Trends in helmet use by motorcycle riders in the decades following the repeal of mandatory helmet laws

Several US states repealed universal motorcycle helmet laws in the 1990s and 2000s. The purpose of this study was to examine national trends in helmet use among adult trauma patients with motorcycle-related injuries. We hypothesized that motorcycle helmet use declined over time. We retrospectively analyzed the National Trauma Data Bank's National Sample Program for 2003–2010. We also obtained data on US motorcycle fatalities reported in the Fatality Analysis Reporting System and population data from the U.S. Census Bureau to calculate motorcycle-related fatality rates over time. A total of 255,914 patients met inclusion criteria, of whom 148,524 (58%) were helmeted. During the study period, helmet use increased from 56% in 2003 to 60% in 2010 (p < 0.001). However, motorcycle-related fatality rates also increased in states with and without universal helmet laws. Nationally, rates of helmet use have increased. However, fatalities due to motorcycle crashes have also increased during the same period.