Increased risk of death or disability in unhelmeted Wisconsin motorcyclists.

OBJECTIVE The purpose of this study is to investigate the relationships among motorcycle rider helmet, alcohol use and the full spectrum of health outcomes following crashes. METHODS Data from the National Highway Traffic Safety Administration-sponsored Crash Outcome Data Evaluation System (CODES) for Wisconsin, 2002, were used to study 2462 motorcycle crash victims. Logistic regression models were used to assess the relationship of helmet and alcohol use with outcomes. RESULTS Compared to helmeted motorcycle riders, unhelmeted riders were more likely to require inpatient hospitalization (Relative Risk Ratio [RRR] = 1.4; 95% confidence interval [CI]:1.1-1.8) or die (RR = 1.9, 95% CI:1.0-3.7) but equally likely to be treated in emergency departments. Injury patterns differed by helmet use. Unhelmeted riders were more likely to suffer injuries of the head (odds ratio [OR] = 2.3, 95% CI:1.5-3.3) or face (OR = 3.0, 95% CI:2.1-4.2) than helmeted riders. No difference was observed in other injuries, including spine/neck injuries. Reported alcohol use was more prevalent among patients who were inpatients or died, and was associated with higher likelihood of not wearing a helmet (OR = 7.0, 95% CI:4.8-12.9). CONCLUSION Motorcycle riders who are inpatients or die in a crash are less likely to be helmeted and more likely to sustain head or face injuries. Alcohol use is associated with unhelmeted riding and increased risk of poor outcomes. These findings support policy and educational efforts promoting helmet use, which seek to decrease these tragedies.