Mandatory Helmet Laws Research Articles

Bicycle helmet laws and educational campaigns: an evaluation of strategies to increase children's helmet use.

The passage of a mandatory bicycle helmet law for children in Howard County, Maryland, provided an opportunity to compare legislation and education as strategies to increase helmet use. In 1991, a survey was mailed to fourth-, seventh-, and ninth-grade students attending a stratified sample of public schools in Howard County and in two similar suburban/rural counties without helmet laws. Of 7217 students surveyed, 3494 responded (48.4%). Self-reported helmet use in Howard County rose from 11% to 37% after the law and accompanying educational campaign went into effect. Helmet use changed from 8% to 13% in Montgomery County, where educational efforts were undertaken, and from 7% to 11% in Baltimore County, where helmet promotion activities were minimal. Predictors of helmet use included having friends who wore helmets, believing helmet laws are good, being in fourth grade, living in Howard County, and using seatbelts regularly. Legislation combined with education appears to increase bicycle helmet use substantially more than does education alone. The Howard County law may be considered a successful model of a strategy to increase children's helmet use.

Aerodynamic Handlebars-Reply

In Reply. —The letter by Dr Jacques adds to the minuscule literature on aerodynamic handlebars. It is reassuring that the riders who were observed using these handlebars were adults and uniformly wore helmets. Overuse injuries from the hyperextended neck position have been reported. 1 However, the forearm rests and resultant neutral wrist position might lessen the risk of carpal tunnel syndrome (Eric S. Smith, MD, written communication, July 1991), a common malady of endurance cyclists. In suggesting more research on aerobars, I did not want to lessen the important research focus on head injury prevention by helmets. As Jacques points out, the majority of bicyclists would benefit from data already available showing that helmets reduce head injury. 2 Trauma might be avoided by a mandatory helmet law. 3 Cycling is increasing in popularity among adult fitness enthusiasts. With this trend and the arrival of another cycling season, physicians can expect

The impact of the Texas 1989 motorcycle helmet law on total and head-related fatalities, severe injuries, and overall injuries.

The State of Texas implemented a mandatory total motorcycle helmet law for all operators and passengers, effective September 1, 1989. In this study the impact of this intervention on frequency of both total and head-related fatalities, severe injuries, and overall injuries for operators during the subsequent year was quantified. This quantification is important because 26 states in the United States fail to have strict, mandatory helmet laws. The Box-Tiao time-series intervention methodology is used to estimate secular trends before and changes after the implementation of the law, analyzing Department of Public Safety monthly injury accident data for a period of 6 years collected from traffic accident reports filed for each motorcycle injury accident. Trends in fatalities and injuries (except for head-related deaths) estimated before implementation of the law approximated the 9.4% average annual decline in motorcycle registrations. Additional declines of 12.6% and 57.0%, respectively, were estimated for total and head-related fatalities during the year after the law was implemented. Declines of 13.1% and 54.6% were estimated for severe injuries for total and head-related accidents. Declines of 12.3% and 52.9% were found for total and head-related injuries overall.

Highway Fund Threat Is No Easy Ride for Motorcycle Helmet Law Opponents

HEADSTRONG opposition to motorcycle helmet laws is running into one of Congress' more powerful tools of persuasion. Federal highway construction funds may triumph where scientific studies have only halfway succeeded. The 1991 federal highway bill dictates that states without mandatory comprehensive motorcycle helmet laws after September 30,1993, will have 1.5% of their federal highway construction money for the following fiscal year reallocated to safety programs. The safety program allotment rises to 3% for any states still recalcitrant after September 30, 1994. Three states—Illinois, Iowa, and Colorado—now have no helmet requirements; another 22 have partial requirements, such as for minors, passengers, or student drivers. At press time, the Rhode Island state legislature was considering a comprehensive law. California, with about one fifth of all registered motorcycles in the United States, started enforcing its law at the beginning of this year and, since then, helmet use has increased from under 50% to

The Public Cost of Motorcycle Trauma

To the Editor. — It comes as no surprise that society pays for the majority of health care for injured motorcyclists. 1 I am surprised, however, that Rivara et al 1 jump to the conclusion that their data support mandatory helmet laws. As stated by the authors, no comparison of helmeted vs nonhelmeted motorcyclists was made in their study. Their conclusion is supported only by reference to a study that dealt with fatalities, not costs. Some people theorize that helmet laws result in greater overall cost to society because individuals who otherwise would have been killed survive with severe permanent disabilities. I was hoping that Rivara et al would address this sobering question.

