Universal Motorcycle Helmet Laws

Motorcycle helmets are highly effective in protecting motorcycle riders’ heads in a crash. The latest research indicates that helmets reduce motorcycle rider fatalities by 22 to 42 percent and brain injuries by 41 to 69 percent ([Coben, Steiner, and Miller, 2007]; [Cummings et al., 2006]; [Deutermann, 2004]; [Liu et al., 2008]; [NHTSA, 2003c]; [NHTSA, 2006c]). A Cochrane Collaboration review of 61 studies concluded that risk reductions were on the high end of the ranges mentioned above, with higher quality studies indicating that the protective effect of helmets was about a 42 percent reduction in risk of death in a crash and 69 percent for risk of a head injury in a crash. This review found that there was insufficient evidence to determine the effect on neck or facial injuries, or the effects of various types of FMVSS [Federal Motor Vehicle Safety Standard] 218 compliant helmets on injury outcomes (Liu et al., 2008). Others have found no evidence that helmets increase the risk of neck injuries ([I. Potts, Garets, et al., 2008], Strategy E1; [NHTSA and Motorcycle Safety Foundation, 2000]; [Ulmer and Preusser, 2003]). (UNC Highway Safety Research Center, 2011, p. 5-7)

State universal motorcycle helmet–use laws are effective at increasing helmet use. DOT-compliant helmet use increased nationally from 63 percent in 2008 to 67 percent in 2009, and use of noncompliant helmets decreased for the second year in a row (from 11 percent to 9 percent; NHTSA, 2009). Although “DOT-compliant helmet use increased in States with and without universal helmet laws” (UNC Highway Safety Research Center, 2011, p. 5-7), helmet use remains much higher in states with universal laws. “In 2009, compliant helmet use was 86 percent across States with a universal helmet law that covers all riders, and 55 percent across States with no law or a law covering only young riders ([NHTSA, 2009])” (UNC Highway Safety Research Center, 2011, p. 5-7).

Studies in States that enacted universal helmet laws observed use rates of 90 percent or higher immediately after the law became effective, compared to 50 percent or lower before the law ([Ulmer and Preusser, 2003], Section II). States that repealed universal helmet laws saw the opposite effect, as use rates dropped from above 90 percent to about 50 percent ([Kyrychenko and McCartt, 2006]; [Preusser, Hedlund, and Ulmer, 2000], Section V; [Ulmer and Preusser, 2003], Sections IV and V [and Mertz and Weiss, 2008]). Reenactment of a universal law in Louisiana (after a cycle of repeals and reenactments since 1968) resulted in an increase in [helmet] use among riders involved in crashes, from 42 percent before reenactment to 87 percent following ([Gilbert et al., 2008]). (UNC Highway Safety Research Center, 2011, p. 5-7)

History

“The first universal motorcycle helmet law was enacted in 1966” (UNC Highway Safety Research Center, 2011, p. 5-7). As a way to increase helmet use, the federal government offered an incentive—certain federal safety programs and highway construction funds—for states that enacted helmet use laws (IIHS, 2011a).

Universal laws were in effect in 47 States and the District of Columbia by 1975. After Federal penalties were eliminated in 1975 for States failing to have a universal law, about half the States repealed their laws. Several States have enacted or repealed helmet laws since then. The Insurance Institute for Highway Safety [IIHS] ([2008, 2010c]) summarizes the helmet law history in each State [see Table B.4]. (UNC Highway Safety Research Center, 2011, p. 5-7)

Use

As of August 2010,

20 States, the District of Columbia, and Puerto Rico had helmet laws covering all riders. Three States (Illinois, Iowa, and New Hampshire) did not have a motorcycle helmet law ([GHSA, 2014a]; [IIHS, 2011a]). Most other States had laws covering only riders under a specified age, typically 18 or 21 ([IIHS, 2011a]). (UNC Highway Safety Research Center, 2011, p. 5-7)

Effectiveness

The U.S. General [Accounting] Office (GAO) reviewed 46 methodologically sound studies of State helmet laws published before 1990. GAO concluded that motorcycle rider fatality rates were 20 to 40 percent lower with universal helmet laws (GAO, 1991; [Ulmer and Preusser, 2003], Section II). Studies since 1990 confirm these results (Cummings et al., 2006; [D. Houston and Richardson, 2008]; [Kyrychenko and McCartt, 2006]; Morris, 2006; [Ulmer and Northrup, 2005]; [Ulmer and Preusser, 2003], Section II). (UNC Highway Safety Research Center, 2011, p. 5-8)

