The effect of motorcycle helmet type, components and fixation status on facial injury in Klang Valley, Malaysia: a case control study

Abstract

BackgroundThe effectiveness of helmets in reducing the risk of severe head injury in motorcyclists who were involved in a crash is well established. There is limited evidence however, regarding the extent to which helmets protect riders from facial injuries. The objective of this study was to determine the effect of helmet type, components and fixation status on the risk of facial injuries among Malaysian motorcyclists.Method755 injured motorcyclists were recruited over a 12-month period in 2010–2011 in southern Klang Valley, Malaysia in this case control study. Of the 755 injured motorcyclists, 391participants (51.8%) sustained facial injuries (cases) while 364 (48.2%) participants were without facial injury (control). The outcomes of interest were facial injury and location of facial injury (i.e. upper, middle and lower face injuries). A binary logistic regression was conducted to examine the association between helmet characteristics and the outcomes, taking into account potential confounders such as age, riding position, alcohol and illicit substance use, type of colliding vehicle and type of collision. Helmet fixation was defined as the position of the helmet during the crash whether it was still secured on the head or had been dislodged.ResultsHelmet fixation was shown to have a greater effect on facial injury outcome than helmet type. Increased odds of adverse outcome was observed for the non-fixed helmet compared to the fixed helmet with adjusted odds ratio (AOR) = 2.10 (95% CI 1.41- 3.13) for facial injury; AOR = 6.64 (95% CI 3.71-11.91) for upper face injury; AOR = 5.36 (95% CI 3.05-9.44) for middle face injury; and AOR = 2.00 (95% CI 1.22-3.26) for lower face injury. Motorcyclists with visor damage were shown with AOR = 5.48 (95% CI 1.46-20.57) to have facial injuries compared to those with an undamaged visor.ConclusionsA helmet of any type that is properly worn and remains fixed on the head throughout a crash will provide some form of protection against facial injury. Visor damage is a significant contributing factor for facial injury. These findings are discussed with reference to implications for policy and initiatives addressing helmet use and wearing behaviors.

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

“…Studies conducted in Western countries and Taiwan [17,[20][21][22][23][24][25] have reported that full-coverage helmets protect from head injuries. In line with previous results, our results indicated that standard helmets have a highly protective role.…”

“…Studies have attempted to examine the effects of different helmet types on head and neck injuries. For example, studies [17][18][19][20][21][22] have reported that riders wearing open-face or half helmets had an increased risk of sustaining facial and neck injuries compared with riders wearing full-face helmets. Rice et al [23] concluded that novelty helmet or nonstandard helmet use was associated with an increased risk of fatal injuries compared with full-face helmet use after adjustment for speed and other risk factors.…”

Preseptal Transconjunctival Approach: A Retrospective Review

“…Only secured helmets which remain attached to the cranium during a collision will provide some protection to the maxillofacial area. 9 Thus, to decrease the incidence of midface trauma, we believe more attention should be given by enforcement agencies on, existing regulations regarding the type of helmet and helmet safety protocols.…”

Análisis de los accidentes y las lesiones de los motociclistas en México

“…Se ha demostrado que un motociclista con casco reduce un 25% la probabilidad de resultar lesionado y un 30% si utiliza otro equipo protector (como ropa de cuero), por lo que en conjunto con todo el equipo los riesgos se reducen cerca del 50% 9 . La prevalencia del uso del casco varía alrededor del mundo; por ejemplo, la literatura muestra valores en países emergentes del 16.2% en Laos 20 , el 40% en Argentina 21 , el 48% en Camboya 22 y el 88.7% en Malasia 23 . Las variaciones se deben a factores culturales, socioeconómicos, ambientales, temporales y normativos propios de cada región [24][25][26][27] .…”

“…Esto apoya la creencia de que las mujeres tienen tasas más bajas de participación en los accidentes, en particular entre los conductores jóve-nes. Tales diferencias de sexo se han encontrado en los análisis de colisiones de numerosas investigaciones sobre motociclistas 23,32 . Sin embargo, la prevalencia de consumo de alcohol, del 13.73%, es mucho menor que las encontradas en otros estudios 33 que indican que entre el 41 y el 80% de los conductores de motocicleta lesionados dieron positivo al consumo de alcohol.…”