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Shool S, Piri SM, Ghodsi Z, Tabrizi R, Amirzade-Iranaq MH, Mashayekhi M, Dabbagh Ohadi MA, Mojtabavi K, Abbasnezhad R, Vasighi K, Atlasi R, Ansari-Moghaddam A, Taghi Heydari S, Sharif-Alhoseini M, Shafieian M, O'Reilly G, Rahimi-Movaghar V. The prevalence of helmet use in motorcyclists around the world: a systematic review and meta-analysis of 5,006,476 participants. Int J Inj Contr Saf Promot 2024; 31:431-469. [PMID: 38628097 DOI: 10.1080/17457300.2024.2335509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/13/2024] [Accepted: 03/23/2024] [Indexed: 08/25/2024]
Abstract
Road traffic injuries present a significant public health burden, especially in developing countries. This systematic review and meta-analysis synthesized global evidence on motorcycle helmet use prevalence by including 299 records across 249 articles involving 5,006,476 participants from 1982 to 2022. The findings revealed a declining trend in helmet use prevalence over the past four decades, with an overall prevalence of 48.71%. The meta-regression analysis did not find any statistically significant change in the overall prevalence. Subgroup analysis showed higher helmet use prevalence in observation/survey records (54.29%) compared to crashed patient records (44.84%). Riders/Motorcyclists demonstrated a higher likelihood of wearing helmets than passengers in both observation/survey records (62.61 vs. 28.23%) and crashed patient records (47.76 vs. 26.61%). Countries with mandatory helmet use laws had higher helmet usage prevalence compared to those without (52.26 vs. 37.21%). The African continent had the lowest helmet use rates, while Latin America and the Caribbean regions had higher rates. This study provides a comprehensive overview of global helmet use prevalence, emphasizing disparities between high and low-income countries, variations in law enforcement, and trends over four decades. Targeted interventions are necessary to improve helmet-wearing habits, especially among passengers and regions with low usage rates. Effective legislation and awareness campaigns are crucial for promoting helmet use and reducing road traffic injuries burden.
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Affiliation(s)
- Sina Shool
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Piri
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Ghodsi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Tabrizi
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Mohammad Hosein Amirzade-Iranaq
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Universal Network of Interdisciplinary Research in Oral and Maxillofacial Surgery (UNIROMS), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mahdieh Mashayekhi
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Kurosh Mojtabavi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reyhane Abbasnezhad
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kasra Vasighi
- Department of Occupational Therapy, School of Paramedical Sciences, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Rasha Atlasi
- Evidence based Practice Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Seyed Taghi Heydari
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahdi Sharif-Alhoseini
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Shafieian
- Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Gerard O'Reilly
- Emergency and Trauma Centre, Alfred Health, Melbourne, Australia
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
- National Trauma and Research Institute, Alfred Health, Melbourne, Australia
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
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Goel R, Tiwari G, Varghese M, Bhalla K, Agrawal G, Saini G, Jha A, John D, Saran A, White H, Mohan D. Effectiveness of road safety interventions: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1367. [PMID: 38188231 PMCID: PMC10765170 DOI: 10.1002/cl2.1367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Background Road Traffic injuries (RTI) are among the top ten leading causes of death in the world resulting in 1.35 million deaths every year, about 93% of which occur in low- and middle-income countries (LMICs). Despite several global resolutions to reduce traffic injuries, they have continued to grow in many countries. Many high-income countries have successfully reduced RTI by using a public health approach and implementing evidence-based interventions. As many LMICs develop their highway infrastructure, adopting a similar scientific approach towards road safety is crucial. The evidence also needs to be evaluated to assess external validity because measures that have worked in high-income countries may not translate equally well to other contexts. An evidence gap map for RTI is the first step towards understanding what evidence is available, from where, and the key gaps in knowledge. Objectives The objective of this evidence gap map (EGM) is to identify existing evidence from all effectiveness studies and systematic reviews related to road safety interventions. In addition, the EGM identifies gaps in evidence where new primary studies and systematic reviews could add value. This will help direct future research and discussions based on systematic evidence towards the approaches and interventions which are most effective in the road safety sector. This could enable the generation of evidence for informing policy at global, regional or national levels. Search Methods The EGM includes systematic reviews and impact evaluations assessing the effect of interventions for RTI reported in academic databases, organization websites, and grey literature sources. The studies were searched up to