Some States have helmet laws that only cover young riders. Helmet use is generally low in these States (GAO, 1991), and non-comprehensive laws do not translate into meaningful reductions in young rider fatalities rates ([D. Houston, 2007]). A reduction in fatality rates among all ages was estimated for partial coverage laws compared to no law by [D. Houston & Richardson, 2008], but the effect was much smaller (7 percent to 8 percent) than that for universal coverage (22 to 33 percent). Moreover, when Florida eliminated the requirement that all motorcycle riders 21 and older wear helmets, there was an 81 percent increase in motorcyclist fatalities ([Ulmer and Northrup, 2005]). Fatalities even increased among riders under age 21 who were still covered by the helmet law. Hospital admissions and treatment costs have also increased following repeal of universal helmet laws (Derrick and Faucher, 2009; GAO, 1991). (UNC Highway Safety Research Center, 2011, p. 5-8)

However, another analysis of Florida found that the increase in fatalities was associated with the increase in registered motorcycles; the adjusted fatality rate per 10,000 motorcycles did not change following repeal (O’Keeffe et al., 2007).

Almost half of all motorcyclists admitted to hospitals lacked sufficient health care insurance or were covered by government services, so the public ultimately shares many of these costs, as well as a greater long-term burden of care (Derrick and Faucher, 2009; GAO, 1991). Hence, the preponderance of evidence is that universal coverage laws provide greater safety and cost benefits than laws that cover only a specific age group. (UNC Highway Safety Research Center, 2011, p. 5-8)

Recent Research on Effectiveness

Recent research has generally supported the effectiveness of helmets and universal helmet laws.

One study using the National Trauma Data Bank, a large national database with trauma registry data, confirmed that helmet users in motorcycle collisions had lower injury-severity scores, mortality, and resource utilization than nonusers. The researchers predicted that helmet use could have saved approximately $32.5 million (or $1,750 per patient) over the seven-year study duration by reducing costs associated with intensive care unit (ICU) hospitalizations (Croce et al., 2009).

Bavon and Standerfer, 2010, examined the effect that repealing Texas’ universal helmet law in 1997 had on motorcyclist fatalities and found decreases in helmet use and significant increases in fatalities, as well as increases in the fatality rate per 100 billion vehicle-miles traveled.

Weiss, Agimi, and Steiner, 2010, used data from the 2005 to 2007 State Inpatient Databases of the Healthcare Cost and Utilization Project and found 38 percent more TBIs among young motorcycle riders in states with a partial helmet use law for only riders under age 21 than young motorcycle riders in states with a universal law. A comparison of three states with no motorcycle laws (New Hampshire, Iowa, and Illinois) and three states with partial helmet use laws for those age 17 or younger (Connecticut, Indiana, and Wisconsin) found no significant difference in average fatality rate per 10,000 registered motorcycles or helmet use in youth motorcycle-related fatalities, indicating that a partial law has no public health benefit over no law at all (Brooks, Naud, and Shapiro, 2010). In another study, the partial helmet use law in Connecticut was also associated with low helmet use (44.2 percent) in all-age motorcycle-related crashes (Landman et al., 2011).

Measuring Effectiveness

The effectiveness of helmet use laws is typically measured by changes in different motorcycle-related fatality metrics. Studies may examine the total number of motorcycle rider deaths, motorcycle rider deaths per billion miles traveled, or motorcycle rider deaths per 10,000 registered motorcycles. Different medical measures, such as severity of injury outcomes, specifically head and brain trauma, hospitalizations, and medical costs (including hospital and treatment costs), are also sometimes reported.

Helmet use is another common measure that can be collected through self-reporting, observation, or police records, although DOT-compliant helmet use may be more difficult to ascertain. The proportion of crashes or fatalities involving riders wearing helmets is also sometimes used to measure effectiveness.

Costs

Once legislation requiring helmet use has been enacted, implementation costs are minimal. The inevitable controversy surrounding the legislation will help to publicize the new law extensively. Motorcycle helmet laws can be enforced during regular traffic patrol operations because helmet use is easily observed. (UNC Highway Safety Research Center, 2011, p. 5-8)

Time to Implement

“A universal helmet use law can be implemented as soon as the law is enacted” (UNC Highway Safety Research Center, 2011, p. 5-8).

Other Issues

Opposition to Motorcycle Helmet Laws

Any effort to enact a universal helmet law can expect immediate, well-coordinated, and highly political opposition ([NHTSA, 2003c]). Helmet law opponents claim that helmet laws impinge on individual rights. They also claim that helmets interfere with motorcycle riders’ vision or hearing, though research shows that these effects are minimal (NHTSA, 1996). (UNC Highway Safety Research Center, 2011, p. 5-8)

States continue to debate helmet use laws. In 2009, legislation was introduced in 19 of the 20 states with a universal helmet law to repeal that law; however, none of the bills was passed (Ecola, Collins, and Eiseman, 2010). D. Houston, 2010, commented that some states have not adopted universal laws, despite the proven public health effectiveness.

