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• From 2010 to 2018, over 7 million visits to Emergency Departments (EDs) were due to concussion. • The vast majority of concussions diagnosed in EDs were not sport-related. • Most concussions were diagnosed in the South, followed by West, Midwest, and Northeast. • The Midwest and Northeast regions of the US had lower odds of concussion diagnoses in EDs. • Geographic region and mechanism of injury patterns inform future concussion efforts. Background : Concussion is a type of traumatic brain injury (TBI) that can be sustained through sport-related and non-sport-related (e.g., motor vehicle accidents, falls, assaults) mechanisms of injury (MOI). Variations in concussion incidence and MOI may be present throughout the four geographic regions (Midwest, Northeast, South, West) of the United States. However, there is limited evidence exploring concussion cause and diagnosis patterns based on geographic region and MOI. These factors have implications for better understanding the burden of concussion and necessary efforts that can translate to the mitigation of safety concerns. Purpose: The purpose of this study was to identify patterns of sport-related concussion (SRC) and non-sport-related concussion (NSRC) across the four geographic regions of the United States. Methods: A descriptive epidemiology study of patient visits to the emergency department (ED) for concussion between 2010 and 2018, using publicly available data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) was conducted. The exposure of interest was geographic region while the main outcome measures were concussion diagnosis and MOI. Descriptive statistics were calculated using population-weighted frequencies and percentages. The association between geographic region and MOI (SRC vs. NSRC) was analyzed using logistic regression models. Odds ratios (OR) presented with 95% confidence intervals (CI) were included. Univariate analyses were conducted followed by multivariable analyses adjusting for sex, age, race/ethnicity, and primary source of payment. Statistical significance was set a priori at p < 0.05 for all analyses. Results: From 2010 to 2018, 1,161 visits resulted in a concussion diagnosis, representing an estimated 7,111,856 visits nationwide. A greater proportion of concussion diagnoses occurred within EDs in the South (38.2%) followed by the West (25.8%), Midwest (21.4%), and Northeast (14.6%). Compared to the West region, patients visiting the ED in the Midwest (OR = 0.75, 95% CI = 0.57–0.98) and Northeast (OR = 0.71, 95% CI = 0.51–0.98) had a lower odds of being diagnosed with a concussion. More patients sustained a NSRC MOI (94.3%) compared to SRC MOI (5.7%). For both mechanisms, the South region had the highest population-weighted frequency of SRC (n = 219,994) and NSRC diagnoses (n = 2,495,753). Univariate and multivariable logistic regression analyses did not reveal statistically significant associations for geographic region and MOI (p > 0.05). Conclusion: Our findings showed that the Midwest and Northeast regions had a lower odds of concussion diagnoses in EDs. Overall, the vast majority of concussions were not sport-related, which has public health implications. These findings improve our understanding of how concussion injuries are being sustained geographically nationwide and help to explain care-seeking patterns for concussion in the ED setting. [ABSTRACT FROM AUTHOR]

• Legislation concerning eye protection specifically is understudied and poorly characterized. • We reviewed all motorcycle safety equipment statutes of all 50 states for information regarding eye protection and graded the rigor of each statute using our novel, six-category Eye Safety Metric. • We found great diversity in the stringency of laws across all jurisdictions, with 14 states lacking eye protection laws and 26 states having eye protection exemptions for windshields, which are a poor form of eye protection. • Despite only two states lacking helmet laws, we found that 14 states lacked eye protection laws. Introduction: Motorcycle accidents cause millions of deaths and injuries globally. It is estimated that billions of dollars would be saved in the United States alone if safety equipment, such as helmets and eye protection, was ubiquitously worn. Legislation concerning eye protection specifically is understudied and poorly characterized. Method: We reviewed all motorcycle-related safety equipment laws in all 50 states of the United States for information regarding eye protection. We graded the rigor of each statute using our six-category Eye Safety Metric and performed a comparative analysis of statutes across all jurisdictions. Results: Fourteen states did not have any statutes regarding eye protection. Among states that did, 23 states had weak statutes (0–2 points), 20 states had moderately stringent statutes (3–4 points), and 7 states had strong statutes (5–6 points). States in western United States tended to have less strict eye protection laws. Twenty-six states had eye protection exemptions for windshields, which are a poor form of eye protection. Six states that had universal helmet laws had no laws requiring eye protection. Conclusions: We characterized eye protection legislation across the country and found great diversity in the stringency of laws across all jurisdictions. Despite only two states lacking helmet laws, we found that 14 states lacked eye protection laws. These findings from our Eye Safety Metric can be used as a springboard for future research, which can be used to determine the need for and significance of eye safety legislation for motorcyclists and to inform legislative decision-making. Practical Applications: With this research, we hope to further the understanding of legislation regarding eye protection for motorcyclists and help policymakers identify states that need improved eye safety standards. [ABSTRACT FROM AUTHOR]