December 2019. Selection Criteria The interventions were divided into five broad categories: (a) human factors (e.g., enforcement or road user education), (b) road design, infrastructure and traffic control, (c) legal and institutional framework, (d) post-crash pre-hospital care, and (e) vehicle factors (except car design for occupant protection) and protective devices. Included studies reported two primary outcomes: fatal crashes and non-fatal injury crashes; and four intermediate outcomes: change in use of seat belts, change in use of helmets, change in speed, and change in alcohol/drug use. Studies were excluded if they did not report injury or fatality as one of the outcomes. Data Collection and Analysis The EGM is presented in the form of a matrix with two primary dimensions: interventions (rows) and outcomes (columns). Additional dimensions are country income groups, region, quality level for systematic reviews, type of study design used (e.g., case-control), type of road user studied (e.g., pedestrian, cyclists), age groups, and road type. The EGM is available online where the matrix of interventions and outcomes can be filtered by one or more dimensions. The webpage includes a bibliography of the selected studies and titles and abstracts available for preview. Quality appraisal for systematic reviews was conducted using a critical appraisal tool for systematic reviews, AMSTAR 2. Main Results The EGM identified 1859 studies of which 322 were systematic reviews, 7 were protocol studies and 1530 were impact evaluations. Some studies included more than one intervention, outcome, study method, or study region. The studies were distributed among intervention categories as: human factors (n = 771), road design, infrastructure and traffic control (n = 661), legal and institutional framework (n = 424), post-crash pre-hospital care (n = 118) and vehicle factors and protective devices (n = 111). Fatal crashes as outcomes were reported in 1414 records and non-fatal injury crashes in 1252 records. Among the four intermediate outcomes, speed was most commonly reported (n = 298) followed by alcohol (n = 206), use of seatbelts (n = 167), and use of helmets (n = 66). Ninety-six percent of the studies were reported from high-income countries (HIC), 4.5% from upper-middle-income countries, and only 1.4% from lower-middle and low-income countries. There were 25 systematic reviews of high quality, 4 of moderate quality, and 293 of low quality. Authors' Conclusions The EGM shows that the distribution of available road safety evidence is skewed across the world. A vast majority of the literature is from HICs. In contrast, only a small fraction of the literature reports on the many LMICs that are fast expanding their road infrastructure, experiencing rapid changes in traffic patterns, and witnessing growth in road injuries. This bias in literature explains why many interventions that are of high importance in the context of LMICs remain poorly studied. Besides, many interventions that have been tested only in HICs may not work equally effectively in LMICs. Another important finding was that a large majority of systematic reviews are of low quality. The scarcity of evidence on many important interventions and lack of good quality evidence-synthesis have significant implications for future road safety research and practice in LMICs. The EGM presented here will help identify priority areas for researchers, while directing practitioners and policy makers towards proven interventions.
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Affiliation(s)
- Rahul Goel
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | - Geetam Tiwari
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | | | - Kavi Bhalla
- Department of Public Health SciencesUniversity of ChicagoChicagoIllinoisUSA
| | - Girish Agrawal
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | | | - Abhaya Jha
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | - Denny John
- Faculty of Life and Allied Health SciencesM S Ramaiah University of Applied Sciences, BangaloreKarnatakaIndia
| | | | | | - Dinesh Mohan
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
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Tirwa M, Joshi P, Sinha AP, Dolma Y, Singh M. A Study to Assess the Awareness and Practices of Helmet Use among Two-Wheeler Riders in Delhi. INDIAN JOURNAL OF NEUROTRAUMA 2022. [DOI: 10.1055/s-0041-1739477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Abstract
Objectives To assess the awareness and practice of two-wheeler riders regarding the helmet use, and to determine the association of awareness and practices with selected variables.
Setting and Design This article is a descriptive survey, which was completed at All India Institute of Medical Sciences (AIIMS) premises, New Delhi, India.
Materials and Methods The pretested and validated tools developed by researcher consisted of demographic sheet (8 items) along with structured awareness and practice questionnaire.
Results and Conclusions Maximum participants were male (71.06%) with majority riding for 8 years. As much as 48% of the sample population had accidents while driving. Only 2.9% of them reported to have sustained severe injury during these accidents. The mean awareness and practice score related to helmet use were 49.58 ± 6.019.75 ± 5.56. There was weak correlation between awareness and practice. Association of awareness and practices with selected variables could not be observed (p-value—0.4870). Although public awareness is present, but law needs to be more stringent. Accidents are fatal and it can happen anywhere and anytime, irrespective of long or short distance, and wearing of helmet can save a person from major injuries.
