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PubMed2002

Hospital cost is reduced by motorcycle helmet use.

BACKGROUND: The purpose of this study was to identify the impact of motorcycle helmet use on patient outcomes and cost of hospitalization, in a state with a mandatory helmet law. METHODS: Patients admitted after motorcycle crashes from July 1996 to October 2000 were reviewed, including demographics, Injury Severity Score, length of stay, injuries, outcome, helmet use, hospital cost data, and insurance information. Statistical analysis was performed comparing helmeted to unhelmeted patients using analysis of variance, Student's test, and regression analysis. RESULTS: We admitted 216 patients: 174 wore helmets and 42 did not. Injury Severity Score correlated with both length of stay and cost of hospitalization. Mortality was not significantly different in either group. Failure to wear a helmet significantly increased incidence of head injuries (Student's test, p < 0.02), but not other injuries. Helmet use decreased mean cost of hospitalization by more than $6,000 per patient. CONCLUSION: Failure to wear a helmet adds to the financial burden created by motorcycle-related injuries. Therefore, individuals who do not wear helmets should pay higher insurance premiums.

Accidents, Traffic↗
PubMed1992

The impact of the Texas 1989 motorcycle helmet law on total and head-related fatalities, severe injuries, and overall injuries.

The State of Texas implemented a mandatory total motorcycle helmet law for all operators and passengers, effective September 1, 1989. In this study the impact of this intervention on frequency of both total and head-related fatalities, severe injuries, and overall injuries for operators during the subsequent year was quantified. This quantification is important because 26 states in the United States fail to have strict, mandatory helmet laws. The Box-Tiao time-series intervention methodology is used to estimate secular trends before and changes after the implementation of the law, analyzing Department of Public Safety monthly injury accident data for a period of 6 years collected from traffic accident reports filed for each motorcycle injury accident. Trends in fatalities and injuries (except for head-related deaths) estimated before implementation of the law approximated the 9.4% average annual decline in motorcycle registrations. Additional declines of 12.6% and 57.0%, respectively, were estimated for total and head-related fatalities during the year after the law was implemented. Declines of 13.1% and 54.6% were estimated for severe injuries for total and head-related accidents. Declines of 12.3% and 52.9% were found for total and head-related injuries overall.

Confidence Intervals↗
PubMed2002

Lawrence of Arabia, Sir Hugh Cairns, and the origin of motorcycle helmets.

When Colonel T.E. Lawrence ("Lawrence of Arabia") was fatally injured in a motorcycle accident in May 1935, one of the several doctors attending him was a young neurosurgeon, Hugh Cairns. He was moved by the tragedy in a way that was to have far-reaching consequences. At the beginning of the Second World War, he highlighted the unnecessary loss of life among army motorcycle dispatch riders as a result of head injuries. His research concluded that the adoption of crash helmets as standard by both military and civilian motorcyclists would result in considerable saving of life. It was 32 years later, however, that motorcycle crash helmets were made compulsory in the United Kingdom. As a consequence of treating T.E. Lawrence and through his research at Oxford, Sir Hugh Cairns' work largely pioneered legislation for protective headgear by motorcyclists and subsequently in the workplace and for many sports worldwide. Over subsequent decades, this has saved countless lives.

Famous Persons↗
PubMed2002

Spinal injury patterns resulting from car and motorcycle accidents.

STUDY DESIGN: Retrospective data analysis. OBJECTIVES: To determine spinal injury patterns and clinical outcomes in patients involved in automotive accidents. SUMMARY OF BACKGROUND DATA: The records of 22,858 patients collected prospectively as part of the Trauma Audit Research Network (UK) Database (1993-2000). METHODS: Analysis of the records of 1121 motorcyclists and 2718 car occupants involved in automotive trauma. RESULTS: Spinal injury occurred in 126 (11.2%) motorcyclists and 383 (14.1%) car occupants. Victims were predominantly young (mean ages: motorcycle 30.2 years, car 37.8 years) and male (motorcycle 88.9%, car 60.6%). The mean Injury Severity Scores were 18.8 and 15.1, respectively. Isolated spinal injuries occurred in 30 (23.8%) motorcyclists and 130 (33.9%) car occupants. The thoracic spine was most commonly injured in motorcyclists (54.8%), and the cervical spine was most commonly injured in car occupants (50.7%). Multiple regions were injured in 14 (10.3%) motorcyclists and 33 (8.5%) car occupants. Nine motorcyclists and 43 car occupants required spinal surgery. Median hospital stays were 11.5 days (range 0-235 days) and 10 days (range 0-252 days) in the motorcyclists and car occupants, respectively. There were 13 (10.3%) motorcycle- and 26 (6.8%) car-related deaths. CONCLUSION: Spinal injury patterns may reflect differing mechanisms of injury between the restrained car occupant and unrestrained motorcyclist. The motorcyclists were more severely injured, had more extremity trauma, a higher mortality rate, and a spinal injury pattern consistent with forced hyperflexion of the thoracic spine. The predominance of cervical injuries and higher incidence of neck and facial injuries in car occupants may reflect abdominothoracic seat belt restraint. The high frequency of multilevel injuries reaffirms the need for vigilance in patient assessment.

