September 5, 2014
Below we provide mainly some number coming from , using a data base; the “registre du Rhone” (Lyon district, France); recording detailed information for 14 478 cyclist victims of road accident in the Rhone county (France). The data under studies have been collected from 1996 to 2007. The level of detail is very high compared to some other data base, and they can help to clarify the helmet debate:
see wikipedia for the AIS and IIS definition and meaning
Injured Body part among cyclists
reported numbers are only for cyclist where the helmeted/unhelmeted status is known
|helmeted 1461||unhelmeted 5620||helmeted 1461||unhelmeted 5620|
This table shows that the helmeted cyclist are less often severely injured to the head, less often injured and seevrely injured to the face. But they are more often injured and severely injured to the Thorax and spine, and more often injured to the upper extremity. This suggesthelemeted cyclist get involved in more severe accident. 2 reasons can be advanced for it
- Helmeted cyclists have a different cyclist practice that non helmeted one (that relate to the infamous MAMIL)
- There is a risk compensation at play along helmeted cyclist
the effect of it is to give an over estimate of the helmet efficiency
The figure below illustrates the % of head injuries oberved for injuried cyclists with an helmet and without:
So we are looking at a global effect of 1%, but severe head injuries can have long term disabilities consequence, so a reduction by 50% of severe head injuries could be considered a worth endeavour:
Below a more detailled view of the head and face injuries specificities:
Head or face Injuried cyclist: type of lesion according to helmet wearing or not
|Helmeted 238||Unhelmeted 1078|
|Unconsciousness without additional descripted lesion or head trauma without further indication||194||73,5%||668||49,3%|
|Destruction skull and brain||0||-||2||0,1%|
In despite of a pretty huge database, significativity is not reached on many lesions types.
According to , Among the 222 cyclists injuried to the skull or its content
- 30 are dead
- 42 will have severe heavy brain disabilities (IIS3) – that represents 0.3% of the injuried cyclist
- 146 will have light brain disabilities – that represents 1% of the injuired cyclist
The effect of the helmet on long term disabilities seems to be measured on a very small cohort:
|unhelmeted 35||helmeted 3|
|%fatalities among total injuried||0,3%||-|
|%fatalities among head injuries||1,4%||-|
|Severe head disabilities (IIS3+)||20||3|
|% Severe disabilities among total injuried||0,4%||0,2%|
|% Severe disabilities among head injuried||1,9%||1,3%|
|% Other severe disabilities in addition of severe head disabilities ||19,8%||21,4%|
Again, we don’t reach significativity to be able to conclude that a “bike helmet saves life”, but it could well reduce significantly the risk of severe head disabilities. The number could suggests 50%, but again with very little confidence.
In anycase, the effect is measured in tenth of 1% of the total injuries: the absolute number of victim is very small.
How bike injuries compare to other transportation mode?
When involved in an accident, cyclists have the lowest fatailities rate compared to other individual transportation mode. They have also the best chance to survive an accident without long term disabilities. Urban cyclists are even much safer than rural or suburban cyclists:
|Injury severities||Uurban 6584||Rural 1726||0-10years 3364||Pedestrians 10131||car 53151||Mopette Motorbike 21831|
|MAIS 4 and 5||0,9%||2,0%||0,3%||2,3%||1,0%||1,5%|
|light diabilities (MIIS1-2)||20,2%||23,8%||11,1%||29,6%||42,8%||23,8%|
|severe disabilities (MIIS3-6)||0,6%||1,2%||0,2%||1,6%||0,7%||1,3%|
When urban cycling is considered alone, helmeted cyclists are observed to have 20% less chance to be severly injured that non helmeted one, whenever involved in an accident, however significativity is not reached .
The figures below eventually help to compare the different pattern of injuries, according to transportation mode, and eventually relativize the impact of a bike helmet on the total number of both severe head injuries and severe disabilities.
those figures provide absolute numbers for the Rhone district (1.7Millions) inhabitant for years 2007-2010…
Even if a bike helmet is able to reduce the severe head injuries and disabilities, by 50%, the saving in term of public health could be relatively insignificant but the more generalized economic cost can be real: It has became clear that an helmet legislation is counterproductive, but even promotion campaigns in favor of bike helmet could be counter productive:
- The money spend on helemet couldn’t justify the health care saving, and could be better invested somewhere else
- Helmet campaign promotions paint cycling as a dangerous transportation, discouraging people to cycle, conducting to a less healthy population
One could object that a low absolute bike injuries number is due to a relatively low cycle ridership. The dramatic increase in cycle ridership over the last decade, especially in urban area, is well documented, and still the number of total injuries has not increased but is decreasing :
The more people bike, the more a bike helmet becomes irrelevant…unless you believe pedestrians should wear an helmet too!
