NTSB Testifys against Nebraska Helmet Choice Bill

The NTSB recently studied 6 motorcycle crashes and came to the conclusion that all states need a mandatory motorcycle helmet law. Ask your US members of Congress to oppose the NTSB's misguided efforts.


www.ntsb.gov/speeches/hart/hac110214.html


Christopher A. Hart, Vice Chairman
National Transportation Safety Board
Before The Transporation and Telecommunications Committee
Nebraska Unicameral Legislature on Legislative Bill 52
Repeal of Nebraska's Universal Helmet Law
Lincoln, Nebraska
February 14, 2011


Good afternoon Chairman Fischer and members of the Transportation and
Telecommunications Committee. It is my pleasure to be here in Lincoln,
at the invitation of Senator Lathrop, to discuss the National
Transportation Safety Board's recommendation on helmet use laws and
therefore our opposition to Legislative Bill (L.B.) 52, a bill that
would reduce the safety benefits that are now provided by Nebraska's
very sound universal helmet wear law.


The National Transportation Safety Board (NTSB) is an independent
federal agency charged by Congress to investigate transportation
accidents, determine their probable cause, and make recommendations to
prevent their recurrence. The recommendations that arise from our
investigations and safety studies are our most important product.


The NTSB is concerned about the growing number of motorcycle riders that
have been killed or injured in motorcycle crashes. From 1997 through
2008, the number of motorcycle fatalities nationwide more than doubled
from 2,116 to 5,290. Although fatalities among motorcyclists declined in
2009, to 4,462, that is still an average of 12 motorcyclists per day,
and an additional 90,000 were injured. Here in Nebraska, during the same
12-year period, there were 145 fatalities, an average of 12 deaths per
year. Based upon experience in other states, the number of motorcyclist
fatalities and injuries can be expected to increase if Nebraska enacts
L.B. 52.


Motorcycles represent only 3 percent of the 257 million vehicles on our
roads, but they account for 13 percent of highways deaths. In 1997, the
motorcycle fatality rate per 100,000 registered vehicles was 55.30. By
2007, the rate per 100,000 registered vehicles was 72.48, an increase of
31 percent, with the result that the number of fatalities grew faster
than the number of registered motorcycles.


Recognizing the safety benefits of motorcycle helmets and the
effectiveness of universal helmet laws in increasing helmet use, in
October 2007, the NTSB recommended that the states lacking a universal
helmet law enact legislation to require all motorcycle riders and
passengers to use a helmet that complies with federal standards. We were
pleased not to have to send that recommendation to Nebraska because, to
its credit, Nebraska already had a universal helmet law in 2007.


Helmets Are Effective


Head injury is a leading cause of death in motorcycle crashes. According
to the National Highway Traffic Safety Administration (NHTSA), the use
of a safety helmet that complies with U.S. Federal Motor Vehicle Safety
Standard (FMVSS) 218 is the "single critical factor in the prevention
[and] reduction of head injury." The main function of the helmet is to
protect the rider's head, especially the brain, during a fall or crash.
A helmet that meets the federal safety standard is designed with a hard
outer shell, an impact-attenuating liner, and a retention system to
protect the structure and contents of the head in a wide variety of
impact scenarios.


Helmets can be effective in both low- and high-speed crashes because
crash speed is not directly related to head impact speed. In the
definitive study on motorcycle cause factors (frequently referred to as
the Hurt Report), the severity of head impacts was determined by
examining crash-involved helmet damage. This study found that 90 percent
of head impacts were less severe than the single test impact required in
FMVSS 218. Thus, FMVSS 218-compliant helmets are well designed to
protect the head for the vast majority of motorcycle crashes.


Experience has abundantly demonstrated the effectiveness of
appropriately designed motorcycle helmets in preventing and mitigating
head injury. The independent Cochrane Review of published studies found
in 2003 that helmets substantially reduced the risk of head injury and
fatality in motorcycle crashes, and found no evidence of an increased
risk of any other types of injury. A 1996 U.S. Department of
Transportation (DOT) report noted that riders not wearing helmets are
three times more likely to suffer brain injury than those riders wearing
helmets. According to another DOT report published in 2004, helmets are
37 percent effective in preventing all fatalities in motorcycle crashes.


