Effect Of Helmet Use Research Articles

Comment on “Injury patterns and outcomes in motorcycle driver crashes in the United States: The effect of helmet use”

Comment on “Injury patterns and outcomes in motorcycle driver crashes in the United States: The effect of helmet use”

Estimating willingness to pay for motorcycle helmet and its determinants through contingent valuation method.

Helmet use has been introduced as one of the most highlighted strategies for preventing death and injury in motorcyclists. On the other hand, the cost of the helmet was introduced as a barrier to use. This study aimed at estimating the willingness to pay (WTP) of motorcyclists in Saqqez to buy and use safety helmets through the contingent valuation method (CVM). This cross-sectional study was conducted in 2021 in Saqqez County, Kurdistan Province, Iran. Sampling was performed by two-stage clustering through probability proportion to the size. The sample size was 570. A preliminary questionnaire was designed and administered for validity and reliability approval. Data analysis was carried out through linear regression models using STATA 15. In total, 510 questionnaires were analyzed. The motorcyclists' mean age was 31.37 years (SD = 8.48). Only 251 individuals (49.22%) had an appropriate license, and approximately 40% declared that they never used a safety helmet. The mean WTP was estimated to be 3900000 Rials (15/6 US$) through CVM. Motorcyclist age, helmet use by the motorcyclist friends, and socio-economic status were found to be significantly correlated with their WTP. The effect of socio-economic status on motorcyclist WTP highlights the significance of adopting supportive policies in this regard, along with stakeholder participation from the private sector and insurance companies. Moreover, the positive effect of helmet use by friends on individuals' WTP shows that improving the general culture of traffic safety can be accompanied by promising results, especially for motorcyclists.

Injury patterns and outcomes in motorcycle driver crashes in the United States: The effect of helmet use

BackgroundMotorcycle crashes pose a persistent public health problem with disproportionate rates of severe injuries and mortality. This study aims to analyze injury patterns and outcomes with regard to helmet use. We hypothesized that helmet use is associated with fewer head injuries and does not increase the risk of cervical spine injuries. MethodsThe National Trauma Data Bank was queried for all motorcycle driver crashes between 2007-2017. Univariable analysis was used to compare demographics, clinical data, injury patterns using abbreviated injury scale, and outcomes between helmeted motorcycle drivers and non-helmeted motorcycle drivers who were injured in traffic crashes. Independent factors associated with mortality were determined by regression analysis after adjustment for potential confounders. ResultsA total of 315,258 patients were included for analysis, 66 % of these patients were helmeted. The sample was 92.5 % male and the median age was 41 years. Non-helmeted motorcycle drivers were more likely to sustain severe head trauma (head abbreviated injury scale ≥ 3: 28.5 % vs. 13.3 %, p < 0.001), had higher intensive care unit-admission (38 % vs. 30.2 %, p<0.001), mechanical ventilation (20.1 % vs. 13 %, p<0.001) and overall mortality rates (6.2 % vs. 3.9 %, p<0.001). Cervical spine injuries occurred in 10.6 % of non-helmeted motorcycle drivers and in 9.5 % of helmeted motorcycle drivers (p<0.001). Helmet use was identified as an independent factor associated with lower mortality [OR 0.849 (0.809–0.891), p<0.001]. ConclusionHelmet use is protective for severe head injuries and associated with decreased mortality. Helmet use was not associated with increased rates of cervical spine injuries. On the contrary, fewer injuries were observed in helmeted motorcycle drivers. Public health initiatives should be aimed at enforcement of universal helmet laws within the United States and across the world.

