Impact of helmets on injuries to riders of all terrain vehicles

Background: While helmet use has been shown to be effective in reducing traumatic brain injuries (TBI) due to motorcycle and bicycle crashes, it is unknown whether helmet use is associated with different injury patterns and severity for users of all terrain vehicles (ATVs).

Research Design: Using the National Trauma Data Bank, we examined the records of 12,153 patients injured as a result of ATV use. We compared the likelihood of receiving a TBI diagnosis as well as differences in injury severity and in-hospital mortality between helmeted and non-helmeted ATV riders.

Results: Compared to helmeted riders, non-helmeted ATV riders had greater mean Injury Severity Score (11.6 vs. 10.6, p<.001), worse mean Glasgow Coma Score in the emergency department (13.6 vs. 14.4, p<.001), and greater in-hospital mortality (3.2% vs. 1.1%, p<.001). After multivariable adjustment, compared to helmeted riders, we observed that non-helmeted riders were more likely to sustain any traumatic brain injury (OR 1.62, 95% CI 1.49-1.76, p<.001) and severe TBI (OR 2.64, 95% CI 2.21-3.17, p<.001). Non-helmeted riders were more likely to die while in the hospital than were helmeted riders (OR 3.13, 95% CI 2.24-4.37, p<.001). Significant injuries to the neck and face regions were also more likely among non-helmeted riders (OR 3.72, 95% CI 1.22-11.34, p=.017 and OR 1.61, 95% CI 1.09-2.37, p=.007 respectively).

Conclusions: ATV riders who do not wear helmets are more likely to receive significant injuries to the brain, face and neck. Prevention strategies and policy interventions to increase helmet use among ATV riders appears warranted.