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Goel R, Tiwari G, Varghese M, Bhalla K, Agrawal G, Saini G, Jha A, John D, Saran A, White H, Mohan D. Effectiveness of road safety interventions: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1367. [PMID: 38188231 PMCID: PMC10765170 DOI: 10.1002/cl2.1367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Background Road Traffic injuries (RTI) are among the top ten leading causes of death in the world resulting in 1.35 million deaths every year, about 93% of which occur in low- and middle-income countries (LMICs). Despite several global resolutions to reduce traffic injuries, they have continued to grow in many countries. Many high-income countries have successfully reduced RTI by using a public health approach and implementing evidence-based interventions. As many LMICs develop their highway infrastructure, adopting a similar scientific approach towards road safety is crucial. The evidence also needs to be evaluated to assess external validity because measures that have worked in high-income countries may not translate equally well to other contexts. An evidence gap map for RTI is the first step towards understanding what evidence is available, from where, and the key gaps in knowledge. Objectives The objective of this evidence gap map (EGM) is to identify existing evidence from all effectiveness studies and systematic reviews related to road safety interventions. In addition, the EGM identifies gaps in evidence where new primary studies and systematic reviews could add value. This will help direct future research and discussions based on systematic evidence towards the approaches and interventions which are most effective in the road safety sector. This could enable the generation of evidence for informing policy at global, regional or national levels. Search Methods The EGM includes systematic reviews and impact evaluations assessing the effect of interventions for RTI reported in academic databases, organization websites, and grey literature sources. The studies were searched up to December 2019. Selection Criteria The interventions were divided into five broad categories: (a) human factors (e.g., enforcement or road user education), (b) road design, infrastructure and traffic control, (c) legal and institutional framework, (d) post-crash pre-hospital care, and (e) vehicle factors (except car design for occupant protection) and protective devices. Included studies reported two primary outcomes: fatal crashes and non-fatal injury crashes; and four intermediate outcomes: change in use of seat belts, change in use of helmets, change in speed, and change in alcohol/drug use. Studies were excluded if they did not report injury or fatality as one of the outcomes. Data Collection and Analysis The EGM is presented in the form of a matrix with two primary dimensions: interventions (rows) and outcomes (columns). Additional dimensions are country income groups, region, quality level for systematic reviews, type of study design used (e.g., case-control), type of road user studied (e.g., pedestrian, cyclists), age groups, and road type. The EGM is available online where the matrix of interventions and outcomes can be filtered by one or more dimensions. The webpage includes a bibliography of the selected studies and titles and abstracts available for preview. Quality appraisal for systematic reviews was conducted using a critical appraisal tool for systematic reviews, AMSTAR 2. Main Results The EGM identified 1859 studies of which 322 were systematic reviews, 7 were protocol studies and 1530 were impact evaluations. Some studies included more than one intervention, outcome, study method, or study region. The studies were distributed among intervention categories as: human factors (n = 771), road design, infrastructure and traffic control (n = 661), legal and institutional framework (n = 424), post-crash pre-hospital care (n = 118) and vehicle factors and protective devices (n = 111). Fatal crashes as outcomes were reported in 1414 records and non-fatal injury crashes in 1252 records. Among the four intermediate outcomes, speed was most commonly reported (n = 298) followed by alcohol (n = 206), use of seatbelts (n = 167), and use of helmets (n = 66). Ninety-six percent of the studies were reported from high-income countries (HIC), 4.5% from upper-middle-income countries, and only 1.4% from lower-middle and low-income countries. There were 25 systematic reviews of high quality, 4 of moderate quality, and 293 of low quality. Authors' Conclusions The EGM shows that the distribution of available road safety evidence is skewed across the world. A vast majority of the literature is from HICs. In contrast, only a small fraction of the literature reports on the many LMICs that are fast expanding their road infrastructure, experiencing rapid changes in traffic patterns, and witnessing growth in road injuries. This bias in literature explains why many interventions that are of high importance in the context of LMICs remain poorly studied. Besides, many interventions that have been tested only in HICs may not work equally effectively in LMICs. Another important finding was that a large majority of systematic reviews are of low quality. The scarcity of evidence on many important interventions and lack of good quality evidence-synthesis have significant implications for future road safety research and practice in LMICs. The EGM presented here will help identify priority areas for researchers, while directing practitioners and policy makers towards proven interventions.
