[Epidemiology of scooter accidents in Italy: the effectiveness of mandatory use of helmets in preventing incidence and severity of head trauma].

The article refers to two surveillance studies, conducted the first in the city of Rome and Naples, in 1999, and the second only in Rome before and after the implementation of the new law on mandatory use of helmet (1999-2000). Personal data, accident circumstances, helmet use, others involved in accident and health data were collected. In the first study we found that only 12% of injured people wear a helmet. Head trauma seems to be influenced by helmet use, with a nearly sixfold increase among non-users (RR = 5.73), while injuries to thorax, abdomen and extremity occurred with identical frequency in helmeted and unhelmeted scooter riders. After adjusting for possible confounders, helmet use has a protective effect in respect to head injury (OR = 0.23; 95% CI: 0.026-0.482). In the pre-post legem study we found that in 1999, injured not wearing a helmet represented 95% of the total injured, while in the two periods of 2000 this percentage dropped to 2.8% and 10% respectively. The number of accidents increased in the second period of 2000, but the number of lesions decreased, especially those affecting head (12.43% in 1999, 7.8% e 3.85% in the first and second period of 2000), and a sensible reduction in the use of head imaging diagnostics was also recorded. Mean length of stay for injured scooter riders was 7.1 days in 1999, 8.7 days in the first period of 2000, and 5.6 days in the second period of 2000. The surveillance studies confirmed that helmet use has a protective effect in all the periods considered reducing the probability of head trauma by 3-4 times.