More citation to come
 Vélo et casque, Journée spécialisée, jeudi 28 mai 2009, Rapport UMRESTTE 0908, May 2009
 doesn’t express it like it, but I am assuming it is due to a typo.
September 3, 2014
The strong bike helmet lobbying push seems to have started with a widely quoted 1989 paper from Thomson & Rivara,  that makes the bold claim that:
“we found that riders with helmets had an 85 percent reduction in their risk of head injury … and an 88 percent reduction in their risk of brain injury”
That finding has been a foundation for helmet legislation calls. Alas, after legislations were passed, be in Australia or in BC, leading to a significant increase in helmet wearing , numbers suggested by  never materialized . Worse, the bike helmet legislation seems to have no impact on bicycling safety , the later study justifying a British Medical Journal editorial advising against helmet legislation .
It quickly appeared that  had many flaws as debunked in , and effectively recognized in a BMJ editorial  …That has not prevented an author of , Rivara, to publish many more papers always claiming impressive efficiency for bike helmet, but always presenting similar flaws as identified in  (confounding factors) . A meta study published in 2001, , was also associating bike helmet with an impressive 64% reduction of risk of head injury and  confirmed those results and reported even more impressive reductions in the risk of head injury. Alas the studies included in both  and  have been demonstrated to be the result of a severe selection bias. After correction of this selection bias,  found that a bike helmet was reducing the risk of head injury by ~15%. The US National Highway Traffic Safety Administration (NHTSA) dropped claim that bike helmets reduce head injury by 85% as this number has no credible basis.
While initial claims on the head injury risk reduction offered by bike helmet has been proven unfounded, and bike helmet legislation shown ineffective at increasing bike safety, it appears that such legislation could discourage cycling , what is eventually conductive to lower bike safety and less physical active population with detrimental effect on the population health . Overall, a bike helmet legislation can quickly be considered as having a negative impact on public health . Wherever more general economic impact is considered, the picture can become even bleaker .
In despite of the above, the bike helmet controversy has side tracked the research community…which focuses more on the way to mitigate the consequence of bike accidents rather than addressing their causes. As an example, several studies have reported an alarming rate of alcohol intoxication among injured and deceased cyclists, but the helmet lobby has totally seized the debate to a ridiculous point:  observing that half of the cyclists who died in Oregon, were alcohol intoxicated, has -in fine- no better recommendation than promoting bike helmet…among drunk cyclists!
It also take considerable energy by cycling promoters to counter misleading claims advanced regularly by the bike helmet lobby. A recent example below:
Following the publication of , The University of Washington and Washington State University, issued a press release titled “Study correlates presence of bike-share programs with more head injuries” stating :
“Risk of head injury among cyclists increased 14 percent after implementation of bike-share programs in several major cities ”.
The journalists, who are not epidemiologists can’t be reasonably blamed to reporting what is told to them by some unscrupulous researchers, considering that the study has been published, after a peer review (How to argue against that?). However in despite of evidence of misrepresentation of facts reported in various social media, they didn’t issued appropriate correction to their original story (and have preferred to close the comment section) and that is a fault.
The unscrupulous researchers can certainly be blamed for their absence of ethic:
We will pass on the unprofessional self promotion of the previous authors’ publications, such as the now well discredited , this, in no uncertain term:
“Solid data from well-designed studies support the effectiveness of bicycle helmets and legislation mandating their use”
As we have seen, that can’t be farther from the true, but the real problem is the thrust of the article and a misplaced conclusion, as well exposed by 
However, the bulk of the blame should go to the American Journal of Public Health editor; Dr. Mary Northridge; to have accepted to publish what appears to be a scientific fraud. Such an article should have never been accepted under such a form and it has clearly not been properly peer reviewed:
Peer reviewing to work, suppose trust in the ethic of the authors (no intention to deceipt…), however, just the name of the authors should have already been sufficient to raise an eyebrow: Frederick P. Rivara, not stranger to deeply flawed studies and scientific controversy, is considered by many as nothing more than a charlatan; noticeably for reason exposed above; and considering this infamous record, the minimum of precaution could have been to choose at least some reviewers showing more scrutinity ability than complacency.
