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PubMed1994

[Head injuries in traffic accidents with emphasis on the comparisons between motorcycle-helmet users and non-users].

Motor-vehicle incidents in Taiwan are a major cause of head injuries. Our objective was to analyze the characteristics of head injuries caused by motor vehicle accidents in terms of the injured person's demographic characteristics, time and types of crash, injury severity on the abbreviated injury scale (AIS), medical cost and benefits of helmet protection. For this purpose we conducted an epidemiologic survey of 2451 consecutive victims of traffic accidents, coming to, or managed at, the emergency care department of a large Taipei metropolitan hospital in 1990. The results showed that the most common cause of head injury in traffic accidents was a motorcycle incident. Motorcycle accident injured patients were generally young males, laborers or students. Most head injuries occurred between 16:00 and 23:00, and peaking at 21:00 in a day. Forty-three points four percent of patients were admitted, major head injury fatalities occurred within one week of the collision. The elderly or patients with high AIS comprised most nonsurvivors. According to our data, helmet usage was about 14% overall. Helmetless young riders were numerous among the total victims. A significant difference was noted in the severity of injury of helmeted users of motorcycles, compared with those who wore no helmet. As expected, patients who did not wear a helmet had a greater AIS average and higher rate of fatality. Forty-one of the 42 fatalities were patients who had been riding on motorcycles without helmets. Helmets provide adequate protection and reduce severity of injury, and medical cost for motorcycle collisions.

Accidents, Traffic↗
PubMed2002

Association of helmet use with death in motorcycle crashes: a matched-pair cohort study.

The association of helmet use with death in a motorcycle crash can be estimated using matched-pair cohort methods. By estimating effects among naturally matched pairs on the same motorcycle, one can account for potential confounding by motorcycle characteristics, crash characteristics, and other factors that may influence the outcome. The authors used Fatality Analysis Reporting System data, from 1980 through 1998, for motorcycles that crashed with two riders and either the driver or the passenger, or both, died. For their main analysis, the authors estimated the relative risk of death using conditional Poisson regression. The relative risk of death, accounting for the matching on motorcycle and adjusted for age, sex, and seat position, for a helmeted rider compared with an unhelmeted rider was 0.61 (95% confidence interval: 0.54, 0.70). The authors suggest that conditional Poisson regression is useful for the analysis of traffic crash data, where occupants are naturally matched in a vehicle and where crash-related confounders may be difficult or impossible to measure.

Accidents, Traffic↗
PubMed1983

Time trends in motorcycle accidents in Britain.

Motorcycle accidents constitute a major cause of death and disability among the young. This paper draws on routinely collected data to describe the trends for motorcycling and motorcycle accidents in Britain between 1951 and 1980. The level of risk (calculated as motorcyclist fatalities per motorcycle kilometre travelled) has fallen, but this effect has been overwhelmed by changes in motorcycle use. The paper discusses some of the factors that may have contributed to these time trends and concludes that accident prevention programmes should address the determinants of use as well as those of risk.

Accidents, Traffic↗
PubMed1997

[Motorcycle accidents in street traffic. An analysis of 86 cases].

A retrospective study of 86 motorcycle accidents that occurred in the year 1992 is reported. Examination of the case histories supplemented by telephone conversations yielded the following results: 90.7% of our patients were male and their average age was 28.8 years; the age group between 25 and 30 years was the most frequently involved (27.9%). Most motorcycle accidents happened during weekend trips out in the summertime. Special injury patterns were found for injuries of the upper and the lower extremity. Lower extremity injuries (46%), and especially open tibia fractures (19.7%), were among the most common injuries sustained by motorcyclists in crashes. Injuries of the upper extremity most frequently took the form of fracture of the distal radius (18.8%). The average stay in our hospital was 35.4 days. In 23.4% of cases the patients had to change their job after the accident. More than half the crashes happened with motorcycles with between 500 and 750 cc stroke volume. Over a third (34.5%) of the patients had held their driving licences for more than 8 years. A plea is made for more preventive measures, such as better driving instruction, better road conditions and legislative changes, against motorcycle crashes. From the aspects of cost and the rate of complications it is reasonable to strive for a surgical treatment as soon as possible after the crash.

