Novelty helmet use and motorcycle rider fatality.

OBJECTIVES: To compare the risk of fatal injury across helmet types among collision-involved motorcyclists. METHODS: We used data from a cohort of motorcyclists involved in police-reported traffic collisions. Eighty-four law enforcement agencies in California collected detailed information on helmet and rider characteristics during collision investigations in June 2012 through July 2013. Multiply-adjusted risk ratios were estimated with log-binomial regression. RESULTS: The adjusted fatal injury risk ratio for novelty helmets was 1.95 (95% CI 1.11-3.40, p 0.019), comparing novelty helmets with full-face helmets. The risk ratios for modular, open-face, and half-helmets, compared with full-face helmets, were not significant. CONCLUSIONS: A more complete understanding of the inadequacy of novelty helmets can be used in educational and law enforcement countermeasures to improve helmet use among motorcycling populations in California and other US states. Law enforcement approaches to mitigating novelty helmet use would seem attractive given that novelty helmets can be visually identified by law enforcement officers with sufficient training.