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Affiliation(s)
- Milan Tirwa
- College of Nursing, All India Institute of Medical Sciences, New Delhi, India
| | - Poonam Joshi
- College of Nursing, All India Institute of Medical Sciences, New Delhi, India
| | - Aditi P Sinha
- College of Nursing, All India Institute of Medical Sciences, New Delhi, India
| | - Yangchen Dolma
- College of Nursing, All India Institute of Medical Sciences, New Delhi, India
| | - Man Singh
- College of Nursing, All India Institute of Medical Sciences, New Delhi, India
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Akbari M, Lankarani KB, Tabrizi R, Vali M, Heydari ST, Motevalian SA, Sullman MJ. The effect of motorcycle safety campaign on helmet use: A systematic review and meta-analysis. IATSS RESEARCH 2021. [DOI: 10.1016/j.iatssr.2021.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Berrick J, Gkritza K. Adolescent noncompliance with age-specific versus universal US motorcycle helmet laws: Systematic review and meta-analysis. JOURNAL OF SAFETY RESEARCH 2021; 76:166-175. [PMID: 33653548 DOI: 10.1016/j.jsr.2020.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 09/18/2020] [Accepted: 12/15/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The U.S. experience with motorcycle helmets affords an important insight into the responses of adolescents to age-specific laws. Political contention has led to a number of U.S. state law changes back and forth between universal and age-specific laws. Because both kinds of law require adolescent motorcyclists to wear helmets, relatively few studies have focused on how the law type affects their behavior. METHOD Differential behavior is tested by a systematic review of literature, leading to a meta-analysis, in relation to the experience of various states' motorcycle helmet laws. An electronic search was conducted for before-and-after studies in U.S. states that include data on adolescent helmet usage - both with a universally applicable motorcycle helmet law, and with an age-restricted law (usually, under-21 or under-18) - from observational, injury or fatality records for a certain period (e.g., 12 months) pre and post the state law change. RESULTS The search yielded ten studies, including two that compared a set of age-specific law states with a set of universal law states over the same time period. Heterogeneity analysis of seven single-state studies with raw data revealed an acceptable fit for a random-effects model. Additional noncompliance with age-restricted laws was indicated by an attributable percentage among exposed of over 65% and odds ratio exceeding 4. CONCLUSIONS About two-thirds of adolescent noncompliance with age-restricted motorcycle helmet usage laws disappears with universal applicability. Evidence from numerous international studies of youth reaction to helmet laws suggests that a large part of the greater compliance with universal laws is due to their conveying a more convincing message that helmets afford protection against injury. Practical Applications: The meta-analysis provides fresh, young-rider perspective on the continuing debate over motorcycle-helmet laws. Broader insight into adolescent psychology suggests considering alternatives to age-restricted laws more widely in safety and health policy.
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Affiliation(s)
- Jon Berrick
- Science Division, Yale-NUS College, 10 College Avenue West #01-101, Singapore 138609, Singapore.
| | - Konstantina Gkritza
- Lyles School of Civil Engineering and Department of Agricultural & Biological Engineering, Purdue University, 550 Stadium Mall Dr, West Lafayette, IN 47907-2093, USA
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Adewoye KR, Aremu SK, Olomofe CO, Adeniyi AM, Agbana RD, Abioye OO, Issa YF. The prevalence and determinants of helmet use amongst commercial motorcyclists in Ido-Osi local government area. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2019; 75:358-364. [PMID: 31599212 DOI: 10.1080/19338244.2019.1673692] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Commercial motorcycle (CM) accidents constitute a major public concern in Nigeria. There is 8:10 chance that injuries resulting from these accidents are severe and debilitating including head and spinal injuries. This study is aimed at producing useful data on the prevalence, frequency, and determinants of helmet use among commercial motorcyclist in Ido-Osi Local Government Area, Ekiti State, Nigeria. The study was a descriptive/cross-sectional study. A total of 360 respondents were selected by multi-stage sampling technique and interviewed using assisted self-administered, semi-structured questionnaire. Data were analyzed using SPSS version 21. Determinants of helmet use examined included age, educational level, marital status and religion. There was a 100% response rate. More than half of the respondents were within the age range of 20-29 years 164(53.6%) with the mean age of the study participants 29.9. The prevalence of helmet usage among commercial motorcyclist was 23.5%. The commonest reason for not using a crash helmet in this study was non-availability. The commonest reason for the non-availability of the welding helmet was the cost of the helmet. Less than half of the respondents were able to show or present helmet although some of the helmet presented were sub-standard (39.7%). The study also revealed irregular use of helmets among the respondents that used a helmet while riding a motorcycle as only 2.7% of them used it for all the five riding sessions assessed in this study. There was a statistically significant relationship between age, educational level, marital status and the use of helmets among respondents with p values of 0.005, 0.027, and 0.009, respectively. The prevalence of the use of helmets among the motorcyclist in this study is low despite the high level of awareness of legislation among the respondents on the use of helmets during riding. There is a need for the government to make provision for a safety helmet for this group of people at a subsidized rate if it cannot be given free of charge because of the economic situation of the country. There is a need to carry out behavioral change communication for this group of people.