Accidents, Traffic↗
PubMed1988

Helmet effectiveness in preventing motorcycle driver and passenger fatalities.

Helmet effectiveness in preventing fatalities to motorcycle drivers and passengers was determined by applying the double pair comparison method to the Fatal Accident Reporting System (FARS) data for 1975 through 1986. Motorcycles with a driver and a passenger, at least one of whom was killed, were used. In order to reduce as much as possible potentially confounding effects due to the dependence of survivability on sex and age, the analysis is confined to male drivers (there were insufficient female driver data), and to cases in which the driver and passenger age do not differ by more than three years. Motorcycle helmet effectiveness estimates are found to be relatively unaffected by performing the analyses in a number of ways different from that indicated above. It was found that helmets are (28 +/- 8)% effective in preventing fatalities to motorcycle riders (the error is one standard error), the effectiveness being similar for male and female passengers, and similar for drivers and passengers. An additional result found was that the fatality risk in the driver seat exceeds that in the passenger seat by (26 +/- 2)%. The 28% effectiveness found generates calculated fatality increases from repeal of mandatory helmet-wearing laws that are compatible with observed increases.

Accidents, Traffic↗
PubMed1992

Travel exposure and choice of comparison crashes for examining motorcycle conspicuity by analysis of crash data.

Much research has been conducted examining the problem of motorcycle road crashes. Most of this research has concluded that motorcyclists have a conspicuity problem, particularly during the day. This type of research has often involved comparing multi-vehicle motorcycle crashes with single vehicle motorcycle crashes occurring during the day and night. The aim of this paper is to point out that comparison of single and multiple vehicle motorcycle crashes juxtaposes subsets of crashes with clearly different causes (car drivers' possible failure to detect a motorcyclist against motorcyclists' loss of vehicle control). Comparing groups of crashes for which conspicuity can be posited as a common cause (car drivers' possible failure to detect a motorcyclist or car) may be a more enlightening comparison. The issue of exposure is also examined in this paper.

Accidents, Traffic↗
PubMed1993

Injury patterns in motorcycle road racers: experience on the Isle of Man 1989-1991.

We report the first prospective study on the incidence of motorcycle accidents of the world's foremost motorcycle road-racing venue, the Isle of Man. Between 1989 and 1991 there were six meetings during which over 2500 riders took part. Racing on essentially normal country and town roads, the motorcycles can reach speeds in excess of 306 km/h and the average lap record is now 198 km/h. During the study, 175 motorcyclists were injured and 16 were killed (9.1 per cent). The most common injury patterns were soft tissue injury (114 riders), head injury (52) and fractures/dislocations (188), of which one-third were open. The injuries sustained were more frequent and of a greater severity than recreational motorcycling. The casualty rate was 15 times, and the fatality rate 87 times the national figures. Of the 16 fatalities only seven reached hospital alive, despite the use of helicopter air ambulance, and 14 had serious head injuries. No fatality was thought to have been avoidable on review. There were no cervical spine injuries and only two major abdominal injuries. Of the injured riders, 93 (56 per cent) were admitted and there were 170 surgical procedures undertaken on 54 riders.

Adolescent↗
PubMed1987

Fatal motorcycle accidents and alcohol.

A series of fatal motorcycle accidents from a 7-year period (1977-1983) has been analyzed. Of the fatalities 30 were operators of the motorcycle, 11 pillion passengers and 8 counterparts. Of 41 operators 37% were sober at the time of accident, 66% had measurable blood alcohol concentration (BAC); 59% above 0.08%. In all cases where a pillion passenger was killed, the operator of the motorcycle had a BAC greater than 0.08%. Of the killed counterparts 2 were non-intoxicated, 2 had a BAC greater than 0.08%, and 4 were not tested. The results advocate that the law should restrict alcohol consumption by pillion passengers as well as by the motorcycle operator. Suggestions made to extend the data base needed for developing appropriate alcohol countermeasures by collecting sociodemographic data on drivers killed or seriously injured should be supported.

