Motorcycle helmet use and the risk of head, neck, and fatal injury: Revisiting the Hurt Study

Abstract

Most studies find strong evidence that motorcycle helmets protect against injury, but a small number of controversial studies have reported a positive association between helmet use and neck injury. The most commonly cited paper is that of Goldstein (1986). Goldstein obtained and reanalyzed data from the Hurt Study, a prospective, on-scene investigation of 900 motorcycle collisions in the city of Los Angeles. The Goldstein results have been adopted by the anti-helmet community to justify resistance to compulsory motorcycle helmet use on the grounds that helmets may cause neck injuries due to their mass. In the current study, we replicated Goldstein’s models to understand how he obtained his unexpected results, and we then applied modern statistical methods to estimate the association of motorcycle helmet use with head injury, fatal injury, and neck injury among collision-involved motorcyclists. We found Goldstein’s analysis to be critically flawed due to improper data imputation, modeling of extremely sparse data, and misinterpretation of model coefficients. Our new analysis showed that motorcycle helmets were associated with markedly lower risk of head injury (RR 0.40, 95% CI 0.31–0.52) and fatal injury (RR 0.44, 95% CI 0.26–0.74) and with moderately lower but statistically significant risk of neck injury (RR 0.63, 95% CI 0.40–0.99), after controlling for multiple potential confounders.

Effect of motorcycle helmet types on head injuries: evidence from eight level-I trauma centres in Taiwan

“…Studies [1,[5][6][7][8][9] have consistently concluded that helmet use is beneficial in preventing head injuries and subsequently reducing injury severity among motorcyclists. By using police-reported crash data in Taiwan, Keng [10] found that helmet use was associated with a decreased odds of deaths among motorcyclists.…”

Helmet Design Based on the Optimization of Biocomposite Energy-Absorbing Liners under Multi-Impact Loading

“…The impact point B was chosen because it is the most common impact. Statistics show that independently of the helmet type, this is the most impacted area [57][58][59][60][61][62][63][64]. In addition, in the previous section, this was the impact point where the EPS helmet had lower accelerations (Figure 4).…”

Factores asociados a los accidentes de motocicleta en Barcelona, España

“…La mayor gravedad encontrada entre los conductores que no usaban casco en el momento del accidente concuerda con lo encontrado en numerosas investigaciones que señalan como la utilización del casco reduce el riesgo de lesiones en la cabeza y la cara, así como de fallecimiento en caso de accidente (Ha et al, 2018;Moskal, Martin & Laumon, 2008;Rice et al, 2016).…”