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Affiliation(s)
- Kayode Rasaq Adewoye
- Department of Community Medicine Federal Teaching Hospital, Ido Ekiti/Afe Babalola University, Ado-Ekiti, Nigeria
| | - Shuaib Kayode Aremu
- ENT Department, Federal Teaching Hospital Ido-Ekiti/Afe Babalola University, Ado-Ekiti, Nigeria
| | | | | | - Richard Dele Agbana
- Department of Community Medicine, College of Medicine and Health Science, Afe Babalola University, Ado-Ekiti, Nigeria
| | | | - Yusuf Funsho Issa
- Department of Community Health, Kwara State University, Malete, Nigeria
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German CA, Soontornmon K, Singkham P, Tanasugarn L, Thienmongkol R, Weeranakin N, Tamura H, Nishi A. A Systematic Review on Epidemiology and Promotion of Motorcycle Helmet Use in Thailand. Asia Pac J Public Health 2019; 31:384-395. [DOI: 10.1177/1010539519860733] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. Road traffic accidents are the fourth leading cause of death in the entire population, and the first among the youth (ages 15-19 years) in Thailand. The situation in Thailand is worse than in neighboring low- to middle-income countries in the Southeast Asia region. Seventy-three percent of the deaths in the country are motorcycle drivers or passengers. Although motorcyclists (both drivers and passengers) have been obligated to wear helmets by law, the prevalence of helmet use nationwide is not high (43.7% in 2010). Methods. We performed a systematic review to examine potential social determinants of helmet use behavior (observational studies) and to summarize previous intervention studies to promote helmet use (interventional studies) in the country. Studies were identified in PubMed and Web of Science, and by additional review of Thai-written literature. Results. We identified 16 relevant studies for social determinants of helmet use and 5 relevant studies for promoting helmet use in Thailand. Our review shows that several factors such as teens and children (age), women (gender), rural areas (geography), and alcohol drinking (interaction with another behavior) are associated with non-helmet use. We also identified 4 interventional studies implemented in Thailand: 1 law enforcement program and 4 community-based educational programs. Although all the studies improved the prevalence of helmet use after the interventions, only 2 studies exceeded 50%. Conclusion. There is consistent evidence that being younger, being a woman, living in non-Bangkok areas, and drinking alcohol are associated with non-helmet use among motorcycle users in Thailand. We also observed that the effect of past intervention programs is limited.
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Affiliation(s)
| | | | - Phathai Singkham
- Bureau of Non-communicable Disease, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Lokachet Tanasugarn
- University of California Los Angeles, CA, USA
- Mahidol University, Bangkok, Thailand
| | | | | | - Hiroshi Tamura
- Kyoto University, Kyoto, Japan
- Kyoto University Hospital, Kyoto, Japan
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Muni K, Kobusingye O, Mock C, Hughes JP, Hurvitz PM, Guthrie B. Motorcycle taxi programme is associated with reduced risk of road traffic crash among motorcycle taxi drivers in Kampala, Uganda. Int J Inj Contr Saf Promot 2019; 26:294-301. [PMID: 31180261 PMCID: PMC8862663 DOI: 10.1080/17457300.2019.1594952] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
SafeBoda is a transportation company that provides road safety training and helmets to its motorcycle taxi drivers in Kampala. We sought to determine whether risk of road traffic crash (RTC) was lower in SafeBoda compared to regular (non-SafeBoda) motorcycle taxi drivers during a 6-month follow-up period. We collected participant demographic and behavioural data at baseline using computer-assisted personal interview, and occurrence of RTC every 2 months using text messaging and telephone interview from a cohort of 342 drivers. There were 85 crashes (31 in SafeBoda and 54 in regular drivers) during follow-up. Over the 6-month follow-up period, SafeBoda drivers were 39% less likely to be involved in a RTC than regular drivers after adjusting for age, possession of a driver's license, and education (RR: 0.61, 95% CI: 0.39-0.97, p = .04). These findings suggest that the SafeBoda programme results in safer driving and fewer RTCs among motorcycle taxi drivers in Kampala.
