Motorcycle Safety
Motorcycle Accident Prevention

Studies have examined the impact of safety helmets or helmet laws consistently found that helmet use reduced the fatality rate, the probability and severity of head injuries, the cost of medical treatment, the length of hospital stay, the necessity for special medical treatments, and the probability of long-term disability. This work reinforces similar conclusions from earlier studies.

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A number of the reviewed studies examined the question of who pays for medical costs. Only slightly more than half of motorcycle crash victims have private health insurance coverage.

Research is sparse in the areas of long-term medical and work-loss costs. For victims of serious head injury, acute hospital care might be only the first stage of a long and costly treatment program. For many crash victims, lost wages from missed work days will outweigh medical costs. And for victims who are permanently disabled, their earnings might be reduced for the rest of their lives. More research is needed on these subjects to provide a more comprehensive picture of the full cost of motorcycle crash injuries.

Increase in Motorcycle Crashes

Almost 4 million motorcycles are registered in the United States. Overall, they accounted for 11.3 billion person-miles of travel in 1998, averaging 2,640 miles per motorcycle (Federal Highway Administration. 1998 Highway Statistics, Washington DC: FHWA, 1999).

Motorcycles are by far the most fuel-efficient class of highway vehicle, at 50 miles per gallon (FHWA 1999).

Because they are capable of high speeds but offer minimal occupant protection, they also are the most hazardous highway vehicles: they have the highest crash costs per person-mile.

Helmets are the best-evaluated way to reduce motorcycle deaths and injuries. They are 29-35 percent effective at preventing motorcycling deaths and substantially more effective against deaths from brain injury.

They also significantly reduce nonfatal brain injury (NHTSA 1989; GAO 1990; CODES Report to Congress). Annually, more than 2,500 motorcyclists die in traffic crashes. The number of motorcyclists dying on the highway fell to a historic low in 1997, and the number of motorcyclists injured in crashes has fallen by 40 percent from the 1990 level.

However, since 1997, motorcyclist fatalities have increased over more than 40 percent and data indicate that motorcycle crash-related injuries are also increasing. Many motorcyclists believe rider training has been instrumental in reducing motorcycle deaths. This belief has been tested only modestly in the literature. Even less examined is the impact of protective clothing on motorcyclist injury. And there simply is no literature evaluating the training of auto drivers about driving safely around motorcycles.

Perhaps because many motorcyclists prize their independence, government attempts to reduce motorcycling deaths, injuries, and costs have met active resistance. Proven rider protection measures, notably helmets, are not required in many states. The federal government has twice enacted and then repealed laws designed to promote state helmet laws.

In the debates over helmets and motorcycle safety, both rider groups and safety advocates are increasingly framing their arguments in terms of statistics from published studies. The complexity of the methods required to analyze data covering limited subsets of motorcycle crashes, however, often makes the results of the studies difficult to interpret. Moreover, sometimes the studies themselves are flawed by data limitations or inadequate methods. In this context, the present survey is intended to aid in evaluating extant studies and arguments based upon them.

The next section summarizes our general approach. Section 4 provides an overview of the topics, data, and methods of the studies we reviewed, highlighting recurring problems and their solutions. Section 5 summarizes and analyzes the findings of the reviewed studies. And Section 6 suggests gaps in the current state of knowledge.

Motorcycle Safety

The most-studied topic in motorcycle safety is the efficacy of helmets in preventing and mitigating head injuries. Most of the publications evaluated for this project studied either helmet use or state helmet laws. The link between head injury and riding without a helmet is by now well established.

Little research has been published, however, on helmet design. Other sorts of safety equipment, notably protective clothing for riders, are less studied. Other factors in motorcycle safety include alcohol intoxication and the roles of rider training and experience. Both of these issues have received some attention in the literature, but much less than helmets.

A further dimension in motorcycle safety analysis of interest for public policy is the cost of motorcycle crashes, especially insofar as this cost is borne by the public. It is easy enough to determine the costs of various safety equipment and programs, but it is more complicated to determine the costs that are saved when injuries are prevented or mitigated by successful safety measures.

The major types of costs resulting from injury are:

1. the cost of medical treatment
2. the value of lost work
3. decreased quality of life.

Most of the publications reviewed in this study made some effort to look at short-term medical costs. But few looked at long-term medical costs or work loss, and only two considered quality of life. Accurate medical cost estimation is complicated by institutional factors that differ between states -- and sometimes between hospitals or payers. The other costs are difficult to ascertain because their computation requires information from a lengthy follow-up period after the crash, particularly in cases where the victim is permanently disabled.

In addition to questions concerning the level of costs, policy discussions often involve the question of who bears the costs -- the rider, other drivers, private insurers, the government, or another party. If an institution is shown to bear a large share of the costs, then it will have a proportionate incentive to reduce those costs. A number of the publications surveyed in this study examined the question of who paid a crash victim's medical costs.

Classifying studies of motorcycle crash costs

The studies reviewed for this project can be categorized by 1) their purpose or focus and 2) by their data and methods. Of the 25 published studies of motorcycle crash costs that we reviewed, nearly half (12) focused on evaluating the benefits of helmet use. Another four addressed the effectiveness of state laws mandating universal helmet use by motorcycle riders. The remaining nine articles addressed a number of different topics -- methods, costs, epidemiology, training, and other safety measures.

A majority of the articles (15) employed state or local data from crash reports, hospitals, or mortality files. Eight of these studies linked data from two or more sources at the level of the individual rider in order to construct a more comprehensive picture of each crash episode than would be possible from a single data source. Such linkage is always a difficult process, and it was more successful in some instances than in others.