Accidents, Traffic↗
PubMed2005

Particle size distribution of polycyclic aromatic hydrocarbons in motorcycle exhaust emissions.

The size distribution of polycyclic aromatic hydrocarbons (PAHs) in emission of a two-stroke carburetor motorcycle was studied. The exhaust gas from the test motorcycle was passed to a dilution tunnel and collected using a 10 cascade micro-orifice uniform deposit impactor (MOUDI) of 0.056-10 microm aerodynamic diameter fitted with aluminum substrates. All MOUDI substrates were analyzed for particulate mass and for PAHs by GC/MS. Most of the 21 analyzed PAHs have two significant modes that peak at <0.1 and 0.18-0.32 microm. For some PAHs, a third peak appears around 1.8 microm. MOUDI impactor samples show that 88.9% particulate and 89.6% PAH mass distributed smaller than 2.5 microm. Mass median diameters of PAHs are about 0.2 microm. Total benzo[a]pyrene toxic equivalency emission factor was 440+/-13.8 ng/km for the test motorcycle. An average of 90.3% of carcinogenicity is observed in particulate smaller than 1.0 microm. The results suggest that submicron particulates predominate in the exhaust from motorcycle and exhibit high carcinogenic potency for these particulate.

Air Pollutants↗
PubMed1999

An evaluation of the general effect of the New Zealand graduated driver licensing system on motorcycle traffic crash hospitalisations.

In 1987, New Zealand introduced a comprehensive Graduated Driver Licensing System (GDLS) which was designed to allow new drivers to gain driving experience while being excluded from high risk situations. This study sought to evaluate the impact of the GDLS on motorcycle traffic crashes that resulted in serious injury. Injury crash data were obtained from the New Zealand Health Information Services national public hospital inpatient data files for the years 1978-1994, inclusive. Cases were disaggregated into three age groups, 15-19 years, 20-24 years, and 25 years or older, for which injury trends were obtained. In order to determine whether trends in motorcycle traffic crashes simply followed national trends in other injury events, two non-traffic comparison groups for the main target group (15-19 years) were included. Using time series analyses, the introduction of the GDLS was found to be closely followed by a significant reduction (22%) in motorcycle traffic crash hospitalizations for the 15-19 year age group. An examination of vehicle registration and driver licensure data suggests that the reduction in injury crashes may, largely, be attributable to an overall reduction in exposure to motorcycle riding.

Accidents, Traffic↗
PubMed2002

An analysis of motorcycle injury and vehicle damage severity using ordered probit models.

PROBLEM: Motorcycles constitute about 19% of all motorized vehicles in Singapore and are generally overrepresented in traffic accidents, accounting for 40% of total fatalities. METHOD: In this paper, an ordered probit model is used to examine factors that affect the injury severity of motorcycle accidents and the severity of damage to the vehicle for those crashes. Nine years of motorcycle accident data were obtained for Singapore through police reports. These data included categorical assessments of the severity of accidents based on three levels. Damage severity to the vehicle was also assessed and categorized into four levels. Categorical data of this type are best analyzed using ordered probit models because they require no assumptions regarding the ordinality of the dependent variable, which in this case is the severity score. Various models are examined to determine what factors are related to increased injury and damage severity of motorcycle accidents. RESULTS: Factors found to lead to increases in the probability of severe injuries include the motorcyclist having non-Singaporean nationality, increased engine capacity, headlight not turned on during daytime, collisions with pedestrians and stationary objects, driving during early morning hours, having a pillion passenger, and when the motorcyclist is determined to be at fault for the accident. Factors leading to increased probability of vehicle damage include some similar factors but also show some differences, such as less damage associated with pedestrian collisions and with female drivers. In addition, it was also found that both injury severity and vehicle damage severity levels are decreasing over time.

Accidents, Traffic↗
PubMed1992

Motorcycle fatalities in New Mexico: the association of helmet nonuse with alcohol intoxication.