David Thom, one of the lead researchers involved with the Hurt Report,
spoke at the NTSB's Motorcycle Forum in September 2006, about the
potential negative effects of helmets on safety. An active motorcyclist
and researcher on motorcycle safety for three decades, Mr. Thom noted
that helmets neither cause nor prevent neck injuries. A large number of
scientific studies confirm Mr. Thom's observations. Similarly, helmets
have not been shown to cause problems with vision or hearing.


Helmets Laws Do Increase Helmet Use


By 1976, following passage of the 1966 National Highway Safety Act,
which withheld federal funding from states that had not enacted
mandatory helmet laws, 47 states, including Nebraska, had mandatory
helmet laws that applied to all motorcycle riders. Since that time,
motorcycle groups have argued extensively against such laws, and
restrictions on federal funding contingent on such laws were removed (in
1976), partially re-enacted (in 1991), and then removed again (in 1995).
Each removal of federal funding restrictions was followed by a wave of
repeals of universal helmet laws. Currently, 20 states, including
Nebraska, have universal helmet laws (requiring all riders to wear a
helmet), 27 states have partial laws (requiring minors and/or passengers
to wear such helmets), and 3 states have no helmet laws.


Unfortunately, these repeals have amounted to a vast experiment
affirming the effectiveness of helmet laws and regulations in reducing
death and injury. A 1991 review of studies of helmet use found that
helmet use under universal laws ranges from 92 to 100 percent, while
without a law or under a partial law (requiring only some riders, such
as teens or novice riders, to wear helmets), helmet use generally ranges
from 42 to 59 percent. A 2009 NHTSA research note indicated that helmet
use in states that require all motorcyclists to wear helmets is at 86
percent, while helmet use in a state without a law or under a partial
law is about 55 percent.


A 1986 study concluded that the repeal of helmet use laws was associated
with a 10.4 to 33.3 percent increase in the fatality rate when
calculated per accident. The study also found that between 158 and 420
fewer motorcycle rider fatalities would have occurred in 1984 had the
laws not been repealed. More recently, studies of states that have
repealed their mandatory helmet laws within the last 10 years have shown
similar patterns.


For example, Arkansas repealed its universal helmet law in 1997, and 18
months after repeal, helmet use dropped by two-thirds (from 97 to 30
percent). Arkansas also experienced more than double the number and rate
of unhelmeted crash scene fatalities, and more than double the hospital
admission rate for unhelmeted motorcycle crash survivors. Associated
with this increase in death and injuries was a substantial increase in
the amount of non-reimbursed charges for initial treatment.


After Texas repealed its universal helmet law in 1997, helmet use fell
from 97 to 66 percent. More than 80 additional motorcyclists died in the
2 years following the law's repeal than in the 2 years preceding it. The
number of unhelmeted riders with traumatic brain injuries increased by a
factor of almost 10 in only 4 years, from 55 in 1997 to 511 in 2001, and
the number of unhelmeted riders who were placed in rehabilitation
facilities saw similar increases, from 9 in 1997 to 90 in 2001. A more
recent study published in the January 2010 edition of the Southern
Medical Journal indicates that in the 7 years since Texas repealed its
mandatory motorcycle law in 1997, fatality rates per vehicle miles
traveled increased by roughly 25 percent.


In Kentucky, helmet usage rates fell from 96 to 65 percent following
repeal of the state's universal helmet law in 1998; motorcycle
fatalities increased from 26 in the year prior to repeal to 42 in the
year following repeal. Accident-involved motorcycle riders who did not
wear helmets in Kentucky were 4 times more likely to suffer a traumatic
brain injury and severe head injury. In addition, hospital charges alone
averaged more than $25,000 more for the unhelmeted motorcyclist than for
the helmeted motorcyclist involved in an accident.