Electric scooter–related accidents: a possible protective effect of helmet use on the head injury severity

Despite electric scooter use has proliferated in Italy since 2019, actionable data regarding injury incidence and patterns associated with electric scooter accidents are limited. This study aims at analyzing the rate, clinical, and demographic features of electric scooter accidents accessed to the Emergency Department (ED) of Fondazione Policlinico Universitario A. Gemelli IRCSS (Rome, Italy). This retrospective study included all patients older than 18 years riding an electric scooter in the ED from June 2019 to April 2022. Personal data, injury circumstances, helmet use, and health data were collected. Abbreviated Injury Scale (AIS) codes of all diagnoses were recorded, and the Injury Severity Score (ISS) was calculated for each patient. The analysis includes 92 patients admitted to the ED due to an e-scooter accident during the study period, with an increase in years. Thirty-two patients presented bone fractures especially concerning the extremities and the face districts. The median Injury Severity Score in the study cohort was 3, with the highest AIS represented by AIS Pelvic-Extremity and AIS External. Moreover, statistical significance was found between AIS Head-Neck and severity of trauma. E-scooters have become a familiar sight in cities worldwide recently, with many new companies renting them for use. But their arrival has also brought new safety concerns. Although most injuries reported are minor, the meager rate of helmet use is critical. Implementing compulsory helmet use for electric scooters for all ages could be a protective factor for being patient with head trauma on urban streets.

Do motorcycle helmets reduce road traffic injuries, hospitalizations and mortalities in low and lower-middle income countries in Africa? A systematic review and meta-analysis

BackgroundStudies in Africa have examined the association between helmet use and injury prevention, however, there has been no systematic review to synthesize the literature within an African context nor has there been any meta-analysis examining the effect of helmet use on injury prevention.MethodsThe review was performed in accordance with the Joanna Briggs Institute for Systematic Reviews. Articles were searched using several databases (e.g. CINAHL, OVID Medline) and select gray literature (e.g. TRID) sources. Articles were included if they were quantitative studies published in English between 2000 and 2019 and examined the association between motorcycle helmet use with head injuries, hospitalizations, and deaths in low- and lower-middle income countries in Africa with comprehensive motorcycle helmet laws. A meta-analysis was performed using pooled effect sizes assessing the impact of helmet use on reducing head injuries.ResultsAfter screening 491 articles, eight studies met the inclusion criteria. Helmet use ranged from 0 to 43%. The mean age of being involved in a crash was 30 years with males being two times more likely to be involved in motorcycle crashes than females. Drivers (riders) were more likely to be involved in a crash, followed by passengers and then pedestrians. Helmet use reduced injury severity and provided an 88% reduction in serious head injuries (OR 0.118, 95% CI: 0.014–0.968, p = 0.049).ConclusionsIn our study, helmet usage significantly reduced the likelihood of fatal head injuries. African countries with no helmet laws should consider adopting helmet use policies to reduce severe head related injuries from motorcycle crashes.

Cycling area can be a confounder and effect modifier of the association between helmet use and cyclists\u2019 risk of death after a crash

The effect of helmet use on reducing the risk of death in cyclists appears to be distorted by some variables (potential confounders, effect modifiers, or both). Our aim was to provide evidence for or against the hypothesis that cycling area may act as a confounder and effect modifier of the association between helmet use and risk of death of cyclists involved in road crashes. Data were analysed for 24,605 cyclists involved in road crashes in Spain. A multiple imputation procedure was used to mitigate the effect of missing values. We used multilevel Poisson regression with province as the group level to estimate the crude association between helmet use and risk of death, and also three adjusted analyses: (1) for cycling area only, (2) for the remaining variables which may act as confounders, and (3) for all variables. Incidence–density ratios (IDR) and their 95% confidence intervals were calculated. Crude IDR was 1.10, but stratifying by cycling area disclosed a protective, differential effect of helmet use: IDR = 0.67 in urban areas, IDR = 0.34 on open roads. Adjusting for all variables except cycling area yielded similar results in both strata, albeit with a smaller difference between them. Adjusting for cycling area only yielded a strong association (IDR = 0.42), which was slightly lower in the adjusted analysis for all variables (IDR = 0.45). Cycling area can act as a confounder and also appears to act as an effect modifier (albeit to a lesser extent) of the risk of cyclists’ death after a crash.

