Research Reports - Motorcycle helmet effectiveness in reducing head, face and brain injuries by state and helmet law

Inj Epidemiol. 2016;3:8. Epub 2016 Mar 7.

Olsen CS(1), Thomas AM(1), Singleton M(2), Gaichas AM(3), Smith TJ(4), Smith
GA(5), Peng J(6), Bauer MJ(7), Qu M(8), Yeager D(9), Kerns T(10), Burch C(10),
Cook LJ(1).

BACKGROUND: Despite evidence that motorcycle helmets reduce morbidity and
mortality, helmet laws and rates of helmet use vary by state in the U.S.
METHODS: We pooled data from eleven states: five with universal laws requiring
all motorcyclists to wear a helmet, and six with partial laws requiring only a
subset of motorcyclists to wear a helmet. Data were combined in the Crash Outcome
Data Evaluation System's General Use Model and included motorcycle crash records
probabilistically linked to emergency department and inpatient discharges for
years 2005-2008. Medical outcomes were compared between partial and universal
helmet law settings. We estimated adjusted relative risks (RR) and 95 %
confidence intervals (CIs) for head, facial, traumatic brain, and moderate to
severe head/facial injuries associated with helmet use within each helmet law
setting using generalized log-binomial regression.
RESULTS: Reported helmet use was higher in universal law states (88 % vs. 42 %).
Median charges, adjusted for inflation and differences in state-incomes, were
higher in partial law states (emergency department $1987 vs. $1443; inpatient
$31,506 vs. $25,949). Injuries to the head and face, including traumatic brain
injuries, were more common in partial law states. Effectiveness estimates of
helmet use were higher in partial law states (adjusted-RR (CI) of head injury:
2.1 (1.9-2.2) partial law single vehicle; 1.4 (1.2, 1.6) universal law single
vehicle; 1.8 (1.6-2.0) partial law multi-vehicle; 1.2 (1.1-1.4) universal law
multi-vehicle).
CONCLUSIONS: Medical charges and rates of head, facial, and brain injuries among
motorcyclists were lower in universal law states. Helmets were effective in
reducing injury in both helmet law settings; lower effectiveness estimates were
observed in universal law states.

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