title: The effect of various types of motorcycle helmets on cervical spine injury in head injury patients: a multicenter study in Taiwan.
abstract: BACKGROUND
  The relationship between cervical spine injury (CSI) and helmet in head injury (HI) patients following motorcycle crashes is crucial. Controversy still exists; therefore we evaluated the effect of various types of helmets on CSI in HI patients following motorcycle crashes and researched the mechanism of this effect.
  
  
  METHODS
  A total of 5225 patients of motorcycle crashes between 2000 and 2009 were extracted from the Head Injury Registry in Taiwan. These patients were divided into case and control groups according to the presence of concomitant CSI. Helmet use and types were separately compared between the two groups and the odds ratio of CSI was obtained by using multiple logistic regression analysis.
  
  
  RESULTS
  We observed that 173 (3.3%) of the HI patients were associated with CSI. The HI patients using a helmet (odds ratio (OR) = 0.31, 95% confidence interval (CI) = 0.19-0.49), full-coverage helmet (0.19, 0.10-0.36), and partial-coverage helmet (0.35, 0.21-0.56) exhibited a significantly decreased rate of CSI compared with those without a helmet.
  
  
  CONCLUSIONS
  Wearing full-coverage and partial-coverage helmets significantly reduced the risk of CSI among HI patients following motorcycle crashes. This effect may be due to the smooth surface and hard padding materials of helmet.
authors.affiliation: Department of Critical and Emergency Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan ; Graduate Institute of Injury Prevention and Control, College of Public Health and Nutrition, Taipei Medical University, No. 250, Wu-Hsing Street, Taipei 110, Taiwan.
authors.forename: Carlos
authors.identifier: 0000-0002-8051-7485
authors.initials: C
authors.lastname: Lam
authors.affiliation: Graduate Institute of Injury Prevention and Control, College of Public Health and Nutrition, Taipei Medical University, No. 250, Wu-Hsing Street, Taipei 110, Taiwan.
authors.forename: Mau-Roung
authors.initials: MR
authors.lastname: Lin
authors.affiliation: School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei 110, Taiwan.
authors.forename: Shu-Fen
authors.initials: SF
authors.lastname: Chu
authors.affiliation: Graduate Institute of Injury Prevention and Control, College of Public Health and Nutrition, Taipei Medical University, No. 250, Wu-Hsing Street, Taipei 110, Taiwan ; Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, Taipei 235, Taiwan ; Department of Emergency Medicine, College of Medicine and Shuang Ho Hospital, Taipei Medical University, Taipei 110, Taiwan.
authors.forename: Shin-Han
authors.initials: SH
authors.lastname: Tsai
authors.affiliation: Department of Public Health, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
authors.forename: Chyi-Huey
authors.initials: CH
authors.lastname: Bai
authors.affiliation: Graduate Institute of Injury Prevention and Control, College of Public Health and Nutrition, Taipei Medical University, No. 250, Wu-Hsing Street, Taipei 110, Taiwan ; Department of Neurosurgery, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan.
authors.forename: Wen-Ta
authors.initials: WT
authors.lastname: Chiu
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D066193:Cervical Cord / Q000293:injuries*; D006259:Craniocerebral Trauma / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006260:Head Protective Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D009049:Motorcycles; D013624:Taiwan; D055815:Young Adult