Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
Int J Epidemiol. 2011 Jun;40(3):794-803. doi: 10.1093/ije/dyr040. Epub 2011 Mar 9.
Differences among three helmet types and the ineffectiveness of improper helmet use in preventing head injuries are speculated about but are seldom explored with evidence. A case-control study was conducted to examine how different helmet types and improper helmet use affected protection against head injuries among motorcyclists in Taiwan.
Case motorcyclists comprised 435 persons who sought emergency care due to head injuries at a medical centre in west-central Taiwan over an 8-month period and 23 motorcyclists who died from head injuries at the scene of the crash; 458 motorcyclists who had non-head injuries were used as the control group, and their crashes occurred within 1 hour earlier or later than the corresponding cases. Information on helmet type was validated by interviewing motorcyclists who were refuelling at petrol stations.
A conditional logistic regression analysis showed that compared with helmeted motorcyclists, non-helmeted motorcyclists were more than four times as likely to have head injuries [odds ratio (OR) 4.54; 95% confidence interval (CI) 1.25-16.5] and ten times as likely to have brain injuries (OR 10.4; 95% CI 1.82-59.2). Compared with motorcyclists wearing full-face helmets, those wearing half-coverage helmets were more than twice as likely to have head injuries (OR 2.57; 95% CI 1.50-4.40) and brain injuries (OR 2.10; 95% CI 1.01-4.38). Compared with motorcyclists with firmly fastened helmets, those with loosely fastened helmets increased their risk of head injury (OR 1.94; 95% CI 1.33-2.82) and were more than twice as likely to have brain injuries (OR 2.50; 95% CI 1.47-4.25).
Of the three helmet types, half-coverage helmets provided motorcyclists the least protection from head injuries. Furthermore, wearing a loosely fastened helmet may compromise any potential protection.
人们推测，不同类型的头盔和头盔使用不当会导致头部受伤，但很少有证据对此进行探究。本病例对照研究旨在调查在台湾，不同类型的头盔和头盔使用不当如何影响摩托车手头部受伤的保护。
病例组包括在台湾中西部一家医疗中心因头部受伤接受紧急治疗的 435 名摩托车手，以及在事故现场因头部受伤死亡的 23 名摩托车手；对照组由 458 名非头部受伤的摩托车手组成，他们的事故发生在与病例组相应人员前后 1 小时内。通过在加油站对摩托车手进行访谈，验证了头盔类型的信息。
条件逻辑回归分析显示，与戴头盔的摩托车手相比，不戴头盔的摩托车手头部受伤的可能性高出四倍以上[比值比（OR）4.54；95%置信区间（CI）1.25-16.5]，脑损伤的可能性高出十倍（OR 10.4；95% CI 1.82-59.2）。与戴全罩式头盔的摩托车手相比，戴半罩式头盔的摩托车手头部受伤的可能性高出两倍以上（OR 2.57；95% CI 1.50-4.40），脑损伤的可能性高出两倍（OR 2.10；95% CI 1.01-4.38）。与头盔佩戴紧固的摩托车手相比，头盔佩戴不紧固的摩托车手头部受伤的风险增加（OR 1.94；95% CI 1.33-2.82），脑损伤的可能性高出两倍以上（OR 2.50；95% CI 1.47-4.25）。
在这三种头盔类型中，半罩式头盔对头部受伤的保护作用最小。此外，佩戴不紧固的头盔可能会影响任何潜在的保护作用。
