Impact of safe community program on motorcyclists' safety with focus on helmet usage in 14 cities of IR Iran

The aim of this study was to evaluate the effectiveness of safe community interventions on motorcyclists' safety. Two cross sectional observations were conducted in 14 cities (five safe community practicing and nine safe community non-practicing cities) independently on 2005 and 2007. Ten percent of registered motorcycles were observed and interviewed (n=1114 in each observation). 87.9% used motorcycle for commercial purposes. All motorcyclists were male and mostly aged 18–29 years old. Death rate significantly rose from 122 to 254 per 100000 motorcyclists in Fars province since the first observation (p < 0.0001). Helmet usage rate was constant (13%). Recorded crashes increased from 16.4% to 23.1% in safe community setting (p < 0.0001). 11% carried more than one pillion. Heat disturbances, embarrassment, hearing blockage, and negligence were the most mentioned excuses for not using helmet. Law enforcement, public education, accessibility to helmets on discount rate, new legislation and, finally, access to new designed helmet were the most suggestions made by motorcyclists to promote helmet usage. No significant effect was noticed between two settings except in injury registration system in safe community. Community involvement in the safety programs could ensure sustainability of initiatives and continuity of interventions in safe communities.     

Road traffic injury among child motorcyclists in Vientiane Capital,Laos: a cross-sectional study using a hospital-based injury surveillance database

This study investigated the distribution of motorcyclists, including drivers and passengers, who were involved in road traffic crashes and admitted to hospital in Vientiane Capital, Laos. The focus was on child motorcycle drivers and passengers under 15 years. A hospital-based injury surveillance database in Vientiane Capital was used. The surveillance was performed in two hospitals. From 1 September to 31 December 2009, 3968 patients were admitted to the participating hospitals with road traffic injuries. Patients under 15 years accounted for 10.8% (427/3968). The majority of patients under 15 years were motorcycle drivers or passengers (71.7%, 306/427). Child motorcyclists including drivers and passengers were less likely to wear a helmet than adults (adjusted odds ratio [OR], 0.3, 95% confidence interval [CI], 0.2–0.5, for children 10–14 years; adjusted OR: 0.1, 95% CI, 0.05–0.4, for children under 10 years). It is suggested that stricter regulation enforcement for child motorcycle drivers and passengers may be needed. In addition, barriers against wearing helmets for motorcycle drivers and passengers in Laos should also be examined in further studies.     

Motorcycle helmet use in Mar del Plata,Argentina: prevalence and associated factors

Injuries resulting from motorcycle crashes constitute a growing problem in Argentina and other Latin American countries. The problem is aggravated because helmet use is not widespread. This observational study analysed the prevalence of helmet use and related factors in a city in Argentina. The sample consisted of 2542 observations of motorcyclists. The results show an incidence of helmet use of 69.8% for drives and 43.4% for passengers. Helmet use was greater among women. Environmental and temporal conditions were related with the rate of helmet use. The findings indicate a considerable increase in helmet use with respect to prior years, providing evidence in favour of government policies. However, the number of motorcycles in circulation has tripled in the past five years, and therefore, the public health impact of injuries due to motorcycle crashes persists.     

A local bicycle helmet ‘law’ in a Swedish municipality – the structure and process of initiation and implementation

On May 1, 1996, the Municipality of Motala in Sweden introduced a local bicycle helmet ‘law.’ It is, however, not an official law in a legal sense, but a municipally endorsed recommendation supported by promotional activities. This ‘law’ applies to children (ages 6–12), although the objective is to increase helmet use among cyclists of all ages. The study is a qualitative evaluation of the structure and process during initiation and implementation of the Motala bicycle helmet law. The aim was to describe the activities that were carried out, which actors took part and the opinions of the most closely involved actors. The results are based on analysis of written material and on interviews with eight of the actors. The mass media focused much attention on the bicycle helmet law, especially during the first six months after its introduction. The name helmet law was presumably of significance in this context. It is essential that relevant target groups provide sufficient support and that committed individuals initiate and promote the work, which, however, must not become dependent on a single individual. All issues concerning bicycle helmets should be coordinated with the law. Also, continuous engagement of the municipal government and a strategy for the control and follow-up of the law are needed. Local bicycle helmet laws of this type have a potential to produce a long-lasting effect on helmet use, provided some of the problems encountered can be avoided and some of the promotional activities are intensified.     

