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Comparative Study
. 2014 Sep 16:73:25191.
doi: 10.3402/ijch.v73.25191. eCollection 2014.

Helmet use among Alaskan children involved in off-road motorized vehicle crashes

Christopher W Snyder  1 , Oliver J Muensterer  2 , Frank Sacco  3 , Shawn D Safford  4
Affiliations
Comparative Study

Helmet use among Alaskan children involved in off-road motorized vehicle crashes

Christopher W Snyder et al. Int J Circumpolar Health. .

Abstract

Background: Off-road motorized vehicle crashes are a common source of trauma among Alaska children. Injury morbidity is worse in Alaska Native children than non-Native children, but the reasons are unclear.

Objective: To evaluate the differences in helmet use between the Native and the non-Native children, and to assess the impact of helmet use on injury patterns and outcomes.

Design: This retrospective cohort study identified patients aged 17 or younger admitted after all-terrain vehicle, snowmobile or motorbike injury between 2001 and 2011 from the Alaska Trauma Registry. Helmeted and non-helmeted patients were compared with respect to demographics, central nervous system (CNS) injury and the overall risk of death or permanent disability. Logistic regression was used to evaluate predictors of helmet use and the effects of ethnicity and helmet use on outcomes.

Results: Of the 921 injured children, 51% were Alaska Native and 49% were non-Native. Helmet use was lower among Native versus non-Native patients on unadjusted comparison (24% vs. 71%) and multivariable logistic regression (OR 0.17, 95% CI 0.11-0.27, p<0.0001). Prevalence of CNS injury was higher among Native children (39.7% vs. 30.4%, p=0.016). However, on logistic regression with adjustment for helmet use, Native ethnicity was not a significant predictor of CNS injury (OR 1.07, 95% CI 0.68-1.68, p=0.78), whereas helmet use was strongly protective against CNS injury (OR 0.28, 95% CI 0.18-0.44, p<0.0001) as well as death or permanent disability (OR 0.26, 95% CI 0.10-0.67, p=0.006).

Conclusions: Helmet use is lower among Alaska Native children involved in off-road motorized vehicle crashes. These ethnic disparities in helmet use contribute to higher rates of CNS injury among Native children. Helmet use significantly improves overall outcome. Helmet promotion efforts should be expanded, especially in Native communities.

Keywords: Alaska; all-terrain vehicle; helmet; motorbike; snowmobile; traumatic brain injury.

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Figures

Fig. 1
Fig. 1
Prevalence of CNS injury after off-road motorized vehicle crash among Alaskan children by ethnicity.
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