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Affiliation(s)
- Rahul Goel
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | - Geetam Tiwari
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | | | - Kavi Bhalla
- Department of Public Health SciencesUniversity of ChicagoChicagoIllinoisUSA
| | - Girish Agrawal
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | | | - Abhaya Jha
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | - Denny John
- Faculty of Life and Allied Health SciencesM S Ramaiah University of Applied Sciences, BangaloreKarnatakaIndia
| | | | | | - Dinesh Mohan
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
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Abhinandan Patel KN, Sneha TR, Reddy KR, Girish G, Nikhila G. Changing Trends in the Pattern of Maxillofacial Injuries in Helmeted Motorcycle Accident Patients when Compared to Non-helmeted Motorcycle Accident Patients. J Maxillofac Oral Surg 2023; 22:18-24. [PMID: 36703678 PMCID: PMC9871138 DOI: 10.1007/s12663-021-01650-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 09/23/2021] [Indexed: 01/29/2023] Open
Abstract
Aim Motorcycle accidents are the most predominant type of road traffic injuries in India. This prospective study aimed to evaluate the patterns of maxillofacial injuries in the three types of helmeted and non-helmeted individuals. Materials and Methods All the patients reporting to the maxillofacial trauma unit of Sanjay Gandhi hospital with maxillofacial injuries were considered. The patients were analyzed for helmet wearing status, type of helmet worn-full-face, open-face and half-helmet, strap and visor fixation status, fit of the helmet, ownership of the helmet, helmet standardization, obeying traffic rules, alcohol consumption status, speed of the vehicle, volume of the engine, licensure of the driver, hard- and soft-tissue maxillofacial injuries were recorded. Results A total of 741 patients participated in the study for a period of 10 months, majority being males and of a mean age of 31 years. Most common injuries to the face in the open- and half-helmet group were lacerations of the chin and mandibular fractures. Patients who wore ISI standard full-face helmets with strap and visor fixed experienced least injuries to the face. Conclusion This study concluded that out of the three commonly used helmets, half-helmets provided the least protection against maxillofacial injuries during a crash, followed by the open-face helmets. The highest protection was provided by the full-face helmets with ISI standardization when secured properly with strap and visor.
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Affiliation(s)
- K. N. Abhinandan Patel
- Department of Faciomaxillary Surgery, Sanjay Gandhi Institute of Trauma and Orthopedics, Bengaluru, India
| | - T. R. Sneha
- Department of Faciomaxillary Surgery, Sanjay Gandhi Institute of Trauma and Orthopedics, Bengaluru, India
| | - Kora Ramya Reddy
- Department of Faciomaxillary Surgery, Sanjay Gandhi Institute of Trauma and Orthopedics, Bengaluru, India
| | - G. Girish
- Department of Faciomaxillary Surgery, Sanjay Gandhi Institute of Trauma and Orthopedics, Bengaluru, India
| | - G. Nikhila
- Department of Faciomaxillary Surgery, Sanjay Gandhi Institute of Trauma and Orthopedics, Bengaluru, India
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Urréchaga EM, Kodadek LM, Bugaev N, Bauman ZM, Shah KH, Abdel Aziz H, Beckman MA, Reynolds JM, Soe-Lin H, Crandall ML, Rattan R. Full-face motorcycle helmets to reduce injury and death: A systematic review, meta-analysis, and practice management guideline from the Eastern Association for the Surgery of Trauma. Am J Surg 2022; 224:1238-1246. [PMID: 35821175 DOI: 10.1016/j.amjsurg.2022.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/11/2022] [Accepted: 06/23/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND While motorcycle helmets reduce mortality and morbidity, no guidelines specify which is safest. We sought to determine if full-face helmets reduce injury and death. METHODS We searched for studies without exclusion based on: age, language, date, or randomization. Case reports, professional riders, and studies without original data were excluded. Pooled results were reported as OR (95% CI). Risk of bias and certainty was assessed. (PROSPERO #CRD42021226929). RESULTS Of 4431 studies identified, 3074 were duplicates, leaving 1357 that were screened. Eighty-one full texts were assessed for eligibility, with 37 studies (n = 37,233) eventually included. Full-face helmets reduced traumatic brain injury (OR 0.40 [0.23-0.70]); injury severity for the head and neck (Abbreviated Injury Scale [AIS] mean difference -0.64 [-1.10 to -0.18]) and face (AIS mean difference -0.49 [-0.71 to -0.27]); and facial fracture (OR 0.26 [0.15-0.46]). CONCLUSION Full-face motorcycle helmets are conditionally recommended to reduce traumatic brain injury, facial fractures, and injury severity.
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Affiliation(s)
| | | | | | | | - Kaushal H Shah
- Department of Emergency Medicine, Weill Cornell Medicine, USA.
| | | | | | | | - Hahn Soe-Lin
- Department of Surgery, St. Joseph's Medical Center, USA.
| | - Marie L Crandall
- Department of Surgery, University of Florida, Jacksonville, USA.
| | - Rishi Rattan
- Department of Surgery, University of Miami, USA.