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Affiliation(s)
- Kennedy Muni
- a Department of Epidemiology, University of Washington , Seattle , WA , USA
| | - Olive Kobusingye
- b Department of Disease Control and Environmental Health, Makerere University , Kampala , Uganda
| | - Charlie Mock
- a Department of Epidemiology, University of Washington , Seattle , WA , USA.,c Department of Global Health, University of Washington , Seattle , WA , USA.,d Department of Surgery, University of Washington , Seattle , WA , USA
| | - James P Hughes
- e Department of Biostatistics, University of Washington , Seattle , WA , USA
| | - Philip M Hurvitz
- f Department of Urban Design and Planning, University of Washington , Seattle , WA , USA
| | - Brandon Guthrie
- a Department of Epidemiology, University of Washington , Seattle , WA , USA.,c Department of Global Health, University of Washington , Seattle , WA , USA
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Nishi A, Singkham P, Takasaki Y, Ichikawa M, Chadbunchachai W, Shibuya K, Tanasugarn C. Motorcycle helmet use to reduce road traffic deaths in Thailand. Bull World Health Organ 2019; 96:514-514A. [PMID: 30104787 PMCID: PMC6083397 DOI: 10.2471/blt.18.215509] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Akihiro Nishi
- Department of Epidemiology, University of California, Los Angeles Fielding School of Public Health, 650 Charles E Young Dr S, Los Angeles, California 90095, United States of America
| | - Phathai Singkham
- Bureau of Noncommunicable Diseases, Ministry of Public Health, Nonthaburi, Thailand
| | - Yohsuke Takasaki
- The Partnership Project for Global Health and Universal Health Coverage, Japan International Cooperation Agency, Bangkok, Thailand
| | - Masao Ichikawa
- Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Witaya Chadbunchachai
- World Health Organization Collaborating Centre for Injury Prevention and Safety Promotion, Khon Kaen Regional Hospital, Khon Kaen, Thailand
| | - Kenji Shibuya
- Institute of Global Health Policy Research, National Center for Global Health and Medicine, Tokyo, Japan
| | - Chanuantong Tanasugarn
- Department of Health Education and Behavioral Sciences, Mahidol University, Bangkok, Thailand
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Muni K, Kobusingye O, Mock C, Hughes JP, Hurvitz PM, Guthrie B. Motorcycle taxi programme increases safe riding behaviours among its drivers in Kampala, Uganda. Inj Prev 2018; 26:5-10. [PMID: 30472678 PMCID: PMC8841091 DOI: 10.1136/injuryprev-2018-043008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 10/29/2018] [Accepted: 11/03/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND SafeBoda is a motorcycle taxi company that provides road safety training and helmets to its drivers in Kampala, Uganda. We sought to determine whether SafeBoda drivers are more likely to engage in safe riding behaviours than regular drivers (motorcycle taxi drivers not part of SafeBoda). METHODS : We measured riding behaviours in SafeBoda and regular drivers through: (1) computer-assisted personal interview (CAPI), where 400 drivers were asked about their riding behaviours (eg, helmet and mobile phone use) and (2) roadside observation, where riding behaviours were observed in 3000 boda-boda drivers and their passengers along major roads in Kampala. RESULTS Across the two cross-sectional studies, a higher proportion of SafeBoda drivers than regular drivers engaged in safe riding behaviours. For instance, helmet use among SafeBoda compared with regular drivers was 21% points higher (95% CI 0.15 to 0.27; p<0.001) based on the CAPI and 45% points higher (95% CI 0.43 to 0.47; p<0.001) based on roadside observation. Furthermore, compared with regular drivers, SafeBoda drivers were more likely to report having a driver's license (66.3% vs 33.5 %; p<0.001) and a reflective jacket (99.5% vs 50.5 %; p<0.001) and were less likely to report driving towards oncoming traffic (4% vs 45.7 %; p<0.001) in the past 30 days. CONCLUSION The SafeBoda programme is associated with increased safe riding behaviours among motorcycle taxi drivers in Kampala. Therefore, the promotion and expansion of such programmes may lead to a reduction in morbidity and mortality due to road injuries.
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Affiliation(s)
- Kennedy Muni
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Olive Kobusingye
- Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda
| | - Charles Mock
- Department of Epidemiology, University of Washington, Seattle, Washington, USA.,Department of Global Health, University of Washington, Seattle, Washington, USA.,Department of Surgery, University of Washington, Seattle, Washington, USA
| | - James P Hughes
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Philip M Hurvitz
- Department of Urban Design and Planning, University of Washington, Seattle, Washington, USA
| | - Brandon Guthrie
- Department of Epidemiology, University of Washington, Seattle, Washington, USA.,Department of Global Health, University of Washington, Seattle, Washington, USA
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Staton C, Vissoci J, Gong E, Toomey N, Wafula R, Abdelgadir J, Zhou Y, Liu C, Pei F, Zick B, Ratliff CD, Rotich C, Jadue N, de Andrade L, von Isenburg M, Hocker M. Road Traffic Injury Prevention Initiatives: A Systematic Review and Metasummary of Effectiveness in Low and Middle Income Countries. PLoS One 2016; 11:e0144971. [PMID: 26735918 PMCID: PMC4703343 DOI: 10.1371/journal.pone.0144971] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 11/25/2015] [Indexed: 11/19/2022] Open
Abstract
Background Road traffic injuries (RTIs) are a growing but neglected global health crisis, requiring effective prevention to promote sustainable safety. Low- and middle-income countries (LMICs) share a disproportionately high burden with 90% of the world’s road traffic deaths, and where RTIs are escalating due to rapid urbanization and motorization. Although several studies have assessed the effectiveness of a specific intervention, no systematic reviews have been conducted summarizing the effectiveness of RTI prevention initiatives specifically performed in LMIC settings; this study will help fill this gap. Methods In accordance with PRISMA guidelines we searched the electronic databases MEDLINE, EMBASE, Scopus, Web of Science, TRID, Lilacs, Scielo and Global Health. Articles were eligible if they considered RTI prevention in LMICs by evaluating a prevention-related intervention with outcome measures of crash, RTI, or death. In addition, a reference and citation analysis was conducted as well as a data quality assessment. A qualitative metasummary approach was used for data analysis and effect sizes were calculated to quantify the magnitude of emerging themes. Results Of the 8560 articles from the literature search, 18 articles from 11 LMICs fit the eligibility and inclusion criteria. Of these studies, four were from Sub-Saharan Africa, ten from Latin America and the Caribbean, one from the Middle East, and three from Asia. Half of the studies focused specifically on legislation, while the others focused on speed control measures, educational interventions, enforcement, road improvement, community programs, or a multifaceted intervention. Conclusion Legislation was the most common intervention evaluated with the best outcomes when combined with strong enforcement initiatives or as part of a multifaceted approach. Because speed control is crucial to crash and injury prevention, road improvement interventions in LMIC settings should carefully consider how the impact of improvements will affect speed and traffic flow. Further road traffic injury prevention interventions should be performed in LMICs with patient-centered outcomes in order to guide injury prevention in these complex settings.
