Presentation prepared by Dan Petterson, Ed.D. April, 2017 Summary of Michigan Motorcyclist Crash Data with focus on the five year periods prior to and after all-rider helmet law repeal Presentation prepared by Dan Petterson, Ed.D. April, 2017 Copyright 2017 - SMARTER

The Source for the Majority of the Data Displayed in the Following Charts Traffic Crash Reporting System, Criminal Justice Information Center. Motorcycle Helmet Traffic Crash Statistics. Data for date range of January 1 to December 31 for the years 2012-2016. Data provided on April 17, 2017. Copyright 2017 - SMARTER

Michigan Motorcyclist Fatalities per Year 1992 - 2016 1992 = 31, 2005 = 121, 2015 = 138 and 2016 = 141. Highest number recorded was in 1973 = 209. 1988 - 2004 was a low period of 55-90 fatalities per year. 2005 was a jump to 122 & fatalities have remained high. We need to go back to 1985 when there were 144 fatalities to exceed the 2015 and 2016 # of 138 and 141. Copyright 2017 - SMARTER

Michigan Motorcyclist Fatalities 2007 - 2016 2009 = 103, 2011 = 109, 2014 = 107. 2015 at 138 and 2016 at 141 = the highest number in 30 years. Copyright 2017 - SMARTER

Average Fatalities per Year Pre & Post All-rider Helmet Repeal The average # of fatalities per year for the 5 year period before the helmet law repeal was 118. The average number of fatalities for the 5 years after the helmet law repeal was 129. The main factor that contributes to a difference in fatalities from year to year is exposure (which is primarily dictated by weather) however averaging 5 year periods is a way to account for these year to year differences leaving the helmet repeal as a main differentiating factor between the periods. Copyright 2017 - SMARTER

Michigan MC Registrations 2007 - 2016 Exposure (how many riders are on the road) is a main contributing factor to the fatality count. Registrations is one way to estimate exposure – the more motorcycles registered, the more can be expected to be on the road. The low in 2007 = 243, 656. The high in 2012 = 266, 589. The 10 year average is 258, 168. These numbers are from the MIDOS and accessed in early August of each year except 2016 is a average of the previous 5 years as MIDOS did not collect the data in Aug. of 2016. Copyright 2017 - SMARTER

Average Registrations Pre & Post Repeal 2007 low of 243,656, 2007 – 2011 Average = 256, 973. Average 2012 – 2016 = 259,363. About 2,400 difference in average. High is 2012 at 266,168 Copyright 2017 - SMARTER

Fatality Rate per 100,000 Registrations The most often used statistic to account for increases or decreases in fatality numbers because of an increase or decrease in the number of riders on the road is Fatality Rate per 100,000 registrations. To calculate the fatality rate per 100,000 registered motorcycles, first divide the total registrations by 100,000 (Example 275,000 ∙/∙ 100,000 =2.75). Second divide the number of fatalities (120) by 2.75= 43.6 fatality rate (fatalities per 100,000 registered motorcycles. As can be seen, there is an upward trend in Fatality Rate per 100,000 registrations in the five year period since the helmet law was repealed. Copyright 2017 - SMARTER

Average Fatality Rate – Registrations Pre & Post Repeal 2007 – 2011 = 45.93 and 2012 – 2016 = 49.65. More riders are dying per 100,000 registrations post repeal. 3.41 riders per 100,000 registrations x 2.58 (the 10 year average registrations of 258,000) = 8.80 additional deaths per year post repeal. 9 deaths per year x 5 years means = 45 unnecessary deaths since helmet repeal. Copyright 2017 - SMARTER

Fatality Rate per Million Population 2007 - 2016 Another way to attempt to account for exposure – the number of riders on the road is to calculate the fatality rate per million population. (1) Reduce population in millions to three decimal places. For example, Michigan’s 2012 population of 9,884,781 would be 9.885 million. Then simply divide the number of MC fatalities 2012 = 128) by 9.885 to get Fatality Rate per million population. For 2012 = 12.94 To calculate the fatality rate per million population change the population in millions to a 3 place decimal (9,999,000 million becomes 9.999. Then divide the fatalities by that number. For 2016 population = 9,928,300 which becomes 9.928 , then divide 138 fatalities by 9.928 = 13.90 Copyright 2017 - SMARTER

Average Fatality Rate per Million Population – Pre & Post Repeal 2007 – 2011 = 11.89 and 2012 - 2016 = 13.04. One additional person per million population. MI population is just below 10 million = about 10 additional deaths per year. So fatality rate per 100,000 registrations indicates an estimated 9 lives lost per year due to helmet repeal and fatality rate per million population indicates an estimated 10 lives lost per year due to helmet repeal. Copyright 2017 - SMARTER