Accidents, Traffic↗
PubMed1992

Motorcycling attitudes and behaviours. II. 14 and 15 year old adolescents.

Of 846 adolescents interviewed near their 15th birthday, 51% could drive a motorcycle. A further 13% intended to learn. Drivers reported friends (mean age 16.5 years) as the most common source of instruction. Forty-four per cent of drivers and 69% of intending learners planned to apply for licences. Thirty-five per cent of the sample had driven or ridden as passengers on a motorcycle on-road in the past year and 85% of these had worn a helmet on the last occasion. The commonest cause of injuries to motorcyclists resulting in hospitalization (lower limb injury) was correctly identified by 52% of the sample. Fear of injury was the reason given for not learning to ride by 55% of confirmed non-drivers. Fifteen medically treated motorcycling injuries were reported for a 2-year recall period. Females reported significantly less exposure and less use of protective clothing than males. The issues of initiation, training, constraints on use and preventive strategies are discussed.

Accidents, Traffic↗
PubMed2004

Relation between motorcycle helmet use and cervical spinal cord injury.

A case-control study was conducted to determine the relationship between motorcycle helmets, including type (i.e. partial or full coverage) and fastening status (i.e. loose or firm), and cervical spinal cord injuries (SCIs) in Taiwan. Based on a nationwide registry consisting of 396 motorcycle riders with traumatic SCIs during the 4-year period from July 1992 to June 1996, 229 subjects injured at cervical levels were defined as cases and 167 injured at other spinal levels as controls. Furthermore, additional information on the type and fastening status of the helmet was collected by telephone interview, and 147 subjects, including 79 with cervical and 68 with noncervical lesions, responded. Results of the logistic regression model show that neither different helmet types nor fastening status increased the occurrence of cervical SCIs when motorcycle riders were involved in severe crashes.

Acute Disease↗
PubMed1995

Compliance with the 1992 California motorcycle helmet use law.

To evaluate helmet use in California before and after the introduction of an unrestricted helmet use law on January 1, 1992, observations of motorcycles and their riders were made at 60 locations in seven California counties, twice before and four times after the law was introduced. Helmet use increased from about 50% in 1991 to more than 99% throughout 1992. Compliance was achieved despite variations in helmet use by motorcycle design and road type. Seven percent of riders used nonstandard helmets after the law. With adequate enforcement, unrestricted helmet use laws can achieve almost 100% compliance and reduce the number of people riding motorcycles.

California↗
PubMed2004

Florida's motorcycle helmet law repeal and fatality rates.

On July 1 2000, the State of Florida exempted adult motorcyclist and moped riders from wearing helmets provided they have medical insurance of 10,000 US dollars. Monthly time series of motorcycle occupant deaths are examined from 1/1994 to 12/2001. The interrupted time series analysis estimates a 48.6% increase in motorcycle occupant deaths the year after the law change. The impact estimate reduces to 38.2% and 21.3% when trends in travel miles and motorcycle registrations are controlled. Our findings suggest that the law's age exemption should be revoked.

Accidents, Traffic↗
PubMed1995

Disablement resulting from motorcycle crashes.

This retrospective study describes the nature and severity of disablement resulting from motorcycle crashes (both traffic and non-traffic). Two hundred and fifty motorcycle crash victims were randomly selected from the total population of motorcycle crash victims (n = 1510) who had received compensation for disablement in the year ending 31 March 1990. Information on the nature and extent of disablement was obtained from official accident compensation files and coded according to the International Classification of Impairments, Disabilities, and Handicaps. Extremity injuries predominated, especially to the lower limb. The majority of these were fractures. Most commonly impairments occurred in the areas of 'skeletal', 'disfiguring' and 'generalized' impairment. Mechanical impairment of a limb was reported in 68% of cases, often with associated disfigurement. Disability mostly involved problems with locomotion and problems coping with physical stresses at work. Occupational handicap was the most common handicap reported, with mobility handicap the next most common. The shortcomings of this study included its retrospective design and the variable quality of the information on disablement. It was most likely, though, that these factors contributed to an underestimation of disablement in the study group.

