Helmet Laws Research Articles

The Health Impact of Mandatory Bicycle Helmet Laws

This article seeks to answer the question whether mandatory bicycle helmet laws deliver a net societal health benefit. The question is addressed using a simple model. The model recognizes a single health benefit--reduced head injuries--and a single health cost-increased morbidity due to foregone exercise from reduced cycling. Using estimates suggested in the literature on the effectiveness of helmets, the health benefits of cycling, head injury rates, and reductions in cycling leads to the following conclusions. In jurisdictions where cycling is safe, a helmet law is likely to have a large unintended negative health impact. In jurisdictions where cycling is relatively unsafe, helmets will do little to make it safer and a helmet law, under relatively extreme assumptions, may make a small positive contribution to net societal health. The model serves to focus the mandatory bicycle helmet law debate on overall health.

Cervical spine injuries and helmet laws

To assess the incidence of cervical spine (C-spine) injuries in patients admitted after motorcycle crash in states with mandatory helmet laws (MHL) compared with states without helmet laws or selective helmet laws. The Nationwide Inpatient Sample from the Healthcare and Utilization Project for the year 2008 was analyzed. International Classification of Diseases and Health Related Problems, Ninth Edition codes were used to identify patients with a diagnosis of motorcycle crash and C-spine injuries. National estimates were generated based on weighted analysis of the data. Outcome variables investigated were as follows: length of stay (LOS), in-hospital mortality, hospital teaching status, and discharge disposition. States were then stratified into states with MHL or selective helmet laws. A total of 30,117 discharges were identified. Of these, 2,041 (6.7%) patients had a C-spine injury. Patients in MHL states had a lower incidence of C-spine injuries (5.6 vs. 6.4%; p = 0.003) and less in-hospital mortality (1.8 vs. 2.6%; p = 0.0001). Patients older than 55 years were less likely to be discharged home (57.5% vs. 72.5%; p = 0.0001), more likely to die in-hospital (3.0% vs. 2.1%; p = 0.0001), and more likely to have a hospital LOS more than 21 days (7.7% vs. 6.2%; p = 0.0001). Patients admitted to the hospital in states with MHLs have decreased rate of C-spine injuries than those patients admitted in states with more flexible helmet laws. Patients older than 55 years are more likely to die in the hospital, have a prolonged LOS, and require services after discharge. III.

Examining the Health‐Risk Tradeoffs of Mandatory Bicycle Helmet Laws

Examining the Health‐Risk Tradeoffs of Mandatory Bicycle Helmet Laws

Equal Treatment and Exemptions

Religious and cultural minorities are today often exempted from rules that continue to bind their fellow citizens, particularly when these rules directly burden minorities' freedom of religion—for example, restric tions on the carrying of knives in public that prevent Sikhs from carrying one of their five articles of faith, the kirpan (a metal dagger)1—but also when the universal enforcement of rules, such as crash helmet laws, would prevent minorities from accessing opportunities more readily available to members of more dominant groups. While multiculturalists celebrate the provision of cultural exemptions as realizing a more sub stantive equality than that achieved under a difference-blind model of citizenship,2 critics argue that cultural exemptions are unwarranted in theory and discriminatory in practice. The fairness of the law, it is ar gued, is not a function of the size of the burden that it imposes upon mi norities and majorities alike but of its facial neutrality. This requirement is met insofar as no individual or group is explicitly discriminated against and all enjoy formally equivalent opportunity sets.3 Indeed, crit ics claim that the provision of exemptions is here not only unnecessary, it is unfair. As Jeremy Waldron puts it, [i]t would be quite repugnant if there were one law for the rich and another for the poor; so why should there be one law for religious minorities and another for the rest of the citizenry? 4 After all, cultural minorities are not the only groups who are

Rate of Compliance with Crash Helmets Use by Powered Two-Wheelers (PTW) in Nigeria

Head injuries remain the main cause of deaths among users of Powered 7lvo- Wheelers (PTW). Therefore, helmet use represents the major measure for reducing the severity of head injuries. However in most developing countries especially in Nigeria, compliance to the use of crash helmets is extremely poor. Using observational surrey, the study evaluated the level of compliance of motorcycle riders to the use of crash helmets on three categories of roads ill Abeokuta, Nigeria. in addition, 250 powered two wheelers (motorcyclists) were served with 250 copies of questionnaire each using systematic sampling, Findings indicated that more than 75% of them were less than 40 years ill age and about 68% had 110 more than secondary education In terms of helmet wearing, 29%, 15% and 62 % compliance rates were recorded 011 Trunk ‘A’, collector and access mads respectively. Also, 34.2% and 27.6% identified heat and cost of the crash helmets as main reasons for poor use of crash helmets. One Way ANOVA showed a significant difference (p<0.05) in the use of crash helmets on the three categories of roads. The paper calls for effective enforcement of crash helmet law, more enlightenment programme and the need to subsidize the cost of crash helmets in order to improve the wearing rate ill the country.

