The Helmet debate and MIPS
I was born in the 1960s and the world was a different place back then when it came to risk assessment and mitigation. I’m not saying our parents at the time were cavalier or reckless, rather no-one knew any better. There was a general societal acceptance of risk that would not be acceptable today. I can recall family camping holidays where my father would pile up the back seat with blankets, sheets and cushions and make a bed on the top for my sister and me to sleep on during the long drive to Cornwall or wherever. No protection and no restraint. Had there been an impact, we would have been propelled forward at high velocity injuring ourselves and the adults in the front seats. I say injuring but the reality is it would probably have been much worse. Fortunately, it never happened but relying on Lady Luck (which is what it was) is not a sensible risk management strategy in any circumstance. The image at the top of this blog post may look rather twee and dated now, but this was no rose tinted world. This is how it used to be and jolly dangerous it was as well!
It became law in the UK to fit seat belts in the front of cars in 1972 but the Government did not manage to make it law to wear them until 1983! Nowadays, it is compulsory for all occupants of a car to wear a seatbelt (unless, rather strangely, the car is reversing). Since 2006, all children have had to be in a car seat and the current Law is all children must use a car seat until they are 12 years old or 135 cm tall, whichever comes first. The world has changed considerably and undoubtedly for the better.
When it comes to helmets for cycling, we are in different place. Even though the Highway Code suggests cyclists should wear a cycle helmet that “conforms to current regulations” there is no law at present to compel someone to do so. We’re not alone. In most countries around the world, it is not mandatory to wear cycle helmets. Australia and New Zealand are two of the few countries to mandate it along with a handful of States in the United States.
In some countries helmets are a requirement for children of varying ages but frequently there are no penalties for non compliance. Often it is the cycling advocacy groups themselves who most strongly oppose mandatory helmet wearing. Their principal objection seems to be that making people wear helmets may put them off cycling in the first place and that the benefits to public health of more cycling outweighs the disbenefit of more accidents. They also say the medical evidence on the benefits of wearing helmets is contradictory.
The Medical Debate
Perhaps surprisingly, there are some mixed medical views. Take Australia again where the wearing of helmets is compulsory. As well as arguing that mandatory wearing of helmets deters people from cycling their way to better health, there have been some claims that the wearing of helmets compounds the risk of increased rotational forces on the brain, causing something called diffuse axonal injury. Diffuse axonal injury is the causing of widespread rather than focused damage to the brain (hence diffuse) and is one of the major causes of unconsciousness and persistent vegetative state following severe head trauma.
More recently though, the medical view in Australia appears to have shifted towards saying that cycle helmets do make a positive difference. A study carried out in 2013 by Michael Dinh, Co-Director of Trauma Services at Royal Prince Alfred Hospital, Sydney, found the risk of severe head injury was more than 5 times higher in cyclists not wearing a helmet compared to helmeted ones. Severe Head Injuries were defined by him as any with significant brain haemorrhage, complex skull fracture or brain swelling. He found 70% of such patients ended up on a ventilator and many are left with permanent brain damage.
The UK Authorities
In the UK, the BMA (British Medical Association) has changed its own position from advisory to the compulsory use of helmets, However, leading advocacy group Cycling UK has long campaigned against the mandatory wearing of helmets. You can read Cycling UK’s views on the subject here. In opposing the mandatory wearing of helmets, Cycling UK contest they are not arguing either for or against the wearing of helmets. Instead, they are arguing against passing a regulation making it mandatory for everyone to wear one. In other words they say it should be down to the individual to decide, there are public health disbenefits of mandatory wearing to be factored into what is a complex debate plus the medical evidence is contradictory.
Such debate is rather discomforting. As adults, we all make our own choices. I will personally wear a helmet when cycling because I can’t see any point in taking unnecessary risks and wearing one doesn’t put me off cycling at all, in fact, quite the contrary. But what if you are a parent and your child is regularly riding a bike, maybe when you are not riding with them. Should you insist on them wearing a helmet or not? How do you decide which is a bigger risk – the risk that some commentators are right and there could be increased rotational forces on the brain if they have an accident when wearing a helmet? Or the risk of generic damage to the skull and potentially severe trauma in any collision if they are not wearing one.
Well a bunch of brilliant Swedish scientists developed a technology twenty years ago which is now becoming more and more prevalent. It addresses directly the question of helmets and the risk of rotational forces on the brain. It’s called MIPS.
What is MIPS?
MIPS stands for Multi-directional Impact Protection System. The story of MIPS began over 20 years ago when a Swedish neurosurgeon, Hans von Holst, working for the World Health Organisation in Geneva, started looking at the general construction of helmets. His research determined the prevalent helmet technology at the time provided for inadequate protection for the brain, especially brain trauma caused by those rotational forces and massive accelerations on violent impact we discussed earlier.
Von Holst joined forces with Peter Halldin, a researcher with the Royal Institute of Technology in Stockholm, Sweden. They combined their years of expertise along with detailed design, analysis and testing to create a patented technology we now all know as MIPS, designed to mimic the brain’s own system for protecting itself from trauma particularly that caused by rotational violence.
The video below demonstrates MIPS Patented technology being used in Bontrager’s helmets.
MIPS provides a liner, separate from the shell of the helmet but connected by a low friction layer. When a MIPS helmet is subject to impact, the low friction layer allows the helmet to slide relative to the head. The result is a helmet system its designers say significantly reduces rotational acceleration on the brain without impacting adversely on the energy-absorbing properties of the helmet overall. Through years of R&D and extensive testing, Halldin was able to demonstrate it was possible to reduce rotational acceleration by nearly 40% but without changing the energy absorbing properties of more traditional helmet designs.
The History of MIPS
From its formal start in 2001, the company MIPS AB moved swiftly from concept to production, initially in the equestrian sector. By 2007 a fully tested product was ready for launch. In 2010, MIPS AB moved into the bike and snow helmet sectors with MIPS technology being increasingly used in skiing, snowboarding, mountain biking and motocross, all sports with heightened risk of head trauma because of the speeds and close proximity to fixed objects.
From 2014 onwards, MIPS has been used increasingly by the world’s leading manufacturers of helmets and by the end of 2015, MIPS AB reached the milestone of producing its 1,000,000 layer. The company continues its growth plans with new and exciting products.
The debate will no doubt continue. Advocacy Groups will presumably continue to argue it’s complex and the individual should decide. Medical groups will no doubt continue to argue (as they did with seatbelts) legislation is required. The Government may or may not act in due course.
At Criterium Cycles, we take the view the wearing of a helmet is a sensible thing to do in all circumstances and whether legislation should or shouldn’t be passed to make it mandatory isn’t relevant – we will always wear one when we are out riding.
As for MIPS though, it does look like a brilliant piece of technology. One area where the medical debate is undoubtedly complex is whether traditional helmets can contribute to the risk of rotational forces on the brain in angled impacts. Van Holst agreed the risk was significant and came up with an elegant solution called MIPS that in our view reduces the ambiguity over whether wearing a helmet is a good thing or not.