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Affiliation(s)
- Catherine Staton
- Emergency Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- * E-mail:
| | - Joao Vissoci
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Enying Gong
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Nicole Toomey
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Rebeccah Wafula
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Jihad Abdelgadir
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Yi Zhou
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Chen Liu
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Fengdi Pei
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Brittany Zick
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Camille D. Ratliff
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Claire Rotich
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Nicole Jadue
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Luciano de Andrade
- Department of Nursing, State University of the West of Parana, Foz do Iguaçu, Parana, Brazil
| | - Megan von Isenburg
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Michael Hocker
- Emergency Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
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Tongklao A, Jaruratanasirikul S, Sriplung H. Risky behaviors and helmet use among young adolescent motorcyclists in Southern Thailand. TRAFFIC INJURY PREVENTION 2015; 17:80-85. [PMID: 26068132 DOI: 10.1080/15389588.2015.1045062] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND In Thailand, road traffic injuries are the leading cause of death for youth ages 15-19 years, with 80% of the injuries and deaths from motorcycle accidents. OBJECTIVES To determine the prevalence of child and young adolescent motorcyclists in Hat Yai municipality and their risk behaviors. METHOD A cross-sectional study was conducted between June 2011 and March 2012 in which 2,471 students, ages 8 to 18 years, were recruited from 9 primary and secondary schools in Hat Yai municipality. The questionnaire included questions on being a motorcycle rider or passenger, risky behaviors, and helmet use while riding. RESULTS Of the total, 1,573 (63.7%) were riders and 898 (36.3%) were pillion passengers. The majority of the riders younger than 15 years rode their motorcycle mainly only in narrow streets for a short trip. Only 30% of the riders wore a helmet every time they rode a motorcycle. About 10% of the participants riding or a passenger on a motorcycle had consumed alcohol at least once before riding their motorcycle. Multiple logistic regression analysis found that motorcycle injuries were significantly associated with speeds greater than 60 km/h, not wearing a helmet while riding, and alcohol consumption before riding (odds ratios 1.63, 1.59, and 3.09, respectively). CONCLUSION Nearly two thirds of young adolescents in Hat Yai municipality were motorcycle riders. These young adolescents were at risk of traffic injuries because more than 50% of them had ridden at high speed or not worn a helmet while riding, and some of them had consumed alcohol before riding.
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Affiliation(s)
- Arunwan Tongklao
- a Department of Pediatrics , Faculty of Medicine, Prince of Songkla University , Hat Yai , Songkhla , Thailand
| | - Somchit Jaruratanasirikul
- a Department of Pediatrics , Faculty of Medicine, Prince of Songkla University , Hat Yai , Songkhla , Thailand
| | - Hutcha Sriplung
- b Epidemiology Unit, Faculty of Medicine, Prince of Songkla University , Hat Yai , Songkhla , Thailand
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Motorcycle-Related Traumatic Brain Injuries: Helmet Use and Treatment Outcome. NEUROSCIENCE JOURNAL 2015; 2015:696787. [PMID: 26317112 PMCID: PMC4437263 DOI: 10.1155/2015/696787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 03/02/2015] [Accepted: 03/05/2015] [Indexed: 11/17/2022]
Abstract
Summary. With increasing use of motorcycle as means of transport in developing countries, traumatic brain injuries from motorcycle crashes have been increasing. The only single gadget that protects riders from traumatic brain injury is crash helmet. Objective. The objectives were to determine the treatment outcome among traumatic brain injury patients from motorcycle crashes and the rate of helmet use among them. Methods. It was a prospective, cross-sectional study of motorcycle-related traumatic brain injury patients managed in our center from 2010 to 2014. Patients were managed using our unit protocol for traumatic brain injuries. Data for the study were collected in accident and emergency, intensive care unit, wards, and outpatient clinic. The data were analyzed using Environmental Performance Index (EPI) info 7 software. Results. Ninety-six patients were studied. There were 87 males. Drivers were 65. Only one patient wore helmet. Majority of them were between 20 and 40 years. Fifty-three patients had mild head injuries. Favorable outcome among them was 84.35% while mortality was 12.5%. Severity of the injury affected the outcome significantly. Conclusion. Our study showed that the helmet use by motorcycle riders was close to zero despite the existing laws making its use compulsory in Nigeria. The outcome was related to severity of injuries.
