Original contribution
Motorcycle crash injuries and costs: Effect of a reenacted comprehensive helmet use law

https://doi.org/10.1016/S0196-0644(05)80886-8Get rights and content

Study objectives:

To document the effect of a reenacted comprehensive helmet use law on injuries and fatalities.

Design:

Retrospective before-and-after analysis.

Setting:

Two urban counties representing 40% of Nebraska's population.

Participants:

Six hundred seventy-one patients reported as injured to the Nebraska Department of Roads in the period from one year before through one year after the reenactment on January 1, 1989.

Results:

The helmet use law was temporally associated with a 26% decrease in the reported rate of motorcycle crashes in Nebraska compared with five other midwestern states. There were sharp declines in the number (and rates) of reported injured, hospital transports, hospital admissions, severe nonhead injuries, severe head injuries, and deaths. Serious head injuries (Abbreviated Injury Score, 3 or higher) decreased 22%. The percentage of injured motorcyclists with serious head injuries was significantly lower among the helmeted motorcyclists (5%) than among the unhelmeted cyclists (14%) for the two years combined.

Conclusion:

The reenactment of a helmet use law resulted in fewer crashes, fatalities, and severe head injuries.

References (58)

  • HaddadJP et al.

    Motorcycle accidents: A review of 77 patients treated in a three-month period

    J Trauma

    (1976)
  • ZettasJP et al.

    Injury patterns in motorcycle accidents

    J Trauma

    (1979)
  • AndrewTA

    A six-month review of motorcycle accidents

    Injury

    (1978)
  • RiceDP et al.

    Cost of Injury for the United States: A Report to Congress

  • BachBR et al.

    Financial charges of hospitalized motorcyclists at the Massachusetts General Hospital

    J Trauma

    (1986)
  • BrayT et al.

    Cost of orthopedic injuries sustained in motorcycle accidents

    JAMA

    (1985)
  • MayC et al.

    Motorcycle helmet use, incidence of head injury, and cost of hospitalization

    J Emerg Nurs

    (1989)
  • McSwainNE et al.

    Motorcycle helmets—Medical costs and the law

    J Trauma

    (1990)
  • RivaraFP et al.

    The public cost of motorcycle trauma

    JAMA

    (1988)
  • SchuchmannJA

    Motorcycle helmet laws—Legislative frivolity or common sense

    Tex Med

    (1988)
  • LloydLE et al.

    Motorcycle deaths and injuries in Texas: Helmets make a difference

    Tex Med

    (1987)
  • CairnsH

    Head injuries in motor-cyclists: The importance of the crash helmets

    Br Med J

    (1941)
  • BriedJM et al.

    Medical and economic parameters of motorcycle-induced trauma

    Clin Orthop

    (1987)
  • LunaGK et al.

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

    West J Med

    (1981)
  • GoldsteinJP

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

    Eval Rev

    (1986)
  • KrausJF et al.

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

    Am J Epidemiol

    (1975)
  • McSwainNE et al.

    Medical consequences of motorcycle helmet nonusage

    J Trauma

    (1984)
  • McSwainNE et al.

    Impact of repeal of motorcycle helmet law

    Surg Gynecol Obstet

    (1980)
  • SoodS

    Survey of factors influencing injury among riders involved in motorized two-wheeler accidents in India: A prospective study of 302 cases

    J Trauma

    (1988)
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    Presented at the Society for Academic Emergency Medicine Annual Meeting in Washington, DC, May 1991.

    This work was supported by the Insurance Institute for Highway Safety.

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