Accidents, Traffic↗
PubMed2006

Injury outcomes in children following automobile, motorcycle, and all-terrain vehicle accidents: an institutional review.

OBJECT: The authors performed an analysis of retrospectively obtained data to compare the outcomes of pediatric patients admitted to their institution for traumatic injuries resulting from car, motorcycle, and all-terrain vehicle (ATV) accidents. METHODS: The authors conducted a retrospective review of Columbus Children's Hospital's Trauma Registry data collected between January 1993 and December 2003. Data obtained in patients admitted with motor vehicle-related injuries were compiled for a total of 1608 patient records. Data regarding sex, age, hospital length of stay (LOS), Glasgow Coma Scale (GCS) score, revised trauma score, injury severity score (ISS), and use of a protective device were analyzed. CONCLUSIONS: Of 1608 patients, 1257 (78%) were injured in automobile accidents, 123 (7.6%) in motorcycle accidents, and 228 (14.2%) in ATV accidents. Injuries sustained in all vehicle types peaked during the summer months. Patients involved in automobile crashes presented with significantly lower GCS scores than those injured in motorcycle and ATV accidents; however, there was no statistically significant difference in LOS among all three injury modalities. Protective devices were underutilized in all three motor vehicle categories but, when used, were associated with significantly higher GCS scores, ISSs, and shorter LOSs among patients admitted after automobile accidents. The correlation of seat belt use with better outcomes underscores the necessity to improve motor vehicle safety education for children, who are less likely to be restrained as they age.

Accidents, Traffic↗
PubMed2005

Bicycle and motorcycle spoke injuries in children as passengers.

OBJECTIVE: To determine the spectrum and severity of injuries seen in children passengers, who get their feet entangled in the spokes of bicycle and motorcycle wheels, and to study the mechanism of this injury to find a pattern. DESIGN: Descriptive and prospective study. PLACE AND DURATION OF STUDY: Combined Military Hospital, Quetta, between July 2001 and June 2003. SUBJECTS AND METHODS: This study included 92 consecutive patients referred to the Paediatric Surgical Department. According to the severity of injury, the patients were divided into three groups. The parents were asked a detailed history about the exact mechanism of injury, and such situations were analysed. RESULTS: The average age was 3.9 years. Seventy-one were males and 21 females. A total of 80 children had their injury while riding a bicycle, the rest had their feet entangled in motorcycle spokes. Majority had type I injury. Motorcycle injuries mostly belonged to type III. There were only 2 fractures. Study of the mechanism of injury showed an obvious pattern. Front wheel injury mainly caused inversion, with laceration over dorsum and medial aspect of the foot and medial malleolus. Rear wheel injury mostly caused eversion, with skin damage to the lateral and posterior aspect of foot and ankle, with lateral malleolus at risk. CONCLUSION: Bicycle/motorcycle is an important means of transport for the whole family in most of the third world countries. Without proper footrests and unguarded spokes severe injury to the feet of young passengers can occur. By ascertaining in which wheel (front or rear) the foot was entangled, injuries can be predicted, and hence not missed.

Bicycling↗
PubMed2000

Conception of the cervico-brachial protector for motorcycle drivers.

The increasing popularity of motorcycles increases the role of motorcycle accidents as a main cause of brachial plexus injuries. In view of the high social cost of treatment of the victims it seemed desirable to devise some kind of protective clothing for motorcyclists. The protective clothing devised by teams from Department of Neurosurgery, TRICOTEXTIL--and Aeronautics and Applied Mechanics Institute, consists of the following parts: cervical collar--acting against force causing lateral bending and extension of cervical spine, shock-absorptive shoulder pads--acting against the impact energy partially absorbing it and partially transmitting to the dorsal stiff bar, dorsal stiff bar and sacroiliac belt--partially immobilizes the thoracic and lumbar spine, acts against its compression, transmits the impact energy to the iliac crests and hips. The expected biomechanical effects of the cervico-brachial protector are as follows: In brachial region it should diminish the impact energy by its partial absorption and partial transmission along dorsal stiff bar to sacroiliac belt. It should act against excessive cervical spine motion--mainly against lateral bending and extension. It should act against excessive depression of the shoulder. The protective system built in the jacket should co-operate with the helmet of motorcycle driver. It should be comfortable for the driver and conform to security standards. Prototype of the protector underwent kinetic sledge tests in Industrial Motorization Institute (PIMOT), Warsaw, with the use of Hybrid Dummy II.

Accidents, Traffic↗
PubMed2002

The effects of motorcycle helmet use between hospitals in states with and without a mandatory helmet law.