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Yasin YJ, Eid HO, Alao DO, Grivna M, Abu-Zidan FM. Reduction of motorcycle-related deaths over 15 years in a developing country. World J Emerg Surg 2022; 17:21. [PMID: 35488275 PMCID: PMC9051744 DOI: 10.1186/s13017-022-00426-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 04/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There have been major improvements in the trauma system and injury prevention in Al-Ain City. We aimed to study the impact of these changes on the incidence, pattern, injury severity, and outcome of hospitalized motorcycle-related injured patients in Al-Ain City, United Arab Emirates. METHODS This is a retrospective analysis of two separate periods of prospectively collected data which were retrieved from Al-Ain Hospital Trauma Registry (March 2003 to March 2006 compared with January 2014 to December 2017). All motorcycle-injured patients who were admitted to Al-Ain Hospital for more than 24 h or died in the Emergency Department or after hospitalization were studied. RESULTS The incidence of motorcycle injuries dropped by 37.1% over the studied period. The location of injury was significantly different between the two periods (p = 0.02, Fisher's exact test), with fewer injuries occurring at streets/highways in the second period (69.1% compared with 85.3%). The anatomical injury severity of the head significantly increased over time (p = 0.03), while GCS on arrival significantly improved (p < 0.0001), indicating improvements in both prehospital and in-hospital trauma care. The mortality of the patients significantly decreased (0% compared with 6%, p = 0.002, Fisher's exact test). CONCLUSIONS The incidence of motorcycle injuries in our city dropped by almost 40% over the last 15 years. There was a significant reduction in the mortality of hospitalized motorcycle-injured patients despite increased anatomical severity of the head injuries. This is attributed to improvements in the trauma care system, including injury prevention, and both prehospital and in-hospital trauma care.
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Affiliation(s)
- Yasin J Yasin
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.,Department of Environmental Health and Behavioral Sciences, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Hani O Eid
- Rescue and Air Ambulance, Abu Dhabi Police Aviation, Abu Dhabi, United Arab Emirates
| | - David O Alao
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.,Emergency Department, Al-Ain Hospital, Al-Ain, United Arab Emirates
| | - Michal Grivna
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.,Department of Public Health and Preventive Medicine, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Fikri M Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.
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Tabary M, Ahmadi S, Amirzade-Iranaq MH, Shojaei M, Sohrabi Asl M, Ghodsi Z, Azarhomayoun A, Ansari-Moghaddam A, Atlasi R, Araghi F, Shafieian M, Heydari ST, Sharif-Alhoseini M, O'Reilly G, Rahimi-Movaghar V. The effectiveness of different types of motorcycle helmets - A scoping review. ACCIDENT; ANALYSIS AND PREVENTION 2021; 154:106065. [PMID: 33689958 DOI: 10.1016/j.aap.2021.106065] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 12/22/2020] [Accepted: 02/28/2021] [Indexed: 05/12/2023]
Abstract
BACKGROUND Protective helmets may reduce the risk of death and head injury in motorcycle collisions. However, there remains a large gap in knowledge regarding the effectiveness of different types of helmets in preventing injuries. OBJECTIVE To explore and evaluate the effectiveness of different types of motorcycle helmets; that is the association between different helmet types and the incidence and severity of head, neck, and facial injuries among motorcyclists. Also, to explore the effect of different helmet types on riders. METHODS A systematic search of different scientific databases was conducted from 1965 to April 2019. A scoping review was performed on the included articles. Eligible articles were included regarding defined criteria. Study characteristics, helmet types, fixation status, retention system, the prevention of injury or reduction of its severity were extracted. RESULTS A total of 137 studies were included. There was very limited evidence for the better protection of full-face helmets from head and facial injury compared to open-face and half-coverage helmets. There was however scarce evidence for the superiority of a certain helmet type over others in terms of protection from neck injury. The retention system and the fixation status of helmets were two important factors affecting the risk of head and brain injury in motorcyclists. Helmets could also affect and limit the riders in terms of vision, hearing, and ventilation. Multiple solutions have been discussed to mitigate these effects. CONCLUSION Full-face helmets may protect head and face in motorcycle riders more than open-face and half-coverage helmets, but there is not enough evidence for better neck protection among these three helmet types. Helmets can affect the rider's vision, hearing, and ventilation. When designing a helmet, all of these factors should be taken into account.
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Affiliation(s)
- Mohammadreza Tabary
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sadegh Ahmadi
- School of Mechanical Engineering, University of Tehran, Iran
| | - Mohammad Hosein Amirzade-Iranaq
- Universal Network of Interdisciplinary Research in Oral and Maxillofacial Surgery (UNIROMS), Universal Scientific Education and Research Network (USERN), Tehran, Iran; International Otorhinolaryngology Research Association (IORA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Maryam Shojaei
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Sohrabi Asl
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Ghodsi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Azarhomayoun
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Rasha Atlasi
- EMRI, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnaz Araghi
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Iran
| | - Mehdi Shafieian
- The Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Seyed Taghi Heydari
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahdi Sharif-Alhoseini
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Gerard O'Reilly
- Emergency and Trauma Centre, Alfred Health, Melbourne, Australia; School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia; National Trauma and Research Institute, Alfred Health, Melbourne, Australia
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Universal Scientific Education and Research Network (USERN), Tehran, Iran; Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran; University of Toronto, Toronto, Canada.