Does wearing helmets reduce motorcycle-related death? A global evaluation

BackgroundThe high risk of injury and death of motorcycle riders is a major global health problem. This study aimed to evaluate the effect of helmet wearing on motorcycle riders’ death rates on a global level. MethodsData for motorcycle riders were collected from 70 countries. These data included motorcycle-related death rates per 100000 population, helmet non-usage percentage, Gross National Income per capita (GNI), number of registered motorized 2–3 wheelers, the effectiveness of law enforcement in each country, and whether there was standards for helmets use or not. Correlations between studied variables were done using Pearson correlation. Multiple linear regression models were used to define factors affecting motorcycle-related death rates. ResultsThe correlation between motorcycle-related death rate and helmet non-usage, was almost significant (p=0.056, r=0.28). Helmet non-usage percentage was significantly correlated with GNI (p<0.0001, r=−0.61) and effectiveness of the law (p<0.0001, r=−0.73). A multiple linear regression model which was highly significant (adjusted R-squared=0.3, F=6.69, p<0.001) has shown that helmet non-usage percentage (p=0.003), motorcycle per person ratio (p=0.01) and the presence of helmet standards (p=0.05) were positively associated with motorcycle-related death rates. A simple linear regression model between helmet usage and road traffic death rate has shown that for each 10% increase in helmet usage, one life per 1000000 inhabitants can be saved per year. ConclusionHelmet non-usage percentage was the most significant factor affecting motorcyclists’ death rate. Wearing a motorcycle helmet reduces the risk of death from a motorcycle crash. Enforcement of motorcycle helmet laws should be effectively supported by motorcycle safety programs.

Donorcycles: Motorcycle Helmet Laws and the Supply of Organ Donors

Traffic safety mandates are typically designed to reduce the harmful externalities of risky behaviors. We consider whether motorcycle helmet laws also reduce a beneficial externality by decreasing the supply of viable organ donors. Our central estimates show that organ donations resulting from fatal motor vehicle accidents increase by 10 percent when states repeal helmet laws. Two features of this association suggest that it is causal: first, nearly all of it is concentrated among men, who account for over 90 percent of all motorcyclist deaths, and second, helmet laws are unrelated to the supply of donors who die in circumstances other than motor vehicle accidents. The estimates imply that every death of a helmetless motorcyclist prevents or delays as many as .33 death among individuals on organ transplant waiting lists.

Road safety in the Eastern Mediterranean Region – findings from the Global Road Safety Status Report

A secondary data analysis using the Global Status Report on Road Safety (GSRRS) was carried out to assess the epidemiology of road traffic injuries (RTIs) and preventive strategies in the Eastern Mediterranean egion (EMR). EMR countries ranked equal first in the world for the highest number of fatalities due to RTIs (32.2 per 100 000 population). The region had about 4% of the world's vehicles with 0.097 registered vehicles per person. The number of injured cases in EMR was 210.1 per 100 000 population. Only 15% of EMR countries had a funded, independent, multisectoral body for road safety. Only 25% had mandatory seat-belt laws for both front-seat and rear-seat passengers, 60% had mandatory helmet laws for both drivers and passengers of motorized two-wheelers and 10% had child restraint laws. Road safety in EMR countries needs more attention and consideration.

Reducing regional inequality in mortality from road traffic injuries through enforcement of the mandatory motorcycle helmet law in Taiwan

BackgroundThis study was conducted to examine whether passage of the mandatory motorcycle helmet law in 1997 reduced the regional inequality in mortality from road traffic injuries (RTIs) across 22 cities/counties...

Relative Risk and Financial Analysis of Motorcycle-Related Facial Trauma Following the Mandatory Pennsylvania Motorcycle Helmet Law Repeal: The Allegheny General Hospital Experience

The mandatory Pennsylvania Helmet Law was repealed in 2003 allowing individuals the freedom of choice not to wear a motorcycle helmet. The objective of this study was to examine the relative risk and provide a financial analysis of individuals who sustained facial trauma from a motorcycle accident.