See [M. Jones and Bayer, 2007] for a history of opposition to helmet laws in the United States. Derrick and Faucher (2009) also discuss national policy, organized opposition, and helmet law changes over the past four decades. (UNC Highway Safety Research Center, 2011, p. 5-8)

Noncompliant Helmets

Some riders in States with universal helmet laws wear helmets that do not comply with FMVSS 218 in order to avoid a helmet law citation ([Glassbrenner and Ye, 2006]). See the discussion in Chapter 5, Section 1.3. (UNC Highway Safety Research Center, 2011, p. 5-8)

Table B.4. Motorcycle and Bicycle Helmet Laws, as of December 2011
State Motorcycle Helmet Requirement Governs Motorcycle Helmet Law Covers All Low-Power Cycles Bicycle Helmet Requirement Governs
Ala. All riders Yes 15 and younger
Alaska 17 and youngera Yes No law
Ariz. 17 and younger All low-power cycles with an engine displacement greater than 50 cc, brake horsepower greater than 1.5, or ability to attain speeds greater than 25 mph are covered by the motorcycle helmet law. No law
Ark. 20 and younger Yes No law
Calif. All riders Yes 17 and younger
Colo. 17 and younger and passengers 17 and younger Yes No law
Conn. 17 and younger Yes 15 and younger
Del. 18 and youngerb All low-power cycles except motorized scooters are covered by the motorcycle helmet law; bicycle helmet is acceptable for a motorized scooter. 17 and younger
D.C. All riders All low-power cycles with an engine displacement greater than 50 cc, brake horsepower greater than 1.5, or ability to attain speeds greater than 35 mph are covered by the motorcycle helmet law. 15 and younger
Fla. 20 and youngerc All low-power cycles with an engine displacement greater than 50 cc, brake horsepower greater than 2, or ability to attain speeds greater than 30 mph and all low-power cycles operated by those 15 and younger are covered by the motorcycle helmet law. 15 and younger
Ga. All riders All low-power cycles are covered by the motorcycle helmet law except that bicycle helmets are acceptable for electric-assisted bicycles. 15 and younger
Hawaii 17 and younger All low-power cycles with an engine displacement greater than 50 cc, brake horsepower greater than 2, or ability to attain speeds greater than 30 mph are covered by the motorcycle helmet law. 15 and younger
Idaho 17 and younger All low-power cycles with an engine displacement greater than 50 cc, brake horsepower greater than 5, or ability to attain speeds greater than 30 mph are covered by the motorcycle helmet law. No law
Ill. No law No law No law
Ind. 17 and younger Yes No law
Iowa No law No law No law
Kan. 17 and younger All low-power cycles except electric-assisted bicycles are covered by the motorcycle helmet law. No law
Ky. 20 and youngerd All low-power cycles with an engine displacement greater than 50 cc, brake horsepower greater than 2, or ability to attain speeds greater than 30 mph are covered by the motorcycle helmet law. No law
La. All riders Yes 11 and younger
Maine 17 and youngere All low-power cycles with an engine displacement greater than 50 cc or more than 1,500 watts are covered by the motorcycle helmet law. 15 and younger
Md. All riders All low-power cycles designed to travel at speeds exceeding 35 mph, scooters with engine displacement greater than 50 cc or brake horsepower greater than 2.7, and mopeds with an engine displacement greater than 50 cc or brake horsepower greater than 1.5 are covered by the motorcycle helmet law. 15 and younger
Mass. All riders Yes 1–16 (riding with children younger than 1 prohibited)
Mich. All riders All low-power cycles with an engine displacement greater than 50 cc, brake horsepower greater than 2, or ability to attain speeds greater than 30 mph and all low-power cycles operated by those 18 and younger are covered by the motorcycle helmet law. No law
Minn. 17 and youngerf Yes No law
Miss. All riders Yes No law
Mo. All riders All low-power cycles with an engine displacement greater than 50 cc, brake horsepower greater than 3, or ability to attain speeds greater than 30 mph are covered by the motorcycle helmet law. No law
Mont. 17 and younger All low-power cycles with an engine displacement greater than 50 cc, brake horsepower greater than 2, or ability to attain speeds greater than 30 mph are covered by the motorcycle helmet law. No law
Neb. All riders Yes No law
Nev. All riders All low-power cycles with an engine displacement greater than 50 cc, brake horsepower greater than 2, or ability to attain speeds greater than 30 mph are covered by the motorcycle helmet law. No law
N.H. No law No law 15 and younger
N.J. All riders Yes 16 and younger
N.M. 17 and younger All low-power cycles with an engine displacement greater than 50 cc or ability to attain speeds greater than 30 mph are covered by the motorcycle helmet law. 17 and younger
N.Y. All riders All low-power cycles designed to travel at speeds of 20 mph or greater are covered by the motorcycle helmet law. 1–13 (riding with children younger than 1 prohibited)
N.C. All riders Yes 15 and younger
N.D. 17 and youngerg Yes No law
Ohio 17 and youngerh Yes No law
Okla. 17 and younger All low-power cycles are covered by the motorcycle helmet law except that bicycle helmets are acceptable for electric-assisted bicycles operated by those 18 and younger. No law
Ore. All riders Yes 15 and younger
Pa. 20 and youngeri All low-power cycles with an engine displacement greater than 50 cc, brake horsepower greater than 1.5, or ability to attain speeds greater than 25 mph are covered by the motorcycle helmet law. 11 and younger
R.I. 20 and youngerj All low-power cycles with an engine displacement greater than 50 cc, brake horsepower greater than 4.9, or ability to attain speeds greater than 30 mph are covered by the motorcycle helmet law. 15 and younger
S.C. 20 and younger Yes No law
S.D. 17 and younger Yes No law
Tenn. All riders Yes 15 and younger
Texas 20 and youngerk Yes No law
Utah 17 and younger Yes No law
Vt. All riders All low-power cycles with an engine displacement greater than 50 cc, brake horsepower greater than 2, or ability to attain speeds greater than 30 mph are covered by the motorcycle helmet law. No law
Va. All riders All low-power cycles operated at speeds greater than 35 mph or with an engine displacement greater than 50 cc are covered by the motorcycle helmet law. No law
Wash. All riders Yes No law
W.Va. All riders All low-power cycles with an engine displacement greater than 50 cc, brake horsepower greater than 2, or ability to attain speeds greater than 30 mph are covered by the motorcycle helmet law. 14 and younger
Wis. 17 and youngerl All low-power cycles designed to travel at speeds exceeding 30 mph and type 1 motorcycles with automatic transmission with an engine displacement greater than 50 cc are covered by the motorcycle helmet law. No law
Wyo. 17 and younger All low-power cycles with an engine displacement greater than 50 cc, brake horsepower greater than 2, or ability to attain speeds greater than 30 mph are covered by the motorcycle helmet law. No law