Efficacy of Helmet Use on Head Injury Reduction in Snow Sports: A Critically Appraised Topic

Context: Review articles published in 2010 concluded that there was strong evidence to support the use of helmets as a way to decrease the risk of sustaining a head injury during snow sport participation. However, new research published over the last decade on this relationship warrants revisiting this primary injury prevention approach. Clinical Question: What is the effect of helmet use on the occurrence of head injuries in snow sports? Clinical Bottom Line: The results from the included studies did not consistently find a reduction in head injury occurrence with helmet use in snow sports. Rather, the collective findings were more supportive of a neutral relationship between helmet use and head injuries. Therefore, these heterogeneous findings indicate there is SORT Level B evidence to support the use of helmets as a primary head injury prevention approach in snow sports. Future initiatives should acknowledge the multifaceted nature of injury occurrence and seek to educate the public more clearly on the limitations of helmet use during skiing and snowboarding.

Sex-based differences in helmet performance in bicycle trauma

ObjectivesTo determine the existence of sex-based differences in the protective effects of helmets against common injuries in bicycle trauma.MethodsIn a retrospective cohort study, we identified patients 18 years or older...

The Association of Helmet Use with the Occurrence of Maxillofacial Injuries Following Bicycle or Scooter Accidents: A Retrospective Cohort Study.

Retrospective Cohort Study. Yearly, bicycle and scooter accidents in the Netherlands amount to 90 thousand emergency department visits. Maxillofacial injuries are common after cycling or scooter accidents. To prevent these injuries, helmet use might be beneficial. However, the effect of helmet use on maxillofacial injuries remains unclear. The aim of this retrospective study is to assess the effect of helmet use on maxillofacial injuries in patients who had a bicycle or scooter accident. We collected data from the emergency department of the Erasmus Medical Center in the period from October 2017 to October 2019. Patients that were involved in a bicycle or scooter accident and subsequently received a CT scan of the head were included. We compared the incidence of maxillofacial injuries in helmeted cyclists and scooter users to non-helmeted users. Descriptive and analytic statistics were computed. Level of statistical significance was set at p < 0.05. Helmet use among scooter users was associated with a significant reduction in maxillofacial fractures (p < 0.001) and soft tissue injuries (p < 0.001). Helmet use among cyclists was not associated with a reduction in maxillofacial fractures (p = 0.17) or soft tissue injuries (p = 0.30). Helmet use was not associated with a reduction in soft tissue injuries of the lower face in both cyclists (p = 0.47) and scooter users (p = 0.24). Helmet use should be considered among cyclists and scooter users to prevent maxillofacial injuries. Especially unhelmeted scooter users might benefit from helmet use as this is associated with a lower incidence of maxillofacial injuries.

Dentoalveolar injuries, bicycling accidents and helmet use in patients referred to a Norwegian Trauma Centre: A 12-year prospective study.

Despite its many benefits, bicycling carries the risk of accidents. Although numerous studies have reported the effect of helmet use on traumatic brain injury, it remains unclear if, and to what extent, helmet use reduces the risk of facial injuries. This is particularly true in regard to injuries of the lower face. In addition, there is limited evidence of the effect of helmet use on dentoalveolar injuries. Thus, the aim of this study was to determine the frequency and distribution of dentoalveolar injuries in bicycling accidents and to explore the influence of helmet use. A total of 1543 bicyclists were included from the trauma registry of a Norwegian tertiary trauma center over a 12-year period. Data were collected prospectively, including patient characteristics, type of injury, and helmet use. The prevalence of dentoalveolar injuries was assessed in conjunction with helmet use and facial fractures. Twenty-five percent of the patients had maxillofacial injuries, and 18% of those with facial fractures exhibited concomitant dentoalveolar injuries. The most common type of dentoalveolar injury was tooth fracture (39%). The most frequent location of facial fractures with combined dentoalveolar injuries was the maxilla, which had fractured in 32 patients. Women had a higher risk of sustaining dentoalveolar injuries compared to men (odds ratio 1.50, 95% confidence interval 1.02-2.22). There were 1257 patients (81%) who had reliable registration of helmet use; 54% of these wore a helmet, while 46% did not. Helmet users had an increased risk of dentoalveolar injuries compared to non-helmeted bicyclists (adjusted odds ratio 1.54, 95% confidence interval 1.02-2.31). Dentoalveolar injuries are fairly common in trauma patients admitted to a trauma center following bicycling accidents. Bicycling helmets are associated with an increased risk of dentoalveolar injuries.

