臺灣安全帽立法後對頭部外傷的成效評估

Analysis of the Effect on Head Injury after the Implementation of Motorcycle Helmet Law in Taiwan

王文玲(Wang Wen-Lin)

指導教授 ： 邱文達

臺北醫學大學/公共衛生暨營養學院/公共衛生學研究所/碩士(2000年)

摘要

由於機車具有經濟、輕便等優點，目前為台灣地區重要且很普遍的交通運輸工具，機車帶來許多便捷的優點，但由於機車穩定性差，缺乏相關應變配備，使得機車騎乘者變成交通事故中絕對的弱者；事故發生時更常因頭部外傷而致命，造成社會上巨大損失。因此台灣地區於1997年6月1日開始實施強制戴安全帽立法，規範機車騎士及乘客需強制戴安全帽，違者罰鍰新台幣五百元，對機車騎士及乘客有所保護。 本研究為確實瞭解機車使用者戴安全帽對預防頭部外傷的效果，係以台灣地區28家地區級以上教學醫院以合作調查的方式，收集87年6月1日至88年6月30日止醫院機車事故頭部外傷發生案例、嚴重度、預後結果，來分析安全帽法案對機車事故頭部外傷防治之影響，以評估機車安全帽對頭部外傷之功效。 本研究以結構式問卷抄錄各合作醫院之機車事故外傷病歷記錄，共收集機車外傷病歷5900例，並與中央健保局對頭部外傷件數及醫療費用支出的情形、交通大隊機車事故案例資料作一分析，藉以比較騎乘機車強制戴安全帽之成效。研究結果發現立法後機車車禍之頭部外傷事故比立法前明顯減少；顱內出血病例數及手術數亦明顯降低，死亡人數減少，預後結果良好則有意義的增加。另事故傷亡特性以19-29歲為主、道路行駛速限40(含)公里以上等特性傷亡較嚴重，由於目前安全帽使用率又有降低的現象，因此必須強而有力的貫徹執行戴安全帽的法令並訂定各段道路行車速限並加強宣導，如此才能挽救更多的生命。

關鍵字

機車事故 ； 安全帽 ； 頭部外傷

並列摘要

Because of its convenience, riding motorcycle is one of the major mean of transportation. There are many motorcycle-related traffic accidents reported daily. The causes of head injury-related death of motorcyclist in most accidents are due to motorcycle’s mechanical structure which has only two wheels but no steel shell for protection. Motorcyclist helmet law has been approved and enforced on the June 1, 1997 with the intention to reduce the mortality and morbidity. Violation is a fine of NT $ 500.00. This study was designed to examine the influence of helmet law in the prevention of head injury. Clinical records are collected from 28 major teaching hospitals from June 1, 1998 to June 30, 1999, to evaluate the effect of helmet law as reflected by its incidence, severity, mortality and of the head injurice as well as morbidity outcomes of the treatment for head injuries. A total of 5,900 cases were collected under the cooperation of the 28 teaching institutions, National Health Insurance Department, and Department of Transportation. The numbers of incidence, intracranial hematoma, mortality, and surgery rate were significantly declined after the implementation of the law. In addition, the surgical outcomes of surgical treatment were also improved. The highest incidence rate of motorcycle accident was observed in the age group of 19-29 years; whereas the most severe outcome was found among motorcyclists who ride above the speed limit of 40 km/h. Currently, the enforcement is less strictive and helmet use rate has been dropping. Stronger implementation of the helmet law and speed limit should be more strictly enforced, and further public education about motorcycle safety should be carried out to save more civilian life.

並列關鍵字

Motorcycle Accident ； Helmet ； Head Injury

參考文獻

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