U.S: Comparing Helmeted and Unhelmeted Motorcyclists

The State of Texas has had an on again, off again relationship with its universal motorcycle helmet laws. In 1968, a universal law was passed, and all motorcyclists and their passengers wore helmets. In 1977, this law was repealed. In 1989, a universal helmet law was again passed. In 1997, the universal law was again repealed, and helmets were not required if the operator was over 21 years old and had successfully completed a motorcycle safety course or was covered by a health insurance plan providing at least $10,000 in medical benefits for injuries incurred as a result of a motorcycle crash.

In light of the current Texas motorcycle helmet exemption law, most riders can make a personal choice to ride a motorcycle without a helmet. Carlos Brown and his colleagues at the University Medical Center at Brackenridge in Austin, Texas, hypothesized that risk factors could be identified that would independently predict who will ride and crash a motorcycle without a helmet.

Using data from the trauma registry at their medical center, characteristics of helmeted and unhelmeted motorcycle operators and passengers were retrospectively compared over a 13-year period. Data compared included age, gender, ethnicity, insurance status, treatment costs, blood alcohol content, outcome, and use of a protective helmet. Nearly 1,800 trauma patients were in the study. Most were Caucasian males with an average age of 38 years. About 59% had health insurance at the time of their injury. Most (91%) were operators, not passengers. Of the 839 who had toxicology tests, 47% had alcohol in their system at the time of the crash. As blood alcohol level increased, the likelihood of not wearing a helmet increased. Also, unhelmeted motorcyclists were more likely to be seriously injured as measured by clinical indicators such as trauma scores and systolic blood pressure.

The authors concluded that riders who are intoxicated, lacking health insurance, or riding as passengers were less likely to be wearing a helmet and be injured in a motorcycle crash. This finding supports previous studies that unhelmeted motorcyclists require significantly more expensive medical treatments than helmeted ones. In addition, unhelmeted riders’ medical costs averaged about $44,750 – far exceeding the required $10,000 minimum insurance coverage (note: even helmeted riders incurred an average of of $31,600 in medical costs, also exceeding the minimum coverage requirement).

Conclusion: After more than 40 years of published reports emphasizing the protective effect of motorcycle helmets, and measuring the differences in outcomes and risk factors for helmeted and unhelmeted motorcyclists, riders continue to ignore these differences.

Brown CV, Hejl K, Bui E et al. Risk factors for riding and crashing a motorcycle unhelmeted. J Emerg Med 2009; doi: 10.1016/j.jemermed.2009.07.024 published online September 25, 2009.

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