The American Academy of Orthopaedic Surgeons endorses laws mandating the use of helmets by motorcycle drivers and passengers, and bicyclists.
Orthopaedic surgeons, the medical specialists most often called upon to treat injuries to motorcyclists, believe a significant reduction in fatalities and head injuries could be effected through the implementation of laws mandating the use of helmets by all motorcycle and bicycle drivers and passengers. The American Academy of Orthopaedic Surgeons strongly endorses such mandatory helmet laws.
Numerous studies in various parts of the United States have shown that helmet use reduces the severity and cost associated with injuries to motorcycle riders. Federal efforts beginning with the Highway Safety Act of 1966 achieved the passage of state laws mandating helmet use and by 1975, 47 states had enacted such laws. With the Highway Safety Act of 1977, however, Section 208 of which relaxed the pressure on states to have helmet laws, the federal government created the opportunity to measure the effectiveness of helmet use when 27 states repealed their helmet laws in the following three years.
In 1991, the U.S. Congress attached a provision to its federal highway legislation dictating that states lacking mandatory comprehensive motorcycle helmet laws after September 30, 1993 will have 1.5 percent of their federal highway construction funds for the following fiscal year reallocated to safety programs. If a state still does not have the mandatory laws in place by September 30, 1994, the safety program reallocation will rise to 3 percent. In the mid 1980s, Congress used a similar provision to force all states to raise their legal drinking age to 21. Congressional opponents of the bill have attempted to introduce other legislation that would repeal this provision.
Objective analysis of data from the mid 70s (when helmet laws were widespread) and the late 70s (when more than half the states had repealed such laws) shows clearly that head injuries and fatalities of motorcycle riders are reduced when motorcyclists wear helmets. Moreover, the costs associated with treating motorcycle riders' head injuries have been demonstrated to be significantly reduced - up to 80 percent in one university study - when helmet laws are in effect.
The American Academy of Orthopaedic Surgeons believes that issues of personal freedom should be seen in the context of the fact that the public at large incurs a major part of the cost for injuries to motorcycle riders.
The repeal of helmet laws in many states was based on issues involving some motorcyclists' claims that mandatory use laws infringed on their right to personal freedom. While it can be argued that the states' laws mandating that motorcyclists be licensed to operate the vehicle are a similar infringement, the more important issue is the cost borne by society when a motorcyclist is injured in an accident. Numerous studies have shown that in cases involving motorcyclists who were not wearing helmets, head injuries were more severe, requiring longer, more expensive hospitalization and rehabilitation. Moreover, it has been shown that the public at large bears a major portion of these increased costs, both in the cases where the injured patients' insurance does not cover all the costs associated with care and through the increasing cost of medical insurance premiums. Society must evaluate the claim of infringement on freedom versus the funding of these costs.
The American Academy of Orthopaedic Surgeons believes that the current diversity of state helmet laws provides too little protection for motorcycle riders and for society at large.
Currently, 25 states have comprehensive motorcycle helmet laws in place. Another 22 have partial requirements for minors, student drivers, or passengers. Three states - Illinois, Iowa, and Colorado - have no helmet requirements at all. With federal statistics showing that a motorcycle driver or passenger is twice as likely to receive a head injury in an accident if he or she is not wearing a helmet, such inconsistencies in state laws seem an egregious lack of responsibility by the legislatures in many states.
The American Academy of Orthopaedic Surgeons believes that mandatory helmet laws should be expanded to cover bicyclists as well as motorcycle riders.
In the past several years, thousands of Americans of all ages have taken up bicycling for fun, health and fitness benefits, and as a mode of transportation. With this increase in popularity, however, has come an increase in bicycle-related injury and death. Each year almost 1,200 bicyclists are killed, 75 percent of those are in collisions between bicycles and motor vehicles. In addition, more than one million bicycle-related injuries are treated each year.
Too few bicycle enthusiasts protect themselves from injury with safety helmets. Three-fourths of bicycle-related deaths and one-third of the injuries involve injury to the head or face. Although studies show that bicycle helmets can reduce head injuries by up to 95 percent, the U.S. Centers for Disease Control and Prevention reports that fewer than 10 percent of all cyclists wear protective helmets, and fewer than 2 percent of those under the age of 15 wear them.
Because one-third of bicycle-related deaths and two-thirds of the injuries involve children under the age of 15, most bicycle safety programs in the United States have been targeted at children. Five states and several more counties currently require the use of bicycle helmets, generally for children under age 16. There are two national safety standards for bicycle helmets sold in this country. Only helmets labeled as meeting the safety requirements of the Snell Memorial Foundation of the American National Standards Institute (ANSI) should be purchased and worn. Bicycle safety programs must also focus on wearing the proper clothing, proper maintenance of the bicycle, and understanding and following the rules of the road.
© December 1985, Revised December 1992 American Academy of Orthopaedic Surgeons
This material may not be modified without the express written permission of the American Academy of Orthopaedic Surgeons.
Document Number: 1110
For additional information, contact Alvin Nagelberg at (847) 384-4138 or email nagelberg@mac.aaos.org