title: Impact of helmets on injuries to riders of all-terrain vehicles.
abstract: BACKGROUND
  Although helmet use has been shown to be effective in reducing traumatic brain injuries (TBIs) due to motorcycle and bicycle crashes, it is unknown whether helmet use is associated with different injury patterns and severity for users of all-terrain vehicles (ATVs).
  
  
  OBJECTIVE
  To compare likelihood of injury and death between helmeted and unhelmeted riders of ATVs.
  
  
  METHODS
  The National Trauma Data Bank for years 2002-2006 was used to examine the records of 11 589 patients hospitalized for injuries resulting from ATV use. The likelihood of receiving a TBI diagnosis or a significant injury to other body regions and differences in injury severity and in-hospital mortality between helmeted and unhelmeted ATV riders were compared.
  
  
  RESULTS
  After multivariable adjustment, compared with helmeted riders, unhelmeted riders were significantly more likely to sustain any TBI (OR 1.62, 95% CI 1.49 to 1.76, p<0.001) and major/severe TBI (OR 3.19, 95% CI 2.39 to 4.25, p<0.001). Unhelmeted riders were significantly more likely to die while in hospital than were helmeted riders (OR 2.58, 95% CI 1.79 to 3.71, p<0.001). Significant injuries to the neck and face regions were also significantly more likely in unhelmeted riders (OR 3.53, 95% CI 1.28 to 9.71, p = 0.015, and OR 1.94, 95% CI 1.32 to 2.84, p = 0.001, respectively).
  
  
  CONCLUSIONS
  ATV riders who do not wear helmets are more likely to receive significant injuries to the head, face, and neck. Prevention strategies and enforceable policy interventions to increase helmet use among ATV riders appear warranted.
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA. bowmanstephenm@uams.edu
authors.forename: S M
authors.initials: SM
authors.lastname: Bowman
authors.forename: M E
authors.initials: ME
authors.lastname: Aitken
authors.forename: J C
authors.initials: JC
authors.lastname: Helmkamp
authors.forename: S A
authors.initials: SA
authors.lastname: Maham
authors.forename: C J
authors.initials: CJ
authors.lastname: Graham
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000453:epidemiology / Q000517:prevention & control; D005151:Facial Injuries / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000453:epidemiology* / Q000517:prevention & control; D015541:Off-Road Motor Vehicles / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D055815:Young Adult