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Lucci C, Piantini S, Savino G, Pierini M. Motorcycle helmet selection and usage for improved safety: A systematic review on the protective effects of helmet type and fastening. TRAFFIC INJURY PREVENTION 2021; 22:301-306. [PMID: 33829931 DOI: 10.1080/15389588.2021.1894640] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 02/12/2021] [Accepted: 02/20/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Motorcycle helmets are the most common and effective protective device to reduce head injuries and mortality in crashes among powered two-wheeler riders. Even if they are globally recognized as effective, there are still concerns regarding their correct use, which is necessary to achieve maximum head protection. The goal of this systematic review is to assess which characteristics of helmet design and use showed a positive influence on rider safety, in order to provide insights to improve end-user helmet usage. METHODS A literature search was carried out combining two sets of keywords, one related with either motorcycle or rider and the other referring to either protective equipment or injuries. After the exclusion of duplicates, 977 papers were screened by reviewers, thus identifying 32 papers that were analyzed in group discussions. RESULTS Among the papers included in this study, no strong conflicting conclusions emerged in their results. The studies focusing on the use of different types of helmets highlighted that full-face helmets, compared with other standard helmets, have a positive influence on head injuries and facial injuries. Correct fastening was clearly beneficial for head and facial injuries, induced injuries, and helmet ejection. CONCLUSIONS This systematic review provides important insights to improve the usage of helmets by end-users. Correct fastening is a crucial factor to avoid helmet roll-off during a crash. Most studies agreed that full-face helmets provide higher protection in comparison with other standard helmets, especially for facial injuries, and no negative influence with respect to neck and spinal injuries.
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Affiliation(s)
- Cosimo Lucci
- Department of Industrial Engineering, University of Florence, Florence, Italy
| | - Simone Piantini
- Department of Industrial Engineering, University of Florence, Florence, Italy
| | - Giovanni Savino
- Department of Industrial Engineering, University of Florence, Florence, Italy
- Monash University Accident Research Centre, Monash University, Victoria, Australia
| | - Marco Pierini
- Department of Industrial Engineering, University of Florence, Florence, Italy
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Abdul Khalid MS, Khamis NK, Abu Mansor MR, Hamzah A. Motorcycle Conspicuity Issues and Intervention: A Systematic Review. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:24-34. [PMID: 34178761 PMCID: PMC8213631 DOI: 10.18502/ijph.v50i1.5069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Conspicuity has been one of the key factors in motorcycle road crashes around the world. The inability and difficulty of other road users in detecting motorcycles either at day or at night have contributed to conspicuity related motorcycle crashes. This literature review attempts to understand the motorcycle conspicuity issues in road traffic. The review also analyses relevant types of conspicuity intervention in terms of its effectiveness in enhancing motorcycle conspicuity that had been discussed in past studies. Methods Using specific keywords and search terms, relevant articles were screened, identified and analyzed systematically using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results Twenty-seven final articles were reviewed and found that almost every part of motorcycle and motorcyclist's conspicuity intervention have been covered in past studies. In terms of conspicuity aids, the majority of past studies discussed conspicuity enhancement in the frontal area, particularly on motorcycle daytime running headlight (DRH) color and configurations. Few other studies have discussed in other areas, particularly on rear running and brake light and motorcycle color. There were also numerous studies looking at motorcyclists' appearances in terms of their attire and helmet color. Conclusion Motorcycle and motorcyclist's appearances are highly associated with the risk of motorcycle crashes. The most important part of enhancing motorcycle conspicuity is to ensure motorcycle appearance is always in contrast with the road traffic environment.
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Affiliation(s)
- Muhamad Syukri Abdul Khalid
- Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, 43600 Bandar Baru Bangi, Selangor, Malaysia.,Malaysian Institute of Road Safety Research (MIROS), Jalan TKS 1, Taman Kajang Sentral, 43000, Kajang, Selangor, Malaysia
| | - Nor Kamaliana Khamis
- Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, 43600 Bandar Baru Bangi, Selangor, Malaysia
| | - Mohd Radzi Abu Mansor
- Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, 43600 Bandar Baru Bangi, Selangor, Malaysia
| | - Azhar Hamzah
- Malaysian Institute of Road Safety Research (MIROS), Jalan TKS 1, Taman Kajang Sentral, 43000, Kajang, Selangor, Malaysia
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Novelli G, Moretti M, De Ponti E, Bozzetti A, Sozzi D, Canzi G. Analysis of different safety devices in the prevention of motorcycle-related craniofacial trauma - A retrospective study. Ann Maxillofac Surg 2021; 11:293-297. [PMID: 35265501 PMCID: PMC8848692 DOI: 10.4103/ams.ams_203_21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/23/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction: Motorcycle accidents are one of the most frequent causes of trauma. Safety devices and helmets can influence the severity of injuries. Our retrospective study wants to evaluate the different effectiveness of Open-face and Full-face helmets in the prevention of craniofacial trauma. Materials and Methods: The sample consists of 440 patients admitted to two Level I Trauma Centres in Northern Italy, between January 2002 and February 2019, because of motorcycle-related craniofacial trauma. For each patient personal data were collected, as well as type and site of fractures, type of helmet, if worn, Comprehensive Facial Injury (CFI) score and Abbreviated Injury Score (AIS-Head) for head injuries. Inferential statistical analysis was then conducted. Results: Two hundred and eighty-eight patients wore Open-face helmets (69.7%) and 125 patients wore Full-face ones (30.3%). Mean CFI score (Standard deviation - SD) observed in patients with Open-face helmets was 7.0 (SD: 6.8) and surgery was required in 149 cases (51.7%); while it was 4.9 (SD: 6.0) in patients with Full-face helmets for whom surgery was required in 43 cases (34.4%) (P < 0.0001 and P = 0.002, respectively). Multivariate analysis shows that severity of facial trauma is a significant risk factor for head injury severity with OR 1.90 (95% confidence interval: 1.43 - 2.51) and P < 0.0001. Discussion: Full-face helmets are definitely considered to be more protective for facial trauma, which is also a significant risk factor for the severity of head injuries. The type of helmet chosen influences the need of surgical treatment in case of craniofacial trauma.
