Non-helmeted motorcyclists: a burden to society? A study using the National Trauma Data Bank.

INTRODUCTION Helmet laws remain controversial. Opponents believe negative findings are a result of biased statistical analyses that fail to account for the impact of alcohol and drugs. In this study, we evaluated the effect that helmet use had upon injury severity, outcome controlling for alcohol or drug use, resource utilization, and financial burden using the National Trauma Data Bank (NTDB). METHODS Two groups of patients, helmeted and non-helmeted motorcyclists, were identified using the NTDB over an 8-year period. Group differences were compared using nonparametric Wilcoxon tests for continuous variables and Fisher's exact test for dichotomous outcomes. To evaluate the effect that alcohol or drug use had on mortality, logistic regression models were created. RESULTS A total of 9,769 patients were identified by the NTDB of which 6756 (69.2%) were helmeted and 3013 (30.8%) were non-helmeted. Helmet use was associated with lower injury severity, mortality, and resource utilization. Non-helmeted motorcyclists accrued greater hospital charges and were significantly less likely to have health insurance. When controlling for alcohol or drug use, mortality continued to be significantly associated with non-helmet use. CONCLUSION Non-helmeted motorcyclists have worse outcomes than their helmeted counterparts independent of the use of alcohol or drugs. Furthermore, they monopolize more hospital resources, incur higher hospital charges, and as non-helmeted motorcyclists frequently do not have insurance, reimbursement in this group of patients is poor. Thus, the burden of caring for these patients is transmitted to society as a whole.

[1]  P J McFeeley,et al.  Motorcycle fatalities in New Mexico: the association of helmet nonuse with alcohol intoxication. , 1992, Annals of emergency medicine.

[2]  P. Czobor,et al.  Psychosocial risk factors associated with suicide attempts and violence among psychiatric inpatients. , 2004, Psychiatric services.

[3]  N. Ialongo,et al.  African American children's reports of depressed mood, hopelessness, and suicidal ideation and later suicide attempts. , 2004, Suicide & life-threatening behavior.

[4]  P. Shekelle,et al.  Preventing violence and related health-risking social behaviors in adolescents. , 2004, Evidence report/technology assessment.

[5]  K. Belton,et al.  Intentional and unintentional injuries across health regions in Alberta, Canada: an implication for policy. , 2004, Crisis.

[6]  J F Kraus,et al.  Compliance with the 1992 California motorcycle helmet use law. , 1995, American journal of public health.

[7]  Lotta Jakobsson.  Evaluation of impact severity measures for AIS 1 neck injuries in frontal impacts using crash recorder data , 2004 .

[8]  Cordelia Erickson-Davis,et al.  Falls and injuries resulting from falls among patients with Parkinson's disease and other parkinsonian syndromes , 2005, Movement disorders : official journal of the Movement Disorder Society.

[9]  J F Kraus,et al.  The impact of two related prevention strategies on head injury reduction among nonfatally injured motorcycle riders, California, 1991-1993. , 1995, Journal of neurotrauma.

[10]  V G Wagle,et al.  Is helmet use beneficial to motorcyclists? , 1993, The Journal of trauma.

[11]  Ian Rivers,et al.  Recollections of bullying at school and their long-term implications for lesbians, gay men, and bisexuals. , 2004, Crisis.

[12]  Ronald V. Maier,et al.  The influence of ethanol intoxication on outcome of injured motorcyclists. , 1983 .

[13]  D. Gray,et al.  Adolescent suicide myths in the United States. , 2004, Crisis.

[15]  T. Bent-Goodley.  Perceptions of domestic violence: a dialogue with African American women. , 2004, Health & social work.

[16]  W. Chiu,et al.  The effect of the Taiwan motorcycle helmet use law on head injuries. , 2000, American journal of public health.

[17]  D. Gunnell,et al.  Suicide by Gunshot in the United Kingdom: A review of the literature , 2004, Medicine, science, and the law.

[18]  E Petrucelli,et al.  Medical consequences of motorcycle helmet nonusage. , 1984, The Journal of trauma.

[19]  Stephen M Cohn,et al.  The impact of a repealed motorcycle helmet law in Miami-Dade County. , 2002, The Journal of trauma.

[20]  N. Mcswain,et al.  Motorcycle helmets--medical costs and the law. , 1990, The Journal of trauma.

[21]  F P Rivara,et al.  Injury prevention strategies to promote helmet use decrease severe head injuries at a level I trauma center. , 1995, The Journal of trauma.

[22]  Edmund R. Becker,et al.  The Impact of the Texas 1989 Motorcycle Helmet Law on Total and Head-Related Fatalities, Severe Injuries, and Overall Injuries , 1992, Medical care.

[23]  F P Rivara,et al.  The impact of motorcycle helmet use. , 1991, The Journal of trauma.

[24]  Joseph A Kufera,et al.  Autopsy study of motorcyclist fatalities: the effect of the 1992 Maryland motorcycle helmet use law. , 2002, American journal of public health.

[25]  J F Kraus,et al.  The effect of the 1992 California motorcycle helmet use law on motorcycle crash fatalities and injuries. , 1994, JAMA.

[26]  M. J. Carey,et al.  The negative impact of the repeal of the Arkansas motorcycle helmet law. , 2002, The Journal of trauma.

[27]  Vicenzio Holder-Perkins,et al.  Environmental risk factors in hospital suicide. , 2004, Suicide & life-threatening behavior.

[28]  D. Kendrick,et al.  Engagement in safety practices to prevent home injuries in preschool children among white and non-white ethnic minority families , 2004, Injury Prevention.

[29]  M Giustini,et al.  Effect of Italy’s motorcycle helmet law on traumatic brain injuries , 2003, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[30]  G. Franklin,et al.  Hospital cost is reduced by motorcycle helmet use. , 2002, The Journal of trauma.