Implementation of a Motorcycle Helmet Law in Taiwan and Traffic Deaths Over 18 Years

In 1994, a trial law was passed in Taipei City requiring motorcycle riders to wear helmets. A pilot study showed an increase in helmet use from 21% to 79% and a 56% reduction in motor vehicle–related deaths. 1 The law was terminated after 4 months, associated with an increase in deaths. In June 1997, a national helmet law was passed by the Taiwanese legislature. A public information campaign was conducted in the year before passage and strict enforcement followed with fines for noncompliance among riders and passengers. We studied motor vehicle–related deaths from 1991 through 2008 in Taiwan. Language: en

The Effect of Traffic Safety Laws and Obesity Rates on Living Organ Donations

This paper uses variation in traffic safety laws and obesity rates as instruments to identify substitution patterns between living and cadaveric kidney donors in the presence of unobserved levels of altruism. The US market for organs is restricted by price controls where organ are donated purely for altruistic reasons. Using panel data from 1988-2008, we find that a 1% decrease in the supply of cadaveric donors per 100,000 increases the supply of living donors per 100,000 by .7%. With respect to traffic safety laws, a national adoption of partial helmet laws is estimated to decrease cadaveric donors by 6%, but leads to a 4.2% increase in the number of living donors, or a net effect of 1.8% decrease in the supply of kidney donations. The recent rise in obesity rates is estimated to increase living donor rates by roughly 18%. Lastly, we find evidence that increases in disposable income per capita is associated with an increase in the number of non-biological living donors within a state, but is not found to have an effect on biological donor rates.

Overview of motorcycling in the United States: A national telephone survey

Objectives Motorcycle registrations have risen in recent years. Although motorcyclist crash fatalities in 2009 were 16% lower than in 2008, they were double the number of deaths in 1997. The present study examined current motorcyclists’ travel patterns and views of motorcycle helmets and other safety topics. Methods Motorcycle drivers were interviewed in a national telephone survey conducted in 2009. A weighted sample of 1,606 motorcyclists resulted from adjusting for the oversampling of those younger than 40 and those in the three states without a motorcycle helmet use law (Illinois, Iowa, New Hampshire). All analyses were based on the weighted sample, which was intended to result in a nationally representative sample of motorcyclists. Results About one-quarter of respondents said they did not always wear helmets. Of these respondents, 57% said a law requiring helmet use would persuade them to do so, and 27% said nothing would. Ninety-four percent of respondents in states with universal helmet laws said they always ride helmeted, compared with about half of respondents in other states. About half of all respondents favored these laws. About three-quarters said they believe helmets keep riders safer, including two-thirds of respondents who oppose universal laws and almost half of drivers who rarely/never wear helmets. Drivers ages 18–29 and drivers of sport/unclad sport, sport touring, and super sport motorcycles were more likely to always wear helmets, support universal helmet laws, and believe helmets keep riders safer. About half of respondents said antilock braking systems (ABS) enhance safety and that they would get ABS on their next motorcycle. Less than one-quarter thought an airbag would protect a motorcyclist in a crash, and even fewer would consider getting one on their next motorcycle. Forty-three percent of motorcyclists said they had crashed at least once; 62% of the most recent crashes involved no vehicles besides the motorcycle. Respondents reported riding their motorcycles about 5,400 miles, on average, during the past year. Drivers ages 18–29 reported riding fewer miles, on average, than older drivers and more often rode at night and to/from work or school. Drivers of touring and sport touring motorcycles traveled more miles and took more long trips. Conclusions Motorcyclists’ travel patterns and views vary widely, but there are distinct patterns by driver age and motorcycle type. Drivers who believe helmets keep riders safer are more likely to always wear them, but this belief appears insufficient to motivate some drivers to wear them. However, universal helmet laws appear effective in increasing helmet use. Many drivers are receptive to purchasing ABS on their next motorcycle. Impact on industry States should be encouraged to enact universal helmet laws, and motorcycle manufacturers should be encouraged to offer ABS.

