Trends in Helmet Use and Head Injuries in San Diego County: The Effect of Bicycle Helmet Legislation

The objective of this study was to evaluate the local effect of the California helmet legislation on bicycle-related head injuries in San Diego County with a year 2000 population of approximately 3 million people. An ecological trend design was used as a study design based on observational data from a trauma registry. Outcome measures include helmet use compliance, site/severity of injury and abbreviated injury scale. There were 1116 bicycle trauma patients recorded in the San Diego County Trauma Registry during the study period 1992-1996. The percentages of pre-legislation and post-legislation helmet use were 13.2 and 31.7%, respectively. Over this study period, the overall helmet use was increased by an average of 43% per year, averaging an 84% rate increase in helmet use among children. Only 16.1% of patients with serious head injury used helmets, compared to 28.2% in those who had no serious head injury. The odds ratio of helmet use against serious head injuries is 0.43 after adjusting for age, ethnicity and time. The p-values for comparing pre- and post-legislation serious head injury rates are p = 0.764, 0.4 and 0.194 for the overall, adult and child populations, respectively. The helmet legislation significantly increased the helmet use in the targeted child population and produced a significant carryover effect in the adult population. Helmet use has been shown to have a protective effect against serious head injury. Despite the increase use of helmets among this population, the present study could not confirm that helmet legislation alone significantly reduced head injury rates in San Diego County during the study period. This failure to show a correlation between the helmet legislation and reduced head injury rates may be due to study limitations.


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  • Accession Number: 01013395
  • Record Type: Publication
  • Files: TRIS, ATRI
  • Created Date: Dec 12 2005 2:37PM