© 2004 American Public Health Association
The author is with the Department of Health Services Administration, University of Arkansas at Little Rock, and the Department of Health Policy and Management, College of Public Health, University of Arkansas for Medical Sciences, Little Rock. Correspondence: Requests for reprints should be sent to Andreas Muller, PhD, UALR, Ross Hall 202, 2801 S University Ave, Little Rock, AR 72204 (e-mail: axmuller{at}ualr.edu).
On July 1 2000, the State of Florida exempted adult motorcyclist and moped riders from wearing helmets provided they have medical insurance of $10 000. Monthly time series of motorcycle occupant deaths are examined from 1/1994 to 12/2001. The interrupted time series analysis estimates a 48.6% increase in motorcycle occupant deaths the year after the law change. The impact estimate reduces to 38.2% and 21.3% when trends in travel miles and motorcycle registrations are controlled. Our findings suggest that the laws age exemption should be revoked.
Between 1997 and 2001, nationwide motorcycle rider fatalities increased by 50% while motorcycle registrations increased by 31%.1,2 The rise in death rates may be related to the concurrent weakening of motorcycle helmet laws in Arkansas, Texas, Kentucky, Louisiana, and Florida. In comparing rates the year before (1996) and the year after (1998) the helmet law change, Preusser et al.3 found a 21% increase in motorcyclist deaths in Arkansas and a 30% increase in Texas. This analysis tries to determine the effect of weakening Floridas motorcycle helmet law. Since July 1, 2000, Florida statutes have required motorcycle riders younger than 21 years of age to wear helmets. Adult motorcycle and moped riders are exempted provided they have insurance for motorcycle accident injuries with minimum medical benefit coverage of $10 000.4 Before July 1, 2000, Florida had a helmet law that required all riders to wear safety helmets. The State of Florida is of interest because it accounts for 9% of all motorcycle rider deaths in the United States. Coinciding with the helmet law change, the number of Floridas motorcycle registrations increased substantially. The number of motorcycle deaths in the state was high enough to permit a monthly time series analysis. The Florida motorcycle helmet law change has not been evaluated statewide.5
Data Floridas monthly motorcycle rider deaths for the period January 1994 to December 2001 were analyzed. Motorcycle rider deaths included operators or passengers of motorcycles, mopeds, minibikes, motorized three-wheelers, off-road, other, and unknown types of motorcycles. All-terrain vehicles were excluded. The definition is intentionally comprehensive to allow for comparisons over time. It matches the National Highway Traffic Safety Administrations definition of motorcycle rider death. The time series data were obtained from the Fatal Accident Reporting System database.1 Yearly issues of Highway Statistics provided motorcycle registration and travel miles for the period 1996 to 2001, and earlier years came from the 1995 summary volume.2 To obtain a more realistic representation of the Florida motorcycle registration and travel trends, annual data were converted into a monthly series by 12-month centered moving averages. The smoothing operation removes 12 observations and reduces the sample size to 84 months, July 1994 to June 2001. The following series were analyzed: motorcycle rider deaths, motorcycle rider deaths per billion travel miles, and motorcycle rider deaths per 10 000 registered motorcycles. Restricting the analysis to rider deaths of adult motorcyclists (>20 years) generates 3 additional series.
Time Series Models
Figure 1
Figure 2
The analysis suggests that exempting adult motorcyclists from wearing helmets increased the number of motorcyclist fatalities in Florida. However, the effect of the law change depends on which "exposure" measures are controlled. Since travel increased in Florida, the impact estimates based on the absolute number of deaths are probably overstated. Conversely, the estimates that correct for the motorcycle registration trend may understate the laws impact. The large increase (19.6%) in Florida motorcycle registrations in 2001 (Figure 1 In 2001, only 53% of Florida underage motorcyclists who died in crashes wore motorcycle helmets; for adults the figure was 39%.1 That is, the legal age restriction is barely effective and amounts to a de facto helmet law repeal.
This study finds that the current age-restricted version of Floridas motorcycle helmet law resulted in more motorcyclist deaths even after adjustment for concurrent increases in motorcycle registrations or miles traveled. Exempting adult motorcycle riders from wearing motorcycle helmets is counterproductive for motorcyclists health and unnecessarily increases insurance and medical care expenses.
I would like to thank the anonymous reviewers for their helpful comments.
Human Participation Protection No protocol approval was needed because no individuals are identified by the analysis. Accepted for publication June 18, 2003.
1. US Dept of Transportation, National Highway Traffic Safety Administration, National Center for Statistics and Analysis. Fatality Analysis Reporting System (FARS) Web-based encyclopedia. Reports: people: motorcyclists. Available at: http://www-fars.nhtsa.dot.gov. Accessed February 18, 2003. 2. US Dept of Transportation, Federal Highway Administration. Highway statistics (multiple years). Available at: http://www.fhwa.dot.gov/policy/ohpi/hss/hsspubs.htm. Accessed February 18, 2003. 3. Preusser DF, Hedlund JH, Ulmer RG. Evaluation of Motorcycle Helmet Law Repeal in Arkansas and Texas. Final Report, DTNH2297-D-05018. Springfield Va: National Technical Information Service; September 2000. 4. Florida Senate. The 2002 Florida Statutes, Title XXIII, Chap 316.211. Available at: http://www.flsenate.gov/Statutes. Accessed March 5, 2004. 5. Hotz GA, Cohn SM, Popkin C, et al. The impact of a repealed motorcycle helmet law in Miami-Dade County. J Trauma. 2002;52:469474.[Medline] 6. Box GEP, Jenkins GM. Time Series Analysis: Forecasting and Control. Rev ed. San Francisco, Calif: Holden-Day; 1976. 7. Pankratz A. Forecasting With Dynamic Regression Models. New York, NY: John Wiley & Sons; 1991. This article has been cited by other articles:
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