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Einy S, Goldman S, Radomislensky I, Bodas M, Peleg K. Maxillofacial trauma following road accidents-An 11-year multi-center study in Israel. Dent Traumatol 2020; 37:407-413. [PMID: 33259691 DOI: 10.1111/edt.12639] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND/AIM Road traffic collisions (RTC) are known to be one of the major causes of maxillofacial trauma (MFT). The road user factor is of crucial importance in the prevalence, severity, and treatment of maxillofacial injuries. The aims of the study were to determine the prevalence of maxillofacial trauma among road users, to illustrate injury patterns and to identify road users at high risk. METHODS This historical prospective multi-center study was based on Israel's Trauma Registry between 2008-2018, which included 4829 hospitalized patients following RTC with MFT. Data were analyzed according to six road user types (vehicle driver, passenger, bicyclist, motorcyclist, pedestrian, and e-bike/scooter), maxillofacial injury location, and maxillofacial treatment. RESULTS MFT, which accounted for 5% of the hospitalized RTC injuries, was not equally distributed among road users, as bicyclists and e-bike/scooters were more prone to maxillofacial trauma (7.2% and 10.1%, respectively) than vehicle drivers (3.2%). Children (age 0-14 years) comprised almost half of the cyclists, 25% of the pedestrians and 20% of the passengers. Some MFT patients experienced multiple injuries, with the majority involving jaw and facial bones and to a lesser extent the mouth, teeth, gingivae, and alveolar bone (mouth and dento-alveolar (DA) trauma). Approximately 30% of hospitalized road casualties with MFT underwent MF surgery, with the need for surgery lowest among pedestrians. CONCLUSION Hospitalized road casualties had different types of MFT in terms of prevalence, location, severity, and treatment, depending on the road user type.
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Affiliation(s)
- Shmuel Einy
- Orthodontic and Craniofacial Department, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel.,Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Sharon Goldman
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Irina Radomislensky
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
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- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Moran Bodas
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Kobi Peleg
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
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A Comparison of Motorcycle Helmet Wearing Intention and Behavior between Urban and Rural Areas. SUSTAINABILITY 2020. [DOI: 10.3390/su12208395] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The motorcycle is one of the important modes of transport for Thai people in all provinces due to its convenience and ability to access all areas and cover short distances, which is especially convenient for rural people. However, according to the accident record, it was found that the motorcycle was the vehicle causing the highest amount of accidents, and helmet wearing could save lives and reduce the level of severe injuries. In this regard, the objective of this study was to study and develop a model of factors that affected helmet use behavior using structural equation modeling (SEM) based on the Health Belief Model (HBM). Further, this study compared urban and rural models, so as to suggest suitable guidelines for the promotion of helmet use in the study areas. The sample comprised 801 motorcycle users divided into 401 urban residents and 400 rural residents. From the parameter invariance testing in the two areas, a chi-square difference test found differences in the factor loading, intercepts, and structural paths between urban and rural societies.
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Guzman LA, Ortiz AIV, Mesa VG, Camargo JP, Allen KA, Hyder AA. The relationships between correct helmet use, enforcement presence, and mortality in a Latin-America city: The case study of Bogotá, Colombia. TRAFFIC INJURY PREVENTION 2020; 21:500-505. [PMID: 32822246 DOI: 10.1080/15389588.2020.1805737] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 07/31/2020] [Accepted: 08/01/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE In Bogotá, Colombia, motorcyclists represent a concern as the proportion of motorcycle users between 2013 and 2018 has increased from 18% to 35%. Despite available risk reduction strategies, the fatality rates are also growing, notably in young adults (15-29 years old). This study aims at identifying correct helmet use patterns and its relationship with official records of injuries and casualties in the city over time. METHODS Between 2015 and 2018, semiannual observational studies of motorcycle users in six randomly selected sites in Bogotá were conducted. Data was collected and analyzed on the number of occupants per vehicle (driver and passengers), gender, approximate age, type of helmet, and whether it was correctly used (strapped) or not. Bivariate and multivariate analyses were performed to identify the determinants of correct helmet use. Additionally, a spatial analysis was conducted to estimate the relationship between motorcycle's casualties and correct use of the helmet (full-face helmet use) prevalence. RESULTS A total of 77,932 motorcycles were observed, showing a high prevalence of helmet use (99% for drivers and passengers), but only 88% use it correctly (89% drivers and 82% passengers). The presence of enforcement (camera or police personnel) increases the correct use of the helmet, especially in principal roads. Female, adults, and single riders are more likely to correctly wear the helmet. Finally, there is a relationship between the concentration of the fatalities and the incorrect helmet use in 80% of the observational sites. CONCLUSIONS Incorrect helmet use has been found by the study to be related to higher mortality among motorcycle occupants in Bogotá. Our data shows that enforcement increases correct helmet use with the potential to reduce deaths among motorcycle occupants.
