The prevalence of non-standard helmet use and head injuries among motorcycle riders

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Abstract

Objectives: This study examined the prevalence of non-standard helmet use among motorcycle riders following introduction of a mandatory helmet use law and the prevalence of head injuries among a sample of non-standard helmet users involved in motorcycle crashes. Methods: Motorcycle rider observations were conducted at 29 statewide locations in the 2 years following the introduction of the mandatory helmet use law in January, 1992. Medical records of motorcyclists who were injured in 1992 for whom a crash report was available and for whom medical care was administered in one of 28 hospitals were reviewed. Chi-squares and analysis of variance were used to describe differences between groups. Results: Prevalence of non-standard helmet use averaged 10.2%, with a range across observation sites from 0 to 48.0%. Non-standard helmet use varied by type of roadway, day of week, and time of day. Injuries to the head were more frequent and of greater severity among those wearing non-standard helmets than both those wearing no helmet and those wearing standard helmets. Conclusions: Non-standard helmets appear to offer little head protection during a crash. Future study is needed to understand the dynamics leading to head injury when different types of helmets are worn.

Introduction

Overwhelming evidence on the effectiveness of motorcycle helmets to protect against head injuries has led many states to introduce mandatory helmet use laws (Kraus et al., 1975, Fayon et al., 1976, National Highway Traffic Safety Association, 1980, Hurt et al., 1981, Krantz, 1985, McSwain and Belles, 1990). California is the most recent of these, introducing a universal helmet use law for all riders effective January 1, 1992.

Since the introduction of the California Mandatory Helmet Use Law, the use of helmets not meeting Department of Transportation Federal Motor Vehicle Safety Standard 218, often referred to as ‘bogus’ helmets, has been observed. These helmets are characterized by very small coverage of the head, less than the required one inch thickness of energy-absorbing lining, and a lining made of less absorbent material. Bogus helmets are worn by some motorcycle riders to protest mandatory helmet legislation, but other riders may unknowingly purchase these helmets.

Wearing a non-standard helmet does not meet the requirements of the 1992 California Mandatory Helmet Use Law, which requires a helmet meeting DOTSS 218 to be worn, and is therefore a citable offense. However, non-standard helmets can appear to meet requirements to the untrained consumer because, like standard helmets, non-standard helmets usually have a sticker indicating DOT approval. This sticker is applied by the manufacturer, and the difficult task of recalling these helmets from the market is the responsibility of the government. This confusion over the consumers ability to determine which helmets are bogus makes it difficult to uphold citations in court. Thus, traffic enforcement officials have little incentive to cite individuals who are wearing helmets they suspect to be bogus. Of greater concern is the possibility of consumers purchasing inexpensive bogus helmets that they believe to offer standard protection.

The use of non-standard helmets has been reported in Florida, Maryland, Massachusetts, and West Virginia (National Highway Traffic Safety Association, 1992). Although non-standard helmets do not satisfy the requirements outlined by DOTSS 218, the level of head protection offered by these helmets has not been determined.

This paper summarizes data gathered to evaluate the California Mandatory Motorcycle Helmet Use Law, implemented January 1, 1992 (Kraus et al., 1994, Kraus et al., 1995). The prevalence of non-standard helmet use among motorcycle riders following the introduction of the law was assessed from roadside observations. The prevalence of head injuries as diagnosed in medical records among a sample of non-standard helmet users was compared with riders wearing and not wearing helmets.

Section snippets

Methods

Observations of motorcycle riders at 29 locations in ten counties throughout the state of California were conducted in September and December of 1992 and March and September of 1993, which represent the first and second years of the mandatory helmet law. The ten counties were chosen to represent California geographically. Observations were conducted for 2–3 h at each site, and included freeway, state, and primary roads. Details of the observations have been described previously (Kraus et al.,

Roadside observations

Among the 5119 motorcycle riders observed, 375 were wearing non-standard helmets and 146 were suspected to be wearing non-standard helmets, for a total of 521 (10.2%) riders wearing suspicious helmets (Table 1). Over 99% of observed riders were wearing a helmet of some type, and these results are discussed in a previous publication (Kraus et al., 1994). Across observation locations, prevalence of non-standard helmet use ranged between 0 and 48.0%. Riders on state roads, which are the most

Discussion

Observations of motorcycle riders show that following the implementation of a mandatory motorcycle helmet law in California, about 10% of riders, knowingly or unknowingly, wore a non-standard helmet. Among the injured riders examined in this sample for whom helmet status was known, non-standard helmets appear to lead to more frequent and more severe head injury than both riders wearing standard helmets and riders not wearing any head protection at all. Riders wearing standard helmets were less

Acknowledgements

This work was supported by the SCIPRC under grant R49/CCR903622 from the Centers for Disease Control and Prevention, the UCLA Brain Injury Research Center, the UCLA Center for Occupational and Environmental Health, the California Office of Traffic Safety, and the Insurance Institute for Highway Safety.

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