The minimum the American Journal of Public Health can do is to issue a correction, clearly stating the observed reduction in head injury in cities having a public bike share program as pointed by K. Teschke , this in a proeminent place and endorsed by its editorial board
In the meantimes, this episode will have helped to make clear how deep is the lack of ethic among the bike helmet supporters, to the point to even embarrasse some of them . It will help to convince more people to be not only very critical of the bike helmet lobby claims, but also aware that a peer review process is unfortunatly not synonym of quality.
 “A case control study of the effectiveness of bicycle safety helmets “, Thompson RS, Rivara FP, Thompson DC , New England Journal of Medicine v320 n21 p1361-7; 1989
 “Effectiveness of bicycle safety helmets in preventing head injuries: a case-control study “ . Thompson DC, Rivara FP, Thompson RS., JAMA 1996 Dec 25;276(24)
 Helmets for preventing head and facial injuries in bicyclists. Cochrane Review. Thompson, D.C., Rivara, F., Thompson, R., 2009. The Cochrane Library (1), 2009
 Bicycle helmet efficacy: a metaanalysis. Attewell, R.G., Glase, K., McFadden, M., Accident Analysis and Prevention 33, 345–352, 2001.
 Publication bias and time-trend bias in meta-analysis of bicycle helmet efficacy: A re-analysis of Attewell, Glase and McFadden, 2001. Accident Analysis and Prevention 43 1245–1251, 2011
 Head injuries and bicycle helmet laws, Robinson DL, Accid Anal Prev. 1996 Jul;28(4):463-75.
 “Bicycle-related head injury rate in Canada over the past 10 years” ,Middaugh-Bonney, T.; Pike, I.; Brussoni, M.; Piedt, S.; MacPherson, A. ; Injury Prevention 16: A228 2010
 Helmet legislation and admissions to hospital for cycling related head injuries in Canadian provinces and territories: interrupted time series analysis.Dennis J, Ramsay T, Turgeon AF, Zarychanski R. BMJ 2013
 Bicycle helmets and the law, Wellcome G. And Spiegelhalter Winton D., BMJ 2013
 misguided doctors or marketing agents? June 11th, 2012, Cyclists Rights Action Group
 The Health Impact of Mandatory Bicycle Helmet Laws, de Jong P. ,Risk Analysis, Vol. 32, No. 5, 2012
 New Zealand bicycle helmet law—do the costs outweigh
the benefits? Taylor M. And Scuffham P. Injury Prevention 2002;8:317–320
 Bikes, Helmets, and Public Health: Decision-Making When Goods Collide. Bateman-House A. ; American Journal of Public Health ; Vol 104, No. 6, June 2014
 Injuries Resulting from Bicycle Collisions Frank E, Frankel P, Mullins RJ, Taylor N. Academic Emergency Medicine, Volume 2, Issue 3, pages 200–203, March 1995
 Few study exist – except maybe  suggesting that the social cost of outfitting every cyclist with an helmet was not economically justified – But as far as we know, there is no comprehensive study examining the implication of transportation mode substitution, under a transportation economic perspective (time saved or not, infrastructure cost…)
 Bicycle helmet use in British Columbia, Foss RD, Beirness DJ, UNC Highway Safety Research Center; Traffic Injury Research Foundation, as cited by cyclehelmet.org
 Bicycle helmet legislation: Can we reach a consensus?, Robinson DL, Accid Anal Prev. 2Volume 39, Issue 1, January 2007, Pages 86–93.
 Public Bicycle Share Programs and Head Injuries; Janessa M. Graves, Barry Pless, Lynne Moore, Avery B. Nathens, Garth Hunte, and Frederick P. Rivara.; American Journal of Public Health: August 2014, Vol. 104, No. 8, pp. e106-e111
 “Study correlates presence of bike-share programs with more head injuries” College of Nursing; Washington State University, June 9, 2014
 “As if we needed another example of lying with statistics and not issuing a correction: bike-share injuries”, Phil Price, andrewgelman.com, June 17, 2014.
 “Hard Evidence: do bikeshare schemes lead to more head injuries among cyclists?”, Woodcock J. and Goodman A.; Theconversation.com ; August 28, 2014
 Health effects of the London bicycle sharing system: health impact modelling study, James Woodcock, Marko Tainio, James Cheshire, Oliver O’Brien and Anna Goodman. BMJ 2014;348:g425
 letter to American Journal of Public Health Editor, Dr. Mary Northridge, by K. Teschke and M. Winters, June 24, 2014
April 25, 2014
This blog uses many reference documents, sometimes not available online except thru this blog: This post gathers those “odd” documents and is aimed to be updated whenever needed.