Background: The recent proliferation of electric standing scooters in major urban areas of the United States has been accompanied by injuries of varying severity and nature, representing a growing public health concern.Objective: Our aim was to characterize imaging utilization patterns for injuries associated with electric scooter (e-scooter) use, including their initial emergency department (ED) management.Methods: We conducted a retrospective review of the electronic medical record for all patients presenting to affiliated EDs for e-scooter-related injuries between July 2018 and April 2020. Demographics, date and time of presentation, imaging study type, resultant injury, and procedural details were recorded.Results: Ninety-seven patients were included; mean age was 27.6 years. Of these, 55 patients (57%) had injuries identified on imaging and 40% of all imaging studies were positive. Most identified injuries (61%) were musculoskeletal, with a small number of neurological (2%) and genitourinary (1%) injuries. The highest prevalence of presentations occurred in August; most patients (72%) presented between 3 pm and 1 am and granular peaks were between 12 am and 1 am and 5 pm and 6 pm.Conclusions: Patients presenting with e-scooter injuries have a high likelihood of injury to the radial head, nasal bone, and malleoli. Emergency physicians should be especially vigilant for injuries in these areas at presentation. Visceral injuries are uncommon but may be severe enough to warrant surgery. [ABSTRACT FROM AUTHOR]

Study Design: Database study.Objective: The purpose of this study was to use a large, nationwide database to determine prevalence of pediatric spine fractures in the United States, associated injuries, mechanisms of injury (MOI), use of safety devices, and mortality rates.Summary Of Background Data: Spinal fractures account for 1% to 2% of pediatric injuries. However, they are associated with significant comorbidities and complications. Motor vehicle accidents (MVAs) are most responsible for increased incidence observed.Methods: Retrospective review of National Trauma Data Bank between 2009 and 2014 (analysis in 2019) for all vertebral fractures in patients under 18 years of age. Subanalysis included those in MVAs where protective device use data were available. Patient demographics, MOI, geographical and anatomical region of injury, concomitant musculoskeletal/organ injury, protective device usage, hospital length of stay, surgical procedures, and mortality were all analyzed.Results: A total of 34,563 patients with 45,430 fractured vertebrae included. Median age was 15 years. Most fractures (63.1%) occurred in patients aged 15 to 17 years, most frequent MOI was MVA (66.8%), and most common geographic location was the South (38%). Males sustained more spine fractures than females, overall (58.4% vs. 41.6%; P < 0.001) and in MVAs (54.4% vs. 45.6%; P < 0.001). Those in MVAs wearing seatbelts had lower odds of cranial (29.6% vs. 70.4%; odds ratio [OR] = 0.85, 95% confidence interval [CI]: 0.82-0.89; P < 0.001) and thoracic (30.1% vs. 69.9%; OR = 0.88, 95% CI: 0.84-0.91; P < 0.001) organ injury, multivertebral (30% vs. 70%; OR = 0.78, 95% CI: 0.73-0.83; P < 0.001) and concomitant nonvertebral fractures (30.9% vs. 69.1%; OR = 0.89, 95% CI:0.73-0.83; P < 0.001), and 21% lower odds of mortality (29.3% vs. 70.7%; OR = 0.79, 95% CI: 0.66-0.94; P = 0.009). Over 70% of drivers were not restrained during MVA, with majority of seatbelt violations incurred by males, ages 15 to 17, in the South.Conclusion: Over 60% of pediatric spinal fractures occur in children aged 15 to 17 years, coinciding with the beginning of legal driving. MVA is the most common cause and has significant association with morbidity/mortality. Nearly two- thirds pediatric spinal fractures sustained in MVAs occurred without seatbelts. Absence of seatbelts associated with >20% greater odds of mortality. Ensuring new drivers wear protective devices can greatly reduce morbidity/ mortality associated with MVA.Level of Evidence: 3. [ABSTRACT FROM AUTHOR]

• One third of all motorcycle drivers were not wearing a helmet at the time of the collision. • Non-helmeted motorcycle drivers were more than twice as likely to suffer severe traumatic brain injury. • Helmet use was not associated with increased risk of neck or cervical spine injuries. • Helmet use was identified as an independent factor associated with lower mortality. Motorcycle crashes pose a persistent public health problem with disproportionate rates of severe injuries and mortality. This study aims to analyze injury patterns and outcomes with regard to helmet use. We hypothesized that helmet use is associated with fewer head injuries and does not increase the risk of cervical spine injuries. The National Trauma Data Bank was queried for all motorcycle driver crashes between 2007-2017. Univariable analysis was used to compare demographics, clinical data, injury patterns using abbreviated injury scale, and outcomes between helmeted motorcycle drivers and non-helmeted motorcycle drivers who were injured in traffic crashes. Independent factors associated with mortality were determined by regression analysis after adjustment for potential confounders. A total of 315,258 patients were included for analysis, 66 % of these patients were helmeted. The sample was 92.5 % male and the median age was 41 years. Non-helmeted motorcycle drivers were more likely to sustain severe head trauma (head abbreviated injury scale ≥ 3: 28.5 % vs. 13.3 %, p < 0.001 ), had higher intensive care unit-admission (38 % vs. 30.2 %, p < 0 . 001 ), mechanical ventilation (20.1 % vs. 13 %, p <0. 001 ) and overall mortality rates (6.2 % vs. 3.9 %, p <0. 001 ). Cervical spine injuries occurred in 10.6 % of non-helmeted motorcycle drivers and in 9.5 % of helmeted motorcycle drivers ( p <0. 001 ). Helmet use was identified as an independent factor associated with lower mortality [ OR 0.849 (0.809–0.891), p <0. 001 ]. Helmet use is protective for severe head injuries and associated with decreased mortality. Helmet use was not associated with increased rates of cervical spine injuries. On the contrary, fewer injuries were observed in helmeted motorcycle drivers. Public health initiatives should be aimed at enforcement of universal helmet laws within the United States and across the world. [ABSTRACT FROM AUTHOR]

