Center for Injury Research and Control, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Pediatrics. 2010 Dec;126(6):1149-55. doi: 10.1542/peds.2010-0902. Epub 2010 Nov 15.
Twenty-seven states have youth-specific helmet laws even though such laws have been shown to decrease helmet use and increase youth mortality compared with all-age (universal) laws. Our goal was to quantify the impact of age-specific helmet laws on youth under age 20 hospitalized with traumatic brain injury (TBI).
Our cross-sectional ecological group analysis compared TBI proportions among US states with different helmet laws. We examined the following null hypothesis: If age-specific helmet laws are as effective as universal laws, there will be no difference in the proportion of hospitalized young motorcycle riders with TBI in the respective states. The data are derived from the 2005 to 2007 State Inpatient Databases of the Healthcare Cost and Utilization Project. We examined data for 17 states with universal laws, 6 states with laws for ages <21, and 12 states with laws for children younger than 18 (9287 motorcycle injury discharges).
In states with a <21 law, serious TBI among youth was 38% higher than in universal-law states. Motorcycle riders aged 12 to 17 in 18 helmet-law states had a higher proportion of serious/severe TBI and higher average Abbreviated Injury Scores for head-region injuries than riders from universal-law states.
States with youth-specific laws had an increased risk of TBI that required hospitalization, serious and severe TBI, TBI-related disability, and in-hospital death among the youth they are supposed to protect. The only method known to keep motorcycle-helmet use high among youth is to adopt or maintain universal helmet laws.
尽管已有研究表明,与全年龄段(通用)头盔法相比,青少年特定头盔法会降低头盔使用率并增加青少年死亡率,但仍有 27 个州制定了专门针对青少年的头盔法。我们的目标是量化针对 20 岁以下青少年的特定年龄头盔法对因创伤性脑损伤(TBI)住院的青少年的影响。
我们通过跨州的生态群组分析,比较了具有不同头盔法的美国各州的 TBI 比例。我们检验了以下无效假设:如果特定年龄的头盔法与通用法一样有效,那么在各自的州中,因 TBI 住院的年轻摩托车骑手的比例应该没有差异。数据来源于医疗保健成本和利用项目的 2005 年至 2007 年州住院患者数据库。我们研究了 17 个实行通用法的州、6 个实行<21 岁法的州和 12 个实行<18 岁法的州的数据(9287 例摩托车损伤出院)。
在实行<21 岁法的州中,青少年严重 TBI 的比例比实行通用法的州高 38%。在 18 个头盔法州中,12 至 17 岁的摩托车骑手发生严重/重度 TBI 的比例以及头区损伤的平均简明损伤评分均高于实行通用法的州。
制定了青少年特定法的州发生需要住院治疗的 TBI、严重和重度 TBI、与 TBI 相关的残疾以及住院死亡的风险更高,而这些州本应保护青少年免受伤害。已知唯一能使青少年戴头盔率保持较高水平的方法是采用或维持通用头盔法。