- Rail Rapid Transit for metropolitan Vancouver, study by the Province of British Columbia, 1962
- The Erickson/Massey plan, commissioned by the Vancouver art council, 1966
- “Beat the Traffic Rush”, The case for rapid Transit, Alderman Harry Rankin, Vancouver 1971
- A Rapid transit study for Burrard Inlet, William H. McCreery, Vancouver, B.C, circa 1972
- Draft memorandum on transit service planning to complement downtown peninsula plans of the City of Vancouver, Bureau of Transit Services, BC Minister of Municipal affairs, Sept 19, 1975
- Environmental Assessment Certification Application for the Richmond Airport Vancouver Rapid Transit Project, December 2004.
- TransLink’s Rapid & Regional Transit Model , PTV America Inc. and Translink, Vancouver and Wilmington, DE, February 2007 and December 2008
- Expo line upgrade strategy, SNC Lavalin, May 2012
- referenced in the post “Rail Rapid Transit for Vancouver in 1962″
- This document focusing on the Block 61 has been presented in “Vancouver 1966: The Erickson/Massey proposal for block 61 and the Downtown core “
- Extensive verbatim is done in “The Case for Rapid Transit…in 1970″
- It is a monorail proposal across the Burrard Inlet
- The key points of this document are presented in The Downtown Vancouver Bus Service vision in 1975
- It is a 144MB zip file
October 9, 2013
A brief historical context is available here
The war on buses is continuing.
The City of Vancouver is losing no occasion to attack the downtown bus system:
Even when a design doesn’t need to threat transit, City of Vancouver can’t refrain to do so:
The site analysis, while showing permanent bus stops on Burrard, and temporary ones on Howe, fails to show a single bus stop on either Robson or Granville. Also surprising is the lack of mention of any major transit corridors in the vicinity (Granville is not considered as such!).
That could be due more to ignorance of the site and unfamiliarity of the bus network by the design team, than malevolent intentions. Nevertheless, the result is still a deceptive material, raising questions on the openness and good faith of the city of Vancouver in regard of the Down Town bus service review.
(why go thru the exercise, when it is all decided as eventually suggested on the left?)
Passing the above provocation, which eventually left little ambiguities on the city intentions if it was any doubts left after the disastrous “block 51 consultation” in fall 2012 , let’s have a look at the proposed designs
Since the VAG is poised to move to Larwill park (Cambie#Georgia), in a relatively near future, the purpose of the exercise is a bit futile, but as the underground vault below the square is leaking: work on the plaza needs to happen as soon as possible. That somewhat can explain the relatively low profile adopted (e.g. no design competition) for one of the most important place in Vancouver, which, potentially temporary, facelift is budgeted at $3 millions. 3 options are presented to the public:
The focal point of the square is obviously the Rattenbury building, and any design should be driven at making the best of this heritage building. This Plalod ring, not only ignoring the Rattenbury building, but also diminishing it, is probably out of place on the North Plaza. One could also infer, it could create some problem for some events. (lighting issue, and sound reverberation).
The fact that it is considered by the design team, and is a favorite with the public  is eventually one reason of despair of the Vancouver culural and urban scene:
Someday, they will propose to demolish the Rattensbury building to increase the size of the north Plaza!
The goal of it is unclear: bring some intimacy to the square?… square being surrounded by traffic sewages on 3 of its sides, that looks:
- A loosing battle
- and an unnecessary one, since the spaces north of Robson street fulfill this need
All those “edges” seriously limit the versatility of the place, think the Vancouver Sun Run:
The fountain along Georgia, seems more inspired by the current “centennial fountain” than anything else. As much as the current fountain, it creates a psychological barrier to the Rattenbury building access. It is worth to note, that a fountain used to sit along Georgia (and is now along Hornby: it is also surprisingly misisng of the site inventory). Why not put restore the historic fountain in its original location?
The site inventory notice a bus stop at the foot of Howe street, so this design turns its back on Howe, and erect a “wall” there, preventing the transit users to be part of the square life…enough is said!
May be the rendering is not making justice to the design, which in some sort is reverberating an early Erickson concept for the square: it doesn’t seem to encouter a great public adhesion , but it is by far the best option among the proposed ones:
- It is the most able to address the formalism and ceremonial aspect of the square
- while offering a versatility of use, and still not offering an empty place
That is the purpose of such a mirror in Bordeaux, and more recently Place de la Republique, Paris, a huge “demonstrating” square, as we have seen before, that said:
- Does the water mirror, need to cover all the square?
- Does the water mirror, is a necessary feature on the North Plaza?
probably not, since it hinders other spontaneous activities
may be, may be not: the square is somewhat small, and a proper surface treatment and other urban furnishings, can be enough, to both compliment the building, and enlivening the square.
