Auto and Road User Journal
June 4, 1997|
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Q&A: Helmet Use Laws
(This article is reproduced with permission from the Insurance Institute for Highway Safety.)
Compared with cars, motorcycles are especially dangerous. Per mile traveled, the number of deaths on motorcycles is about 20 times the number in cars. Motorcycles often have excessive performance capabilities, including especially rapid acceleration and high top speeds. They're less stable than cars in emergency braking and less visible. Motorcyclists are more prone to crash injuries than car drivers because motorcycles are unenclosed, leaving the rider vulnerable to contact hard road surfaces. This is why wearing a helmet is so important. Helmets are the principal countermeasure for reducing crash-related head injuries, the leading cause of death among unhelmeted riders.
How effective are helmets?
Helmets decrease the severity of injury, the likelihood of death, and the overall cost of medical care. They're designed to cushion and protect riders' heads from the impact of a crash. Just like safety belts in cars, helmets can't provide total protection against head injury or death, but they do reduce the incidence of both. Studies show helmets are about 29 percent effective in preventing motorcyclist deaths. An unhelmeted rider is 40 percent more likely to suffer a fatal head injury and 15 percent more likely to incur a nonfatal head injury than a helmeted motorcyclist, the National Highway Traffic Safety Administration (NHTSA) estimates. Helmets are even more effective in preventing brain injuries. NHTSA estimates helmets are 67 percent effective in preventing this injury type.
Are there drawbacks to helmet use?
Claims have been made that helmets increase the risk of neck injuries and reduce peripheral vision and hearing, but there's no credible evidence to support these arguments. A study by J.P. Goldstein is often cited by helmet opponents as evidence that helmets cause neck injuries, allegedly by adding to head mass in a crash. More than a dozen studies have refuted Goldstein's findings. A study reported in the Annals of Emergency Medicine in 1994 analyzed 1,153 motorcycle crashes in four midwestern states and determined that "helmets reduce head injuries without an increased occurrence of spinal injuries in motorcycle trauma."
Regarding claims that helmets obstruct vision, studies show full-coverage helmets provide only minor restrictions in horizontal peripheral vision - less than 3 percent from that of an unhelmeted rider. A 1995 study by A. James McKnight analyzed the effects of motorcycle helmet use on seeing and hearing. The study found that wearing helmets "restricts neither the ability to hear horn signals nor the likelihood of visually detecting a vehicle in an adjacent lane prior to initiating a lane change." To compensate for any restrictions in lateral vision, riders increased their head rotation prior to a lane change. Subjects in the hearing study showed no differences in hearing thresholds under three helmet conditions: no helmet, partial coverage, and full coverage. The noise generated by a motorcycle is such that any reduction in hearing capability that may result from wearing a helmet is inconsequential. Sound loud enough to be heard above the engine can be heard within a helmet, a NHTSA study concluded.
How many motorcyclists wear helmets when not required by law to do so?
Without a helmet law only about 50 percent of motorcyclists wear helmets. Helmet use is near 100 percent when a law requiring all motorcyclists to wear helmets is implemented.
What is the history of helmet use laws in the United States?
Before 1967, only three states had motorcycle helmet use laws. The federal government in 1967 began requiring states to enact motorcycle helmet use laws in order to qualify for certain federal safety program and highway construction funds. Thirty-seven states enacted helmet use laws between 1967 and 1969. By 1975, all but three states mandated helmets for all motorcyclists.
As the Department of Transportation in 1976 moved to assess financial penalties on states without helmet laws, Congress responded to state pressure by revoking the department's authority to assess penalties for noncompliance. Between 1976 and 1978, 19 states weakened their helmet use laws to apply only to young riders, usually under age 18. Seven states repealed helmet use requirements for all motorcyclists.
Then, in the 1980s and early 1990s, several states reinstated laws applying to all riders. Congress in the 1991 Intermodal Surface Transportation Efficiency Act created incentives for states to enact helmet use and safety belt use laws. States with both laws were eligible for special safety grants, but states without them by October 1993 had up to 3 percent of their federal highway allotment redirected to highway safety programs.
Four years after establishing the incentives, Congress again reversed itself. In the fall of 1995, Congress lifted federal sanctions against states without helmet use laws, paving the way for state legislatures to repeal helmet laws. As of January 1, 1996, 25 states and the District of Columbia have helmet laws covering all riders, and 22 states have laws covering some riders, usually those under 18. Colorado, Illinois, and Iowa don't have helmet laws.
How do helmet laws affect motorcyclist deaths and injuries?