Motorcycle-related head and neck injuries: increased risk among ethnic minorities

BackgroundEthnic disparities have been associated with injury and mortality. The impact of ethnicity on head and neck injury (HNI), traumatic brain injury (TBI), in-hospital mortality and resource utilization following a motorcycle crash (MCC) is undetermined. This study explored the influence of ethnicity in these aspects and the effect of helmet use on HNI and TBI following a MCC.MethodsThe National Trauma Registry provided hospitalization data on motorcycle riders and passengers between 2008 and 2017. Ethnicity was classified as Jews or Arabs, the two major ethnic groups in Israel. Univariate followed by multivariable logistic models were applied to examine ethnic disparities. Mediation effect was tested by structural equation modeling.ResultsAmong 6073 MCC casualties, Arabs had increased odds of HNI (OR = 1.37,95% CI = 1.12–1.65) and TBI (OR = 1.51,95%CI = 1.12–1.99), and a six-fold decreased odds of helmet use (OR = 0.16,95%CI = 0.12–0.22). The HNI and TBI associations with ethnicity were mediated by helmet use. Arabs had significantly higher odds for admission to intensive care unit (OR = 1.36,95%CI = 1.00–1.83), and lower odds for ambulance evacuation (OR = 0.73,95%CI = 0.61–0.89) and discharge to rehabilitation (OR = 0.55,95%CI = 0.39–0.7). In-hospital mortality was not associated with ethnicity.ConclusionsHelmet non-use is an important etiologic factor associated with motorcycle-related HNI and TBI among Arabs. While in Israel, ethnic equality exists in in-hospital health care, disparities in ambulance and rehabilitation utilization was found. Intervention programs should target the Arab population and focus on helmet compliance.

Are helmeted cyclists taking more risk at signalized intersections?

Objective The aim of the present study was to investigate the relationship between bicycle helmet use and safety behavior at signalized intersections. Two hypotheses were investigated: The first states that bicycle helmet use leads to risker behavior because of the increased sense of protection (risk compensation), the other states that helmeted cyclists have a general inclination toward safer behavior (safety package) and that helmet use is one of several behaviors for improving safety. Method Based on video recordings of 1031 cyclists at 12 signalized intersections in Denmark, two indicators of risky behavior were compared between helmeted and unhelmeted cyclists: Speed and time after the onset of yellow at which the cyclists crossed the stop line. Linear regression models were developed with gender, type of bicycle, and intersection characteristics as predictor variables, in addition to helmet use. Results Helmeted and unhelmeted cyclists do not differ in how many seconds after the onset of yellow they cross the stopping line. This is consistent with the absence of both risk compensation and safety package, alternatively with a general inclination of helmeted cyclists toward safer behavior which is about offset by risk compensation. Helmeted cyclists had higher speed on average, which indicates that risk compensation may occur. However, the higher speed may also be due to the generally better fitness of helmeted cyclists which is likely to result from larger cycling volumes. Moreover, the effect of helmet use on speed may be overestimated because of a lack of control for potential confounding variables. The results show further that, regardless of helmet use, before-red (lights on a separate bicycle signal shift to red before the main signal) is related to later crossings of the stop lane after the onset of yellow and that cyclists stop earlier on average at intersections with right-turn signals. Conclusions The results do not provide support for the position that promoting or mandating bicycle helmet use will have adverse safety effects because of more risky behavior among helmeted cyclists.

