This section focuses on the research showing the effectiveness of helmets in preventing death and injury and reducing the severity of head, brain and face injury in the event of a crash. It is a subsection of the research regarding Helmets and Helmet Laws. In some way each of the other helmet and helmet laws subsections provide research regarding the effectiveness of helmets. In addition, helmet effectiveness is also addressed in many of the crash causation and injury outcome research reports.
In motorcycling, the first step in preventing injury is to minimize the probability of crashing. Not crashing and hitting your head is infinitely better than crashing and relying on your helmet to protect your head. No helmet can protect against all possible impacts, and the impact may exceed the helmet’s protection capability. No helmet protects any part of the head that it does not cover, so even if the head injury is avoided but you chose to wear a ¾ or ½ helmet you may have smashed your face or broken your jaw.
The core question addressed in this section is “Do motorcycle helmets work for their intended purpose?” The answer is a resounding “yes.” There are so many studies on this question that we cannot possibly post them all. The studies listed are a few of the more recent, most comprehensive or most often referenced.
Helmet use consistently has been shown to reduce motorcycle crash–related injuries and deaths. Reviews of the literature find strong evidence of effectiveness and conclude that use of motorcycle helmets (1) decreases the overall death rate from motorcycle crashes when compared with non-helmeted riders (2) decreases the incidence of lethal head injury in motorcycle crashes when compared with non-helmeted riders and (3) decreases the severity of nonlethal head injury in motorcycle crashes when compared with non-helmeted riders. Motorcycle helmets are found to reduce the risk of death by 42 percent and head injury by 69 percent in motorcyclists who crashed.
In general, research regarding helmet effectiveness can be divided into two types: (1) studies that look in-patient hospital data to compare the injury and death rates of helmeted with non-helmeted motorcycle riders and (2) studies that look on the change in death rates for states which have instated or repealed mandatory helmet laws or compare the death and injury rates in states which have mandatory helmet laws with states which do not have mandatory helmet laws.
The first type assesses the risk of being killed based on injured riders but because the severity of injury is often not reported in the study, the percentage of deaths varies considerably between the studies. The second type of study examines crash or injury data and in that regard provide us information regarding the impact of helmet use or nonuse as well as the effect of mandatory helmet laws, and the helmet law studies in turn provide us information regarding the impact of helmet use. For these types of studies, it is difficult to account for all the factors which may affect the number of crashes, injuries and death of motorcycle riders so they need to be evaluated carefully. This is one reason, we feel reviews of the literature are so valuable because experts have evaluated the methodologies of the studies and only include studies for review that meet strict standards.
Helmet Effectiveness Research Studies
This study exhibits that up to 3.4 million deaths might result from motorcycle crashes between 2008 and 2020. As many as 1.4 million of those fatalities can be avoided with the proper use of safety helmets. A policy on wearing motorcycle helmets is, therefore, essential for promoting safety.
2016 – “Motorcycle Helmet Effectiveness in Reducing Head, Face and Brain Injuries by State and Helmet Law”
Medical charges and rates of head, facial, and brain injuries among motorcyclists were lower in universal law states. Helmets were effective in reducing injury in both helmet law settings; lower effectiveness estimates were observed in universal law states.
2016 – “Impact of Helmet Use on Injury and Financial Burden of Motorcycle and Moped Crashes in Hawai’i”
This study sought to quantify, on a statewide level, the healthcare burden of unhelmeted motorcycle and moped riders. Protective associations with helmet use are stronger among motorcyclists than moped riders, suggesting the protective effect is augmented in higher speed crashes. The public financial burden is higher from unhelmeted riders who sustain more severe injuries and are less likely to be insured.
2015 – “Estimating Lives and Costs Saved by Motorcycle Helmets With Updated Economic Cost Information”
This is the 2015 NHTSA annual report (2013 data). In 2013, an estimated 1,630 lives were saved in the United States by motorcycle helmets; an estimated 715 additional fatalities could have been prevented if all motorcyclists1 had worn helmets.
This is a table listing the research reports reviewed by the Community Guide Task Force. Following completion of the review of the available literature, the task force recommended universal motorcycle helmet laws based on strong evidence of helmet effectiveness.