Louisiana saw its helmet usage rate drop from 100 to 52 percent after it
amended its helmet law in 1999 to remove the universal requirement for
helmet use. The motorcycle fatality rate increased by more than 25
percent following the repeal, with unhelmeted accident-involved riders
experiencing head injuries at twice the rate of helmeted riders. Nearly
60 more motorcyclists died in the 2 years following the law's repeal
than in the 2 years preceding it. In spite of their requirement for
unhelmeted riders to carry health insurance, the insurance coverage for
unhelmeted riders involved in accidents actually decreased by half
following the change in the law. In 2004, in response to the continuing
rise in deaths and injuries, Louisiana reenacted the universal helmet
law and saw the total number of motorcyclist deaths decline in 2004 and
2005.


Florida repealed its universal helmet law in 2000. After the repeal,
helmet wear decreased from 100 to 53 percent, motorcycle deaths
increased by almost 50 percent, and the number of serious brain injuries
doubled. An estimated 117 motorcycle deaths in Florida could have been
avoided from 2001 to 2002 if the universal law had remained in place.


The most recent study examining the results of a helmet law repeal was
completed in 2008 by the University of Pittsburgh. The study looked at
motorcycle injuries and fatalities in Pennsylvania for the 2 years
before and after Pennsylvania limited its motorcycle law to riders with
limited experience and riders and passengers under age 21. In the 2
years after Pennsylvania changed its law, the number of non-head injury
deaths increased 25 percent, but the number of head injury deaths
increased by 66 percent. Motorcycle-related head injury hospitalizations
increased an astounding 78 percent compared to 28 percent for non-head
injury hospitalizations. The increase in the number of head injury
deaths or hospitalizations significantly outpaced the increase in the
number of motorcycle registrations. Acute care hospital charges for
motor-cycle related head injuries increased 132 percent, and the number
of head-injured hospitalized motorcyclists requiring additional care at
other facilities, such as rehabilitation or long-term care, increased 87
percent, compared with a 16 increase for non-head injured motorcyclists.


The results of this legislative "experiment" on motorcycle riders are
the same in every state where it has been performed. When universal
helmet laws are repealed, helmet usage rates decrease dramatically, and
motorcycle deaths and injuries increase markedly, even when accounting
for the changes in ridership that may be associated with the repeal of
the universal law. It is likely that hundreds of deaths and thousands of
serious injuries could have been avoided had the states that recently
repealed their universal helmet laws not done so.


Most states that have repealed universal helmet laws recognize that
younger riders may be unable to make a fully informed decision regarding
helmet use. They have, therefore, required that riders under a certain
age wear helmets. These younger riders are likely to be among the least
experienced riders and are the most likely to engage in risky behaviors,
often with an incomplete understanding of potential consequences.
Unfortunately, it is difficult to ascertain the age of a motorcycle
rider for the purposes of enforcing such a requirement without verifying
the rider's age during a traffic stop. As a result, the young
motorcyclist helmet law becomes unenforceable and helmet usage rates for
minors drop dramatically when universal helmet laws are repealed. Thus,
the most vulnerable and least risk-averse segments of the motorcyclist
population are more likely to be unprotected in the absence of universal
laws. Moreover, motorcyclists under age 21 generally represent less than
10% of the national fatality total.



A number of motorcycle-related groups, including the National
Association of State Motorcycle Safety Administrators, the Motorcycle
Safety Foundation, and the American Motorcyclist Association, encourage
riders to wear motorcycle helmets, and most do not oppose laws mandating
such use by minors. The National Agenda for Motorcycle Safety (NAMS)
report, which was supported by NHTSA, the Motorcycle Safety Foundation,
and motorcycle manufacturers such as BMW, Ducati, Harley-Davidson,
American Honda Motor Company, Kawasaki, Suzuki, and Yamaha, included an
urgent recommendation to increase the use of FMVSS 218-compliant
helmets. A national survey performed in 2006 by the Scripps Survey
Research Center at Ohio University noted that, even of those individuals
who had previously ridden a motorcycle without a helmet, 61 percent
favored state legislation requiring motorcycle helmet use.