Effectiveness of interventions to prevent motorcycle injuries: systematic review of the literature

Globally, 49% of deaths from traffic crashes occur among vulnerable road users, including pedestrians, bicyclists, and motorcyclists. Approximately, a quarter of those killed are motorcyclists. The authors carried out a systematic review of the literature to evaluate the effectiveness of interventions to prevent motorcycle crashes and the associated morbidity and mortality. The studies included in this review provide evidence for the effectiveness of helmet use, protective clothing, training, and penalties for alcohol consumption and speeding in preventing injury and death to motorcyclists. The use of helmets is effective, especially if it is universally required by law for drivers and passengers. Training to obtain a license also has positive effects but not when it is totally voluntary. There is limited but consistent evidence that strengthening laws for penalties related to alcohol consumption or speeding has an impact on risk. Traffic calming interventions could help reduce crashes in urban areas. In jurisdictions where there is limited regulation or adherence to effective measures, such as the use of helmets, efforts should be directed primarily at expanding such practices. In other areas, efforts can focus on approaches based on alternative effective measures or on more innovative interventions adapted to local conditions.     

An application of the theory of planned behaviour to understand compliance with daytime running headlights law among motorcycle riders

Abstract

Fatal motorcycle crashes are a persistent problem in Southeast Asia. In many respects, road safety experts have acknowledged conspicuity issue as one of the main causes of such accidents. To mitigate this deficiency, daytime running headlights (DRHs) law has been documented among the widely exercised countermeasures. The present study aimed to explore socio-psychological factors shaping intentions towards use of DRHs among Malaysian motorcyclists, because compliance level with this rule has remained constant since 1996 (80%). For this purpose, a model was constructed through the Theory of Planned Behaviour (TPB) to evaluate factors affecting motorcyclists’ intentions towards compliance with DRHs law. A series of statistical analyses were performed to explain the effect of these factors and to predict degree of compliance with this rule. The model applied on a sample of university students (N?=?398) demonstrated that the TPB components could significantly predict motorcycle riders’ behaviours and degree of compliance with DRHs law. Moreover, it would be of assistance to policy-makers to recognize groups of motorcyclists more likely to cause an increase in traffic accidents. In general, regular educational campaigns were recommended to raise awareness regarding consequences of not using DRHs and also to nurture factors influencing motorcyclists’ attitudes towards DRHs.     

A local bicycle helmet ‘law’ in a Swedish municipality – the effects on helmet use

The municipality of Motala in Sweden introduced a local bicycle helmet ‘law’ on May 1, 1996. This is not a legally enacted ordinance, but instead a legislated recommendation backed up by information and education. Formally, the law applies to children (aged 6–12 years), although the intention is to increase helmet use by all cyclists. The objective of the present study was to quantitatively evaluate the impact of the Motala helmet law on observed use of helmets by children and adults. Bicycle helmet use was monitored in Motala (n = 2,458/year) and in control towns (n = 17,818/year) both before and after adoption of the helmet law (1995–1998). Chi-square tests showed that helmet wearing 1995–1998 increased in Motala among all bicyclists (from 6.1% to 10.5%) and adults biking on cycle paths (from 1.8% to 7.6%). Helmet use by school children aged 6–12 increased during the first 6 months after introduction of the law (from 65.0% to 75.7%) but then progressively decreased to the pre-law level. Considering children cycling on cycle paths and for recreation in housing areas, there was a tendency towards increased helmet use during the first post-law year, but this was followed by a reduction to a lower level in 1998 than in 1995. Logistic regression analysis taking into account data from the control towns indicated that the helmet law had a positive effect on children cycling to schools during the first 6 months, and a weak delayed but more long-term positive effect on adult cyclists on cycle paths. There were no positive effects on children in housing areas and on cycle paths. The Motala helmet law probably would have had greater and more lasting effects on helmet use by bicyclists, if certain problems had been avoided during the initiation phase. Moreover, although it did have a positive influence on both school children and adults, it is not legally binding, and hence no penalties can be imposed. Presumably, compulsory legislation would have a more substantial impact on helmet wearing than a non-mandatory helmet ‘law’ such as that introduced in Motala.     

