Abstract
Background
Helmet use significantly reduces the risk of traumatic brain injury among cyclists; however, the influence of alcohol use on helmet-wearing adherence remains understudied in large national data sets. The goal of this study was to investigate the relationship between alcohol use and helmet use in injured cyclists.
Methods
This study is a retrospective cross-sectional analysis of 155 766 cyclists with traumatic injuries from the National Trauma Data Bank spanning 8 years (2017–2023). Cyclists were categorized by blood alcohol concentration (BAC) as follows: not screened, sober (BAC
Results
Alcohol use was associated with a dose-response decrease in helmet use. Helmet adherence was 45.9% in sober cyclists (n=51 566), compared with 19.9% in impaired (n=1592), 9.8% in intoxicated (n=8327), and 6.2% in multidrug intoxicated cyclists (n=3823; p
Conclusions
Alcohol use demonstrated a significant dose-response relationship with helmet non-usage among cyclists, particularly among those with substance use disorders. This relationship represents a critical public safety concern requiring further investigation to address its public health implications.
Level of Evidence
Retrospective Epidemiologic/Prognostic study, Level III.