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Sumner SA, Pallangyo AJ, Reddy EA, Maro V, Pence BW, Lynch C, Turner EL, Egger JR, Thielman NM. Effect of free distribution of safety equipment on usage among motorcycle-taxi drivers in Tanzania--A cluster randomised controlled trial. Injury 2014; 45:1681-6. [PMID: 24861418 PMCID: PMC4213314 DOI: 10.1016/j.injury.2014.04.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 04/16/2014] [Accepted: 04/21/2014] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Deaths due to road traffic injuries, particularly motorcycle crashes, have increased rapidly in many African nations and context-specific strategies to improve preventative behaviours are needed. Although adhering to conspicuity measures by wearing reflective safety vests is a highly effective crash prevention strategy and mandated by law among motorcycle-taxi drivers in some African countries, actual use is currently low. We aimed to test whether eliminating cost-barriers through the provision of free reflective, fluorescent motorcycle safety vests would lead to increased utilisation among a high-risk population of motorcycle-taxi drivers in Tanzania. METHODS A cluster randomised controlled trial was conducted among 180 motorcycle-taxi drivers. Participants randomised to the intervention arm (90) received free, reflective, fluorescent vests; participants randomised to the control arm (90) did not receive free vests. Participants' use of reflective vests was then observed on city streets over a three month period and differential uptake was estimated using mixed-effects logistic regression. RESULTS Baseline use of reflective vests was 3.3% in both arms. Seventy-nine drivers in the intervention arm and 82 drivers in the control arm were observed during follow-up. The average proportion of observations during which motorcycle drivers were using a reflective vest was 9.5% in the intervention arm, compared to 2.0% in the control arm (odds ratio: 5.5, 95% confidence interval: 1.1-26.9, p-value: 0.04). CONCLUSION Although distribution of free reflective vests led to a statistically significant increase in vest usage, the absolute increase was modest. Additional strategies beyond removing economic barriers are important to augment adherence to road safety behaviours for injury prevention.
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Affiliation(s)
- Steven A. Sumner
- Duke University, Hubert Yeargan Center for Global Health, Durham, United States
| | | | - Elizabeth A. Reddy
- Duke University, Department of Infectious Diseases and International Health, Durham, United States
| | - Venance Maro
- Kilimanjaro Christian Medical Centre, Department of Medicine, Moshi, Tanzania
| | - Brian W. Pence
- Department of Epidemiology, the University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Catherine Lynch
- Duke University, Division of Emergency Medicine and Duke Global Health Institute, Durham, United States
| | | | - Joseph R. Egger
- Duke University, Duke Global Health Institute, Durham, United States
| | - Nathan M. Thielman
- Duke University, Department of Infectious Diseases and International Health, Durham, United States
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Jiwattanakulpaisarn P, Kanitpong K, Ponboon S, Boontob N, Aniwattakulchai P, Samranjit S. Does law enforcement awareness affect motorcycle helmet use? evidence from urban cities in Thailand. Glob Health Promot 2014; 20:14-24. [PMID: 23986378 DOI: 10.1177/1757975913499030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although helmet use has been compulsory for motorcycle drivers and passengers in Thailand since the enactment of the Helmet Act in 1994, recent surveys show that the prevalence of helmet usage remains low, particularly among passengers. This paper has sought to explore motorcyclists' awareness of helmet law enforcement in Thailand and examine whether it affects their helmet use behaviour. A total of 2,429 drivers and 1,328 passengers in urban cities nationwide were interviewed in 2009, and the data were analysed using a multivariate ordered logit regression technique. About 60% of the drivers and only 28% of the passengers reported that they always wore a motorcycle helmet. Apart from basic demographics (i.e. age and gender) and riding frequency, our analysis reveals that the awareness of helmet law enforcement was among the contributing factors influencing the use of motorcycle helmets in Thailand. Regardless of riding position, the prevalence of helmet use tended to be greater among those frequently observing the police's checkpoints for helmet wearing and those perceiving the high risk of being caught for non-helmet use. However, the use of helmets appeared to be lower among drivers who perceived the checkpoints to take place at the same times and locations, which were likely predicted. For motorcycle passengers, it was found that the low prevalence of helmet use was potentially attributable to the absence of knowledge on the compulsory helmet law for passengers and the perception that the law was not enforced by the police. Thus, if motorcycle helmet use in Thailand is to be increased, considerable efforts need to be given to increasing the perceived risk of apprehension for non-helmet use (e.g. more police presence and random scheduling of enforcement activities), improving the awareness of the existing helmet law for passengers, and ensuring that helmet wearing by passengers is more strictly enforced.