Socio-economic determinants of helmet-wearing behaviour in Pune city,India

This study was an attempt to investigate the socio-economic determinants of helmet wearing in an urban setting of India. A household survey using multistage cluster random sampling was conducted among 9014 individuals in Pune city from March 2008 to February 2009. Among 2259 individuals who reported driving two-wheeled vehicles, 1509 (66.8%) reported possession of a helmet, and among those who had reported possession of a helmet, only 700 (46.0%) reported regular use of helmets. The results of multiple logistic regression analysis showed that residence, type of family, gender and socio-economic status were significantly associated with possession of helmet, and gender, residence and family type were significantly associated with regular helmet use while possessing one. In conclusion, this study showed that helmet-wearing behaviour is mostly influenced by the neighbourhood environment and norms and family and peer influence on behaviour rather than education and economic status.     

Cyclists' helmet usage and characteristics in central and southern Malawi: a cross-sectional study

The objective of this study was to determine the prevalence of, and factors associated with, bicycle helmet usage in southern and central Malawi. This study was across-sectional observation of public behaviour. The urban and rural roadways in southern and central Malawi were studied during the dry season. In total, 1900 bicyclists were observed along the roadways of southern and central Malawi over a four-day period. Observer ascertainment of cyclists' helmet status, approximate age, sex and bicycle operator or passenger status were measured. Of the 1900 cyclists observed, no cyclist was identified as wearing a helmet (exact 95% CI: 0.0–0.2%). There was no variation by age, sex or operator/passenger status. Nearly, 91.5% of observed cyclists were males and 87.7% were operating the bicycle. The sizeable majority of male cyclists were classified as young adults from adolescence to 25 years old (47.2%) or adults over age 25 (44.9%); 7.9% of male cyclists were pre-adolescent. Passengers were more likely to be female than operators (39.1% versus 4.2%), though, even for passengers, a higher proportion were males than females (p < 0.001). In Malawi, helmet usage is so rare as to be non-existent. This suggests an opportunity for significant improvement. Based on the observed cyclists' characteristics, interventions should be targeted to adult and young adult males.     

Measuring compliance with Viet Nam's mandatory motorcycle helmet legislation

The objective of this roadside observational study was to monitor helmet wearing among motorcycle riders and passengers in three provinces (Yen Bai, Da Nang and Binh Duong) in the Socialist Republic of Viet Nam, before and after a mandatory helmet law took effect on 15 December 2007. A total of 665,428 motorcycle riders and passengers were observed between November 2007 and February 2011 at 45 randomly selected sites covering the entire road network. Across all locations and time periods, correct helmet wearing averaged 40.1% before the law and 92.5% after; however, there were significant differences between time points and locations. The Viet Nam Government's decision to require all motorcycle riders and passengers to wear helmets has been thoroughly implemented nation wide and the results show that high wearing has been sustained. Further study is required on how high helmet wearing has and will translate into a reduction in motorcycle head injuries; however, Viet Nam's motorcycle helmet legislation should be seen as an important policy example for other low- and middle-income countries with a high utilization of motorcycles for personal transport.     

Pillion riders' cloth related injuries and helmet wearing patterns: a study of Lahore,Pakistan

This study aims at investigating the burden and pattern of clothing related pillion riders' injuries and their helmet wearing pattern in Lahore, Pakistan. Data were collected for nine months (July 2013 to March 2014), reporting 13,248 motorcycle related injuries, out of which 8751 (66%) cases were related to the clothing related pillion riders' injuries. Out of these injuries 10.30% were severe injuries which can be prevented or reduced by proper safety measure, e.g. wearing helmet. It was also found that most of the fatalities were not wearing helmet. Injuries due to wearing of loose fitting clothes and absence of helmet are not uncommon in Pakistan and other underdeveloped parts of the world. Such accidents may be reduced by creating awareness and safety sense in the riders, where use of safe dress and helmet should be encouraged in order to avoid such fatal damages.     