In the states that either reinstated or enacted a motorcycle helmet law in the past decade, helmet use has dramatically increased, and motorcyclist deaths and injuries have decreased:
Helmet use laws may also lead to a decline in motorcycle thefts, possibly because some potential thieves don't have helmets, and not wearing a helmet would attract police notice. After Texas enacted its universal helmet law, motorcycle thefts in 19 Texas cities decreased 44 percent from 1988 to 1990, according to the Texas Department of Public Safety. Motorcycle thefts dropped dramatically in three European countries after the introduction of laws that fined motorcyclists for failure to wear helmets. In London, motorcycle thefts fell 24 percent after Great Britain enacted a helmet law in 1973. The Netherlands saw a 36 percent drop in thefts in 1975 when its law was enacted. And in former West Germany, where on-the-spot fines were introduced in 1980, motorcycle thefts plummeted 60 percent.
How do motorcycle helmet use laws impact health care costs?
Unhelmeted riders have higher health care costs as a result of their crash injuries, and many lack health insurance. Results of NHTSA's Crash Outcome Data Evaluation System study released in April 1995 show average inpatient hospital charges for unhelmeted motorcycle crash victims were 25 percent higher than for helmeted riders- $15,447 compared with $12,374. After California introduced a helmet use law in 1992, studies show health care costs associated with head-injured motorcyclists declined. Average charges for head-injured motorcyclists admitted to hospitals in San Diego County fell 32 percent from 1991 to 1992, from $53,875 to $36,744, and average charges for all injured motorcyclists fell 17 percent. For head-injured patients treated and released from emergency rooms, the drop was even more substantial - 43 percent. The total charges for head-injured motorcyclists seen in San Diego County trauma centers fell from $9.8 million in 1991 to $5.5 million in 1992 and $5.4 million in 1993. A study of the effects of Nebraska's reinstated helmet use law on hospital costs found the total acute medical charges for injured motorcyclists declined 38 percent after the law was implemented.
Studies conducted in Nebraska, Washington, Massachusetts, and Texas indicate how injured motorcyclists burden taxpayers. Forty-one percent of motorcyclists injured in Nebraska from January 1988 to January 1990 lacked health insurance or received Medicaid or Medicare. In Seattle, 63 percent of trauma care for injured motorcyclists in 1985 was paid by public funds. In Sacramento, public funds paid 82 percent of the costs to treat orthopedic injuries sustained by motorcyclists in 1980-83. Forty-six percent of motorcyclists treated at Massachusetts General Hospital in 1982-83 were uninsured. At Brackenridge Hospital in Austin, Texas, 41 percent of injured motorcyclists who were unhelmeted had no insurance, compared with 27 percent of injured helmeted riders treated between February 1985 and January 1986.
Are helmet use laws applying to only young motorcyclists effective?
There's no evidence that weak helmet use laws (i.e., those that apply only to young riders) reduce deaths and injuries. In states that mandate helmet use for riders younger than 18, 3 percent of motorcyclists killed in crashes in 1994 were under 18, the same percentage killed in states without helmet laws. Helmet use rates for all riders remain low in states where restricted laws are in effect, and death rates from head injuries are twice as high in states with weak or no helmet laws, compared with rates in states with helmet laws applying to all riders.
How have courts resolved challenges to helmet use laws?
Courts have repeatedly upheld motorcycle helmet use laws under the U.S. Constitution. In 1972 a federal court in Massachusetts told a cyclist who objected to the law: "The public has an interest in minimizing the resources directly involved. From the moment of injury, society picks the person up off the highway; delivers him to a municipal hospital and municipal doctors; provides him with unemployment compensation if, after recovery, he cannot replace his lost job; and, if the injury causes permanent disability, may assume responsibility for his and his family's subsistence. We do not understand a state of mind that permits plaintiff to think that only he himself is concerned." This decision was affirmed by the U.S. Supreme Court.
Are motorcycle education/training courses a substitute for helmet laws?
There is no scientific evidence that motorcycle rider training reduces crash risk. "Numerous studies have shown that formal motorcycle education and training is not an effective loss reduction strategy," state authors of a 1989 Traffic Injury Research Foundation of Canada report. Some support for motorcycle training was found in a California study in which training was associated with reduced motorcycle crash risk. However, later research contradicted the results of this study, finding an increased crash risk associated with training. The most thorough analysis of motorcycle rider training was conducted in New York between 1981 and 1985 by the New York Department of Motor Vehicles. Motorcycle operator's license applicants were randomly assigned to one of three training programs or to New York's standard knowledge and driving test. Despite the fact that more riders were licensed sooner under New York's standard procedures, these riders had fewer motorcycle crashes in the subsequent two years than riders in the three experimental groups.
Do other countries have motorcycle helmet use laws?
Laws requiring motorcyclists to wear helmets are in effect in most countries outside the United States. Among them are Australia, Belgium, Canada, Czech Republic, Denmark, Finland, France, Germany, Hungary, India, Indonesia, Ireland, Italy, Japan, Luxembourg, Malaysia, Netherlands, New Zealand, Norway, Portugal, Singapore, South Africa, Spain, Sweden, Switzerland, Thailand, and the United Kingdom. Victoria, Australia had the first motorcycle helmet use law in the world. It took effect January 1, 1961.