Helmet use, patterns of in jury, medical outcome, and costs among motorcycle drivers in Maryland

doi:10.1016/0001-4575(92)90051-J

Accident Analysis & Prevention

Volume 24, Issue 4, August 1992, Pages 385-396

https://doi.org/10.1016/0001-4575(92)90051-J Get rights and content

Abstract

A comprehensive study was conducted of all motorcycle traffic crashes occurring in Maryland during a one-year period. All available medical and cost data were linked with police crash reports. During the study period, 1,900 motorcycle drivers were involved in crashes. The data indicated that (i) helmet usage was 35% overall, 30% among fatally injured drivers, and only 16% among drivers with a history of drug/alcohol conviction, (ii) unhelmeted drivers seen at an emergency department were almost twice as likely to have sustained head injury (40%) as were helmeted drivers (21%) (the corresponding percentages for hospitalized drivers were 55% and 38%), and (iii) acute care cost for unhelmeted drivers was three times ($30,365) that of helmeted drivers.

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The Orthopedic Injury Burden of Personal Mobility Devices in Singapore – Our Experience in the East Coast
2021, Journal of Clinical Orthopaedics and Trauma
Personal mobility devices (PMDs) have become increasingly popular as a modality of transport worldwide. Starting out as novelty toys, PMDs are gradually being adopted as the mainstream mode of travel. There is an increasing number of accidents involving both PMD riders and other road users since its introduction, leading to a concomitant increase in demand for healthcare resources to manage the injuries. The main objective of this study was to evaluate the inpatient cost and the orthopedic injury pattern due to PMD accidents.
All patients admitted to the Department of Orthopedic Surgery between December 2016 to February 2018 with injuries due to PMD accidents were recruited. Data collection was performed retrospectively on the demographic profiles, injury patterns, admission related outcomes and expenditures of these patients.
43 patients were included in this study. The mean duration of admission was 7.81 days and the median cost of admission was S$7835.01 (approximately US$5620). These were comparable to accidents arising from other modes of transport, such as motorcycles and bicycles. In addition, more than 80% of patients were not wearing protective gear at time of accident. These patients had a slightly higher median cost payable per patient as compared to those who donned protective gear, with a difference of S$1669.78 (approximately US$1221).
There is a significant health and financial cost to the individual and society from PMD injuries and admission. This can be reduced with strict regulations on PMD use, advocating protective gear use, and promoting awareness on safety measures and the consequences of PMD accidents. The most common injury mechanism and orthopedic injury type for PMD accidents are different from motorcycle accidents.
Trends and patterns in fatal US motorcycle crashes, 2000–2016
2019, Traffic Injury Prevention
Objective: To investigate trends of motorcyclist fatalities and identify at-risk populations by motorcyclist demographics and crash characteristics.
Methods: We used the Fatality Analysis Reporting System (FARS) database (2000–2016) to track fatality rate trends, which were quantified by using Poisson mixed-effects regression models comparing 2000–2001 and 2007–2008, as well as 2009–2010 and 2015–2016.
Results: The overall fatality rate per 100,000 population increased from 2000 to 2016, defined by two trend lines—before and after the economic recession in 2008–2009. The overall fatality rate ratio between 2000–2001 and 2007–2008 was 1.60 [95% Confidence Interval (CI): 1.51–1.70], and between 2009–2010 and 2015–2016 was 1.09 (95% CI: 1.02–1.18). Fatality rates increased among all age groups, particularly for motorcyclists aged 60 and older. Those aged 18–29 had the highest fatality rates overall. Age-and-sex standardized state fatality rates were consistently highest in Wyoming, South Dakota, and South Carolina and lowest in Massachusetts, New York and New Jersey.
Conclusion: Motorcycle fatality rates increased overall and across all age groups between 2000 and 2016. Fatalities for the oldest riders showed the steadiest increasing trends. Results highlight the continued public health burden of motorcyclist fatalities and, by extension, the importance of improving motorcycle safety.
An observational study of restraint and helmet wearing behaviour in Malaysia
2018, Transportation Research Part F: Traffic Psychology and Behaviour
Unrestrained and unhelmeted occupants are at increased risk of severe injury or death in the event of a crash, and there is evidence that children, particularly in low and middle income countries, have low restraint and helmet wearing rates.
Roadside observations of occupants of passing vehicles (7247 cars, vans and taxis and 2897 motorcycles) in nearside lanes were made at seven selected road sites located around the Klang Valley (greater Kuala Lumpur) area representing a variety of demographic locations.
The findings revealed an overall low rate of seat-belt wearing in vehicles (front seat drivers: 44.6%; front seat adult passengers: 33.8%; front seat child passengers: 11.8%; rear seat adult passengers: 5.2%; and, rear seat child passengers: 5.8%). For motorcyclists, the majority of adult riders and pillions wore helmets (93.4% and 85.8%, respectively), however a substantial proportion (40%) did not fasten their helmet properly. Of children observed on motorcycles, only 30.5% wore helmets.
This study shows low seat-belt and helmet wearing rates, despite enactment of legislation that requires all vehicle passengers to be restrained and for all motorcyclists to wear helmets. This was particularly evident for children (front and rear seating positions) and rear seat adult passengers. It is suggested there is a general lack of awareness of safety and the benefits of restraint/helmet use, and lack of adequate and appropriate enforcement. The implications of the findings are discussed in terms of promoting restraint/helmets use, enforcement of legislation and implementation of technologies to increase appropriate restraint/helmet use.
Influence of demographics on risky driving behaviour among powered two wheeler riders in Kerala, India
