| PREVENTION
OF BRAIN INJURY [ back
to Brain Injury 101 ]
Because traumatic brain injury is not reversible or curable,
at our current level of medical knowledge and skill,
prevention is still the best way to avoid the disabling
effects of a TBI. Remarkably adults still ride in cars without
wearing their seatbelts, and they still forget or neglect
to properly fasten infant car seats. A tragic example from
the newspapers is the needless death of Kansas CIty Chiefs
linebacker Derrick Thomas 2/8/2000. He suffered head injuries
and severance of his cervical spinal cord from a car accident,
because he chose not to wear his seatbelt while
driving with friends at night in bad weather. On 1/30/2000
the national BIA reported that 30% of children still ride
unrestrained in cars, and that 85% of infant car seats are
not properly fastened. A new TBI occurs every 15 seconds in
our country. Each day one child dies and 50 others sustain
permanent brain injuries from bicycle accidents. Nationally
the rate of helmet wearing by child cyclists is very low.
This is not acceptable.
However, there are some bright spots. In Seattle, WA, physicians
Abe Bergman and Fred Rivara developed a program for subsidized
production of safer bike helmets with instruction on
proper usage for school age children, and reduced the rate
of TBIs from childhood cycling accidents by two-thirds. BMW
has just begun selling a car with improved seat and headrest
design to lower the incidence of TBI in rear-end auto crashes.
NHTSA is taking steps to reduce the incidence of TBI. One
example is collecting and releasing data concerning the relative
risk that a given automobile will "roll over" in
an accident along with an easy to understand ranking scale.
Another, is its recommendation that all states enact laws
to require child safety seats for all children lighter than
80 pounds. As of August 2000 California was moving to enact
a law requiring car safety seats for children younger than
6 or lighter than 60 pounds.
Here in California, as a result of lobbying by our state brain
injury association, the legislature enacted a helmet law effective
1/1/92 requiring all motorcycle riders to wear a helmet. In
1991 there were 512 deaths and 16,910 injuries from motorcycle
crashes in California. Although motorcyclists made up just
4.2% of licensed drivers, they accounted for 11.3% of all
motor vehicle fatalities and 17.5% of all severe injuries,
and most of them did not carry medical insurance, so taxpayers
footed the huge health care bills to treat their catastrophic
head injuries. As a result of that law, and police enforcement,
fatalities from motorcycle accidents dropped 30% and injuries
dropped 20% in 1992, and have continued to decline since then.
Consequently total medical care costs for injured motorcyclists
dropped by $35 million (a 35% reduction) in 1993. See, "Putting
a Lid on Injury Costs: The Economic Impact of the California
Motorcycle Helmet Law." by Wendy Max, Phd et al. in Journal
of Trauma, Injury, Infection and Critical Care Vol. 45, Issue
3 (Sept. 1998). Yet, every year Harley Davidson finances a
sophisticated lobbying effort to repeal that law, and every
year the Brain Injury Association of California Board of Directors
must drive to Sacramento and counter-lobby legislators to
block repeal, and save the law. Traffic fines for non-compliance
with the motor cycle helmet law have raised over $1 million
per year for public funding of TBI rehab services to persons
who cannot afford it.
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