Does the Repeal of Mandatory Motorcycle Safety Legislation Affect the Deaths of Motorcyclists? An Autopsy-Based Study Evaluating the Impact of Michigan's Universal Helmet Law Repeal on Immediately Fatal Motorcycle Crashes

• Published in: The American surgeon 2020-04, Vol.86 (4), p.205-207
• Main Authors: Saunders, Rachel N., Witte, Amanda B., Adams, Nicholas S., Dull, Matthew B., Davis, Alan T., Gibson, Charles J., Iskander, Gaby A., Rodriguez, Carlos H., Cohle, Stephen D., Chapman, Alistair J.
• Format: Article
• Language: English
• Subjects: Accidents, Traffic - mortality; Adult; Autopsies; Autopsy; Brain Injuries, Traumatic - etiology; Brain Injuries, Traumatic - mortality; Cause of Death; Crashes; Evaluation; Fatalities; Female; Forensic pathology; Head injuries; Head Protective Devices; Helmets; Hospitals; Humans; Legislation; Male; Mandatory Programs - legislation & jurisprudence; Medicine; Michigan - epidemiology; Mortality; Motorcycles; Motorcycles - legislation & jurisprudence; Neurosurgery; Protective equipment; Retention; Studies; Surgery; Traumatic brain injury
• ISSN: 0003-1348; 1555-9823
• DOI: 10.1177/000313482008600415

Multiple studies have evaluated the impact of repealing the universal motorcycle helmet law on hospitalized patients in Michigan.1' 2 These studies have identified a significant postrepeal decrease in the use of helmets and an increase in the incidence of traumatic brain injury (TBI) and neurosurgical procedures.1, 2 Despite decreased helmet use and increased TBI, in-hospital fatalities have not increased.1, 2 Several studies briefly commented that on-scene fatalities had not increased after the helmet law change, but the cause of on-scene fatalities before and after the helmet law change has not been examined. The helmet law repeal's effect on helmet retention (wearing helmet after the crash) has not been examined, despite helmet retention being crucial in protecting the head.1, 2 We, therefore, evaluated the impact of the legislative change on the cause of death (COD) and helmet use/ retention for on-scene deaths in the state of Michigan. Helmet retention is a critical aspect of helmet use and directly correlates with the presence and severity of head injury.3 Helmet retention is associated with the helmet type and proper helmet fixation; multiple studies have demonstrated a lack of proper helmet use.4 Our prior work demonstrated that of the on-scene motorcycle fatalities helmeted before the crash' only 36.6 per cent retained their helmet; this suggested that 63.4 per cent of helmets became dislodged or destroyed during the crash.4 We have now demonstrated that helmet retention significantly declined from 50 per cent prerepeal to 13 per cent postrepeal of the universal helmet law.