Despite the increasing popularity of the bicycle as a mode of urban transport in the United States, compared to much of the industrialized West, the US cycling scene continues to struggle with a high fatality and severe injury rate, and comparatively low levels of cycling. In contrast to the most bicycle-friendly countries, which have achieved high rates of safe cycling not through widespread adoption of bicycle safety helmets, but through bicycle-friendly infrastructure and policy, the US appears to have maintained a greater fixation on, and a higher rate of use of, bicycle helmets. In this paper, I seek to examine whether there is evidence of a helmet fixation, to sketch out the broad strokes of such a fixation as a discourse, and to offer an explanation of the effects of this discourse. Using a qualitative analysis of the official online presence of 25 US city planning departments relating to bicycling and bicycle safety, I first provide evidence that the helmet does in fact take a central place in the US urban bike safety discourse, and I characterize four rhetorical strategies used to encourage helmet use. I then argue that this helmet fixation is ultimately tied to the (re)production of unfettered automobility, and that it arguably hampers efforts to actually improve bicycle safety. I subsequently suggest implications for research, practice, and advocacy. [ABSTRACT FROM AUTHOR]

Background: This study aimed to characterize bodily injury patterns associated with helmet usage by comparing trauma sustained by helmeted and helmetless cyclists admitted to a large US health-care system. Materials and Methods: A prospective trauma registry associated with a large regional United States health-care network was queried for bicycle injuries resulting in hospital admission over a 5-year period. Data pertaining to helmet usage, demographics, injury description (s), Abbreviated Injury Scale score, Injury Severity Score, and hospital length of stay were collected from 140 patients treated for bicycle-related injuries. Mann–Whitney tests were performed. Results: Fifty-six of the injured cyclists were helmeted (40%) and 84 were not helmeted (60%). A significantly greater proportion of helmeted cyclists exhibited abrasions and a higher incidence of injury across all injury types (P = <0.001 and 0.003). The number and severity of injury to the external body (P = <0.001 and 0.001) and overall injury severity (P = 0.004) for patients with multiple injuries were also significantly greater among helmeted cyclists. Helmeted cyclists did demonstrate significantly shorter hospital stays (P = 0.021). Conclusion: While the helmeted and helmetless riders admitted to the emergency department exhibit few differences in injury patterns, when significant injury differences were detected, they were more prevalent in helmeted riders. These differences were represented by minor-to-moderate injuries relative to morbidity and mortality, suggesting that the trauma profile of the helmeted and helmetless riders is relatively comparable. Yet, helmetless wearers did have significantly longer hospital stays, which may indicate underlying health disparities and/or behavioral differences. [ABSTRACT FROM AUTHOR]

Maxillofacial injury is a common injury resulting from bicycle (including e-bike) and scooter accidents. With 80,000 admissions to emergency departments in 2019, bicycle accidents account for more than half of all traffic-related emergency department visits in the Netherlands. The United States reports approximately 130,000 injuries and 1000 fatalities related to cycling annually. This systematic review and meta-analysis was performed to examine the protective effect of helmets against maxillofacial injuries resulting from bicycle and scooter (including e-bike and e-scooter) accidents. After a systematic literature search, 14 studies were found to be eligible for this systematic review. Of these, 11 were included in the meta-analysis. None of the included studies focused on vehicles with motors (e-bikes and e-scooters); all focused only on non-motorized vehicles. All included studies were non-randomized, which could have led to bias in the pooled results. Data from the included studies were tested for heterogeneity using the binary random-effects model (DerSimonian-Laird method), and the odds ratio for the occurrence of maxillofacial injury in cyclists wearing a helmet versus those not wearing a helmet was calculated by random-effects meta-analysis. Patients who had worn a helmet suffered significantly fewer maxillofacial injuries than patients who had not, in bicycle accidents (odds ratio 0.682). In conclusion, wearing a helmet has a significant protective effect against maxillofacial injury, indicating the need for strict helmet legislation., Competing Interests: Competing interests None., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

