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Oxford epidemiologist Dr. Bette Liu (email: bette.liu@ceu.ox.ac.uk) is the lead author of a new--i.e. updated--international motorcycle helmet study summarized below. As you might expect, her research confirms the UTILITY OF HELMETS, with which I agree. My concern, however, is that it will be used to perpetuate the FUTILITY OF HELMET LAWS, with which I do not. I ask that you please read the information below, and then:

1. Give your feedback to the lead author of the report, Dr. Bette Liu, by emailing her here:

bette.liu@ceu.ox.ac.uk

2. Post your comments about the report online here:

http://tinyurl.com/33qmq3

3. Share your thoughts on the ramifications of this report in open forum here:

http://tinyurl.com/38ketk

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HELMETS FOR PREVENTING INJURY IN MOTORCYCLE RIDERS

Authors: Liu BC, Ivers R, Norton R, Boufous S, Blows S, Lo SK

Source: http://www.cochrane.org/reviews/
en/ab004333.html

SUMMARY

Helmets are shown to reduce motorcyclist head injury and death. Motorcyclists are at high risk in traffic crashes, particularly for head injury. A review of studies concluded that helmets reduce the risk of head injury by around 69% and death by around 42%. There is, so far, insufficient evidence to compare the effectiveness of different types of helmet. Some studies have suggested that helmets may protect against facial injury and that they have no effect on neck injury, but more research is required for a conclusive answer. The review supports the view that helmet use should be actively encouraged worldwide for rider safety.

This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2007 Issue 4, Copyright © 2007 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X). This record should be cited as: Liu BC, Ivers R, Norton R, Boufous S, Blows S, Lo SK. Helmets for preventing injury in motorcycle riders. Cochrane Database of Systematic Reviews 2004, Issue 2. Art. No.: CD004333. DOI: 10.1002/14651858.CD004333.pub3

This version first published online: April 19. 2004 Date of last subtantive update: October 25. 2007

ABSTRACT

Background

Motorcycle crash victims form a high proportion of those killed or injured in road traffic crashes. Injuries to the head, following motorcycle crashes, are a common cause of severe morbidity and mortality. It seems intuitive that helmets should protect against head injuries but it has been argued that motorcycle helmet use decreases rider vision and increases neck injuries. This review will collate the current available evidence on helmets and their impact on mortality, and head, face and neck injuries following motorcycle crashes.

Objectives

To assess the effects of wearing a motorcycle helmet in reducing mortality and head and neck injury following motorcycle crashes.

Search strategy

We searched the Cochrane Injuries Group Specialised Register, Cochrane Central Register of Controlled Trials (The Cochrane Library issue 2, 2007), MEDLINE (up to April 2007), EMBASE (up to April week 16, 2007), CINAHL (January 1982 to February 2003), TRANSPORT (up to issue 12, 2006) (TRANSPORT combines the following databases: Transportation Research Information Services (TRIS) International Transport Research Documentation (ITRD) formerly International Road Research Documentation (IRRD), ATRI (Australian Transport Index) (1976 to Feb 2003), Science Citation Index were searched for relevant articles. Websites of traffic and road safety research bodies including government agencies were also searched. Reference lists from topic reviews, identified studies and bibliographies were examined for relevant articles.

Selection criteria

We considered studies that investigated a population of motorcycle riders who had crashed, examining helmet use as an intervention and with outcomes that included one or more of the following: death, head, neck or facial injury. We included any studies that compared an intervention and control group. Therefore the following study designs were included: randomised controlled trials, non-randomised controlled trials, cohort, case-control and cross-sectional studies. Ecological and case series studies were excluded.

Data collection and analysis

Two authors independently screened reference lists for eligible articles. Two authors independently assessed articles for inclusion criteria. Data were abstracted by two independent authors using a standard abstraction form.

Main results

Sixty-one observational studies were selected of varying quality. Despite methodological differences there was a remarkable consistency in results, particularly for death and head injury outcomes. Motorcycle helmets were found to reduce the risk of death and head injury in motorcyclists who crashed. From four higher quality studies helmets were estimated to reduce the risk of death by 42% (OR 0.58, 95% CI 0.50 to 0.68) and from six higher quality studies helmets were estimated to reduce the risk of head injury by 69% (OR 0.31, 95% CI 0.25 to 0.38). Insufficient evidence was found to estimate the effect of motorcycle helmets compared with no helmet on facial or neck injuries. However, studies of poorer quality suggest that helmets have no effect on the risk of neck injuries and are protective for facial injury. There was insufficient evidence to demonstrate whether differences in helmet type confer more or less advantage in injury reduction.