Relationship between head and neck injuries and helmet use in fatal motorcycle and moped crashes in Denmark

Abstract Motorcycle- and moped crashes are prevalent in motorised societies and carry a significant risk of serious injury. Whereas helmet use has reduced the frequency and severity of head injuries, the association between helmet use and neck injury risk is less clear. In the present retrospective study, we examined the relationship between helmet use and various types of head and neck injuries resulting from fatal motorcycle and moped crashes during a 20-year period. Eighty-three cases were included of whom 56 were analysed in detail based on their confirmed use/non-use of helmet. Intracranial haemorrhage was the most common finding, followed by CNS disruption and skull fracture. There was a significantly lower prevalence of skull vault fractures and epidural haemorrhage in the helmeted cases. Injuries to the brainstem and cervical spine fracture/dislocation were more common in the helmeted cases, although this was likely a function of higher speeds among motorcycle riders rather than an effect of helmet use per se. Further investigation of these findings require additional detailed information regarding the nature and severity of the crash, as well as helmet use and type, in order to assess non-confounded associations with the anatomical distribution, type and severity of observed head and neck injuries.

Helmet use and injury severity among crashed motorcyclists in Brazilian state capitals: an analysis of the violence an accidents survey 2017.

To analyze the effect of helmet use on injury severity among motorcyclists and passengers involved in traffic accidents. Cross-sectional study of traffic accidents involving motorcyclists attended at the emergency healthcare units participating in the Violence and Accidents Survey Conducted in Sentinel Emergency Departments (Viva Survey) 2017. There was a predominance of individuals aged 18 to 29 years old (46.6%), black (75.2%), with high school education (50.6%). Alcohol use was observed in 14.1% of cases. Helmet use was associated with a 76% reduction in the occurrence of head trauma and a 28% reduction in the referral, hospitalization or death. Young, male, black individuals and those with low education were the most frequent victims of accidents. Helmet use was protective for severe injuries.

Does a full-face helmet effectively protect against facial injuries?

BackgroundThe effectiveness of helmet use in preventing or reducing the severity of head injuries has been largely demonstrated. However, the effectiveness of different types of helmets in reducing facial or non-facial head injuries has received much less attention.MethodsA postal survey on motorized two-wheeler crashes was conducted in 2016. 7148 riders of motorized two-wheelers (MTW) injured in a crash between 2010 and 2014 and identified in the Rhône Trauma Registry were invited to complete a questionnaire in order to collect detailed information about their accidents. The analysis was based on a population of 405 helmeted riders who declared having received an impact on the head. Facial and non-facial head injury risks were estimated according to helmet type (full face or other) by logistic regression, controlled for type of object hit by the head (and gender for risk of non-facial head injury), and weighted to take nonresponse into account.ResultsThree-quarter of helmeted MTW drivers were wearing a full-face helmet at the time of the accident. Victims wearing a full-face helmet were about three times less likely to have sustained injury to the face, compared to victims wearing another type of helmet (adjusted OR = 0.31; 95% CI: 0.11–0.83). On the other hand, the presence of non-facial head injury did not vary significantly according to whether a full-face or other helmet was worn (adjusted OR = 0.84; 95% CI: 0.33–2.13).ConclusionsOur study suggests that full-face helmets provide better facial protection for MTW users compared to other types of helmets, whereas there is no evidence of any difference in protection afforded the skull or the brain.

Protective effect of helmet use on cervical injury in motorcycle crashes: A case–control study