The aim of this study was to compare hospital outcomes for patients in a motorcycle collision with and without helmet use. The study was conducted as a retrospective analysis of the National Trauma Data Bank's 2013 data set, which included reported data from 100 hospitals across the United States. Inclusion criterion for this study is a motorcycle crash involving a driver or passenger. The total number of patients in motorcycle crashes as reported by the National Trauma Data Bank in 2013 was 10,345. Helmet use, hospital stay, ICU and ventilation days, mortality, Glasgow Coma Score, Injury Severity Score, patient payer mix, and complication data were obtained. Patients were divided into two groups: those wearing a helmet (n = 6250) and those without (n = 4095). Patients not wearing a helmet had an increased risk of admission to the ICU (OR = 1.36, P < 0.001, CI 1.25-1.48), requiring ventilation support (OR = 1.55, P < 0.001, CI 1.39-1.72), presenting with a Glasgow Coma Score of eight or below (OR = 2.15, P < 0.001), and in-patient mortality (OR = 2.00, P < 0.001, CI 1.58-2.54). Unhelmeted patients were more likely to have government insurance or be uninsured than those patients wearing a helmet (P < 0.001). It is not well understood why many states are repealing or have repealed universal helmet laws. Lack of helmet use increases the severity of injury in traumatized patients leading to a substantial financial impact on health care costs. Our analysis suggests the need to revisit the issue regarding laws that require protective headwear while riding motorcycles because of the individual and societal impact. III. [ABSTRACT FROM AUTHOR]

Nowadays crash helmets are tested by dropping a free or unrestrained headform in Europe but a guided or restrained headform in the United States. It remains unclear whether the free fall and the guided fall produce similar impact kinematics that cause head injury. A finite element helmet model is developed and compared with experimental tests. The resulting head kinematics from virtual tests are input for a finite element head model to compute the brain tissue strain. The guided fall produces higher peak force and linear acceleration than the free fall. Eccentric impact in the free fall test induces angular head motion which directs some of the impact energy into rotational kinetic energy. Consequently, the brain tissue strain in the free fall test is up to 6.3 times more than that in the guided fall. This study recommends a supplemental procedure that records angular head motion in the free fall test. [ABSTRACT FROM AUTHOR]

Abstract Background Wilderness travel and rock climbing are increasingly popular. Urban falls from height have been reported from trauma centers; however, there have been no trauma center reports of rock climbing or wilderness falls (WFs) in the United States. We sought to describe the injury pattern of WF and to determine whether rock climbers represent a distinct pattern of injury. Materials and methods The trauma database from our level 1 trauma center was queried from 1/1/06 to 12/31/16 for the diagnosis of "fall from cliff" (ICD9: e884.1, ICD10: w15.xx). Demographics, injury characteristics, and trauma center care were analyzed. Data were analyzed using two sample unequal variance T-tests, two sample Z-tests for proportions, and Fisher's exact tests. Results One hundred fifty-one falls were analyzed (40 climbers, 111 nonclimbers). WF victims were predominantly male (79%), moderately injured (mean injury severity score = 13.2), frequently intoxicated (34%), and fell from an average of 43 feet (7-200 ft). The most frequent injures were soft tissue (55%), spine (50%), head (43%), lower extremity (38%), and chest (39%). Climbers were younger, more often sustained upper extremity and soft tissue injuries, more often flown from the scene, injured during daytime, and were better insured. Helmet use was rare (one climber and one nonclimber). There were 3 (2%) deaths, including one climber. Conclusions WFs have a distinct injury pattern and demographic and occur from a height greater than twice those reported in urban falls. Rock climbing falls involve another distinct demographic and pattern of injury. Injury prevention strategies may include helmet use and avoiding nighttime wilderness travel and drug/alcohol use. [ABSTRACT FROM AUTHOR]

Objective: Research has found that mandatory motorcycle helmet laws increase helmet use and reduce motorcycle-related fatalities. However, the association between state moped helmet laws and helmet use in the United States has not been examined. This study investigated this association among a census of fatally injured moped riders in the United States.Methods: A logistic regression model was constructed to analyze data extracted from the Fatality Analysis Reporting System (FARS) to examine risk factors for helmet nonuse among 572 moped riders fatally injured between 2011 and 2015.Results: Fatally injured moped riders in states with universal helmet laws had 69 times the odds of wearing a helmet (P < .001).Conclusions: Findings suggest that universal moped helmet laws increase helmet use. However, additional research is needed to examine helmet laws and use among nonfatally injured moped riders. [ABSTRACT FROM AUTHOR]

