline had predicted 120. But police and sheriffs can do more. This well-done 13 minute video is too Oregon-specific to just be shown elsewhere, but it is an idea that might be useful in other states. It is available from the Oregon Health Division, and is also available to borrow from the Transportation Safety Section, 555 13th St. NE, Salem OR 97310 Phone (503)986-4190.We got our copy from the Bicycle Helmet Program, Oregon Department of Human Resources, 800 N. Oregon St, #825, Portland, OR 97232, (503) 731- 4399. We have that one copy to lend. [This article edited for the Web after paper copies were mailed.]


    "Toy" Helmets Appear on U.S. Market

    A resident of West Virginia informed us that the Value City Department Store in their area was selling "toy" helmets which had no standards sticker and no energy management foam. The helmets did have a sticker warning that the helmet was a toy helmet and not intended for skateboarding, bicycling, etc. But the helmets were on the shelf with the store's bicycle helmets despite the label, and were selling for $2. When this resident approached the manager about the helmets he was told that they would be pulled and sent back. Instead they were moved to the store's closeout table and discounted to 85 cents.

    Can this helmet be sold with bicycle accessories in the U.S. market? Does a sticker of this nature protect the manufacturer against the requirements of the CPSC Interim Rule on helmets? We have asked CPSC's Compliance division to look into this helmet, and the West Virginian sent us samples which we passed on to CPSC. Their staff says the matter is "in compliance proceedings" and they can not discuss it with us at present.


    CPSC Final Standard May be Ready Soon

    The Consumer Product Safety Commission is nearing the end of the process it must follow to publish the national bicycle helmet standard. The main elements still to be determined are the permissible g level for child helmets (250 g rather than the usual 300 g in the draft standard provoked some protests), the required amount of head coverage and whether or not to require reflective tape. The publication of the Harborview study was supposed to bear heavily on the g level question, and CPSC is undertaking a study of nighttime bicyclist conspicuity during which the reflectivity question should be answered. For the time being we understand they are considering in draft the language developed by BHSI, 3M and Reflexite for a reflectivity requirement in the ASTM standard. Meantime, under their Interim Rule CPSC has required that for any helmet to be sold in the U.S. the manufacturer must meet one of seven voluntary standards.


    CPSC Amnesty for Manufacturers Not Used

    Last year we noted that the Consumer Product Safety Commission had announced a program to permit manufacturers to reveal any flawed products they had not reported in the past, without paying any of the usual penalties. The amnesty was available for six months, but CPSC has informed us that no helmet manufacturers took advantage of it.


    ANSI Chooses ASTM for ISO Secretariat

    The Snell Foundation, the current Administrator for the US participation in the International Standards Organization committee on headgear, sent out a ballot to all members of the U.S. Technical Advisory Group to ISO/TC94/SCI asking if they wanted to continue with Snell/ANSI administration or shift to the ASTM F-8.53 headgear committee as the administrator. At issue is the need to press ISO to develop a bicycle helmet standard which would bring the many current national standards closer to convergence. At present they are going their separate ways, with many parameters either differing significantly or actually conflicting with those adopted by other national standards bodies. Consumers will suffer if the standards create barriers to trade and their only helmet choices must come from their own national suppliers.

    The ballot was accompanied by letters of support from various sources, mainly manufacturers supporting ASTM and Channing Ewing of the Snell Board supporting Snell. The winner will be the U.S. Administrator for the TAG and will then apply to ISO to head up the committee.

    We returned our ballot supporting the ASTM solution. The Snell Foundation has a long and distinguished track record in this activity, and Ed Becker is as competent a helmet standards developer as can be found, but ASTM has its priorities more directly in line with making progress in ISO, and we think it is the better choice. A large majority of committee members agreed. The next step is up to ANSI's staff.


    ASTM Standard Revisions Stalled

    ASTM's F-8 Committee has been working on a number of changes to its bicycle helmet standards, but has been largely unable to make progress due to a combination of editorial problems and philosophical differences between committee members. If this wording seems familiar, it is probably because it is exactly what we said last year. We will report when ASTM actually achieves final approval of changes or new standards. At present there are a number of items in the works, including a rolloff standard, an inline skating standard, a downhill bicycle racing standard, a reflective surface requirement for bicycle helmets, a roller hockey standard and a number of technical revisions.


    ANSI Slow to Adopt ASTM Standard

    As we reported last year, the ANSI Z-90.4 bicycle helmet standard passed its 10th birthday on December 31, 1994 and was "administratively withdrawn" by ANSI. The Z-90 committee met twice and in May of 1995 approved the adoption of the ASTM F-1446/F-1447 standard as the ANSI standard, updating the entire ANSI standard in one action. Harmonizing the two standards could eliminate a source of confusion for consumers and reduce the amount of repetitive testing needed. Unfortunately the follow-up on the committee vote has been very slow, and ANSI does not yet have the update in place.