BACKGROUND: Motorcycle injuries and mortality are different depending on the use of a helmet. Helmet use varies greatly depending on state laws. METHODS: Retrospective study using trauma registry data from two Level 1 Trauma Centers in states with (NY) and without (CT) a mandatory helmet law, from 1996 through 1998. RESULTS: Motorcycle accident victims in both states were similar for sex, age, RTS, TRISS probability of survival, GCS on arrival and ISS. Helmet use was higher in New York than in Connecticut (91% vs 18%, P < .01). Mortality was higher in Connecticut than in New York (15% vs 6%, P < .05). CONCLUSION: The demographics and injury severity of motorcycle accident victims presenting to Level 1 Trama Centers were very similar in the two adjoining states. The most significant difference between the states is that of helmet use. This is closely related to the decreased mortality rate and the higher GCS at discharge seen in the state with the mandatory helmet law.

Accidents, Traffic↗
PubMed2006

Motorcycling freedom: a paraplegics dream.

People with disabilities have the same rights as other members of society in directing and implementing the decisions which affect their lives, although it is not always afforded them due to physical limitations. A chance encounter by the author, a University of Western Australia mechanical engineering student, with a paraplegic man who expressed his dream of being able to ride a motorcycle again led to the design and build of a specially modified motorcycle that could be ridden safely and comfortably by a person without the use of their legs. The prototype involved several modifications which allow it to be ridden by a paraplegic person. They included, a thumb controlled pneumatic gear shifter, an integrated front and rear brake actuated with a single hand lever, ergonomic supports to hold the riders legs in place and an automatic stabilising system to balance the motorcycle at low speeds. The benefits that result from the inclusion of people with disabilities into regular leisure activities include normalisation as well as a sense of independence and freedom for the individual. It also allowed one man the chance to reach for his dreams.

Equipment Design↗
PubMed1991

Helmet use improves outcomes after motorcycle accidents.

To determine the effects of motorcycle helmet use on the outcome of patients admitted to a Level I trauma center, we studied patient outcomes and demographic and epidemiologic variables of 474 patients injured in motorcycle collisions and treated at such a center over a 45-month period. Of those involved in a motorcycle collision, 50% were not wearing a helmet, 23% were wearing a helmet, and in 27% helmet use was unknown. Those who were wearing a helmet had fewer and less severe head and facial injuries, required fewer days on a ventilator, and sustained no serious neck injuries; fewer patients who wore helmets were discharged with disability, and hospital charges were lower. These data support the need for both increased public education regarding helmet use and mandatory helmet use legislation.

Accidents, Traffic↗
PubMed1994

Head injuries associated with motorcycle use--Wisconsin, 1991.

From 1989 through 1991, a total of 9913 persons in the United States died as a result of crashes while operating or riding motorcycles (1). Although use of motorcycle helmets is an effective means for preventing crash-related fatal injuries (2), 25 states and the District of Columbia have not yet enacted laws requiring the universal use of motorcycle helmets (1). This report describes a study by the University of Wisconsin and the Wisconsin Department of Transportation in which linked police reports and hospital discharge records for 1991 were used to assess the risk for head injury for motorcyclists in motor-vehicle crashes, the initial inpatient hospital charges for motorcyclists with head injuries resulting from crashes, and the reduction in injuries and fatalities associated with universal helmet use.

Accidents, Traffic↗
PubMed1996

Helmet use among adolescent motorcycle and moped riders--Rome, Italy, 1994.

In Italy, motor-vehicle crashes are the leading cause of death among persons aged 15-20 years, and motorcycles account for a substantial proportion of traffic-related fatalities: in 1993, of the 6349 traffic-related deaths reported in Italy, 1342 (21.1%) occurred among motorcycle and moped users, and 261 (19.4%) of these deaths were among persons aged 15-20 years. Because of the risks for head injury and death, in 1986 a national law was enacted requiring operators of motorcycles or mopeds to use helmets under specified conditions. To asses compliance with this law and factors associated with helmet use among adolescents in a metropolitan area, in October 1994 the National Institute for Health conducted a survey of a sample of high school students in Rome. This report presents findings of this survey, which indicate that helmet use was low, particularly among moped users and among passengers.

Accidents, Traffic↗
PubMed1996

A study of some anthropometric characteristics of motorcycle riders.

As there is little published data on motorcyclists, an anthropometric survey of 140 UK motorcyclists was undertaken, together with a brief questionnaire survey covering demographic details and motorcycling experience. Additionally an investigation of knee position on a static motorcycle test rig was undertaken. Six body dimensions relevant to the design of the riding package of a motorcycle were considered. It was found that the population of motorcyclists, both male and female, were taller than the general population with mean statures of 1774.0 and 1639.7 mm, respectively. The knee position study indicated that there was wide variation in the forward position of the knee (range 228 mm).

Journal Article↗