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November 11, 1992

Helmets for Motor Cyclists: Lower Fatal Head Injury Rate but More Crashes Mean More Study

Author Affiliations

Walnut Creek, Calif

JAMA. 1992;268(18):2518. doi:10.1001/jama.1992.03490180050023

To the Editor.  —I read with interest the data presented by Sosin and Sacks1 regarding motorcycle helmet-use laws. I found the data particularly interesting in that the lower rate of death due to head injury was countered by a higher crash rate, resulting in comparable overall death rates.The authors suggest, but in no way demonstrate, that the higher crash rate "may reflect riskier conditions, riskier behaviors, or differences in crash reporting." There do not appear to be adequate data to exclude the increased helmet use itself as a possible cause of the increased crash rate. Notwithstanding the studies cited by Sosin and Sacks, decreased sensory input or other mechanisms not yet studied might be implicated in the increased crash rate.I feel that further study into this question is needed. Until such time as the increased crash rate and the lack of improvement in overall mortality can be