Crash/fatality Ratio 2007 - 2016 This chart answers the question: How many crashes does it take to produce a fatality? The higher the number the better which would indicate riders are more often surviving crashes. As the number goes down it means fewer riders are surviving their crash – main factors that contribute to not surviving are (1) multi-vehicle vs. single vehicle (2) crashing at higher speed and (3) reduced protective gear. Copyright 2017 - SMARTER

Average Crash/Fatality Ratio Pre – Post Repeal Averaging the 5 year periods is one way to attempt to account for type of crash and speed (we have nothing to indicate that there are major differences in type and speed comparing the two five year periods) but there is certainly a difference in protective gear use. Pre-repeal a death occurred once every 30 crashes, post repeal a death occurs once every 25 crashes. Copyright 2017 - SMARTER

Percent Helmet Use - Fatalities 2008 - 2016 This chart displays the change in helmet use among fatally injured motorcyclists (data for 2007 not available). Note – this is not the same as use among all riders on the road but the numbers are similar. A motorcycle helmet use survey in the State of Michigan was conducted in 2006 through funding from the Michigan Office of Highway Safety Planning (OHSP) (Data, T.K., McAvoy, D, and Grillo, L. Motorcycle Protective Gear Use Observational Survey – Final Report. Wayne State University, Michigan Office of Highway Safety Planning, Lansing, Michigan, 2006.). This survey was conducted concurrently with the 2006 post-Click it or Ticket (CIOT) safety belt use survey. In the 2006 survey, a total of 2,274 motorcycle riders were observed and the overall usage rate among all riders was 99.4 percent. The most recent survey was conducted throughout the summer of 2013 by the Wayne State University Transportation Research Group and found a rate average rate of 73% which mirrored the helmet use rate among crash-involved motorcyclists. Helmet use was highest for those riding sport bikes at 94.5 percent. It was lowest for riders of choppers and custom bikes at 33.3 percent. Women were more likely to wear a helmet at 59.6 percent, compared to men at 55.2 percent. Riders 60 and older had the highest helmet use rate at 70 percent, while riders 30 to 59 years old had the lowest use rate at 50.8 percent. (2013 Direct Observation Survey of Motorcycle Helmet Use – Final Report, Savolainen, P, Gates, T, Morden, J, and Hacker, E., September 2013.) Copyright 2017 - SMARTER

Helmet Choice % Compared to % of Fatalities This chart shows the % of riders wearing helmets or not involved in crashes versus the percent of fatalities. In all years for helmet wearers the percent of riders in the crash population exceeds the percent of fatalities by helmet wearers. The exact opposite is true for riders choosing not to wear a helmet – the percent of non-helmet wearers in the crash population is less than the percent of fatalities for unhelmeted. For 2016, 61.40% of riders in crashes were wearing helmets but only 44.29 % of fatalities were wearing helmets. 28.81 % of riders in crashes were not wearing helmets but 50 % of the fatalities were not wearing a helmet. Copyright 2017 - SMARTER

“Death Rate” Crash Victims by Helmet Use This is another way to look at the data regarding helmet use choice and fatalities. Unhelmeted riders involved in crashes die at more than 2x the rate of riders wearing helmets. Less than 3 helmeted rider die per 100 crashes compared to more that 6 unhelmeted riders per 100 crashes. Copyright 2017 - SMARTER

Actual Fatalities Compared to Predicted Fatalities had all Riders in Crashes died at the Rate of Riders Wearing Helmets The difference in “death rate” – the rate at which riders die (helmet group/no helmet group) allows calculate the lower predicted total fatalities if all riders had worn helmets – assuming that all would have died at the yearly helmet wearers rate. In 2016 the actual # of fatalities was 140 – the predicted number had all rider worn helmets is 101. Copyright 2017 - SMARTER

Five year Total of Predicted vs. Actual Fatalities This chart displays the 5 year summary of predicted number of death had all rider in crashes died at the lower helmeted wearer rate versus the actual number of fatalities because riders choosing not to wear a helmet died at more than twice the rate of helmeted riders (except 2015 when the rate was slightly less than 2x). Predicted had all riders worn a helmet = 479. Actual = 644. This mean that a potential 165 riders died because we no longer have an all-rider helmet law. Is 33 deaths per year worth the freedom for a few to ride without a helmet? Copyright 2017 - SMARTER