IntroductionHelmet use during motorcycle crashes (MCCs) has been shown to reduce traumatic brain injury and mortality. However, preventive effects of its use on cervical spine injury remain controversial. In this study, we evaluated whether helmet use can reduce cervical spine injury during MCCs. Patients and MethodsA case–control study using data from the Emergency Department-based Injury In-depth Surveillance (EDIIS) registry was conducted. Cases were defined as patients with cervical spine injury [≥2 points in the Abbreviated Injury Scale (AIS)] in MCCs from 2011 to 2016. Four controls were matched to one case with strata which included age and sex from the EDIIS registry. Primary outcome was cervical spine injury, secondary outcome was intensive care unit (ICU) admission, and tertiary outcomes was mortality. Multivariable logistic regression analysis was used to calculate odds ratios (OR) with 95% confidence intervals (CIs) to evaluate the associations between helmet use and related outcomes. ResultsIn total, 2600 patients were analysed; among these, 1145 (44.0%) used helmets at the time of crashes. The helmet group showed lower alcohol consumption and mortality rates than the no helmet group (alcohol: 3.2% vs. 9.2%, respectively, and mortality: 2.4% vs. 7.1%, respectively; p < 0.01). Compared with the no helmet group, the helmet group was less likely to have cervical spine injury [adjusted OR, 0.62 (0.51–0.77)]. In addition, helmet use has been shown to help prevent ICU admission and mortality [adjusted OR, 0.45 (0.36–0.56) and 0.32 (0.21–0.51), respectively]. ConclusionHelmet use was found to have significant preventive effects on cervical spine injury during MCCs.

Effect of helmet use on visual and auditory reaction time and peripheral field of vision

Background: In many Asian countries, motorcycles are an important means of transportation. The effectivity of helmets in reducing head injuries is studied, but the effect of helmets on the auditory and visual reaction time and peripheral field of vision of riders is of great concern. Moreover, the Indian markets are providing a large range of substandard helmets. Hence, the present study was designed to assess the effect of standard and substandard helmets on vision and hearing. Aims and Objectives: The aim of the study was to assess the following parameters - auditory reaction time, visual reaction time and peripheral field of vision without helmet, with standard helmet, and with substandard helmet and compare the same statistically. Materials and Methods: This comparative study was done in 57 subjects of the age group 18–25 years. The auditory and visual reaction time and peripheral field of vision were noted. A well informed written consent was taken from all the subjects. The statistical analysis was done by analysis of variance test and Paired “t”- test. Results: The helmet (standard and substandard) does not cause any significant change in visual reaction time and auditory reaction time for low-frequency sound as compared to without helmet. The auditory reaction time for high-frequency sound was significantly reduced in the substandard helmet. The field of vision is significantly decreased by the helmets in all four directions. Conclusion: A quiet, lighter, full-face helmet with minimum restriction of the field of vision should be redesigned. The use of substandard helmets should be discouraged.

Effect of Helmet Use on Traumatic Brain Injuries and Other Head Injuries in Alpine Sport

Sport helmet effectiveness in preventing traumatic brain injury (TBI) has been repeatedly questioned. This study assesses the effect of helmet use on risk of TBI and other types of head injury (OTHI) in alpine sports. From 2012 to 2014, data on the injured population were collected by physicians in on-mountain clinics in 30 French ski resorts, and interviews were conducted on the slope to sample a noninjured control population. Two sets of cases (1425 participants with TBI and 1386 with OTHI) were compared with 2 sets of controls (2145 participants without injury and 40,288 with an injury to a body part other than the head). The effect of helmet use on the risk of TBI and OTHI was evaluated with a multivariate logistic regression adjusted for age, sex, sport, skill level, crash type, and crash location. Using participants without injury as control, we found that helmet wearers were less likely to sustain any head injury (odds ratio [OR]TBI = 0.65; OROTHI = 0.42). When considering participants with an injury to another body part as control, the risk of OTHI was lower among helmet wearers (OROTHI: 0.61). However, no significant effect was found for the risk of TBI. Participants with low skill levels, those aged <26 and >50 years, snowboarders, and those involved in collision and in snowpark accidents were at higher risk of head injury. This study confirms the effectiveness of helmets in protecting users from head injuries but questions their effects on TBI, especially concussion.

