Motorcycle Injury Prevention

Interventions Changing the Context

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What are universal motorcycle helmet laws?

Universal motorcycle helmet laws require that all motorcycle riders, both operators and passengers, wear helmets on public roads. The purpose of these state laws is to increase the use of helmets by motorcycle riders. Evidence shows that these laws are associated with higher rates of helmet use and lower rates of motorcycle-related deaths and injuries.[1-7]  In April 2022, universal motorcycle laws are in place in 18 states and the District of Columbia. There are also partial laws (e.g., helmet requirements only for riders under specific ages and/or cycles with an engine displacement of 50cc or less in 29 states, and no motorcycle helmet laws in three states.[8, 9]

What’s the public health issue?

The National Highway Traffic Safety Administration (NHTSA) tracks fatal and non-fatal injuries suffered in motor vehicle traffic crashes.  In the United States, motorcycles account for three percent of registered vehicles and only 0.6 percent of vehicle miles traveled.[8] Yet, according to NHTSA, motorcyclists accounted for 14 percent of all traffic fatalities in 2019 and three percent of all traffic injuries.[10]

NHTSA also found that traffic crashes in 2019 resulted in motorcyclist fatalities 29 times more frequently than passenger car occupant fatalities per vehicle mile traveled.[10] Unfortunately, the number of deaths continues to increase. Data from NHTSA’s Fatality Analysis Reporting System show that motorcycle related deaths doubled between 1999 to 2019.[11]

NHTSA estimates that $8.9 billion in comprehensive costs and $1.5 billion in economic costs could have been saved in 2017 alone if all motorcycle riders wore helmets.[12]  When helmet laws are repealed, motorcycle fatalities and head injuries rise.[1, 13] Debilitating injuries and deaths from motorcycle crashes are costly, but preventable.[7, 13]

What is the evidence of health impact and cost effectiveness?

Motorcycle helmets are 37 percent (for riders) and 41 percent (for passengers) effective in preventing deaths[12]  and the risk of head injury by 69 percent.[14]  Helmets are the most effective motorcycle safety measure shown to save lives in crashes, and the universal helmet law (one that covers all motorcycle operators and passengers) has been shown to be the best way to ensure helmet use.[1, 15, 16]  Helmet laws work to save lives[7]. Following implementation of the law, helmet use typically climbs immediately to more than 90 percent from 50 percent or less.[15] In 2004, Louisiana reinstated a universal helmet law. After the law passed:

  • Motorcycle crash victims were 11.7 times more likely to wear a helmet.
  • Fatalities were 30 percent less likely.
  • Severe and moderate injuries also decreased.[6]

Weakening legal requirements for helmet use has been shown to decrease helmet use and increase injury and death from motorcycle crashes.[1, 17, 18] In 2012, Michigan replaced the state’s universal motorcycle helmet law with a law allowing individuals 21 years and older to ride without a helmet.  A 2017 study compared helmet use with crash data 12 months before and after the repeal.[17]  The study documented a 24% – 27% decline in helmet use for riders involved in crashes and a 14% increase in head injury[17].

According to a NHTSA report, helmets saved an estimated 1,872 lives and more than $3.5 billion in economic costs and $21 billion in comprehensive costs in 2019.[12] Economic costs were defined as tangible losses resulting from crashes, including medical care, lost productivity, legal and court costs, insurance costs, work place costs, and property damage. Comprehensive costs included economic costs as well as the estimated costs associated with lost quality of life.[12] NHTSA first published these findings in a report, “The Economic and Societal Impact of Motor Vehicle Crashes, 2010[13] and later provided updated methods for calculating the estimates in a research note in 2015.[19]

Map of motorcycle helmet laws by state, as of April 2022: [9]