    Canadian Standard: Lower g's for Children

    The biggest news in standards this year is that CSA has adopted a new Canadian child helmet standard with much lower g levels than the usual 300 g used in all current U.S. standards. The new Canadian standard requires that helmets keep g levels recorded in the headform to no more than 200 g when helmet and headform are dropped from a height of 1.5 meters onto a flat anvil, representing the most likely crash surface. At 1.0 meters on the cylindrical anvil the maximum reading permitted is less, only 150 g. At the same time, the Canadian standard reduces the dropped mass for the smallest child headform to 3.1 kg rather than the U.S. requirement of 5.0 kg. This has the effect of reducing the energy in the test crash but requiring a softer landing for the head, which should result in less dense foam in Canadian child helmets. This provoked a statement by the Snell Foundation that the change was too radical, and had not been justified by research data demonstrating the need for change. (Snell itself has no child helmet standard.) The Canadians acknowledge that many current child helmets will be too stiff to pass the new standard, but believe that child helmet foam is in fact much too stiff for optimal protection.


    Study Recommends 200 g Fail Point

    A recent study by an Australian-German team has concluded that current standards are setting their injury threshold too high. The study was done by McIntosh, et al, and is titled "An Evaluation of Pedal Cycle Helmet Performance Requirements." It concludes that current 300 g standards (all U.S. standards) and the 400 g Australian standard (just lowered in 1996 to 300 g) are tolerating far too much impact energy to the wearer's head. Injuries were found to occur at much lower levels, averaging only 180 g, as opposed to the old data which indicated that up to 400 g did not cause injury. And testing of current helmets showed the good ones to all be easily capable of meeting a much lower g standard. The team recommends lowering the permissible g level to 200 g.


    Study Suggests Laws Work - Maybe

    A new study published in July in the Archives of Pediatric and Adolescent Medicine reports (according to the Washington Post--we haven't seen it yet) that a survey of Georgia parents indicated large increases in helmet use after the state passed a child helmet law. Parents were surveyed a month before the law went into effect in 1993 and over a five month period after. Those reporting that they owned a helmet for their children went up from 39% to 57%, while positive responses on the question of whether or not the helmet was being used increased from 33% to 52%. The authors concluded that awareness of the law was a key factor.

    There are some red flags here. Where did they find a sample with 39% already owning helmets before the law was passed? Maybe they really measured 39% saying yes, whether they owned a helmet or not. And would you expect that percentage to rise after a law is passed and a negative response indicates you are breaking the law? And would you expect awareness of the law would be a key factor in deciding whether or not to say yes regardless of helmet ownership?

    We continue to believe that the only valid helmet surveys are field counts.


    Austin Dissidents Organize Helmet Law Protest

    Opponents of the Austin, Texas, all-ages helmet law organized a protest on July 11th against the new city ordinance. They have continued to protest since, and the City has considered minor modifications to the law to placate them. Politicians in most other states and cities have limited their helmet laws to children to avoid antagonizing adults. In September Austin agreed to permit medically-necessary exceptions to the law with a physician's statement approved by the city's health department.


    Bell Returning to Financial Health?

    Bicycle Retailer and Industry News reports that Bell Sports, Inc has begun to improve its financial performance following its spurt of acquisitions. Bell now owns Giro, SportRack, American Recreation, Blackburn, Rhode Gear, VistaLite and CycleTech, plus some others. Consolidation of both its U.S. and Canadian operations permitted the company to show its first profit in recent years, totaling $624,000 in the quarter ending March 30. We have links to Bell's current stock price and financial reports on our Web server.


    British Columbia Helmet Law Covers All Ages

    The Canadian west coast province of British Columbia has passed a helmet law effective September 3rd requiring helmets for all cyclists on public roads. Parks and bike paths are not covered, but may be added by individual municipalities. The law provides for a "rigorous" education and awareness campaign. The fine for non-compliance is $25. Children will not be ticketed, but their parents can be. The law specifies the same seven standards used by CPSC for its Interim Rule, unfortunately including ANSI Z90.4-1984, which is outdated and much too easy to meet.

    We are enclosing with this issue our current list of helmet laws.


    UK Articles Debate Helmets: For and Against

    The March issue of the UK's Child: care, health and development has articles on Children and Cycle Helmets: the Case For and the Case Against. The case against concludes that helmet statistics may reflect other factors than just helmet effectiveness, since parents who buy helmets for their kids may also supervise them better and make sure they are in a safer environment. (In UK terms that is summed up "Child accident rates and the wearing of helmets both have a steep social class gradient.") The author also believes that cars are the main risk to child cyclists, that children should be able to ride in safety, and that "A profound change in the habits of adults is needed, rather than suits of armour for children." Some interesting ideas there.


    German Magazine Launches Helmet Promotion

    The German magazine Bike has launched a six-issue helmet promotion campaign, complete with their own magazine coverage, TV spots and more hoop-la. Sponsors for the campaign include Bell, Giro, Louis Garneau and Sachs. The campaign opened with the May issue and is limited to Germany.


    BHSI News

    We are alive and well. You will find this newsletter, our latest annotated bibliography, our Toolkit for Helmet Program Organizers, our helmet standards comparison, statistics and a lot of other helmet stuff on our Web server at http://www.bhsi.org. We still have our 24-hour interactive Fax on Demand service at our regular voice and fax phone number, (703) 486-0100. Faxes available include the most-accessed documents on our Web server. Our next newsletter will include an update to our Annotated Bibliography, a report on helmets for the 1997 season, and perhaps even a report on the final CPSC national bicycle helmet standard.

    Randy Swart
    Director



    The Helmet Update
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    Bicycle Helmet Safety Institute
    4611 Seventh Street South
    Arlington, VA 22204
    (703) 486-0100 (voice or Fax on Demand)
    Internet email: info@helmets.org
    Web Server: http://www.bhsi.org




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