Commercially-available location-based services (LBS) data derived primarily from mobile devices may provide an alternative to surveys for monitoring physically-active transportation. Using Spearman correlation, we compared county-level metrics of walking and bicycling from StreetLight with metrics of physically-active commuting among U.S. workers from the American Community Survey. Our strongest pair of metrics ranked counties (n = 298) similarly for walking (rho = 0.53 [95% CI: 0.44–0.61]) and bicycling (rho = 0.61 [0.53–0.67]). Correlations were higher for denser and more urban counties. LBS data may offer public health and transportation professionals timely information on walking and bicycling behavior at finer geographic scales than some existing surveys. • Active transportation data from mobile devices may have public health applications. • We compared data from StreetLight Inc. and the American Community Survey (ACS). • Most correlations between the StreetLight and ACS metrics were strong or moderate. • Correlations were higher for denser and more urban counties. • Population mobility data may enhance surveillance of walking and bicycling behavior. [ABSTRACT FROM AUTHOR]

The aim of our study was to assess the impact of helmet legislations on the incidence and the mortality rate of motorcycle collision (MCC)-related traumatic brain injury (TBI) in young adult trauma patients. A 1-year (2011) retrospective analysis was performed of all patients under 21 years old with trauma-related hospitalization using the Nationwide Inpatient Sample database (representing 20% of all in-patient admissions). Patients with MCC were identified using E-codes. States were classified into three groups based on helmet legislations: universal age helmet legislation, <18 years helmet legislation, and <21 years helmet legislation. Outcome measures were the rates of TBI and mortality. Linear regression analysis was used to assess outcomes among the states. A total of 1,165,150 patients with trauma-related hospitalizations across 29 states were reviewed of which, 587 patients with MCC were included. Ten states had universal age legislation; 13 states had age <18 years legislation, and 6 states had age <21 years legislation. There was a lower incidence in the rate of TBI (P = 0.03) in states with universal helmet legislations compared with states with age-restricted helmet legislation. Universal helmet legislations lowered the rate of MCC-related TBI injures by a factor of 2.15 (β coefficient: 2.15; 95% confidence interval: 0.91-10.18; P = 0.04). States with age-restricted helmet legislations have a higher rate of traumatic brain injury and mortality compared with states with universal helmet legislations. Establishing universal helmet legislations across the states may provide a potential preventive strategy against traumatic brain injury. [ABSTRACT FROM AUTHOR]

Introduction: Helmet use prevents injury and mortality if a bicyclist is in a collision while riding. This cross-sectional study sought to identify domain-specific (recreation versus transportation) correlates of helmet use among U.S. adult bicyclists, using nationally representative data from 2012.Methods: This analysis, conducted in 2015-2016, utilized data from the 2012 National Survey of Bicyclist and Pedestrian Attitudes and Behaviors, administered for the National Highway Traffic Safety Administration. Bivariate logistic regressions identified sociodemographic, behavioral, and environmental correlates of helmet use among U.S. adult bicyclists. Backwards elimination procedures selected final multivariate models for bicyclists' helmet use in both domains.Results: Among recreation cyclists, helmet use was significantly associated with income ($30,000-$75,000, OR=1.79, 95% CI=1.04, 3.10; ≥$75,000, OR=2.34, 95% CI=1.38, 3.97), safety training (OR=2.94, 95% CI=1.46, 5.93), not riding at dark (OR=1.92, 95% CI=1.24, 2.98), feeling threatened while riding (OR=2.24, 95% CI=1.12, 4.45), and using bike lanes/paths (OR=2.04, 95% CI=1.42, 2.93). Helmet use among transportation riders was significantly associated with education (less than high school, OR=2.45, 95% CI=1.13, 5.32; post-high school, OR=3.55, 95% CI=1.96, 6.42), income ($30,000-$75,000, OR=2.11, 95% CI=1.17, 3.8; ≥$75,000, OR=2.33, 95% CI=1.26, 4.27), unemployment (OR=0.29, 95% CI=0.11, 0.76), not using electronics while riding (OR=2.3, 95% CI=1.41, 3.75), safety training (OR=3.19, 95% CI=1.44, 7.07), and injury while riding within the past 2 years (OR=2.81, 95% CI=1.14, 6.94).Conclusions: Correlates of helmet use among bicyclists are domain specific. Although confirmatory longitudinal studies are needed, findings suggest that interventions to increase bicyclists' helmet use consider riding domain. [ABSTRACT FROM AUTHOR]

Jockeys are exposed to high risk of head injuries while riding. Therefore, helmets are vital for protection. Carbon fibre is widely used in sports technology due to its mechanical properties. Applying carbon fibre in jockey helmet shells could decrease the risk of fatal head injuries. The aim of the research was to investigate the safety performance of jockey helmet shells made out of carbon fibre. Four different shell types were produced with the same prepreg material. They differ in the number of layers (four or five) and patterns (two and four). Peak deceleration was used to compare the different type of shells through 2-wire drop tests. Gaussian and Mean curvatures of the impact sites were also measured to obtain a better understanding of the impact behaviour. The two-patterned shell with the five layers (2P5) showed the best overall performance during the standard impact test. [ABSTRACT FROM AUTHOR]