2010 – “An Evidence-Based Review: Helmet Efficacy to Reduce Head Injury and Mortality in Motorcycle Crashes”
This is a high quality review of the literature. Forty-five studies from more than 500 identified were included in the review. The authors concluded that the use of motorcycle helmets 1) decreases the overall death rate from motorcycle crashes when compared with nonhelmeted riders. 2) decreases the incidence of lethal head injury in motorcycle crashes when compared with nonhelmeted riders. ) decreases the severity of nonlethal head injury in motorcycle crashes when compared with nonhelmeted riders.
Abstract. This 13-year (1994-2006) retrospective study of adult motorcycle crashes admitted to a Level II trauma center compares helmeted to unhelmeted motorcyclists. The author’s conclusion is clear and simple: Unhelmeted motorcyclists sustain more severe injuries and adverse outcomes.
This report examines the relationship between motorcycle helmet use and motorcycle crash outcomes in terms of injury types, hospital charges, and other variables employing data from the Crash Outcome Data Evaluation System (CODES), a program facilitated by the National Highway Traffic Safety Administration. Helmeted motorcyclists were less likely to experience facial and head injuries compared to unhelmeted motorcyclists. Helmeted motorcyclists were significantly less likely to experience a traumatic brain injury. TBIs are of particular concern in our study. TBI was associated with significantly higher hospital charges.
Abstract. Unhelmeted motorcycle crash patients suffer more severe brain injuries, consume more resources, and have the worst payor mix.
This is a high quality literature review by The Cochrane Collaboration. Sixty-one observational studies were selected of varying quality. Despite methodological differences there was a remarkable consistency in results, particularly for death and head injury outcomes. Motorcycle helmets were found to reduce the risk of death and head injury in motorcyclists who crashed. Helmets were estimated to reduce the risk of death by 42% were estimated to reduce the risk of head injury by 69%.
Abstract. This is a special report by the Virginia Commonwealth University Transportation Safety Training Center Crash Investigation Team. The purpose of the study was to compare unhelmeted riders involved in serious crashes with helmeted riders in similar crashes. One main factor identified in this study is that riders who wear approved safety helmets decrease their chances of incurring serious or fatal head injuries during motorcycle crashes.
This is a National Highway Traffic Safety Administration (NHTSA) report that uses data from the Fatality Analysis Reporting System (FARS) to estimate helmet effectiveness. This report looks at data from 1993 through 2002 and is a “revisit” to an earlier report that used data from 1982 through 1987. The earlier report found helmets to be 29 percent effective in preventing fatalities and this report says that due to technological changes over the past 15 years have led to improvements in helmet design and materials. Recalculating the effectiveness of helmets in preventing fatalities, using more recent data, shows that helmets have indeed improved in this respect. The effectiveness of helmets has increased to 37 percent.
Abstract. This is an earlier version of the 2008 Cochrane Collaboration literature review. Fifty-three observational studies were identified of varying quality. Motorcycle helmets appear to reduce the risk of mortality although, due to heterogeneity in study design, an overall estimate of effect was not calculated. There was some evidence that the effect of helmets on mortality is modified by speed. Motorcycle helmets were found to reduce the risk of head injury estimated to be 72%.
This is a unique study design that focuses on examination of the collision-involved helmet. Observable helmet damage is not an indication of head injury. In different cases with different crash circumstances, it is possible for a helmet to be significantly damaged and no head injury will be present because the helmet provided adequate protection. Conversely, it is possible for helmeted individuals involved in collisions to sustain an injury to the head area without observable helmet damage. This study provides an analysis of helmet effectiveness using collision-involved helmets, where a significant head/helmet impact was known.
Linked data from the Crash Outcome Data Evaluation System (CODES) in seven states were used by the National Highway Traffic Safety Administration as the basis of a 1996 Report to Congress on the Benefits of Safety Belts and Motorcycle Helmets. This study measured motorcycle helmet effectiveness using mortality, morbidity, severity and costs. The CODES data showed that motorcycle helmets are effective in preventing injuries or death in general, but even more effective in preventing brain injuries in particular.