SOURCE: IIHS, 2011a.
a Alaska’s motorcycle helmet use law covers passengers of all ages, operators younger than 18, and operators with instructional permits.
b In Delaware, every motorcycle operator or rider age 19 and older shall have in his or her possession a safety helmet approved by the secretary.
c In Florida, the law requires that all riders younger than 21 years wear helmets, without exception. Someone 21 years or older may ride without a helmet only if he or she can show proof that he or she is covered by a medical insurance policy.
d In Kentucky, the law requires that all riders younger than 21 years wear helmets, without exception. Someone 21 years or older may ride without a helmet only if he or she can show proof that he or she is covered by a medical insurance policy. Motorcycle helmet laws in Kentucky also cover operators with instructional or learner’s permits.
e Motorcycle helmet laws in Maine cover operators with instructional learner’s permits and any operator in his or her first year of licensure. Maine’s motorcycle helmet use law also covers passengers 17 years and younger and passengers if their operators are required to wear helmets.
f Motorcycle helmet laws in Minnesota cover operators with instructional or learner’s permits.
g North Dakota’s motorcycle helmet use law covers all passengers traveling with operators who are covered by the law.
h Ohio’s motorcycle helmet use law covers any operators during the first year of licensure and all passengers of operators who are covered by the law.
i Pennsylvania’s motorcycle helmet use law covers all operators during the first two years of licensure unless the operator has completed the safety course approved by the Pennsylvania Department of Transportation (PennDOT) or the Motorcycle Safety Foundation.
j Rhode Island’s motorcycle helmet use law covers all passengers (regardless of age) and any operator during the first year of licensure (regardless of age).
k Texas exempts a rider 21 years or older if he or she can either show proof of successfully completing a motorcycle operator training and safety course or can show proof of having a medical insurance policy. A peace officer may not stop or detain a person who is the operator of or a passenger on a motorcycle for the sole purpose of determining whether the person has successfully completed the motorcycle operator training and safety course or is covered by a health insurance plan.
l Motorcycle helmet laws in Wisconsin cover operators with instructional or learner’s permits.


CDC Vital Signs: Motor Vehicle Crash Deaths. In 2013, the US crash death rate was more than twice the average of other high-income countries. www.cdc.gov/vitalsigns/motor-vehicle-safety