THE IMPACT OF 2 RELATED PREVENTION STRATEGIES ON HEAD-INJURY REDUCTION AMONG NONFATALLY INJURED MOTOR CYCLE RIDERS, CALIFORNIA, 1991-1993

Although the traumatic injury death rate in the United States decrease d during the last 20 years, the percent of all injury deaths attributa ble to brain injuries has remained steady. Head injuries are a leading cause of injury among motorcycle riders in crashes, and the helmet is an effective measure to reduce these injuries. To reduce the burden a nd cost of motorcycle injuries, many states have increased helmet use by introducing mandatory helmet legislation. This report presents evid ence on the effects of the motorcycle helmet and helmet use legislatio n-two interrelated prevention strategies which decrease traumatic brai n injury among motorcycle riders. Nonfatally injured motorcyclists wer e included if they crashed between January 1, 1991 and December 31, 19 93 and were treated in one of 18 hospitals in 10 California counties. Medical records for all injured motorcyclists admitted to these 18 hos pitals and those treated in the emergency department and released in e ight of these hospitals were individually reviewed. Complete lists of injury diagnoses for each rider were coded according to the 1990 Abbre viated Injury Severity Scale by trained clinical staff. Before the uni versal helmet law was introduced (when only a third of injured riders wore helmets) 38.2% of riders sustained head injuries. When helmet use increased to over 85% of injured riders following the law, less than 25% of riders sustained head injuries. Both the severity and the numbe r of head injuries per individual rider decreased after the mandatory helmet use law led to increased helmet use. Riders wearing helmets suf fered fewer skull fractures, fewer intracranial injuries, had less fre quent and shorter periods of loss of consciousness, more favorable GCS scores, and shorter hospital stays. Mandatory motorcycle helmet use l aws are an effective mechanism to increase helmet use among riders and thus prevent head and brain injuries resulting from motorcycle crashe s.