And The red carpet
All presented proposals seem to be relatively weak, focusing more at addressing the need of a 3 days Jazz festival, rather than addressing the place itself. As such they are relatively uninspiring, especially when compared to the “red carpet” as presented by Hapa collaborative, at the “Where’s the square?”, VPSN design competition.
The surface treatment
All design are based on “Hard landscaping” landscaping because it is “more durable and long lasting”: If Granville mall, where the city believes an outstanding job has been done, is an indication, one should not hold his breath on it. Since, the setting could be temporary, the city could be well inspired to use a compacted fine gravel surface, which has the merit to be much cheaper than a good quality hard surface, and easy to recycle, whenever a new arrangment of the square is required by a different use of the Rattenbury building.
And why not also keep the space as a blank page?… pretty much like Place Bellecour in Lyon, France, which Viva, or other group could program (instead of organizing a blockade on bus routes), and revisit our options when we will have more clarity on the future use of the Rattenbury building?
 see “block 51” public consultation, which has left a sour taste with many observers, as we have already noticed here and there. In despite of all evidences, VPSN, a group advocating for aggressive pedestrianism and co-organizeer of the block 51 consultation, unsurprinsingly and sadly, still believe it was a good consultation.
 According to a poll by Vancity buzz (3 stunning design revealed for new Vancouver art Gallery North Plaza, Kenneth Chan, VancityBuzz, Oct 1st, 2013), 65& of its polled prefer the “plalo Ring”, while 20% prefer the “wet” concept, with 8% liking the “active edge” one.
 flickr user hisgett
 This is paraphrasing Victor Hugo, whose famously said, “somedays, they will destroy the cathedral Notre Dame, to increase its parvis”, about the Haussmann work in Paris
August 29, 2013
Only one week-end before back to school: it is time to draw some conclusions when memory are still fresh on the Viva Vancouver 2013 season
Judging the Viva programming is certainly a question of view point:
Some minor projects here and there, like the park-lets or the public pianos, are certainly positive actions for our public spaces, but the Viva signature projects will be on Robson square and Granville street. It is the focus on in this post
For some, the Viva 2013 program will be considered as a tremendous success:
- Closing Granville Mall to bus, for the sake to provide space to a for profit car company subsidiary, is a noticeable achievement
For others, it will be considered simply as disappointing, if not a failure:
This Year flagship installation, Corduroy Road at Robson square, was providing some seating using warm material, bringing the street partially at level with the sidewalk. Alas, as noticed before by Stephen Rees, it never get used much more than a glorified foodcourt, and beside lunch time, the place was looking too empty to be attractive :
- The installation itself, providing little interactivity, at the difference of the very popular 2012 PopRock, or the 2011 Picnurbia, could be at cause.
- The fact that both side of the 700 block of Robson street are going under renovation, was not helping either
But more probably, the “Olympic atmosphere” memories which people could have been looking at when wandering on the Vancouver street in the previous summers is simply fading, and the interest for the programming of our public spaces is disappearing. More simply, there is not enough pedestrian traffic to “fill-up” the offered space, which is too big considering the pedestrian traffic .
That is a disappointment. A particularly sunny summer makes it even bitter.
It becomes a significant failure, when the goal is to demonstrate the viability of a year round closure, and in despite of a generous funding, Viva was not even able to meaningfully program the space it seized, for the 2 most favourable months of the year: Presenting a “car2go” booth as a way to program our public space, has turned the experience into a farce, to not say a full scale fiasco.
The conclusion on the viability of a permanent Robson square closure should be obvious, and the last year experiment- keeping Robson square pedestrian only during the fall 2012- should have given hints:
Where are the people?
As we have mentioned before, the Vancouver geography of public spaces has changed with the introduction of the Canada line: The Georgia#Granville intersection (and more specifically the plaza in front of the London Drugs) has replaced Robson Square as a major Vancouver’s focal point. That reminds us the importance of transit as it comes to define the geography of the city public space, and pedestrians activity, this for the best and the less good:
Transit, and transit users need to be accomodated, not hidden, and if the City of Vancouver is true to its transportation 2040 plan, the “problem” illustrated above will become more acute in the future: It should be addressed and not made worse.
We eagerly await the return of the bus 5 on its historic route and hope reason will prevail at City Hall
 Robson street is 80′ wide. There is virtually no example of pedestrian only street in Europe with such width. New York Broadway Avenue, at ~80′ wide, could be the closest, but the pedestrianized block around Times Square see a traffic of 350,000 pedestrians/day