Factors associated with child passenger motorcycle helmet use in Cambodia

This study examines factors associated with child passenger helmet use in five Cambodian provinces. We performed an analysis of periodic roadside observations of helmet use over a four-year period. A total of 62,039 child passengers 12 years of age and younger met inclusion criteria and were included in the analysis. Overall, 1369 (2.1%) of child passengers were observed to be wearing a helmet. Most significantly, children were six times more likely to wear a helmet if the driver was wearing a helmet (OR 6.2; 95% CI 5.1–7.5). In addition, the odds of helmet use were noted to be significantly different depending on province, day of the week, time of day and number of passengers on the motorcycle. This study highlights the extremely low rate of child passenger helmet use in Cambodia, and provides priorities for interventions and enforcement to ensure all children are protected from head injury.     

Matched analysis of parent’s and children’s attitudes and practices towards motor vehicle and bicycle safety: an important information gap

The purpose of this study was to compare parents’ and children’s attitudes and habits towards use of bicycle helmets and car seat belts. We hypothesized that parental perception of their children’s safety practices did not reflect actual behavior and further, that parental practices, rather than their beliefs about a particular safety practice, have a greater affect on their child’s risk-taking behavior. The study population consisted of children in grades four and five and their parents/guardians. Participation in the cross-sectional study was voluntary and confidential anonymous questionnaires were used. In separate and independent surveys, children and parents were questioned in parallel about their knowledge, habits and attitudes toward bicycle helmet use and car safety practices. In the study, 731 students participated with 329 matched child-parent pairs. Ninety-five percent of the children own bicycles and 88% have helmets. Seventy percent of parents report their child always wears a helmet, while only 51% of children report always wearing one (p &lt; 0.05). One-fifth of the children never wear a helmet, whereas parents think only 4% of their children never use one (p &lt; 0.05). Parents report their children wear seat belts 92% of the time while 30% of children report not wearing one. Thirty-eight percent of children ride bicycles with their parents and wear their helmets more often than those who do not ride with their parents (p &lt; 0.05). Parents who always wear a seat belt are more likely to have children who sit in the back seat and wear a seat belt (p &lt; 0.05). Parents’ perceptions of their children’s safety practices may not be accurate and their actions do affect their children’s. Injury prevention programs that target both parents and children may have a greater impact on reducing risk-taking behaviors than working with each group in isolation.     

Fatal motorcycle crashes: a growing public health problem in Cambodia

This study examines the risk characteristics of fatal motorcycle crashes in Cambodia over a 5-year period (2007–2011). Secondary data analyses were conducted using the Cambodia Road Crash and Victim Information System, the only comprehensive and integrated road crash surveillance system in the country. Researchers from the Centers for Disease Control and Prevention and Handicap International found that (1) males are dying in motorcycle crashes roughly seven times more frequently than females; (2) motorcyclist fatalities increased by about 30% from 2007 to 2011; (3) the motorcyclist death rates per 100,000 population increased from 7.4 to 8.7 deaths from 2007 to 2011; and (4) speed-related crashes and not wearing motorcycle helmet were commonly reported for motorcyclist fatalities at approximately 50% and over 80% through the study years, respectively. Additionally, this study highlights that Cambodia has the highest motorcycle death rate in South-East Asia, far surpassing Thailand, Malaysia, and Myanmar. By recognising the patterns of fatal motorcycle crashes in Cambodia, local road-safety champions and stakeholders can design targeted interventions and preventative measures to improve road safety among motorcyclists.     

Motorcycle Helmet Laws: A Case Study of Consumer Protection

This study examines the losses to society from federal legislation in 1976 on state motorcycle helmet laws. Two major responses were (1) repeal of helmet laws or failure to enact laws and (2) modification of helmet laws. Losses ranged from $75 million to $244 million for states without helmet laws and from $71 million to $229 million for states with modified helmet laws. Comprehensive state helmet laws would have been cost effective with cost-benefit ratios ranging from 0.05 to 0.18. The fact that thirty-one states did not have comprehensive helmet laws in 1981 raises questions concerning the degree that society should intervene on behalf of consumers.