Background: The effect of helmet use in the prevention of head injury has been clearly shown. However, the relationship between helmet compliance and other bodily (noncranial) injury has not been explored, yet may have important impact on strategies for injury prevention. The purpose of this study was to examine helmet use in an injured population to evaluate its association with noncranial trauma.
Methods: All entries in the Canadian National Trauma Registry were surveyed from 2000 to 2004 and limited to injuries sustained in recreational sports associated with helmet use.
Results: Over the 5-year period, 2,205 injuries met inclusion criteria. Cycling-related injuries were most frequent (43.5%). Alcohol consumption correlated significantly with lack of helmet use. Nonhelmeted individuals suffered significantly more noncranial injuries (85% vs. 68%, p < 0.0001) and had twice as many severe head injuries (Glasgow Coma Scale score ≤ 8) (odds ratio [OR]: 2.13, 95% confidence interval [CI]: 1.35-3.37) or any abnormal Glasgow Coma Scale score (OR: 1.96, 95% CI: 1.55-2.47). While controlling for age, sex, or type of sport activity performed, multivariate regression confirmed a reduction in associated noncranial injuries when helmets were used (OR: 0.86, 95% CI: 0.83-0.89).
Conclusions: Within an injured population from sports-related activities, helmet use is associated with fewer noncranial injuries of all types suggesting reduced overall risk of injury in this group. In addition, use of helmets is associated with less frequent and less severe head injury. Alcohol consumption is related to increased risk of injury and is more prevalent in injured individuals who abstain from helmet use.
Level of evidence: III, prognostic study.