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Motorcycle Helmet and Helmet-Law Effectiveness

Studies Show Helmets Save Lives and Reduce Injuries and that All-Rider Helmet Laws Are a Scientifically Proven Lifesaving Intervention. SMARTER has compiled a Research Reference List regarding motorcycle and motorcycle helmet law effectiveness including economic impacts.

Download a special edition of SMARTER's newsletter Riding SMART! (Sept/Oct 2014) for a quick reference that (1) summarizes the below research and/or literature reviews related to helmet use and helmet-use laws, (2) provides a brief history of helmet use and helmet-use laws, and (3) reviews the components and goals of a comprehensive motorcyclist-safety program.  

  • Helmets for Preventing Injury in Motorcycle Riders (Review) - a high quality review of the research regarding the effectiveness of helmets in reducing the risk of death and injury. Sixty-one observational studies were selected for review; references for each are provided along with the results and a brief description of the characteristics of each study, references for 18 studies excluded from the review, and 28 additional references. Despite methodological differences in the 61 included studies, the results showed remarkable consistency, particularly for death and head-injury outcomes.

    Motorcycle helmets were found to reduce the risk of death by 42 percent and head injury by 69 percent in motorcyclists who crashed.

  • An Evidence-Based Review: Helmet Efficacy to Reduce Head Injury and Mortality in Motorcycle Crashes - a review of the U.S. National Library of Medicine literature from 1990 through 2009, with 507 citations identified. The abstract for each was reviewed, and 197 candidate articles having possible applicability to the guideline topic were retrieved and reviewed. General reviews, letters to the editor, single case reports, and retrospective reviews of poor quality were excluded, leaving 45 articles that were reviewed in detail. References for each are provided along with the results and a brief description of the characteristics of each study.

    Summary of conclusions: (1) the use of motorcycle helmets decreases the overall death rate of motorcycle crashes when compared with nonhelmeted riders; (2) the use of motorcycle helmets decreases the incidence of lethal head injury in motorcycle crashes when compared with nonhelmeted riders; (3) the use of motorcycle helmets decreases the severity of nonlethal head injury in motorcycle crashes when compared with nonhelmeted riders; and (4) geographical areas that have mandatory universal helmet laws have reduced rates of mortality and head injury compared with areas that do not.

  • Use of Motorcycle Helmets: Universal Helmet Laws
    The Community Guide, July 2014
    - an extensive and rigorous review of the literature on the effectiveness of helmet use, the effectiveness of universal motorcycle helmet laws, and the economic impact of repeal or implementation of universal helmet laws. The review of helmet-use and helmet-law effectiveness was completed August 2013, and the economic-impact review was completed October 2013.

    The Community Preventive Services Task Force recommends universal motorcycle helmet laws (laws that apply to all motorcycle operators and passengers) based on strong evidence of effectiveness. Evidence indicates that universal helmet laws increase helmet use; decrease motorcycle-related fatal and nonfatal injuries; and are substantially more effective than no law or than partial motorcycle helmet laws, which apply only to riders who are young, novices, or have medical insurance coverage above certain thresholds.

