Unintentional injury remains the leading cause of death and disability for people 1 to 44 years of age in the United States. The majority of injuries are from motor vehicle accidents, including automobiles, trucks, motorcycles, and bicycles, as well as pedestrians hit by vehicles. Injuries resulting in traumatic brain injury result in >30% of the deaths and contribute to significant morbidity for survivors. Traumatic brain injury is estimated to affect 1.5 million Americans yearly and results in 52 000 deaths and $60 billion in medical costs and lost wages. Injury prevention devices include safety belts for automobiles and helmets for 2-wheeled vehicles. Many steps in legislation have been taken to enforce seatbelt use for injury prevention, and now 49 of 50 states have mandatory seatbelt laws enforced by fines for adults. Helmet requirements lack such legislation, and currently only 20 states have universal helmet laws. In regard to helmet use, numerous observational studies demonstrate that motorcycle helmets reduce the risk of death and head injury up to 42% and 69%, respectively. Despite these data, Florida does not currently have a mandatory helmet law; the Florida legislature repealed its helmet law in 2000. In the 10 years since this change, helmet use has dropped dramatically, and motorcycle fatalities have increased rapidly. The current law states that helmets are not required for riders of motorized 2-wheeled vehicles who are >21 years of age with at least $10 000 of health insurance coverage. Current research has demonstrated an increased risk of neurological injury and death associated with no helmet use in motorcycles; however, few studies have evaluated discharge outcomes and hospital and societal costs. In addition, controversy still exists regarding the actual healthcare impact of Florida's helmet law repeal. In this study, we analysed all 2-wheeled vehicle accidents evaluated at a level l trauma center over a 5-year period, comparing all outcomes, costs, and insurance status for helmeted and non-helmeted riders. (Author/publisher)
Abstract