The NTSB recognizes, however, that some motorcyclists and many
motorcycling organizations oppose mandating the use of motorcycle
helmets by all riders. Most do not argue against the safety benefits of
such helmets; instead, they contend that the government has no role in
protecting the individual from foreseeable adverse outcomes if the
individual chooses not to be so protected.


In the 1980s, opponents of seat belt use laws similarly asserted their
personal freedom to drive without wearing seat belts. However, in 1985,
the Motor Vehicle Manufacturers Association stated, "the evidence is
clear and dramatic ... safety belt users ... experienced 80 percent
fewer deaths from head injuries." NHTSA estimates that from 1975 through
2005, seat belts saved more than 211,000 lives nationwide. During that
same period, all states, except New Hampshire, enacted mandatory seat
belt use laws; and usage rates have increased nationwide from about 12
percent in the early 1970s to 84 percent today. The NTSB is confident
that there is ample evidence that similar life saving results can be
achieved through motorcycle helmet laws that apply to all riders and
passengers.


The argument regarding helmet laws is often framed in terms of personal
choice (for example, "it's my head"). Such an argument typically invokes
the idea that motorcyclists are only hurting themselves by deciding to
ride unprotected. For more than 14 years, the NTSB has been responsible
for assisting families of those killed and injured in transportation
accidents. We do not accept the notion that surviving friends and family
are not affected when riders decide not to wear a helmet and are killed
or injured.


Societal Costs


In addition to family and friends, society as a whole pays the
well-documented excess costs for unhelmeted riders: medical care costs
and the potentially even greater costs from productivity losses of
individuals injured, disabled, or killed. Especially tragic are the
fatalities and injuries involving unhelmeted riders in accidents that
would have required only a new helmet and cosmetic repairs to the
motorcycle, had the rider been wearing a protective helmet.


The costs of motorcycle crashes and the effect of helmets on these costs
were presented at the NTSB's 2006 forum by Dr. Ted Miller, Director of
the Public Services Research Institute at the Pacific Institute for
Research and Evaluation. According to Dr. Miller, in 2005, 110,000
motorcyclists were involved in police reported motorcycle crashes, and
the motorcycle crash injuries cost $17.5 billion, including the costs of
medical treatment, lost work, and quality of life. Although unhelmeted
motorcyclists accounted for 36 percent of all motorcycle crashes, they
represented 70 percent of the total cost of those crashes or $12.2
billion. Dr. Miller also estimated the 2005 average cost per
crash-involved motorcyclist as $71,000 for helmeted and $310,000 for
unhelmeted motorcyclists. Thus, in a time of tight public budgets, it
would not be fiscally prudent to create a situation that will
foreseeably increase the need for resources, mostly public resources, to
care for injured motorcyclists and their families.


It is because of the costs to society and survivors that personal
freedoms must be balanced with the need to protect individuals from
preventable illness, injuries, and fatalities. We are likely to hear
passionate debate today about the personal freedom of motorcycle riders
to not wear helmets. However, the remarkable effectiveness of universal
helmet laws in preventing death and disability among motorcyclists
operating on public roads, particularly in light of rising rates and
total numbers of individuals killed and injured in motorcycle crashes
across our country, is a powerful argument for the adoption and
maintenance of such laws.


Conclusion


L.B. 52 is not good public safety policy. The NTSB opposes its
enactment. We ask the Committee to table this bill. Experience has shown
that when universal helmet laws are weakened, motorcyclist deaths and
injuries rise. The NTSB does not want to see deaths and injuries rising
in Nebraska as we have seen in every state that has taken a repeal
action.


Thank you, Madam Chair and Committee members for this opportunity to
testify in opposition to this bill. I would be happy to answer any
questions.