2017, Transportation Research Part F: Traffic Psychology and Behaviour
Citation Excerpt :
The effects of age, gender and socioeconomic status have been reported globally as major factors of motorcycle crash severity and crash risk (Fernandes, Job, & Hatfield, 2007; Golias & Karlaftis, 2002; Keall & Newstead, 2012; Lin, Chang, Pai, & Keyl, 2003). Studies reveal that, young people are more involved in grievous accidents than elderly and experienced drivers (Lin et al., 2003; McKnight & McKnight, 2003; Shankar, Ramzy, Soderstrom, Dischinger, & Clark, 1992), whereas males have higher risks of accidents than females (Laapotti, Keskinen, Hatakka, & Katila, 2001; Lonczak, Neighbors, & Donovan, 2007). The association between driver’s age, gender, and driving behaviour are the key factors in developing traffic safety strategies (Dobson, Brown, Ball, Jennifer Powers, & McFadden, 1999; Jung, Xiao, & Yoon, 2013; Lin et al., 2003).
This study is designed to explore the statistical significance of the demographic variables with respect to six risky driving behaviour variables, i.e., drunken drive (DD), helmet usage (HU), cell phone usage (CU), family involvement (FI), commitment to safety (CS) and negligence of vehicle examination (NE), which influence risky driving behaviour of Powered Two Wheeler (PTW) riders. A questionnaire survey is conducted among the PTW riders from all districts of Kerala State. The results show that, male riders are significantly more involved in drunken driving and cell phone usage, while female riders are significantly more inclined to helmet usage and family involvement. The age of the rider shows significant difference on cell phone usage. The educational level of the rider exhibit significant difference on all six variables. The riders educated up to degree and above degree level are found to be more inclined to helmet usage, while drunken driving, cell phone usage and negligence of vehicle examination are found appreciably low among them compared to riders educated up to Grade 10 and Grade 12. Results of this study can be used to conduct appraisal and counselling programme about the unsafe and risky driving acts, resulting from drunken drive, helmet non usage, cell phone usage while driving and negligence of PTW examination among the male and young riders educated up to 12 Grade.
Impact of compulsory helmet legislation on mortality rate and types of head and facial injuries in Jabalpur
2017, Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology
Motorized two-wheeler users make up a high proportion of overall traffic injuries and deaths, particularly in India. Injuries to the head and neck are the main cause of death and severe disability among them. The objective of this study was to quantify the impact of compulsory helmet law imposed in Jabalpur city, for those driving two-wheelers, in reducing mortality, and head and facial injuries including the types of injuries often seen in road traffic accidents.
People of all ages involved in motorcycle–moped–scooter accidents who reported to emergency department of eight major hospitals and trauma centers of Jabalpur city or were brought in dead to these hospitals during the eight months before and after helmet legislation were included in this study. The data were compiled into overall deaths and types of head and facial injuries noted in these hospitals before and after helmet legislation.
Highly significant reduction in contused lacerated wounds of the scalp and face, upper and middle 1/3 facial fractures and head and traumatic brain injuries was noted in motorized two-wheeler accidents since September 2014 after compulsory helmet legislation. A significant reduction was also observed in cranial vault fractures with no significant reduction in lower 1/3 facial fractures and mortality rate after helmet law.
It has been confirmed through this study that mandatory use of helmets, with compulsory helmet law, is an effective measure for reducing soft tissue, head, brain and upper and middle 1/3 facial injuries in motorized two-wheeler accidents.
The effect of helmets on motorcycle outcomes in a level I trauma center in Connecticut
2016, Traffic Injury Prevention
Objective: The State of Connecticut has a partial motorcycle helmet law, which has been linked to one of the lowest helmet compliance rates in the Northeast. We examine the clinical and financial impact of low motorcycle helmet use in the State of Connecticut.
Methods: A retrospective cohort study comparing the outcomes between helmeted and nonhelmeted motorcycle crash victims over a 12.5-year period, from July 2, 2002, to December 31, 2013. All patients who were admitted to the hospital after a motorcycle crash were included in the study. Patients were stratified into helmeted and nonhelmeted cohorts. Group differences were compared using t-test or Wilcoxon rank test for continuous variables and chi-square test for dichotomous outcomes. Regression models were created to evaluate predictors of helmet use, alcohol and drugs as confounding variables, and factors that influenced hospital costs.
Results: The registry included 986 eligible patients. Of this group, 335 (34%) were helmeted and 651 (66%) were nonhelmeted. Overall, nonhelmeted patients had a worse clinical presentation, with lower Glasgow Coma Scale (GCS; P <.01), higher Injury Severity Score (ISS; P <.01), higher incidence of loss of consciousness (LOC; P <.01), longer intensive care unit (ICU; P <.01) admissions, and higher incidence of head (P <.01) or face injuries (P <.01). Nonhelmeted patients were also twice as more likely to die from their injuries (P =.04, odds ratio [OR] = 1.89, 95% confidence interval [CI], 1.02–3.45). Financially, nonhelmeted patients incurred mean hospital costs of $18,458, whereas helmeted patients incurred $14,970 (P =.18). ISS, GCS, and ICU length of stay were significantly correlated with increased hospital costs (P <.01). Not using a helmet was a significant predictor of mortality (P =.04) after adjusting for alcohol/drug use and age.
Conclusions: Helmet use is associated with lower injury severity and increased survival after a motorcycle crash. These outcomes remained consistent even after controlling for age and alcohol and drug use. The medical and financial impact of Connecticut's partial helmet law should be carefully evaluated to petition for increased education and enforcement of helmet use.