Background: Motorcycle helmets reduce both motorcycle-related fatalities and head injuries. Motorcycle crashes are a major public health concern which place economic stress on the U.S. healthcare system.Discussion: Although statewide universal motorcycle helmet laws effectively increase helmet use, most state helmet laws do not require every motorcycle rider to wear a helmet. Herein, we propose and outline the solution of implementing federal motorcycle helmet law, while addressing potential counterarguments.Conclusions: The decision to ride a motorcycle without a helmet has consequences that affect more than just the motorcyclist. In an effort to prevent unnecessary healthcare costs, injuries, and deaths, public health efforts to increase helmet use through education and legislation should be strongly considered. Helmet use on motorcycles fits squarely within the purview of the federal government public health and economic considerations. [ABSTRACT FROM AUTHOR]

The article focuses on the need for government intervention in the regulation of youth football helmet requirements. Topics include the effectiveness of voluntary industry oversight, the increased risk of concussion in school-aged athletes, and the U.S. Children's Sports Athletic Equipment Safety Act.

Motorcyclists contribute significantly to road trauma around the world through the high incidence of serious injuries and fatalities. Around one fourth of motorcyclist fatalities may be attributed to collisions with fixed objects. A greater understanding of factors associated with fatalities occurring from fixed object collisions will enable safer roadway infrastructure design for motorcyclists. In this article, a multiple variable logistic regression model is developed to determine such factors, from a nationally representative weighted sample of around 30,000 single-vehicle fixed object motorcycle collisions which occurred in the United States over the 10-year period between 2000 and 2009. Additionally, a single variable logistic regression model is developed for motorcyclist fatality risk from fixed object collisions as a function of travel speed. This model may be a useful predictive tool for implementing motorcyclist safety strategies. [ABSTRACT FROM AUTHOR]

Objective: Injured all-terrain vehicle (ATV) riders contribute to the national trauma burden. The importance of helmet use on injury severity and outcomes in ATV drivers versus passengers that receive care is unknown along with the association of payor status and helmet use in this population. An investigation of whether helmet use protects ATV drivers and passengers resulting in less severe injuries, better outcomes, and a lower cost burden to society is to be conducted. Methods: A retrospective review of injured ATV riders in the National Trauma Data Bank from the United States for 2000-2004. Results: Helmet use status was recorded for 5897 drivers and 836 passengers; 83 percent of drivers were male; 41 percent of passengers were female. Helmets were not widely worn (35% of drivers, 19% of passengers, p < .0001) and were less common among female than male drivers who crashed and received care (26% versus 37%, p < .0001). Drivers were older than passengers (p < .0001) and had more thorax, spine, and upper extremity injuries (p < .05). Helmets protected drivers and passengers: decreased head injuries, face injuries, injury severity, and mortality with increased likelihood of being discharged home rather than elsewhere (p < .0001). Personal insurance was more frequent in helmeted riders: 66 percent versus 55 percent of helmeted versus nonhelmeted drivers (p < .0001) and 69 percent versus 55 percent of helmeted versus nonhelmeted passengers (p = .03). Conclusions: Helmets are frequently not worn by ATV riders. Helmets protect ATV drivers and passengers and decrease societal costs associated with ATV crashes. [ABSTRACT FROM AUTHOR]

This article presents news briefs related to life sciences, including a report on the incidence of traumatic brain injuries to U.S. soldiers in the Iraq and Afghanistan Wars and research that could lead to a change in the shape of the military helmet. Another news brief announces the winners of the 2010 AIBS (American Institute of Biological Sciences) Emerging Public Policy Leadership Award. Blog posts from www.actionbioscience.org are also presented.

Military paratroopers are inherently at risk for a variety of injuries when they jump, including traumatic brain injuries (TBIs). U.S. Army paratroopers rely on their ballistic helmets for protection against TBIs when jumping. Currently, two different helmets are available to Army paratroopers, that is, the personnel tumor system for ground troops helmet and the advanced combat helmet. This study compared the incidence of self reported, jump-related TBIs in a small sample of paratroopers (N - 585) using each type of helmet. Data were obtained from surveys of soldiers at Fort Bragg, North Carolina. The overall relative risk of sustaining a TBI while jumping was 2.3 times (95% confidence interval, 1.3-4.3) higher for personnel armor system for ground troops helmet users. Most of the increase in risk was accounted for by the most-minor TBIs American Academy of Neurology grade I or 2 concussion). [ABSTRACT FROM AUTHOR]

The article discusses the provisions of motorcycle helmet laws, ways to promote helmet use and reducing damages in the U.S. It explores the Highway Safety Act (HSA) enacted by the Congress in 1966, the development of motorcycle enthusiasts groups to challenge such laws, the elimination of incentives for such laws and current status. It examines the effect of helmet use on motorcycle accident morbidity and mortality in various states. It provides background on helmet standards and perception of motorcyclists on helmets.