Michigan Specific Research Five Important Reports Chapman AJ, Titus R, Ferenchick H, Davis A, Rodriguez C. Repeal of the Michigan helmet law: early clinical impacts. Am J Surg. 2014; 207(3):352–356. Flannagan Carol A.C, Bowman Patrick J. Analysis of Motorcycle Crashes in Michigan 2009-2012. UMTRI-2014-35 November, 2014. Rebecca H. Striker, D.O. , Alistair J. Chapman, M.D., Rachel A. Titus, M.D., Alan T. Davis, Ph.D., Carlos H. Rodriguez, M.D., F.A.C.S. Repeal of the Michigan helmet law: the evolving clinical impact. Am J Surg. Volume 211, Issue 3, March 2016, Pages 529–533. Patrick M. Carter, MD, Lisa Buckley, PhD, Carol A. C. Flannagan, PhD, Jessica B. Cicchino, PhD, Mark Hemmila, MD, Patrick J. Bowman, MS, Farideh Almani, MS, and C. Raymond Bingham, PhD. The Impact of Michigan’s Partial Repeal of the Universal Motorcycle Helmet Law on Helmet Use, Fatalities, and Head Injuries. American Journal of Public Health, November 2016. Nicholas S. Adams et al. The Effects of Motorcycle Helmet Legislation on Craniomaxillofacial Injuries, Plastic and Reconstructive Surgery (2017). Copyright 2017 - SMARTER

Repeal of the Michigan helmet law: early clinical impacts. RESULTS After the repeal, nonhelmeted motorcyclists rose from 7% to 29%. There was no difference in mortality rate after admission; however, Crash scene fatalities increased significantly. Intensive care unit length of stay, mechanical ventilation time, and cost of stay were also higher in the nonhelmeted cohort. CONCLUSIONS Our study highlights the negative ramifications of repealing a mandatory helmet law. Motorcyclists not wearing helmets increased significantly in a short period of time. Nonhelmeted motorcyclists more frequently died on the scene, spent more time in the intensive care unit, required longer ventilator support, and had higher medical costs. Copyright 2017 - SMARTER

Analysis of Motorcycle Crashes in Michigan 2009-2012. Key results: In the crash population, helmet use dropped from 98% in 2008-2011 to 74% in 2012 and 2013 after modification of the helmet law. Before and after the modification, the percentage of out-of-state riders who were involved in Michigan crashes has remained stable at 5%. This is one way of estimating whether there has been any change in out-of-state ridership after the modification. Helmet use rates for crash-involved riders age 16-20 dropped from 97% before the modification to 86% afterwards. Riders without motorcycle endorsements are somewhat less likely to wear a helmet, compared those with endorsements. Risk of fatality is 2.8 times higher for motorcycle riders who are not wearing a helmet. Risk of incapacitating injury is 1.4 times higher for motorcycle riders who are not wearing a helmet. The fatality rate in 2013 is the highest in 5 years at 3.6% of crash-involved riders. The overall rate since the modification is 8% higher than the overall rate for the three previous years. Regression models were used to estimate the number of fatalities and serious injuries attributable to changes in helmet use since the modification. Based on these models, 20% (24 per year) of fatalities and 10% (71 per year) of serious injuries were estimated to have resulted from reduced helmet use after the helmet-law modification. Copyright 2017 - SMARTER

Repeal of the Michigan helmet law: the evolving clinical impact. RESULTS: Nonhelmeted riders increased from 7% to 28% after the repeal. Nonhelmeted crash scene fatalities were higher after the repeal. The nonhelmeted cohort had significantly higher in-patient mortality. The nonhelmeted cohort had significantly higher injury severity score. The nonhelmeted cohort had significantly higher abbreviated injury scale head. Nonhelmeted riders had increased alcohol use, intensive care unit length of stay and need for mechanical ventilation. The median hospital cost for the non-helmeted cohort was higher. CONCLUSIONS: The impact of the Michigan helmet law repeal continues to evolve. Three years after this legislative change, we are now observing increased injury severity score, higher in-patient mortality, and worse neurologic injury. Copyright 2017 - SMARTER

The Impact of Michigan’s Partial Repeal of the Universal Motorcycle Helmet Law on Helmet Use, Fatalities, and Head Injuries. FINDINGS Helmet use decreased in crash involved riders after repeal Helmet use decreased in trauma involved riders after repeal Overall fatalities did not change Head injuries and neurosurgical intervention increased after repeal Helmet nonuse, alcohol intoxication, intersection crashes and crashes at higher speed limits increased fatality risk. Helmet nonuse and alcohol intoxication increased odds of head injury. Conclusions Michigan’s helmet law repeal resulted in a 24% to27% helmet use decline among riders in crashes and a 14% increase in head injury. Copyright 2017 - SMARTER

The Effects of Motorcycle Helmet Legislation on Craniomaxillofacial Injuries CMF injuries were analyzed 3 yrs. before and 3 yrs. after law change Under the new law, the proportion of motorcycle trauma patients who were riding w/o helmets more than doubled Compared to helmeted patients, those not wearing helmets were about twice as likely to sustain CMF injuries The difference was significant for both fractures and soft tissue injuries. Patients w/o helmets has higher injury severity scores Before & after the change in the helmet law, unhelmeted patients had higher blood alcohol content. Copyright 2017 - SMARTER

Conclusion Five years of data and five Michigan specific research studies show: Repealing our all-rider helmet law was a tragic, costly and deadly mistake Copyright 2017 - SMARTER