Effectiveness of bicycle helmet laws in preventing injuries among youth

描述（由申请人提供）：虽然州和地方强制性头盔法律已在美国普及，但几乎没有关于此类法规是否实际上减少了自行车相关事故的伤害的信息。第一个目标是使用来自国家电子伤害监测系统（NEISS）的年度医院级汇总数据，以评估1991年至2007年期间在美国各州和地方实施的强制性头盔法律是否有效地减少了青少年的伤害。我们专注于5至18岁的青少年中与自行车相关的创伤性头部损伤，需要急诊室治疗。由于头盔法律在目标年龄组（例如12岁以下，18岁以下）中差异很大，我们还计划评估适用于不同年龄组的头盔法律的相对有效性。第二个目的是使用NEISS的数据来评估头盔法律是否对年龄组和法律没有特别针对的其他娱乐活动产生了溢出效应。虽然大多数自行车头盔法律适用于幼儿，但这些法律可能会鼓励年龄较大的儿童和成年人戴头盔，从而也可以减少这些群体的头部受伤。此外，骑自行车时被要求戴头盔的儿童在参加类似运动时可能更有可能戴头盔（例如，亚视骑），潜在地减少头部受伤与这些运动以及。为了实现这两个目标，我们使用回归分析将医院一级的受伤率与州和地方一级的头盔法联系起来，控制一系列影响受伤率的其他因素。在敏感性分析中，我们将调查头盔法律是否与青少年使用头盔的增加有关，以及法律是否对危险的自行车行为和乘车人数产生影响。 公共卫生相关性：这项研究将是第一个考虑自行车头盔法律对医院急诊部门报告的自行车相关伤害的影响。这项研究的结果将为政策制定者提供新的重要信息，不仅关于现有头盔法律的有效性，而且关于如何设计这些法律以最大限度地发挥其预防效益。

DESCRIPTION (provided by applicant): Although state and local mandatory helmet laws have become widespread in the US, there is almost no information on whether such regulations actually decrease injuries from bicycle-related accidents. The first aim is to use pooled, annual, hospital-level data from the National Electronic Injury Surveillance System (NEISS) to assess whether mandatory helmet laws implemented in states and localities in the United States between 1991 and 2007 were effective in reducing injuries among youth. We focus on bicycle-related traumatic head injuries among youth aged 5 to 18 that require emergency room treatment. Since helmet laws vary widely in the age groups targeted (e.g. under 12, under 18), we also plan to assess the relative effectiveness of helmet laws that pertain to different age groups. The second aim is to use data from the NEISS to assess whether helmet laws have had spillover effects on age groups and on other recreational activities not specifically targeted by the laws. Although the majority of bicycle helmet laws pertain to young children, the laws may encourage older children and adults to wear helmets, and thus may reduce head injuries in those groups as well. In addition, children who are required to wear helmets while bicycling may be more likely to wear helmets while participating in similar sports (e.g., ATV riding), potentially reducing head injuries associated with those sports as well. To address both these aims, we use regression analyses to link hospital-level injury rates to state and local level helmet laws, controlling for a range of other factors that affect injury rates. In sensitivity analyses, we will investigate whether helmet laws are associated with increases in helmet usage among youth, and whether there are effects of laws on risky cycling behaviors and ridership. PUBLIC HEALTH RELEVANCE: This study would be the first to consider the effects of bicycle helmet laws on bicycle-related injuries that are reported by hospital emergency departments. The results from this study will provide policymakers with new, important information not only about the effectiveness of existing helmet laws, but also about how these laws can be designed to maximize their preventive benefits.