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Affiliation(s)
- Luis A Guzman
- Grupo de Sostenibilidad Urbana y Regional, SUR. Department of Civil and Environmental Engineering, Universidad de los Andes, Bogota, Colombia
| | - Andres Ignacio Vecino Ortiz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins International Injury Research Unit, Baltimore, Maryland, USA
| | - Vanessa Guzman Mesa
- Grupo de Sostenibilidad Urbana y Regional, SUR. Department of Civil and Environmental Engineering, Universidad de los Andes, Bogota, Colombia
| | - Jose Pablo Camargo
- Grupo de Sostenibilidad Urbana y Regional, SUR. Department of Civil and Environmental Engineering, Universidad de los Andes, Bogota, Colombia
| | - Katharine A Allen
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Adnan A Hyder
- Department of Global Health, The Milken Institute School of Public Health, Washington, DC, USA
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Saunders RN, Witte AB, Adams NS, Dull MB, Davis AT, Gibson CJ, Iskander GA, Rodriguez CH, Cohle SD, Chapman AJ. Does the Repeal of Mandatory Motorcycle Safety Legislation Affect the Deaths of Motorcyclists? An Autopsy-Based Study Evaluating the Impact of Michigan's Universal Helmet Law Repeal on Immediately Fatal Motorcycle Crashes. Am Surg 2020. [DOI: 10.1177/000313482008600415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Amanda B. Witte
- College of Human Medicine Michigan State University Grand Rapids, Michigan
| | | | - Matthew B. Dull
- Spectrum Health Michigan State University Grand Rapids, Michigan
| | - Alan T. Davis
- Department of Surgery Spectrum Health College of Human Medicine Michigan State University Grand Rapids, Michigan
| | - Charles J. Gibson
- Acute Care Surgery Spectrum Health Hospital College of Human Medicine Michigan State University Grand Rapids, Michigan
| | - Gaby A. Iskander
- Acute Care Surgery Spectrum Health Hospital College of Human Medicine Michigan State University Grand Rapids, Michigan
| | - Carlos H. Rodriguez
- Department of Surgery Spectrum Health Hospital College of Human Medicine Michigan State University Grand Rapids, Michigan
| | - Stephen D. Cohle
- Office of the Medical Examiner- Kent County Grand Rapids, Michigan
| | - Alistair J. Chapman
- Acute Care Surgery Spectrum Health Hospital College of Human Medicine Michigan State University Grand Rapids, Michigan
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Wu D, Dufournet M, Martin JL. Does a full-face helmet effectively protect against facial injuries? Inj Epidemiol 2019; 6:19. [PMID: 31240168 PMCID: PMC6544930 DOI: 10.1186/s40621-019-0197-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 04/01/2019] [Indexed: 11/10/2022] Open
Abstract
Background The effectiveness of helmet use in preventing or reducing the severity of head injuries has been largely demonstrated. However, the effectiveness of different types of helmets in reducing facial or non-facial head injuries has received much less attention. Methods A postal survey on motorized two-wheeler crashes was conducted in 2016. 7148 riders of motorized two-wheelers (MTW) injured in a crash between 2010 and 2014 and identified in the Rhône Trauma Registry were invited to complete a questionnaire in order to collect detailed information about their accidents. The analysis was based on a population of 405 helmeted riders who declared having received an impact on the head. Facial and non-facial head injury risks were estimated according to helmet type (full face or other) by logistic regression, controlled for type of object hit by the head (and gender for risk of non-facial head injury), and weighted to take nonresponse into account. Results Three-quarter of helmeted MTW drivers were wearing a full-face helmet at the time of the accident. Victims wearing a full-face helmet were about three times less likely to have sustained injury to the face, compared to victims wearing another type of helmet (adjusted OR = 0.31; 95% CI: 0.11-0.83). On the other hand, the presence of non-facial head injury did not vary significantly according to whether a full-face or other helmet was worn (adjusted OR = 0.84; 95% CI: 0.33-2.13). Conclusions Our study suggests that full-face helmets provide better facial protection for MTW users compared to other types of helmets, whereas there is no evidence of any difference in protection afforded the skull or the brain.