Motorcycle-related injuries in the United Arab Emirates

ObjectivesTo study the anatomical distribution, severity, outcome, and age by nationality of hospitalized motorcycle-related injured patients in Al-Ain, United Arab Emirates so as to improve preventive measures. MethodsAll motorcycle riders involved in a road traffic collision and admitted to Al-Ain Hospital for more than 24h or who died in hospital after arrival were studied. Patient data were retrieved from Al-Ain Hospital Trauma Registry. Data had been prospectively collected during four and half years (March 2003–October 2007). Demography of patients, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), Hospital stay, mortality, nationality, time, day of week, and month of occurrence were analyzed. ResultsThere were 95 patients (93 males). Mean (SD) age was 29.8 (11.5) years. 35% were United Arab Emirates (UAE) nationals. Upper limbs were most frequently involved (54%) followed by lower limbs (48%), head (41%), and face (30%). On arrival at hospital, median (range) ISS was 4.5 (1–36) and median (range) GCS was 15 (3–15). Mean (range) hospital stay was 8.8 (1–79) days. 14 patients (15%) were admitted to the Intensive Care Unit. In-hospital mortality was 6%. UAE national victims were significantly younger and had more abdominal injuries than expatriates, who had lower limb injuries. ConclusionsThe most common mechanism of motorcycle crashes was hitting a moving vehicle. Young UAE national motorcyclists are at a higher risk of being injured compared with non UAE nationals. This may be due to risk-taking behavior of young motorcyclists who are mainly riding for leisure. Extremities were the most common injured body region. Severe head injury was the main cause of death. This signifies the need for effective application of motorcycle helmet law in the UAE along with other preventive measures that might include increasing the licensing age.

Intended and Unintended Consequences of Youth Bicycle Helmet Laws

AbstractMore than 20 states have adopted laws requiring youths to wear a helmet when riding a bicycle. We confirm previous research indicating that these laws reduced fatalities and increased helmet use, but we also show that the laws significantly reduced youth bicycling. We find this result in standard two-way fixed-effects models of parental reports of youth bicycling and in triple-difference models of self-reported bicycling among high school youths that explicitly account for bicycling by youths just above the age threshold of the helmet law. Our results highlight important intended and unintended consequences of a well-intentioned public policy.

Web Alert

Sports Trauma & Overuse Prevention (STOP) Campaign: www.stopsportsinjuries.org Description: The STOP campaign was initiated by the American Orthopedic Society for Sports Medicine and is supported by the American Academy of Orthopedic Surgeons, American Academy of Pediatrics, American Medical Society for Sports Medicine, and other reputable professional organizations. The STOP Web site contains information to educate medical providers, coaches, parents, and athletes about the prevalence of youth sporting injuries, opportunities to remove or minimize risk, and basic information about care. It also includes relevant consensus statements from professional organizations regarding the care of youth athletes. The site includes a search function, but information is most easily found via the dropdown menus. The quantity of material is somewhat limited, but it provides a reliable resource for coaches, parents, athletes, and physicians. Cost: Free. Bicycle Helmet Safety Institute: www.bhsi.org Description: The Bicycle Helmet Safety Institute Web site was reviewed here several years ago (2004), but the Institute has continued to expand and update its information. It provides extensive information about bicycle helmets, including performance, comfort, fit, and effectiveness. There is a selection of downloadable PDF files addressing common questions and tools to encourage helmet use. They provide a brief summary of bicycle helmet laws in the United States and include links to many other resources. The site is logically arranged, enabling straightforward navigation to the information. It provides references for its statements and generously encourages use of its material to increase bicycle helmet use. It provides valuable information useful for sports medicine professionals trying to increase bicycle helmet use. Cost: Free. The Dr. Glass DPM Podcast: http://drglass.org Description: "Dr. Glass DPM-Learning Resources" is an alias for a team effort producing video podcasts and other academic educational material about foot and ankle injuries, biomechanics, and surgery. The volume of material is not extensive, but the quality of the videos and the narration this group has created is impressive. It is an excellent resource to improve understanding of foot and ankle mechanics and for teaching. The videos are available on YouTube and are easily accessed for teaching and review. Cost: Free. American Orthopaedic Foot and Ankle Society: www.aofas.org Description: This is the official site of the American Orthopaedic Foot and Ankle Society (AOFAS). It provides information for patients regarding common foot complaints and treatment, children's feet and development, routine foot care, and shoe selection for both children and adults. Physician-level information regarding injury mechanisms and AOFAS position statements also are included. The information is reliable, and patients will intuitively navigate the site. Expanded content would significantly add to the site's value to physicians. Cost: Free access to the information above. Membership in AOFAS provides access to additional resources. Musculoskeletal MRI: www.freitasrad.net Description: An interactive introduction to normal musculoskeletal anatomy seen on magnetic resonance images (MRI). The site provides labeled MRI studies and allows the user to scroll through sample images as they would with a patient's MRI. It is an excellent learning tool for residents and fellows learning MRI interpretation. It also provides a convenient reference for the practicing physician. The volume of material is limited, but the design is straightforward, allowing rapid access to the images of interest. Cost: Free.