Authors' conclusions

Motorcycle helmets reduce the risk of death and head injury in motorcycle riders who crash. Further well-conducted research is required to determine the effects of helmets and different helmet types on mortality, head, neck and facial injuries. However, the findings suggest that global efforts to reduce road traffic injuries may be facilitated by increasing helmet use by motorcyclists.

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MOTORCYCLE HELMETS KEEP RIDERS ALIVE, INTERNATIONAL REVIEW CONFIRMS

Author: Bruce Sylvester, Contributing Writer, Health Behavior News Service

Source: http://www.hbns.org/getDocument.cfm?documentID=1646

Fewer than half of U.S. states require every motorcycle rider -- drivers and passengers -- to wear a helmet; and four states have no helmet requirements whatsoever. Around the world, the same patchwork legal pattern exists.

Now, an international group of researchers has combined data from a variety of studies to determine how effective helmets really are. Their findings confirm what seems intuitive: Helmet use is highly significant in reducing both accidental death and injury, reducing head injury risk by 69 percent and death by 42 percent.

"Motorcycle helmets protect motorcyclists who crash from sustaining head injury, and the results also suggest that motorcycle helmets protect motorcyclists who crash from death," said lead author Dr. Betty Liu, epidemiologist at Oxford University in England.

"The findings are important to consider in those countries with without mandatory motorcycle helmet laws, as well as in jurisdictions with weak or partial helmet legislation," added co-author Dr. Rebecca Ivers, head of the Injury Prevention Program at the George Institute for International Health in Sydney, Australia.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

This review is an update to one conducted by the same researchers, published in 2004. They include data from eight additional studies in the new review.

The review "confirms the belief of specialists in emergency medicine and should put an end to any further debate about the protective role of helmets regarding head injury in motorcycle riders," said Robert McNamara, M.D., chairman of the emergency medicine department at Temple University School and spokesman for the American Academy of Emergency Medicine.

McNamara said that, at this point, "the debate over mandating use in adults should center on personal freedom to accept a known risk." The authors say that, despite differences in methodology of the 61 included studies, there was a "remarkable consistency" in results, especially pertaining to death and head injury.

"The review supports the view that helmet use should be actively encouraged worldwide for rider safety," they conclude.

The reviewers say that the analysis could not specify the effects of helmet use on facial and neck injuries, and there was insufficient evidence to determine which type of helmet is most protective.

Addressing the public policy implications of the findings, McNamara said, "The personal freedom issue must be balanced with the cost to society of the care of patients with catastrophic head injury. Riders cite the pleasure of going helmet-less, but often the cost of care for the injured motorcyclist is passed on to society at large."

Motorcycle riders might not realize how much is at stake, he said. They "may not fully understand the scientifically demonstrated level of risk involved in riding without a helmet and might assume the risks are acceptable if the law does not prohibit it. In that context, the American Academy of Emergency Medicine believes that states should require helmet use in all age groups."

In many developing nations, a majority of traffic-related injuries occur among pedestrians and motorcycle/motorbike riders, the authors said; they cite the example of Malaysia where, in 1994, 57 percent of all road deaths were riders of motorized two-wheeled vehicles. They conclude that, given the significant influence on worldwide mortality of impact head injuries, "The results of this review should be contemplated widely."

# # # # FOR MORE INFORMATION: Health Behavior News Service: Lisa Esposito, Editor, at (202) 387-2829 or www.hbns.org.

The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit http://www.cochrane.org for more information.

Liu BC, et al. Helmets for preventing injury in motorcycle riders (Review). The Cochrane Database of Systematic Reviews 2008, Issue 1. FOR MORE INFORMATION: Health Behavior News Service: (202) 387-2829 or www.hbns.org.

Center for the Advancement of Health
Health Behavior News Service
Contact: Lisa Esposito, Editor
202.387.2829
hbns-editor@cfah.org

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1. Give your feedback to the lead author of the report, Dr. Bette Liu, by emailing her here:

bette.liu@ceu.ox.ac.uk

2. Post your comments about the report online here:

http://tinyurl.com/33qmq3

3. Share your thoughts on the ramifications of this report in open forum here:

http://tinyurl.com/38ketk

***

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