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Affiliation(s)
- Dan Wu
- Univ Lyon, Université Lyon 1, IFSTTAR, UMRESTTE UMR_T 9405, 25 Avenue François Mitterrand, 69675 Bron Cedex, France
| | - Marine Dufournet
- Univ Lyon, Université Lyon 1, IFSTTAR, UMRESTTE UMR_T 9405, 25 Avenue François Mitterrand, 69675 Bron Cedex, France.,2Clinical and Research Memory Centre of Lyon (CMRR); Geriatrics Unit, Lyon Institute For Elderly, Hospices civils de Lyon, Lyon, France
| | - Jean-Louis Martin
- Univ Lyon, Université Lyon 1, IFSTTAR, UMRESTTE UMR_T 9405, 25 Avenue François Mitterrand, 69675 Bron Cedex, France
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Arif MZ, B R R, Prasad K. The Role of Helmet Fastening in Motorcycle Road Traffic Accidents. Craniomaxillofac Trauma Reconstr 2019; 12:284-290. [PMID: 31719953 DOI: 10.1055/s-0039-1685458] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 02/07/2019] [Indexed: 10/27/2022] Open
Abstract
Road traffic accidents are the leading cause of death among the Indian population. Motorcycle accidents are the most prominent type of injuries among road traffic accidents in India. In this prospective cross-sectional study, all the patients attending three centers in north Bangalore, with facial injuries occurring from a motorcycle accident, were included. The subjects were analyzed for the type of collision, helmet use, type of helmet use, and fastening status of the helmets. A total of 311 motorcyclists were included in this study for a period of 18 months (December 2015 to June 2017). There were 79.7% males and 20.3% females. The most prominent age group was 21 to 30 years. The percentage of riders sustaining facial injuries was significantly more in the non-helmeted group. The most common injuries in open face helmets were in the middle and lower third of the face, whereas in closed face helmets it was in the middle third of the face. The numbers of injuries were significantly higher in the nonfastened helmet group as compared with fastened helmet group. Helmet fixation is an important characteristic along with helmet type for the better effectiveness and safety of the helmets for the motorcyclists.
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Affiliation(s)
- Md Zeeshan Arif
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, Karnataka, India
| | - Rajanikanth B R
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, Karnataka, India
| | - Kavitha Prasad
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, Karnataka, India
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Park GJ, Shin J, Kim SC, Na DS, Lee HJ, Kim H, Lee SW, In YN. Protective effect of helmet use on cervical injury in motorcycle crashes: A case-control study. Injury 2019; 50:657-662. [PMID: 30765183 DOI: 10.1016/j.injury.2019.01.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 01/17/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Helmet use during motorcycle crashes (MCCs) has been shown to reduce traumatic brain injury and mortality. However, preventive effects of its use on cervical spine injury remain controversial. In this study, we evaluated whether helmet use can reduce cervical spine injury during MCCs. PATIENTS AND METHODS A case-control study using data from the Emergency Department-based Injury In-depth Surveillance (EDIIS) registry was conducted. Cases were defined as patients with cervical spine injury [≥2 points in the Abbreviated Injury Scale (AIS)] in MCCs from 2011 to 2016. Four controls were matched to one case with strata which included age and sex from the EDIIS registry. Primary outcome was cervical spine injury, secondary outcome was intensive care unit (ICU) admission, and tertiary outcomes was mortality. Multivariable logistic regression analysis was used to calculate odds ratios (OR) with 95% confidence intervals (CIs) to evaluate the associations between helmet use and related outcomes. RESULTS In total, 2600 patients were analysed; among these, 1145 (44.0%) used helmets at the time of crashes. The helmet group showed lower alcohol consumption and mortality rates than the no helmet group (alcohol: 3.2% vs. 9.2%, respectively, and mortality: 2.4% vs. 7.1%, respectively; p < 0.01). Compared with the no helmet group, the helmet group was less likely to have cervical spine injury [adjusted OR, 0.62 (0.51-0.77)]. In addition, helmet use has been shown to help prevent ICU admission and mortality [adjusted OR, 0.45 (0.36-0.56) and 0.32 (0.21-0.51), respectively]. CONCLUSION Helmet use was found to have significant preventive effects on cervical spine injury during MCCs.
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Affiliation(s)
- Gwan-Jin Park
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
| | - Jaeho Shin
- School of Mechanical and Automotive Engineering, Kyungil University, South Korea.