OBJECTIVES. The goals were to calculate injury rates among high school baseball players and to characterize the general epidemiological features of high school baseball injuries and, more specifically, injuries attributed to being hit by a batted ball. METHODS. We analyzed baseball exposure and injury data collected over the 2005-2006 and 2006 -2007 school years from a nationally representative sample of 100 US high schools by using an injury surveillance system, Reporting Information Online. RESULTS. Nationally, an estimated 131 555 high school baseball-related injuries occurred during the 2005-2006 and 2006-2007 academic years, for an injury rate of 1.26 injuries per 1000 athletic exposures. The most commonly injured body sites were the shoulder (17.6%), ankle (13.6%), head/face (12.3%), hand/finger (8.5%), and thigh/upper leg (8.2%). The most common injury diagnoses were ligament sprains (incomplete tears) (2 1.0%), muscle strains (incomplete tears) (20.1%), contusions (16.1%), and fractures (14.2%). Although the majority of injuries resulted in a time loss of <7 days, 9.7% resulted in medical disqualification for the season, and 9.4% required surgery. Of the 431 reported baseball injuries, 50 (11.6%) were attributed to being hit by a batted ball. Greater proportions of injuries attributed to being hit by a batted ball were to the head/face (48.0%) and mouth/teeth (16.0%), compared with injuries not attributed to being hit by a batted ball (8.2% and 1.3%, respectively). A greater proportion of injuries attributed to being hit by a batted ball required surgery (18.0%), compared with other baseball-related injuries (6.8%). CONCLUSIONS. Although high school baseball is relatively safe, targeted, evidence-based interventions could reduce the rate of high school baseball-related injuries. On the basis of our findings, we strongly recommend that helmets with face shields or at least mouth guards and eye protection be used by pitchers, infielders, and batters at the high school level. [ABSTRACT FROM AUTHOR]

Background. All-terrain vehicles (ATVs) continue to be a source of morbidity and mortality in the pediatric population despite recommendations from the American Academy of Pediatrics that children <16 years old not ride in or drive ATVs. ATV injuries have increased significantly in both children and adults most years since 1997. Objective. To assess the effectiveness of ATV regulations for children on serious injuries by comparing ATV-related admissions to level I and II trauma hospitals in a state with and a state without ATV regulations. Design. Ecologic study. Patients. Children <16 years old who died and/or were treated in the trauma system of Pennsylvania or North Carolina after ATV crashes. Outcome Measures. Injury types and cause of death were examined for all children. Comparisons were made by state (Pennsylvania [regulated] and North Carolina [unregulated]) for patterns of injury, place of injury, helmet use, and death. Results. There were 1080 children identified in the trauma registries between January 1997 and July 2000. Forty-four percent required intensive care. Head injuries were the primary cause of death (45.7%). Fewer North Carolina children than Pennsylvania children (16.7% vs 35.8%) wore helmets, and they were more likely to be <11 years old (35.1% vs 27.8%). Living in North Carolina was an independent predictor for not wearing a helmet. Conclusions. Living in Pennsylvania was associated with decreased risk factors for ATV injury such as young age and riding unhelmeted. However, despite regulations, many children suffered serious morbidity and mortality. These data support the recommendation that children <16 years old should be prohibited from riding or driving ATVs. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Studies have shown that head injuries are the leading cause of death on ski slopes. Statistics on helmet rental practices at ski areas across the United States have never been reported. This study sought to determine the prevalence of United States ski areas offering helmet rental during the 2002-03 ski season. Secondarily it sought to analyze the relationships of geographic region and size of ski area with helmet rental availability and to gather information on ski helmet rental cost to the consumer. METHODS: and setting: A stratified cross sectional telephone survey of a sample of 331 United States ski area onsite rental shops during February 2003. RESULTS: Altogether 50% of ski areas offered helmet rental with significant variation in the prevalence of helmet rental among ski areas of differing regions and sizes (p<0.01). A majority of Northeastern (57%), Western (63%), and Rocky Mountain (71%) ski areas rented helmets, whereas a minority of Southern (37%) and Midwestern (23%) ski areas rented helmets. Twenty five percent of the smallest ski areas (< or =50 acres) rented helmets compared with 74% of the largest ski areas (> or =501 acres). CONCLUSIONS: United States ski area helmet rental practices vary by region of the country and ski area size. Winter sports participants interested in wearing protective headgear should be aware of the helmet rental practices at the ski area in which they plan to visit and consider helmet purchase if they visit mainly smaller ski areas or areas within the South or Midwest. [ABSTRACT FROM AUTHOR]