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^☆: Presented at the 34th Annual Meeting of the Association for the Advancement of Automotive Medicine, October 1–3, 1990, Scottsdale, AZ. This research was partially funded by the National Highway Safety Administration, US DOT and Maryland DOT.

^†: Present address: University of Pittsburgh, Department of Epidemiology/GSPH, 130 DeSoto Street, Pittsburgh, PA 15261.

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Helmet use, patterns of in jury, medical outcome, and costs among motorcycle drivers in Maryland☆

Abstract

Am. J. Surg.

Accid. Anal. Prev.

Abbreviated Injury Scale, 1985 Revision

The Injury Severity Score: A method for describing patients with multiple injuries and evaluating emergency care

J. Trauma

Motor vehicle trauma in northeastern Ohio. I: Incidence and outcome by age, sex, and road-use category

Am. J. Epidemiol.

Medical and economic pararneters of motorcycle-induced trauma

Clin. Orthop.

Injury patterns and helmet effectiveness among hospitalized motorcyclists

Minn. Med.

Patterns of injury in motor vehicle trauma

N. Z. Med. J.

The economics of safety deregulation: Lives and dollars lost due to repeal of motorcycle helmet law

J. Heaith Polit. Policy law

Some epidemiologic features of motorcycle collision injuries: II. Factors associated with severity of injuries

Am. J. Epidemiol.

The role of helmets in reducing head injuries from motorcycle accidents: A political or medical issue?

West. J. Med.

Functional recovery and medical costs of trauma: An analysis by type and severity of injury

J. Trauma

Classifying trauma severity based on hospital discharge diagnosis

Medical Care

Impact of repeal of motorcycle helmet law

Surg. Gynecol. Obstet.