Current map of motorcycle helmet laws by state
  1. Peng Y, Vaidya N, Finnie R, et al. Universal Motorcycle Helmet Laws to Reduce Injuries: A Community Guide Systematic Review. American Journal of Preventive Medicine. 2017;52(6):820-832. doi:Universal Motorcycle Helmet Laws to Reduce Injuries: A Community Guide Systematic Review
  2. Derrick AJ, Faucher LD. Motorcycle helmets and rider safety: a legislative crisis. J Public Health Policy. 2009;30(2):226-42. doi:10.1057/jphp.2009.11
  3. Muelleman R, Mlinek E, Collicott P. Motorcycle crash injuries and costs: effect of a reenacted comprehensive helmet use law. Ann Emerg Med. 1992;21(3):266-72.
  4. Auman KM, Kufera JA, Ballesteros MF, Smialek JE, Dischinger PC. Autopsy study of motorcyclist fatalities: the effect of the 1992 Maryland motorcycle helmet use law. Am J Public Health. Aug 2002;92(8):1352-5.
  5. Rowland J, Rivara F, Salzberg P, Soderberg R, Maier R, Koepsell T. Motorcycle helmet use and injury outcome and hospitalization costs from crashes in Washington State. Am J Public Health. Jan 1996;86(1):41-5.
  6. Gilbert H, Chaudhary N, Solomon M, Preusser D, Cosgrove L. Evaluation of the Reinstatement of the Universal Motorcycle Helmet Law in Louisiana. 2008. DOT HS 810 956. Motorcycle Safety: Overview
  7. Olsen CS, Thomas AM, Singleton MD, et al. Motorcycle helmet effectiveness in reducing head, face and brain injuries by state and helmet law. Injury Epidemiology. 2016;3:1-11.
  8. National Center for Statistics and Analysis. Motorcycle helmet use in 2021 – Overall results. 2022. Traffic Safety Facts Research Note Report No DOT HS 813 270. Accessed April 20, 2022. Motorcycle Helmet Use in 2021—Overall Results
  9. Insurance Institute for Highway Safety Highway Loss Data Institute. Motorcycle helmet use. 2022. Accessed April 20, 2022. Motorcycle helmet use laws by state
  10. National Center for Statistics and Analysis. Summary of motor vehicle crashes: 2019 data. 2021. Accessed April 20, 2022. Traffic Safety Facts: 2019 Data
  11. National Highway Traffic Safety Administration. Fatality Analysis Reporting System (FARS) Encyclopedia 2019. Accessed March 25, 2022. National Highway Traffic Safety Administration
  12. National Center for Statistics and Analysis. Lives and costs saved by motorcycle helmets, 2017. 2019. Traffic Safety Facts Crash – Stats Report No DOT HS 812 867. Accessed April 20, 2022. Lives and Costs Saved by Motorcycle Helmets, 2017
  13. Blincoe L, Miller TR, Zaloshnja E, Lawrence BA. The economic and societal impact of motor vehicle crashes, 2010 (Revised). 2015. The Economic and Societal Impact Of Motor Vehicle Crashes, 2010 (Revised)
  14. Liu BC, Ivers R, Norton R, Boufous S, Blows S, Lo SK. Helmets for preventing injury in motorcycle riders. Cochrane Database Syst Rev. 2008;(1):CD004333. doi:10.1002/14651858.CD004333.pub3
  15. Venkatraman V, Richard CM, Magee K, Johnson K. Countermeasures That Work: A Highway Safety Countermeasure Guide for State Highway Safety Offices, 2020. 2021. BSR Countermeasures That Work. 2021. Accessed April 20, 2022. Countermeasures That Work: A Highway Safety Countermeasure Guide for State Highway Safety Offices, 10th Edition, 2020
  16. Centers for Disease Control and Prevention. Motorcycle Safety: How to Save Lives and Money. 2012. CS231978-A. Accessed April 20, 2022. Motorcyle Safety
  17. Carter PM, Buckley L, Flannagan CAC, et al. The Impact of Michigan’s Partial Repeal of the Universal Motorcycle Helmet Law on Helmet Use, Fatalities, and Head Injuries. American Journal of Public Health. 2017;107(1):166-172. doi:10.2105/ajph.2016.303525
  18. Lee J, Abdel-Aty M, Wang J-H, Lee C. Long-Term Effect of Universal Helmet Law Changes on Motorcyclist Fatal Crashes: Comparison Group and Empirical Bayes Approaches. Transportation Research Record. 2017;2637(1):27-37. doi:10.3141/2637-04
  19. National Highway Traffic Safety Administration. Traffic Safety Facts: Estimating Lives and Costs Saved by Motorcycle Helmets With Updated Economic Cost Information. 2015. DOT HS 812 206. Accessed April 20, 2022. Estimating Lives and Costs Saved by Motorcycle Helmets With Updated Economic Cost Information