The impact of the repeal of Michigan's universal helmet law on traumatic brain injury: A statewide analysis - 24/04/18

Doi : 10.1016/j.amjsurg.2017.09.033

Rachel N. Saunders ^a,^⁎ , Nicholas S. Adams ^b, Alistair J. Chapman ^c, Alan T. Davis ^d, Tracy J. Koehler ^d, Luke T. Durling ^c, Gaby A. Iskander ^c, John A. Girotto ^e
^a Spectrum Health/Michigan State University General Surgery Residency, 221 Michigan NE, Suite 402, Grand Rapids, MI 49503, United States
^b Spectrum Health/Michigan State University Plastic Surgery Residency, 221 Michigan NE, Suite 402, Grand Rapids, MI 49503, United States
^c Spectrum Health Hospital, Acute Care Surgery, Michigan State University College of Human Medicine, 221 Michigan NE, Suite 402, Grand Rapids, MI 49503, United States
^d Grand Rapids Medical Education Partners, 945 Ottawa Ave NE, Grand Rapids, MI 49503, United States
^e Spectrum Health Helen DeVos Children's Hospital, Pediatric Plastic and Craniofacial Surgery, Michigan State University College of Human Medicine, 426 Michigan St NE, Suite 304, Grand Rapids, MI 49503, United States

^∗Corresponding author.

Abstract

Background

In April of 2012, Michigan repealed its 35-year-old universal motorcycle helmet law in favor of a partial helmet law, which permits motorcyclists older than 21 years old with sufficient insurance and experience to drive un-helmeted. We evaluated the clinical impact of the repeal.

Methods

The Michigan Trauma Quality Improvement Program's trauma database was queried for motorcycle crash patients between 1/1/09–4/12/12 and between 4/13/12–12/31/14.

Results

There were 1970 patients in the pre-repeal analysis and 2673 patients in the post-repeal analysis. Following the repeal, patients were more likely to be un-helmeted (p < 0.001) and to have a traumatic brain injury (p < 0.001). Patients were also more likely to require neurosurgical interventions (relative risk 1.4, p = 0.011).

Conclusion

Following the repeal of the universal helmet law, there has been a significant increase in traumatic brain injuries and neurosurgical interventions. This analysis highlights another detrimental impact of the repeal of the universal helmet law.

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Highlights

•	Michigan replaced a universal motorcycle helmet law with a partial helmet law.
•	Under the partial helmet law.
•	Patients were more likely to be un-helmeted.
•	Patients were more likely to have a traumatic brain injury.
•	Patients were more likely to require a neurosurgical procedure.