Motorcycle Safety and Motorcycle Education: Past Research and Survey Results

RALPH B. WELLER is an Associate Professor of Marketing at the Lumpkin College of Business, Eastern Illinois University. E. WAYNE CHANDLER is an Associate Professor of Marketing at the Lumpkin College of Business, Eastern Illinois University. The principles of social marketing, in general, and the techniques of marketing research in particular, have been applied to a variety of social causes. That marketing thought should not be restricted to commercial enterprises has gained widespread acceptance [Kotler and Levy 1969; Levy and Kotler 1979]. Social issues, for example, have been the focus of numerous marketing studies [Yavas and Riecken 1985; Reid and Timmerman 1987; Sachs, Blair and Richter 1987; Varandarjan and Menon 1988]. A social issue which may be appropriately analyzed by using marketing techniques is the question of highway safety and, more specifically, the issue of safety. Since 1966, forty-seven states have enacted helmet usage laws for two reasons: (1) in hopes that the number of fatalities and/or injuries in accidents involving motorcycles would decrease; and (2) in response to the passage of the U.S. Highway Safety Act of 1966. During the same period several states have issued legislation mandating that riders (drivers) must successfully pass a safety education course prior to being licensed to operate a motorcycle. Since the passage of these laws, numerous studies have been conducted in an attempt to determine if the laws have had the desired effect, i.e., has their enactment and enforcement reduced the number of related fatalities and injuries. Unfortunately, the results of these studies have been both conflicting and inconclusive. According to Goldstein [1985; 1986; 1988a; 1988b], studies that explored these issues have suffered from the lack of accurate and detailed data or at minimum, from the failure to integrate causal models into their analysis. Nevertheless, from 1976 to 1983, thirty-one states repealed or weakened mandatory helmet laws [Status of Laws Pertaining to Motorcycle Riding 1989]. The enactment of safety legislation and the subsequent repeal of many of the laws reflect the problems that occur as society attempts to deal with complex issues such as product safety. The operation of a may be appropriately considered under the rubric of product safety. Moreover, product safety is no longer just the province of the legal scholar. Rather, marketing scholars now recognize that the issue of product safety, which includes how and under what conditions the product is used, is an important facet of the developing public policy pertaining to the practice of marketing [Adams and Browning 1986; Moss and Evans 1986]. As such, they are increasingly concerned with identifying issues that need resolution and, through the use of the tools of analysis, aid in resolving them. This study is a contribution to that growing body of knowledge. This research attempts to organize the various studies which have been conducted by stressing the themes that have been developed. Furthermore, the knowledge and attitudes of the public at large, legislators, and members of a enthusiasts club (hereafter motorcycle enthusiasts.) relative to the safety and consequent product liability issues are assessed. These data are useful to those charged with the responsibility for developing public policy, since they indicate how much education must take place and to whom it must be directed. The purpose of this assessment is to determine, in part, whether three different groups were knowledgeable about the safety issues. JPP&M, Vol. 8 (1989), 93-108

The effect of motorcycle helmet use on the probability of fatality and the severity of head and neck injuries: A latent variable framework

This study uses repeated cross-sections of individual level crash data to study the effectiveness of motorcycle helmet legislation. Results suggest that motorcycle helmet laws reduce average individual fatality risks by 20.5%. From a policy standpoint, large states such as Florida and Texas can reduce annual motorcycle fatalities by an average 100 deaths through reinstating universal helmet laws. Valuing these fatality reductions at the U.S. DOT suggested $9.4 million value of a statistical life yields aggregate annual state benefits of approximately $940 million. The effectiveness of helmet legislation can be attributed to the technological efficacy of helmets as well as enhancing behavior in the form of reduced risk taking among motorcyclists. Specifically, motorcyclists who use helmets in order to comply with mandatory helmet laws are 29.8% less likely to receive a traffic citation for risky driving behavior (speeding, alcohol, etc.), travel at a 6 mph lower average speed, and have a 47.4% reduction in the probability of “severely” damaging their motorcycle in a crash.

The prevention of injury from motorcycle use: Epidemiologic success, legislative failure

Following the repeal of the North Dakota mandatory motorcycle helmet law in 1977, the State Highway and Health Departments initiated a study to examine the impact of the change on driver safety. Motorcycle crash data gathered by the State Highway Patrol and other law enforcement agencies was augmented by death and injury reports submitted to the State Health Department by medical care providers. The combined data set produced 2934 crashes, 2162 traumatized victims, 3718 injuries and 53 deaths between January 1977 and December 1980. Reporting from medical providers increased the volume of crash reports, improved the reliability of the highway data and added an unrecognized population of victims to the data base. In spite of the clear indication that injuries and deaths had increased among motorcycle users who rode without helmet protection, legislative passage of a mandatory helmet law in either the 1979 or the 1981 North Dakota legislative session failed. The reasons behind the legislative rejection of efforts to improve highway safety are examined. The forces that affect politics are reviewed.

Repeal and Modification of Mandatory Motorcycle Helmet Legislation

In 1975, Congress relieved the Secretary of Transportation of the power to impose sanctions upon states for not having a law requiring the use of helmets by motorcyclists. Shortly afterward, some of the states having such laws began repealing or modifying them. This paper reviews the available literature on the subject of mandatory motorcycle helmet legislation, and presents the results of a survey of states that have repealed their laws. From the information available, it was determined that the use of motorcycle helmets reduces the incidence of serious and fatal head injury among motorcyclists without interfering with their ability to operate their vehicles safely. Additionally, it was determined that the mandatory motorcycle helmet laws are constitutional and that they have the support of both the general public and motorcyclists in Virginia.