| | - Sang-Chul Kim
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
| | - Dae-Seok Na
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
| | - Hae-Ju Lee
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
| | - Hoon Kim
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
| | - Seok-Woo Lee
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
| | - Yong-Nam In
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
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Kumphong J, Satiennam T, Satiennam W. The determinants of motorcyclists helmet use: Urban arterial road in Khon Kaen City, Thailand. JOURNAL OF SAFETY RESEARCH 2018; 67:93-97. [PMID: 30553434 DOI: 10.1016/j.jsr.2018.09.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 09/19/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Currently, Thailand incurs the highest death toll of motorcyclists in the world. The aim of this study was to explore the factors influencing helmet use of motorcyclists in Khon Kaen City, Thailand by using the Logistic regression analysis. METHOD The samples, consisting of 27,977 riders and 6,947 riding passengers, were collected by CCTV installed at several signalized intersections along urban arterial roads. RESULTS The observation results reveal that only 67% of motorcyclists wore the helmets. The analysis results reveal that the helmet use of motorcyclists was significantly associated with the riding status, number of passengers, apparent age, motorcycle class, time of day, the presence of police booths at intersections and, especially, red light running behavior. The riders tended to wear helmets at 2.7 times higher rates than passengers. Adult motorcyclists tended to wear the helmets at 2.8 times higher rates than children. The motorcyclists riding the motorcycles over 125 cc tended to wear the helmets 1.9 times higher than those riding motorcycles under 125 cc. The motorcyclists riding in the morning and the afternoon tended to wear the helmets 5.0 and 3.8 times higher than in the evening. The motorcyclists riding through intersections with police booths tended to wear the helmets 2.2 times higher than those riding through intersection without police booths. However, the red light running riders intend to wear the helmets 0.6 times less than the legal riders. CONCLUSIONS The outcome of this study could determine the factors influencing motorcyclist's helmet use. PRACTICAL IMPLICATIONS It will be useful for a development of 100% helmet use program designed to lessen the fatality of motorcyclists along the urban arterial roads.
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Affiliation(s)
- Jetsada Kumphong
- Faculty of Engineering, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Thaned Satiennam
- Faculty of Engineering, Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Wichuda Satiennam
- Faculty of Engineering, Khon Kaen University, Khon Kaen, 40002, Thailand.
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Soft Tissue Injuries of the Maxillofacial Region Occurring from Motorcycle Accidents. J Maxillofac Oral Surg 2018; 18:432-439. [PMID: 31371887 DOI: 10.1007/s12663-018-1149-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 08/27/2018] [Indexed: 10/28/2022] Open
Abstract
Introduction Soft tissue injuries are the most common type of injury occurring from a motorcycle accident. Not many studies have been conducted to determine the incidence and pattern of soft tissue injuries and the effectiveness of helmet to prevent them. Methods In this prospective cross-sectional study, all the patients attending three centres in North Bangalore, with facial injuries occurring from a motorcycle accident, were included. The subjects were analysed for the type of collision, helmet use, type of helmet use and incidence and pattern of extra-oral and intra-oral soft tissue injuries. Results A total number of 311 motorcyclists were included in this study for a period of 18 months (December 2015-June 2017). The most prominent age group was 21-30 years. Abrasions were the most common type of injury followed by the lacerations, contusions and communication. Injuries to the middle third and lower third of the face were significantly higher in non-helmeted and open-face-helmeted patients. Middle third injuries were most common in the full-face helmet group. Conclusion Abrasions are the most common type of soft tissue injury, and most common site was the nose, followed by the forehead, orbit and chin. Full-face helmets are more effective and protective as compared to open-face helmets. Open-face helmets offer minimal protection against facial injuries occurring from road traffic accidents.
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Freitas CA, Furtado AM, Petterle RR, Pimentel SK, Carvalho FH. Helmet retention system types as a risk factor to properly attach the chin strap. TRAFFIC INJURY PREVENTION 2018; 19:173-178. [PMID: 28758794 DOI: 10.1080/15389588.2017.1356022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 07/11/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES This study aimed to determine the factors associated with the incorrect use of a helmet retention system (loose or open) and how often this happens. METHODS This was an observational transversal study conducted in Curitiba, Brazil. Trained observers positioned at traffic lights collected information about the helmet fixation mode, the helmet model (full-face, open-face, modular, half), and the helmet retention system model (micrometric, double-D, fast-release). Additional data including position on the motorcycle, gender, and function of the motorcycle (as a work vehicle) were collected. The observers, collection site, and periods were randomly selected by lots. RESULTS From a total of 3,050 motorcyclists, 1,807 (59.2%) had their helmets fastened correctly, 907 (29.7%) had the retention system fastened loosely, and in 336 (11.0%), the retention system was completely open. Increased odds of incorrect use were observed for the fast-release and double-D buckles compared to the micrometrics buckles, with a fixed odds ratio (OR) of 4.62 (95% confidence interval [CI], 3.89-5.51) and 3.54 (95% CI, 2.46-5.09), respectively (P <.0001). Full-face helmets had a higher chance of incorrect use (P <.0001), and passengers had a higher incidence of incorrect use of the helmet than drivers (P <.0001). CONCLUSION An important risk factor related to the incorrect use of the helmet was the type of retention system. The helmet model and being a passenger had a secondary influence on incorrect use of helmets.
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Affiliation(s)
- C A Freitas
- a University Federal of Paraná , Curitiba , Brazil
| | - A M Furtado
- a University Federal of Paraná , Curitiba , Brazil
| | - R R Petterle
- b Medical School , Federal University of Paraná , Curitiba , Brazil
| | - S K Pimentel
- c Department of Surgery, Medical School, Hospital do Trabalhador , Federal University of Paraná , Curitiba , Brazil
| | - F H Carvalho
- c Department of Surgery, Medical School, Hospital do Trabalhador , Federal University of Paraná , Curitiba , Brazil
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