Objective: To compare the distribution and observation of helmet use patterns among 4 common childhood leisure activities—bicycle riding, in-line skating, skateboarding, and scooter riding—in a setting with no helmet use legislation. Design: A cross-sectional, unobtrusive, direct observation of children engaged in 1 of the 4 activities was conducted during an 8-week period. Setting: Eight communities of at least 1000 persons each in a 2-county Central Texas area. Main Outcome Measures: Prevalence of activity, helmet use, and correct helmet use. Results: Of 841 children observed, most rode bicycles (74.8%); only 4.2% rode skateboards. They included 127 children estimated to be younger than 6 years (15.1%) and 495 estimated to be aged between 6 and 12 years (58.9%). Most were male (67.3%) and observed in urban communities (61.7%). The locations of highest concentration of the 4 activities were minor streets for bicycle riding, playgrounds for in-line skating, and sidewalks for skateboarding and scooter riding. The rate of overall helmet use was 13.6% and did not vary significantly by activity: in-line skating, 18.2%; skateboarding, 14.3%; bicycle riding, 13.5%; and scooter riding, 11.5%. However, the observed correct helmet use prevalence of 72.6% differed significantly by activity. Most children riding scooters wore their helmets incorrectly. Helmet use was positively associated with helmet use by accompanying children and/or adults. Conclusions: While bicycle riding was the most popular activity observed, helmet use was most prevalent among in-line skaters and least prevalent among scooter riders, many of whom also wore them incorrectly. Observed helmet use was influenced mostly by adult and peer helmet use, indicating that public education and interventions should target children and their parents as well as scooter riders. [ABSTRACT FROM AUTHOR]

This article seeks to point out the various issues and policy concerns that will confront both practitioners and the judiciary as a result of this statutory amendment. With the passage of the bill, Florida aligned itself with 27 other states that allow operators above a certain age to decide whether to ride with or without a helmet. Twenty states have mandatory helmet laws for all operators, and three states (Colorado, Illinois, and Iowa) have no laws relating to helmet usage. National Highway Transportation and Safety Administration (NHTSA) studies show that when states have mandatory helmet laws, compliance is nearly 100 percent. However, without mandatory helmet laws, helmet usage drops to roughly 50 percent. [ABSTRACT FROM AUTHOR]

Focuses on the use of helmets in soccer to protect players against chronic cognitive impairments in the U.S. Relation of repetitive concussions to soccer; Determination of the effect of repetitive heading on soccer players; Risk of injury.

Two experiments were performed to examine how frame of reference (world-referenced vs. screen-referenced) and target expectancy can modulate the effects of target cuing in directing attention for see-through helmet-mounted displays (HMDs). In the first experiment, the degree of world referencing was varied by the spatial accuracy of the cue; in the second, the degree of world referencing was varied more radically between a world-referenced HMD and a hand-held display. Participants were asked to detect, identify, and give azimuth information for targets hidden in terrain presented in the far domain (i.e., the world) while performing a monitoring task in the near domain (i.e., the display). The results of both experiments revealed a cost-benefit trade-off for cuing such that the presence of cuing aided the target detection task for expected targets but drew attention away from the presence of unexpected targets in the environment. Analyses support the observation that this effect can be mediated by the display: The world-referenced display reduced the cost of cognitive tunneling relative to the screen-referenced display in Experiment 1; this cost was further reduced in Experiment 2 when participants were using a hand-held display. Potential applications of this research include important design guidelines and specifications for automated target recognition systems as well as any terrain-and-targeting display system in which superimposed symbology is included, specifically in assessing the costs and benefits of attentional cuing and the means by which this information is displayed. [ABSTRACT FROM AUTHOR]

Evaluates the effectiveness of motorcycle and bicycle helmets in preventing injuries. Medical costs of not using helmets; Ways of ensuring the use of helmets; Occurrence and prevention of motorcycle- and bicycle-related injuries.

Investigates the effect of the 1992 California motorcycle helmet use law on motorcycle crash fatalities and injuries. Study of fatalities and injury data; Evaluation of the number and pattern of head injuries incurred from motorcycle accidents; Changes in the distribution of severity and anatomical location of injuries before and after implementation of the law.

Focuses on the MORE HEALTH bicycle safety project implemented in elementary schools in Hillsborough County, Florida. Project features; Evaluation of pilot program; Number of children who participated in program; Helmut use rate among children.

Assesses the effect of a community-wide bicycle helmet campaign on helmet use by children in Seattle, Washington and Portland, Oregon. Increase in helmet use after the campaign; Associations found between helmet use and white compared with black or other race; Reduction of financial barriers to the purchase of helmets.

Identifies the factors influencing the use of bicycle helmets among undergraduate students. Influence; Knowledge of safety of using helmets; View on policies requiring helmet use in campuses.

This article presents a critical evaluation of comments given by researchers Roberta S. Cohen and Harvey S. Cohen regarding effective legal regulation. The researchers speculate that there may be an interaction compliance when the two laws helmet and daytime headlight are examined simultaneously. This means that they think helmet laws may affect headlamp use and headlamp laws may affect helmet use. Since helmet use was virtually 100 percent in the U.S. with helmet laws whether or not they had headlamp use laws, there is no reason to believe that a headlamp use law has an effect on helmet use in the U.S. with helmet use laws.