    To provide easier access to the results and to emphasize the comprehensiveness of this particular study, we have chosen to post it below in four separate sections and have provided a description of each:
    • Helmet Effectiveness - this section provides a summary and review of the Task Force Findings and Rationale Statement regarding the effectiveness of helmet use in preventing death, injury, and reducing the severity and risk of head injury, including the results of
      • ⇒41 studies on helmet use
        ⇒37 studies comparing fatalities
        ⇒35 studies comparing fatalities per registered motorcycle
        ⇒7 studies comparing fatalities per mile traveled
        ⇒14 studies comparing fatalities per crash
        ⇒12 studies regarding head injury fatalities
        ⇒18 studies regarding nonfatal injuries total
        ⇒18 nonfatal head injuries
    • Helmet-Law Effectiveness - this section provides a summary of the results of
      • ⇒the impact of repealing a universal helmet law, including ⇒the impact of implementing a universal helmet law
        ⇒comparison of death and injury data across states with universal, partial, or no helmet law
        ⇒the impact on death, injury, and use of a helmet among young riders with repeal of universal helmets laws, implementation of a universal helmet law, and comparison across states with different types of laws or no law
        • • 19 studies regarding helmet use
          • 17 studies on total deaths
          • fatality rates per registered motorcycle (17), per vehicle mile traveled (3), and per crash (10)
    • Supporting Material: Helmet and Helmet-Law Effectiveness - this section provides reference information for
      • ⇒69 studies that were included in the review
        ⇒6 papers that provided more information about included studies
        ⇒13 studies determined ineligible due to study country or article language
        ⇒20 studies determined ineligible due to unsuitable study type
        ⇒15 studies determined ineligible due to lack of outcomes of interest
    • Supporting Material: Economic Impact - this section provides reference information for the 22 studies that provided the information for assessment of economic impact of repeal or implementation of universal helmet laws
  • Motorcycle Helmets Use Reduces Mortality and Resource Utilization, Annals of Surgery, September 2010, A review. Helmet use reduces motorcycle rider mortality rates and resource utilization. Such helmet use occurs more often where laws prescribe helmet use. This large database study clearly shows that helmets provide protection for motorcycle riders from mortality and other injuries. Head injury is also less severe. Health care resource utilization is also diminished. Because more non-helmeted riders do not have health insurance, helmets therefore reduce societal costs of injuries suffered by motorcycle riders. Because helmet use is greater when laws dictate their use, such laws benefit the individual by reducing mortality and society by reducing costs.
  • Current Motorcycle Helmet Laws and Fatality Rates - an April 2014 downloadable and printable chart prepared by the National Council of State Legislatures (NCSL) that shows the percentage of people killed in motorcycle crashes by state, in 2011, who were not wearing helmets compared to type/kind of state motorcycle helmet law
  • How Safe Is Your Motorcycle Helmet? Study on Motorcycle Helmet Types. ‚Äč
    • American Association of Oral and Maxillofacial Surgeons, 2014
    • Facial Injury Severity score was significantly higher for unhelmeted riders compared with fullface helmet riders with no difference between unhelmeted riders and open-face helmet users 
    • TBI were statistically greater for those wearing open-face helmets compared with full-face helmets. 
  • Effectiveness of Different Types of Motorcycle Helmets and Effects of Their Improper Use on Head Injuries - a case-control study conducted to examine how different helmet types and improper helmet use affected protection against head injuries among motorcyclists in Taiwan

    Differences among three helmet types and the ineffectiveness of improper helmet use in preventing head injuries are speculated about but are seldom explored to derive empirical evidence.

    Summary of conclusions: (1) nonhelmeted motorcyclists were more than four times as likely to have head injuries than helmeted motorcyclists and ten times as likely to have brain injuries; (2) compared with motorcyclists wearing full-face helmets, those wearing half-coverage helmets were more than twice as likely to have head injuries and brain injuries; and (3) compared with motorcyclists with firmly fastened helmets, those with loosely fastened helmets increased their risk of head injury; and were more than twice as likely to have brain injuries.

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Evaluation of the Effects of Helmet-Law Introduction,
Repeal, and/or Reinstatement

Studies Show Helmet Laws Save Lives and Reduce Injuries

Several pivotal research studies have established the fact that helmet laws save lives and reduce injuries:

  • An Analysis of Motorcycle Helmet Use In Fatal Crashes (2008) - additional research that found that the odds of a rider wearing a helmet, in both single-vehicle and two-vehicle crashes, were significantly reduced in states without a universal helmet law
  • Motorcycle Safety and the Repeal of Universal Helmet Laws - an assessment published in the Nov. 2007 American Journal of Public Health of the implications for motorcyclist safety of repeals of universal helmet laws in six U.S. states by examining cross-sectional time-series data from the 50 states and the District of Columbia for the period 1975 through 2004. When compared to state experience with no helmet mandate, universal helmet laws were associated with an 11.1% reduction in motorcyclist fatality rates, whereas rates in states with partial-coverage statutes were not statistically different from those with no helmet law
  • The Effectiveness of Motorcycle Helmets and Mandatory Helmet Laws - Dec. 9, 2006, study by Louisiana State University

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Evaluation of the Effects of Helmet Laws on Injury Outcomes

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Evaluation of the Effects of Helmet Laws on Youthful Riders

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