The protective effect of helmet use in motorcycle and bicycle accidents: a propensity score\u2013matched study based on a trauma registry system

BackgroundTransportation by motorcycle and bicycle has become popular in Taiwan, this study was designed to investigate the protective effect of helmet use during motorcycle and bicycle accidents by using a propensity score–matched study based on trauma registry system data.MethodsData of adult patients hospitalized for motorcycle or bicycle accidents between January 1, 2009 and December 31, 2015 were retrieved from the Trauma Registry System. These included 7735 motorcyclists with helmet use, 863 motorcyclists without helmet use, 76 bicyclists with helmet use, and 647 bicyclists without helmet use. The primary outcome measurement was in-hospital mortality. Secondary outcomes were the hospital length of stay (LOS), intensive care unit (ICU) admission rate, and ICU LOS. Normally distributed continuous data were analyzed by the unpaired Student t-test, and non-normally distributed data were compared using the Mann–Whitney U-test. Two-sided Fisher exact or Pearson chi-square tests were used to compare categorical data. Propensity score matching (1:1 ratio using optimal method with a 0.2 caliper width) was performed using NCSS software, adjusting for the following covariates: sex, age, and comorbidities. Further logistic regression was used to evaluate the effect of helmet use on mortality rates of motorcyclists and bicyclists, respectively.ResultsThe mortality rate for motorcyclists with helmet use (1.1%) was significantly lower than for motorcyclists without helmet use (4.2%; odds ratio [OR] 0.2; 95% confidence interval [CI]: 0.17–0.37; p < 0.001). Among bicyclists, there was no significant difference in mortality rates between the patients with helmet use (5.3%) and those without helmet use (3.7%; OR 1.4; 95% CI: 0.49–4.27; p = 0.524). After propensity-score matching for covariates, including sex, age, and comorbidities, 856 well-balanced pairs of motorcyclists and 76 pairs of bicyclists were identified for outcome comparison, showing that helmet use among motorcyclists was associated with lower mortality rates (OR 0.2; 95% CI: 0.09–0.44; p < 0.001). In contrast, helmet use among bicyclists was not associated with a decrease in mortality (OR 1.3; 95% CI: 0.30–5.96; p = 0.706). The hospital LOS was also significantly shorter for motorcyclists with helmet use than for those without (9.5 days vs. 12.0 days, respectively, p < 0.001) although for bicyclists, helmet use was not associated with hospital LOS. Fewer motorcyclists with helmet use were admitted to the ICU, regardless of the severity of injury; however, no significant difference of ICU admission rates was found between bicyclists with and without helmets.ConclusionsMotorcycle helmets provide protection to adult motorcyclists involved in traffic accidents and their use is associated with a decrease in mortality rates and the risk of head injuries. However, no such protective effect of helmet use was observed for bicyclists involved in collisions.

How motorcycle helmets affect trauma mortality: Clinical and policy implications

ABSTRACTBackground: Motorcycles are the most popular vehicles in Taiwan, where more than 14.8 million motorcycles (1 motorcycle per 1.6 people) are in service. Despite the mandatory helmet law passed in 1997, less than 80% of motorcyclists in Taiwan wear helmets.Objective: The objective of this study was to analyze the effect of using motorcycle helmets on fatality rates.Methods: A clinical data set including 2,868 trauma patients was analyzed; the cross-sectional registration database was administered by a university medical center in Central Taiwan. A path analysis framework and multiple logistic regressions were used to estimate the marginal effect of helmet use on mortality.Results: Using a helmet did not directly reduce the mortality rate but rather indirectly reduced the mortality rate through intervening variables such as the severity of head injuries, number of craniotomies, and complications during therapeutic processes. Wearing a helmet can reduce the fatality rate by 1.3%, the rate of severe head injury by 34.5%, the craniotomy rate by 7.8%, and the rate of complications during therapeutic processes by 1.5%. These rates comprise 33.3% of the mortality rate for people who do not wear helmets, 67.3% of the severe head injury rate, 60.0% of the craniotomy rate, and 12.2% of the rate of complications during therapeutic processes.Discussion: Wearing a helmet and trauma system designation are crucial factors that reduce the fatality rate.