Effectiveness of bicycle helmet laws in preventing injuries among youth

描述(申请人提供)：尽管州和地方强制性头盔法规在美国已经普及，但几乎没有信息表明这些法规是否真的减少了与自行车相关的事故造成的伤害。第一个目标是使用国家电子伤害监测系统(NEISS)收集的年度医院级数据，以评估美国各州和地方在1991年至2007年期间实施的强制性头盔法律是否有效地减少了年轻人的伤害。我们的重点是需要急诊室治疗的5至18岁年轻人中与自行车相关的创伤性头部损伤。由于头盔法律在目标年龄组(如12岁以下、18岁以下)中差异很大，我们还计划评估与不同年龄段相关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具体针对的其他娱乐活动产生了溢出效应。尽管大多数自行车头盔法律与幼儿有关，但这些法律可能会鼓励年龄较大的儿童和成年人戴头盔，因此也可能减少这些群体的头部受伤。此外，被要求在骑自行车时戴头盔的儿童可能更有可能在参加类似的运动(如骑亚洲车)时戴头盔，这也有可能减少与这些运动相关的头部损伤。为了达到这两个目标，我们使用回归分析将医院级别的伤害率与州和地方级别的头盔法律联系起来，控制了一系列其他影响伤害率的因素。在敏感性分析中，我们将调查头盔法律是否与年轻人中头盔使用量的增加有关，以及法律是否对危险的骑自行车行为和骑行产生影响。 公共卫生相关性：这项研究将是第一次考虑自行车头盔法律对医院急诊科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，而且还关于如何设计这些法律以最大限度地提高其预防效益。

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.