Association of alcohol use with helmet use in cyclists: analysis of the National Trauma Data Bank.

Cross-sectionalTrauma surgery & acute care open· 2026

Association of alcohol use with helmet use in cyclists: analysis of the National Trauma Data Bank.

Daniel C Brock, Gaibo Yan, Chad T Wilson, Emanuel Narcis Husu

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Public Health & General Preventive MedicineCross-sectionalQ2IF 1.7

Helmet use in cyclists dropped sharply as blood alcohol level rose

Association of alcohol use with helmet use in cyclists: analysis of the National Trauma Data Bank.

Daniel C Brock … Emanuel Narcis Husu

Trauma surgery & acute care open · 2026

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.

Purpose

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).

n = 51

Results

sober cyclists wore helmets far more often than those who had been drinking

Sober

45.9%

Impaired

19.9%

Intoxicated

9.8%

Multidrug intoxicated

6.2%

More results

Alcohol use was associated with a dose-response decrease in helmet use.

Alcohol use was associated with higher mortality rates (OR=2.3; p<0.001) and a greater proportion of injuries in the head and neck region (OR=1.4; p<0.001).

More results

Alcohol use when cycling was significantly associated with comorbid alcohol, tobacco, and substance use disorders (p<0.001).

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Conclusion · 1 of 2

Alcohol use demonstrated a significant dose-response relationship with helmet non-usage among cyclists, particularly among those with substance use disorders.

Conclusion · 2 of 2

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.

Association of alcohol use with helmet use in cyclists: analysis of the National Trauma Data Bank.

Association of alcohol use with helmet use in cyclists: analysis of the National Trauma Data Bank.

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