STUDY OBJECTIVE: To determine the relationship among helmet use, alcohol use, and ethnicity in people killed on motorcycles. DESIGN: Retrospective review of all motorcycle fatalities in New Mexico from 1984 through 1988. SETTING: Office of the Medical Investigator, State of New Mexico. TYPE OF PARTICIPANTS: All decedents of motorcycle crashes in New Mexico from 1984 through 1988. INTERVENTIONS: Review of all autopsies, medical investigator reports, traffic fatality reports, and toxicological studies on fatally injured motorcyclists. RESULTS: Nine of the helmeted drivers (18%) were legally intoxicated compared with 67 of the nonhelmeted drivers (51%) (chi 2 = 15.7, P less than .0001); 42 of the white nonHispanic decedents (37%), ten of Hispanic decedents (12%), and none of the Native-American decedents were wearing helmets. The head and neck region was the most severely injured body region in 42 of the nonhelmeted cases (84%) and in eight of the helmeted cases (50%) (Fisher's exact test, P less than .02). CONCLUSION: There is an association between nonuse of helmets and alcohol intoxication in fatally injured motorcyclists in New Mexico. Strategies for preventing motorcycle fatalities should address alcohol abuse and ethnicity in conjunction with helmet use.

Abbreviated Injury Scale↗
PubMed2003

Association of alcohol-related laws with deaths due to motor vehicle and motorcycle crashes in the United States, 1980-1997.

The authors compared US motor vehicle and motorcycle mortality rates during periods when each of several alcohol-related laws were in effect with mortality rates during other periods. During the period 1980-1997, there were 792,184 deaths due to motor vehicle crashes and 63,052 deaths due to motorcycle crashes. An estimated 26% and 49% of these fatalities, respectively, were attributable to alcohol use. The incidence of alcohol-related mortality in motor vehicle crashes was lower when laws specifying a blood alcohol concentration of 0.08 g/dl per se (laws stating that it is a criminal offense to drive with a blood alcohol concentration above the state's legal limit) were in effect (adjusted rate ratio (RR) = 0.86, 95% confidence interval (CI): 0.83, 0.88). For motorcycle deaths, the adjusted rate ratio was 0.87 (95% CI: 0.79, 0.95). The incidence of alcohol-related mortality in motor vehicle crashes was also lower during periods when two other types of laws were in effect: zero tolerance laws (adjusted RR = 0.88, 95% CI: 0.86, 0.90) and administrative license revocation laws (adjusted RR = 0.95, 95% CI: 0.93, 0.98). Overall motorcycle mortality was lower when administrative license revocation laws were in effect (adjusted RR = 0.95, 95% CI: 0.92, 0.98).

Accidents, Traffic↗
PubMed2001

Crash severity, injury patterns, and helmet use in adolescent motorcycle riders.

BACKGROUND: This study examined crash severity and injury patterns between helmeted and unhelmeted adolescent motorcycle riders. METHODS: Among an initial population of 4,721 junior college students, 1,284 students were involved in 1,889 motorcycle crashes during a 20-month follow-up period. Crash severity was measured by both the type of collision object and the repair cost of motorcycle damage. RESULTS: The incidence rates of crash, injury, hospitalization, and deaths per 1,000 person-years in the cohort were 358, 104, 14, and 1.3, respectively. Compared with helmeted riders, unhelmeted riders had more noncollisions and fewer collisions with a moving car but there was no significant difference in repair cost of motorcycle damage between these groups. More injuries to the external skin, face, and head and more severe injuries occurred in unhelmeted than in helmeted riders. Among crashes resulting in hospitalization/death, more injuries to the face and head occurred in unhelmeted riders than in helmeted riders. CONCLUSION: Crashes involving unhelmeted riders were not more severe but more frequently involved face and head injuries than crashes involving helmeted riders.

Accidents, Traffic↗
PubMed2003

Agricultural motorcycle injuries in WA adolescents.

