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Bicycle Helmet Safety Institute

An article from the
London Sunday Times.




Summary: This article covers one of a series of injuries and deaths in European pro cycling that led to the adoption of the UCI's helmet rule years later.




The Sunday Times

July 23,1995.

The hard truth behind a waste of life

Fabio Casartelli may not have died
if he had been wearing a helmet.

Richard Weekes on the disturbing
facts behind a Tour tragedy


OFFICIAL accounts of the head injury that killed Fabio Casartelli on the 15th stage of the Tour de France last Tuesday were misleading.

The third death of a competitor since the Tour began in 1903 caused shock among the riders and embarrassment to the organisers. From the outset, race officials sought to head off speculation that the 24-year-old Casartelli's life might have been saved had he been wearing a hard protective helmet.

Gerard Porte, the Tour's senior doctor, claimed that the question of protection was academic since the fatal blow was to an area of Casartelli's head that would not have been covered by a helmet.

But Michel Disteldorf, the French doctor who examined Casartelli's body on behalf of the coroner in Tarbes, where the rider was flown by helicopter after he crashed while on a fast descent in the Pyrenees, told The Sunday Times that the point of impact was on the top of the skull.

Disteldorf said: "There was a small but very violent impact to the top of the skull a few centimetres to the left of the central axis. Contrary to several reports, there were no facial injuries. The impact caused several fractures within the cranium, causing blood to emerge from the nose, ears and mouth." Disteldorf added that had Casartelli been wearing a hard helmet "some injuries could have been avoided".

Although Casartelli was accustomed to wearing his Motorola team's standard hard-shell helmet, the Specialized Air Piranha, on mountain descents, two factors might have led to his decision not to use it as he began the 4,000ft descent from the Col de Portet d'Aspet. The first was the extreme heat in the Pyrenees. The second, according to Massimo Testa, the Motorola team doctor, was that "Fabio saw it was a short descent, and then there was quite a long climb on the Col de Mente. Perhaps he thought that, for a few minutes, it wasn't worth the bother."

In the middle of the peloton, Casartelli prepared to take a left-hand bend, flanked on the right-hand side of the road by square concrete blocks designed to prevent cars skidding off into the ravine. Suddenly a couple of riders fell in front of him. Casartelli was thrown off, and slid on his left side towards the precipice.

While other riders involved in the collision suffered back and leg fractures, the Italian's misfortune was that his momentum was broken by the impact of his head on one of the concrete blocks.

The facial bleeding initially led Porte to say: "In my opinion, a helmet would not have helped, because it was his face and not his head that was hurt. He later changed his statement, saying: "I do not believe a helmet would have saved him because the blow was to the base of the skull rather than the top of the head."

Since Testa persuaded the forensic doctor in Tarbes not to perform an autopsy on the grounds that the cause of death was clear, the only record of Casartelli's injuries lies in Disteldorf's report to the coroner. But Testa echoed the Porte line on helmets, saying that even with his usual helmet "he would not have survived".

The riders showed solidarity with their fallen colleague by allowing the whole Motorola team to cross the line first on Wednesday's stage, repeating a gesture made to Tommy Simpson's team after the Briton died on Mont Ventoux in 1967, but few cared to challenge the official line.

On Friday, the day after Casartelli was buried in his hometown near Lake Como, Marino Lejarreta, of Banesto, said: "It's a personal thing. There's only a certain degree of danger that you can avoid."

Helmets remain a sore point with Tour riders. Although they are compulsory for professionals in Belgium, Holland and the USA, they are discretionary in France and Italy. When the International Cycling Union (UCI) last tried to enforce their use in France in 1991, a strike by Tour riders, who claimed they increase the risk of heat stroke, forced the ruling body to back down.

Hein Verbruggen, the UCI chairman, has no wish for another fight: "We have indicated the risk to the riders, but I believe that if you can't apply certain rules on people it is better to drop them."

One common fallacy repeated in cycling circles is that heat lost through the top of the head is disproportionately high. Research by Prof William Keatinge, head of physiology at Queen Mary and Westfield College, has shown that, though that is true in a cold environment, the rate of heat loss from all exposed parts of the body in hot conditions is even. "The answer for a cyclist using a helmet is to have low insulation on all parts of the body and to wear light, permeable clothing," he said.

A glance at the helmet ads in the cycling press shows manufacturers need no prompting on the professionals' demand for maximum ventilation. Airblast, Air Wave and Air Piranha are just a few of the brands on the market. Advances in design include the use of breathable fibres inside hard-shell helmets to reduce moisture build-up and a reduction in their weight to around six ounces. However, as Brian Walker, European director of testing for Snell, the safety standards body, observed: "There is always a trade-off between safety and the needs of the competitor."

Ultimately, risk-taking in dangerous sports must be a decision for the individual. Britain's Tony Doyle, 37, twice world track champion, tells how a life-threatening accident changed his view on helmets. In 1989, in the Munich six-day race, a mistake by a Russian rider sent Doyle crashing headfirst on to the concrete infield.

"I suffered multiple fractures and bruising to the brain. When you come back from something like that, you realise that safety must come first. You owe that to your wife and family. Now, even just going down the road to post a letter, the helmet goes on. It's second nature, like wearing a seatbelt."




This page was last revised on: March 30, 2005.

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