Youth Motorcycle-Related Brain Injury by State Helmet Law Type: United States, 2005–2007

BACKGROUND AND OBJECTIVES: Twenty-seven states have youth-specific helmet laws even though such laws have been shown to decrease helmet use and increase youth mortality compared with all-age (universal) laws. Our goal was to quantify the impact of age-specific helmet laws on youth under age 20 hospitalized with traumatic brain injury (TBI). METHODS: Our cross-sectional ecological group analysis compared TBI proportions among US states with different helmet laws. We examined the following null hypothesis: If age-specific helmet laws are as effective as universal laws, there will be no difference in the proportion of hospitalized young motorcycle riders with TBI in the respective states. The data are derived from the 2005 to 2007 State Inpatient Databases of the Healthcare Cost and Utilization Project. We examined data for 17 states with universal laws, 6 states with laws for ages <21, and 12 states with laws for children younger than 18 (9287 motorcycle injury discharges). RESULTS: In states with a <21 law, serious TBI among youth was 38% higher than in universal-law states. Motorcycle riders aged 12 to 17 in 18 helmet-law states had a higher proportion of serious/severe TBI and higher average Abbreviated Injury Scores for head-region injuries than riders from universal-law states. CONCLUSIONS: States with youth-specific laws had an increased risk of TBI that required hospitalization, serious and severe TBI, TBI-related disability, and in-hospital death among the youth they are supposed to protect. The only method known to keep motorcycle-helmet use high among youth is to adopt or maintain universal helmet laws.

[1]  Harold B Weiss,et al.  Changes in motorcycle-related head injury deaths, hospitalizations, and hospital charges following repeal of Pennsylvania's mandatory motorcycle helmet law. , 2008, American journal of public health.

[2]  J B Weisbuch,et al.  Motorcycle-related trauma and helmet usage in North Dakota. , 1982, Annals of emergency medicine.

[3]  S. Boufous,et al.  Helmets for preventing injury in motorcycle riders. , 2008, The Cochrane database of systematic reviews.

[4]  J D Langley,et al.  Head injuries to bicyclists and the New Zealand bicycle helmet law. , 2000, Accident; analysis and prevention.

[5]  R. Ulmer,et al.  Evaluation of the Repeal of the All-Rider Motorcycle Helmet Law in Florida , 2005 .

[6]  H. Ross,et al.  Deterring the Drinking Driver: Legal Policy and Social Control. , 1983 .

[7]  Mary L. Chipman,et al.  Injury Control: A Guide to Research and Program Evaluation , 2001 .

[8]  M. Aitken,et al.  Trends in Hospitalizations Associated With Pediatric Traumatic Brain Injuries , 2008, Pediatrics.

[9]  David J Houston,et al.  Are helmet laws protecting young motorcyclists? , 2007, Journal of safety research.

[10]  D. L. Robinson.  No clear evidence from countries that have enforced the wearing of helmets , 2006, BMJ : British Medical Journal.

[11]  Francesco Zambon,et al.  Socioeconomic differences and motorcycle injuries: age at risk and injury severity among young drivers. A Swedish nationwide cohort study. , 2006, Accident; analysis and prevention.

[12]  Colin Macarthur,et al.  Impact of mandatory helmet legislation on bicycle-related head injuries in children: a population-based study. , 2002, Pediatrics.

[13]  Ann M Dellinger,et al.  Motor vehicle crash injury rates by mode of travel, United States: using exposure-based methods to quantify differences. , 2007, American journal of epidemiology.

[14]  Frederick P Rivara,et al.  Arguments against helmet legislation are flawed , 2006, BMJ : British Medical Journal.

[15]  Ted R Miller,et al.  Characteristics of motorcycle-related hospitalizations: comparing states with different helmet laws. , 2007, Accident; analysis and prevention.

[16]  R. Norton,et al.  Increasing age and experience: are both protective against motorcycle injury? A case-control study , 2000, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[17]  Peter Cummings,et al.  Injury Control: A Guide to Research and Program Evaluation , 2009 .

[18]  T. Miller,et al.  Incidence of Long‐term Disability Following Traumatic Brain Injury Hospitalization, United States, 2003 , 2008, The Journal of head trauma rehabilitation.

[19]  Harold Weiss,et al.  Youth Motorcycle-Related Hospitalizations and Traumatic Brain Injuries in the United States in 2006 , 2010, Pediatrics.

[20]  Anne T McCartt,et al.  Florida's Weakened Motorcycle Helmet Law: Effects on Death Rates in Motorcycle Crashes , 2006, Traffic injury prevention.