OBJECTIVE: To determine and compare the prevalence, nature and predictors of agricultural motorcycle injuries (2, 3 & 4 wheels) in a high-risk cohort of Western Australian adolescents. METHODS: A cross-sectional survey of 326 students (Years 11 and 12) was drawn from the six designated agricultural colleges, in Western Australia. The survey instrument was assessed as reliable and measured riding exposure, vehicle type and maintenance, use of protective equipment, training and injury experience. RESULTS: For those subjects with access to an agricultural motorcycle (n = 240), a total of 53% (n = 127) had incurred an injury. Of these, 73% (n = 92) resulted from two wheelers and 24% (n = 31) from ATVs, with 3% (n = 4) not specified. No significant differences in the nature of injury or body parts injured was observed. Approximately one-third of those injured required medical treatment. Predictors of injury were maximum travelling speed exceeding 101 km/hour (OR 4.53) and only sometimes wearing a helmet (OR 4.10). CONCLUSIONS: Agricultural motorcycle injuries are a significant issue in rural areas, with potential intervention points relating to improving rider training and reducing specific risk-taking behaviours. IMPLICATIONS: Further work to investigate the efficacy of rider training interventions for agricultural motorcycles are warranted.

Accidents↗
PubMed2003

Effect of Italy's motorcycle helmet law on traumatic brain injuries.

OBJECTIVES: To evaluate the impact of a revised Italian motorcycle-moped-scooter helmet law on crash brain injuries. DESIGN: A pre-post law evaluation of helmet use and traumatic brain injury (TBI) occurrence from 1999 to 2001. SETTING: Romagna region, northeastern Italy, with a 2000 resident population of 983 534 persons. PARTICIPANTS: Motorcycle-moped rider survey for helmet use compliance and all residents in the region admitted to the Division of Neurosurgery of the Maurizio Bufalini Hospital in Cesena, Italy for TBI. OUTCOME MEASURES: Helmet use compliance and change in TBI admissions and type(s) of brain lesions. RESULTS: Helmet use increased from an average of less than 20% to over 96%. A comparison of TBI incidence in the Romagna region shows that there was no significant variation before and after introduction of the revised helmet law, except for TBI admissions for motorcycle-moped crashes where a 66% decrease was observed. In the same area TBI admissions by age group showed that motorcycle mopeds riders aged 14-60 years sustained significantly fewer TBIs. The rate of TBI admissions to neurosurgery decreased by over 31% and epidural hematomas almost completely disappeared in crash injured moped riders. CONCLUSIONS: The revised Italian mandatory helmet law, with police enforcement, is an effective measure for TBI prevention at all ages.

Accidents, Traffic↗
PubMed2000

The effect of the Taiwan motorcycle helmet use law on head injuries.

OBJECTIVES: This study evaluated the effect of the motorcycle helmet law implemented in Taiwan on June 1, 1997. METHODS: Collecting data on 8795 cases of motorcycle-related head injuries from 56 major Taiwanese hospitals, we compared the situation 1 year before and after implementation of the helmet law. RESULTS: After implementation of the law, the number of motorcycle-related head injuries decreased by 33%, from 5260 to 3535. Decreases in length of hospital stay and in severity of injury and better outcome were also seen. The likelihood ratio chi 2 test showed that severity decreased after the law's implementation (P < .001). Full helmets were found to be safer than half-shell helmets. CONCLUSION: The helmet law effectively decreased the mortality and morbidity from motorcycle-related head injuries.

Accidents, Traffic↗
PubMed2002

Autopsy study of motorcyclist fatalities: the effect of the 1992 Maryland motorcycle helmet use law.

OBJECTIVES: This study sought to determine the impact of Maryland's all-rider motorcycle helmet law (enacted on October 1, 1992) on preventing deaths and traumatic brain injuries among motorcyclists. METHODS: Statewide motorcyclist fatalities occurring during seasonally comparable 33-month periods immediately preceding and following enactment of the law were compared. RESULTS: The motorcyclist fatality rate dropped from 10.3 per 10 000 registered motorcycles prelaw to 4.5 postlaw despite almost identical numbers of registered motorcycles. Motorcyclists wearing helmets had a lower risk of traumatic brain injury than those not wearing helmets (odds ratio = 0.31, 95% confidence interval = 0.14, 0.68). CONCLUSIONS: Maryland's controversial motorcycle helmet law appears to be an effective public health policy and may be responsible for saving many lives.

Accidents, Traffic↗