Effectiveness of bicycle helmet laws in preventing injuries among youth

描述（由申请人提供）：尽管州和地方的强制性头盔法律在美国已经变得普遍，但几乎没有关于这些法规是否真的减少了自行车相关事故的伤害的信息。第一个目标是使用国家电子伤害监测系统（NEISS）汇总的年度医院级数据来评估1991年至2007年间美国各州和地方实施的强制性头盔法是否有效减少了青少年的伤害。我们重点关注5至18岁需要急诊室治疗的青少年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（例如12岁以下，18岁以下）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。第二个目的是利用NEISS的数据来评估头盔法是否对年龄群体和法律没有明确针对的其他娱乐活动产生了溢出效应。虽然大多数关于自行车头盔的法律都是针对幼儿的，但这些法律可能会鼓励年龄较大的儿童和成年人戴头盔，从而也可能减少这些群体的头部受伤。此外，要求在骑自行车时戴头盔的儿童在参加类似运动（例如，骑全地形车）时更有可能戴头盔，这也可能减少与这些运动相关的头部损伤。为了解决这两个目标，我们使用回归分析将医院一级的伤害率与州和地方一级的头盔法律联系起来，控制影响伤害率的一系列其他因素。在敏感性分析中，我们将调查头盔法律是否与青少年头盔使用的增加有关，以及法律是否对危险的骑行行为和骑行产生影响。

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.