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Alcohol is a risk factor for helmet non-use and fatalities in off-road vehicle and motorcycle crashes

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Objectives

Off-road vehicle (ORV) and motorcycle use is common in Canada; however, risk of serious injury is heightened when these vehicles are operated without helmets and under the influence of alcohol. This study evaluated the impact of alcohol intoxication on helmet non-use and mortality among ORV and motorcycle crashes.

Methods

Using data collected from the Nova Scotia Trauma Registry, a retrospective analysis (2002–2017) of ORV and motorcycle crashes resulting in major traumatic brain injury was performed. Patients were grouped by blood alcohol concentration (BAC) as negative (< 2 mmol/L), legally intoxicated (2-17.3 mmol/L) or criminally intoxicated (> 17.3 mmol/L). Logistic regression models were constructed to test for helmet non-use and mortality.

Results

A total of 424 trauma patients were included in the analysis (220 ORV, 204 motorcycle). Less than half (45%) of patients involved in ORV crashes were wearing helmets and 65% were criminally intoxicated. Most patients involved in motorcycle crashes were helmeted at time of injury (88.7%) and 18% were criminally intoxicated. Those with criminal levels of intoxication had 3.7 times the odds of being unhelmeted and were 3 times more likely to die prehospital compared to BAC negative patients. There were significantly increased odds of in-hospital mortality among those with both legal (OR = 5.63), and criminal intoxication levels (OR = 4.97) compared to patients who were BAC negative.

Conclusion

Alcohol intoxication is more frequently observed in ORV versus motorcycle crashes. Criminal intoxication is associated with helmet non-use. Any level of intoxication is a predictor of increased in-hospital mortality.

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Data availability

No datasets were generated or analysed during the current study.

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Acknowledgements

The authors acknowledge the support provided by Beth Sealy and Karen Ssebazza, Registry Coordinators of the Nova Scotia Trauma Registry. Data used in this research was made available by the Nova Scotia Department of Health and Wellness. Any opinions expressed by the authors do not necessarily reflect the opinion of the Nova Scotia Department of Health and Wellness or the Nova Scotia Health Trauma Program.

Funding

This study was funded by a grant from the Nova Scotia Department of Health and Wellness.

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Authors and Affiliations

  1. Department of Surgery, Division of Neurosurgery, Dalhousie University, Halifax, NS, B3H 4R2, Canada

    Nelofar Kureshi, Simon Walling & David B. Clarke

  2. Nova Scotia Health Trauma Program, Nova Scotia Health, Rm 1-026B Centennial Building, 1276 South Park Street, Halifax, NS, B3H 2Y9, Canada

    Mete Erdogan, Izabella Opra & Robert S. Green

  3. Department of Emergency Medicine, Dalhousie University, Halifax, NS, B3H 4R2, Canada

    Robert S. Green

  4. Department of Critical Care, Dalhousie University, Halifax, NS, B3H 4R2, Canada

    Robert S. Green

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  1. Nelofar Kureshi
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Contributions

N.K, D.B.C, M.E., and R.G were involved in the conceptualization, methodology, analysis, and writing. S.W and I.O were involved in the methodology, analysis, and writing. All authors reviewed the final manuscript.

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Correspondence to Nelofar Kureshi.

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Kureshi, N., Walling, S., Erdogan, M. et al. Alcohol is a risk factor for helmet non-use and fatalities in off-road vehicle and motorcycle crashes. Eur J Trauma Emerg Surg (2024). https://doi.org/10.1007/s00068-024-02572-1

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