State-Level Helmet Use Laws, Helmet Use, and Head Injuries in EMS Patients Involved in Motorcycle Collisions

Area of Science:

• Public Health
• Trauma Surgery
• Epidemiology

Background:

• Motorcycle helmets are crucial for preventing fatalities and reducing head injuries in motorcycle collisions (MCC).
• In 2022, 18 states mandated helmet use for motorcyclists aged 21 years and older.
• Variations in helmet laws necessitate comparing outcomes between states with and without these mandates.

Purpose of the Study:

• To compare helmet usage rates among adult motorcyclists involved in MCCs.
• To assess the incidence of head trauma in relation to helmet use in states with differing helmet laws.
• To analyze factors influencing head injury severity in motorcycle accident patients.

Main Methods:

• Analysis of the 2022 national emergency medical services (EMS) dataset (ImageTrend Collaborate).
• Inclusion criteria: 9-1-1 responses for motorcyclists (ICD-10 V20-V29) aged 21+ years involved in transport accidents.
• Outcomes assessed: EMS-documented helmet use and head injury (clinician impression/chief complaint), using chi-square tests and multivariable logistic regression.

Main Results:

• 15,891 patient encounters were analyzed; 67.6% were in states without helmet laws.
• States without helmet laws showed higher rates of unhelmeted patients (56.8% vs. 24.2%) and moderate/severe head injuries (4.6% vs. 2.3%).
• Unhelmeted patients had significantly higher adjusted odds of moderate/severe head injury (3.17 times).

Conclusions:

• States without universal helmet laws have a greater proportion of unhelmeted motorcyclists involved in collisions.
• Unhelmeted individuals face a significantly increased likelihood of sustaining head injuries.
• EMS agencies in states lacking helmet laws should anticipate and prepare for a higher burden of head injuries from MCCs.