Abstract
BACKGROUND: The effectiveness of helmet use in preventing or reducing the severity of head injuries has been largely demonstrated. However, the effectiveness of different types of helmets in reducing facial or non-facial head injuries has received much less attention. METHODS: A postal survey on motorized two-wheeler crashes was conducted in 2016. 7148 riders of motorized two-wheelers (MTW) injured in a crash between 2010 and 2014 and identified in the Rhône Trauma Registry were invited to complete a questionnaire in order to collect detailed information about their accidents. The analysis was based on a population of 405 helmeted riders who declared having received an impact on the head. Facial and non-facial head injury risks were estimated according to helmet type (full face or other) by logistic regression, controlled for type of object hit by the head (and gender for risk of non-facial head injury), and weighted to take nonresponse into account. RESULTS: Three-quarter of helmeted MTW drivers were wearing a full-face helmet at the time of the accident. Victims wearing a full-face helmet were about three times less likely to have sustained injury to the face, compared to victims wearing another type of helmet (adjusted OR = 0.31; 95% CI: 0.11-0.83). On the other hand, the presence of non-facial head injury did not vary significantly according to whether a full-face or other helmet was worn (adjusted OR = 0.84; 95% CI: 0.33-2.13). CONCLUSIONS: Our study suggests that full-face helmets provide better facial protection for MTW users compared to other types of helmets, whereas there is no evidence of any difference in protection afforded the skull or the brain.