(P2-87) Policy Study of the Helmet Legislation in Kerala, India and its Implications

BackgroundWhen implemented properly, universal helmet law increases helmet use substantially, bringing along a reduction in mortality and morbidity due to head injuries. Kerala has seen tremendous success in regards to various indicators for health within India. But when it comes to wearing helmets, the state lags behind others with reported rates as less as 27%.MethodA cross-sectional survey of 300 two-wheel drivers in Thiruvananthapuram City was preformed, which looked into helmet wearing patterns, their determinants, and the risk perception among the respondents. Further, a content analysis of newspaper reports pertaining to helmet legislation from the Thiruvananthapuram edition of two leading newspapers was performed. The reports included were from the periods of July 2003 to June 2005 and July 2008 to June 2010. Lastly, in-depth interviews were conducted with informants from among the key stakeholders in helmet policy of the state.ResultsThe study found 36.8% of the respondents wear a helmet. A scale to measure risk perception was developed for the purpose of this study. The four-item scale has been found to have internal consistency with a Cronbach alpha value of 0.74. The risk perception measured by using this scale has significant relation with helmet-wearing behavior. The content analysis helped in deriving a historical perspective of the policy along with the themes of reporting. The informant interviews provided expert opinions, problem identification, and specific recommendations.DiscussionThe practice of wearing a helmet is low, and people with lower risk perception have greater tendency not to wear helmets. Other findings also show that there are gaps in policy and lack of visionary leadership as far as the policy toward helmet legislation and its implementation.

Paid organ donation: the case against

Paid organ donation: the case against

Risk Compensation and Bicycle Helmets

This study investigated risk compensation by cyclists in response to bicycle helmet wearing by observing changes in cycling behavior, reported experience of risk, and a possible objective measure of experienced risk. The suitability of heart rate variability (HRV) as an objective measure of experienced risk was assessed beforehand by recording HRV measures in nine participants watching a thriller film. We observed a significant decrease in HRV in line with expected increases in psychological challenge presented by the film. HRV was then used along with cycling pace and self-reported risk in a field experiment in which 35 cyclist volunteers cycled 0.4 km downhill, once with and once without a helmet. Routine helmet users reported higher experienced risk and cycled slower when they did not wear their helmet in the experiment than when they did wear their helmet, although there was no corresponding change in HRV. For cyclists not accustomed to helmets, there were no changes in speed, perceived risk, or any other measures when cycling with versus without a helmet. The findings are consistent with the notion that those who use helmets routinely perceive reduced risk when wearing a helmet, and compensate by cycling faster. They thus give some support to those urging caution in the use of helmet laws.

Motorcycle Helmets Associated with Lower Risk of Cervical Spine Injury: Debunking the Myth

There has been a repeal of the universal helmet law in several states despite definitive evidence that helmets reduce mortality, traumatic brain injury, and hospital expenditures. Opponents of the universal helmet law have successfully claimed that helmets should not be required because of greater torque on the neck, which is thought to increase the likelihood of a cervical spine injury. There is currently insufficient evidence to counter claims that helmets do not increase the risk of cervical spine injury after a motorcycle collision. The objective of this study was to determine the impact of motorcycle helmets on the likelihood of developing a cervical spine injury after a motorcycle collision. We reviewed cases in the National Trauma Databank (NTDB) v7.0 involving motorcycle collisions. Multiple logistic regression was used to analyze the independent effect of helmets on cervical spine injury. Cases were adjusted for age, race, sex, insurance status, anatomic (Injury Severity Score) and physiologic injury severity (systolic blood pressure < 90 mmHg), and head injury (Abbreviated Injury Score > 3). Between 2002 and 2006, 62,840 cases of motorcycle collision were entered into the NTDB; 40,588 had complete data and were included in the adjusted analysis. Helmeted riders had a lower adjusted odds (0.80 [CI 0.72 to 0.90]) and a lower proportion of cervical spine injury (3.5% vs 4.4%, p < 0.05) compared with nonhelmeted riders. Helmeted motorcyclists are less likely to suffer a cervical spine injury after a motorcycle collision. This finding challenges a long-standing objection to mandatory helmet use that claims helmets are associated with cervical spine injury. Re-enactment of the universal helmet law should be considered in states where it has been repealed.