To wear a helmet or not to wear a helmet?

In most states, motorcyclists don’t have to make the decision — the answer is a resounding “yes.” But Iowa remains one of three states without a mandatory motorcycle helmet law in spite of an increasing number of fatalities over the past decade.

“Wearing a helmet is very important,” said Azeem Ahmed, a UI clinical associate professor of emergency medicine. “In my career as an emergency physician, I’ve seen patients who otherwise did not have any major bodily injury but died or were severely disabled because of a head injury.”

In 1996, Iowa saw a modern-day low in its number of motorcycle fatalities, with 16 motorcyclists losing their lives on Iowa roadways, according to the state Department of Transportation.

But things have changed.

In 2007, the state recorded 61 motorcycle fatalities, a 25-year high. Only eight of those killed were wearing helmets, and the trend has continued into 2008 and 2009, said Scott Falb, a driver-safety specialist with the Iowa DOT.

One explanation for the increase in fatalities is a corresponding rise in motorcycle registration. In 1996, there were 108,670, compared with 153,273 in 2007, according to the Iowa DOT.

Falb said two factors contribute to the pattern. One is the high price of gasoline for cars. The other is baby boomers, many of whom rode motorcycles before they had children and are once again making the transition from four wheels to two.

“After the children had left home, they found themselves with a disposable income and a renewed interest in motorcycling,” Falb said. “They’re coming in with a much larger bike, often with too little practice and too big of jump between [previous decades] and now in terms of [motorcycle] size, and we’re seeing that in our statistics.”

In 2007, motorcyclists between the ages of 45 and 54 made up nearly one-third of Iowa’s 61 fatalities. Only two were wearing helmets.

Still, many motorcyclists don’t want anyone telling them what to do.

Rod Holst, the 41-year-old owner of Iowa City Motorsports, 155 Escort Lane, said he and the majority of his customers are against helmet laws — regardless of their effectiveness.

Still, they voluntarily wear helmets some of the time.

“Helmets are a safety thing. They’re great,” he said. “I just don’t want to be forced to wear one.”

Neither does Iowa City motorcyclist Don Patten, 54, who said he never wears a helmet because he believes they block vision and hearing.

“You’ve gotta ride [motorcycles] with respect if you’re gonna ride one,” he said. “[Wearing a helmet] oughta be up to the individual; let those who ride decide.”

Statistically, it may seem like an easy decision. Numerous studies have shown fatality rates are lower in states with universal helmet laws than in those whose laws cover some or — in the case of Iowa, Illinois, and New Hampshire — no riders, according to the Insurance Institute for Highway Safety and the Highway Loss Data Institute.

It’s not that Iowa lawmakers haven’t considered such laws. In fact, the state implemented a universal helmet law from Sept. 1, 1975, to July 1, 1976, when the government pressured states to pass helmet laws. States that did not comply risked having some of their highway funds taken away and put toward safety program funds, Falb said.

During those 10 months, motorcycle fatality rates were 30 percent lower than in the same time period the following year, according to the Iowa Governor’s Traffic Safety Bureau and the Iowa DOT.

But the law was obviously short-lived. Soon after the government stopped pressuring states, Iowa lawmakers — who were taking heat from motorcyclists who opposed the law — repealed it, Falb said.

But a statement of support is not enough, some say. Pete Leehey, a Cedar Rapids personal injury lawyer who focuses on helping victims of motorcycle accidents, said “there is no active effort underway to reinstate a helmet law in Iowa.”

For now, the decision may be a simple question of comfort.

“It really boils down to, ‘Do I want a hard plastic thing on my head for hours at a time?’ ” said Iowa City police Sgt. Troy Kelsay, a motorcyclist. While Kelsay said he always wears a helmet when required by law, he admitted wearing one just doesn’t seem essential.

“I feel uncomfortable if I get in a car and don’t buckle my seat belt,” Kelsay said. “But I don’t have that same sense when I get on a motorcycle.”