France: Motorcycle Helmets and Neck/Spine Injury

Some say that the possibility of increased neck and spinal injuries is one of the reasons for not wearing a helmet. In a recent study from France’s Transportation and Safety Research Institute (INRETS), researchers found that motorcycle helmets do not cause increased neck and spine injuries.

Methods
The study – by Moskal, Martin, and Laumon of INRETS – used data from a trauma registry in the Rhone Department that includes the city of Lyon. The area has about 1.6 million people, and the registry captures information on the victims of all road crashes in the Department. These data include demographic, crash, and injury severity information. The INRETS researchers identified all fatally and non-fatally injured motorcycle users who were involved in crashes from 1996 to 2005. They compared outcomes among those with and without a helmet as in a case-control study using the injury severity score (ISS) as an indirect measure of the crash severity. After excluding those victims whose information was incomplete as well as those who had only injuries to the head, neck and face, 17,361 injured persons were eligible for the study.

Results
Head injuries were diagnosed in 1,459 (10.9%) of the victims and cervical spine injuries in 712 (5.3%). The proportion of motorcyclists with head injuries was significantly higher (19.5%) in the unhelmeted riders, compared to the helmeted ones (10.2%).  There was no association between helmet use and neck or cervical spine injuries.

There was a significant effect of age, nature of the crash, and ISS (severity) on the risk of head, face, neck, or cervical spine injury. Time of crash and gender were also significantly associated with the risk of neck and cervical spine injury.

Conclusions
Although there were some limitations to this study (almost one-quarter of the victims were eliminated from the data set because there was no information on helmet use), it is a good one. It provided data on the significant protective effect of motorcycle helmets in preventing head and facial injury. The results also showed that helmet use did not increase the risk of neck or cervical spine injury in a crash. If there were an increased risk of neck or cervical spine injury with helmet use, it is likely that this risk is outweighed by the benefits of wearing a helmet. The benefits are largely in preventing head and facial injury.

Moskal A, Matin JL, Laumon B. Helmet use and the risk of neck or cervical spine injury among users of motorized two-wheel vehicles. Inj Prev 2008;14:238.44.

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