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Siviroj P, Peltzer K, Pengpid S, Morarit S. Helmet use and associated factors among Thai motorcyclists during Songkran festival. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012. [PMID: 23202686 PMCID: PMC3499868 DOI: 10.3390/ijerph9093286] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of this study was to assess helmet use and associated factors among motorcycle riders during Songkran festival in Thailand. A cross-sectional survey was conducted to determine the prevalence of helmet use among Thai motorcycle riders (sample size = 18,998) during four days of the Songkran festival. For this sample, the population of motorcycle riders was consecutively selected using quota sampling from 12 petrol stations in four provinces from each of the four main geographical regions of Thailand. The study was conducted at petrol stations at roads in town, outside town and highway at different time intervals when trained field staff administered a structured questionnaire and performed an observation checklist. Results indicate that 44.2% of the motorcycle riders and 72.5% of the motorcycle passengers had not been using a helmet. In multivariable analysis demographics, environmental factors, helmet use experiences and attitudes and recalling a lower exposure to road safety awareness (RSA) campaign were associated with non-helmet use among motorcyclists. It appears that the RSA campaign may have some positive effect on reducing non-helmet use among motorcycle riders during the Songkran festival.
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Affiliation(s)
- Penprapa Siviroj
- Department of Community Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Karl Peltzer
- HIV/AIDS/SIT/and TB (HAST), Human Sciences Research Council, Pretoria 0001, South Africa
- Department of Psychology, University of the Free State, Bloemfontein 9300, South Africa
- Author to whom correspondence should be addressed; ; Tel.: +27-12-302-2000; Fax: +27-12-302-2067
| | - Supa Pengpid
- Department of Health System Management and Policy, University of Limpopo, Medunsa Campus, Pretoria 0204, South Africa;
| | - Sompong Morarit
- Health Promotion Region 10, Ministry of Public Health, Chiang Mai 5000, Thailand;
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Ditsuwan V, Veerman JL, Bertram M, Vos T. Sobriety checkpoints in Thailand: a review of effectiveness and developments over time. Asia Pac J Public Health 2011; 27:NP2177-87. [PMID: 22186383 DOI: 10.1177/1010539511430851] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This review describes the legal basis for and implementation of sobriety checkpoints in Thailand and identifies factors that influenced their historical development and effectiveness. The first alcohol and traffic injury control law in Thailand was implemented in 1934. The 0.05 g/100 mL blood alcohol concentration limit was set in 1994. Currently, 3 types of sobriety checkpoints are used: general police checkpoints, selective breath testing, and special event sobriety checkpoints. The authors found few reports on the strategies, frequencies, and outcomes for any of these types of checkpoints, despite Thailand having devoted many resources to their implementation. In Thailand and other low-middle income countries, it is necessary to address the country-specific barriers to successful enforcement (including political and logistical issues, lack of equipment, and absence of other supportive alcohol harm reduction measures) before sobriety checkpoints can be expected to be as effective as reported in high-income countries.
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Affiliation(s)
- Vallop Ditsuwan
- Thaksin University, Phatthalung Province, Thailand The University of Queensland, Brisbane, Australia
| | | | | | - Theo Vos
- The University of Queensland, Brisbane, Australia
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Amirjamshidi A, Ardalan A, Nainei KH, Sadeghi S, Pahlevani M, Zarei MR. Comparison of standard and nonstandard helmets and variants influencing the choice of helmets: A preliminary report of cross-sectional prospective analysis of 100 cases. Surg Neurol Int 2011; 2:49. [PMID: 21660267 PMCID: PMC3108430 DOI: 10.4103/2152-7806.79771] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2010] [Accepted: 03/13/2011] [Indexed: 12/04/2022] Open
Abstract
Background: The literature does not offer the rate of protection provided by different types of helmets used, especially as it applies to developing countries. We hypothesize that standard versus nonstandard types of helmets might differ in the rate of complications of head and neck trauma occurring in victims of motorcycle accidents. Here we report the rate of occurrence, the type of injuries and differences thereof in standard and nonstandard helmet bearers, and its relevance to protection from serious injury. Methods: The data were gathered from a data set of motorcycle accident victims admitted to the emergency department of Sina Hospital (Teheran/Iran). A cross-sectional study was designed for a 6-month period of time, June to December 2007. Variants analyzed included: demographics, types of helmets used, level of education of the victims (as in: being trained for using helmets and status of holding a valid driving license). The latter variants were evaluated for possibly influencing the outcome of the injured motorcyclists using either kind of helmets. Results: Among a total of 576 injured motorcyclists who had head, face, or neck injuries, 432 (75%) were using some kind of helmet. A total of 144 (25%) of the injured patients were admitted to the neurosurgical emergency service. There were 100 patients whose data sheets contained all variables which could be included in the pilot analysis of this cohort. Discussion: All 100 subjects were male patients with the age range of 32 ± 11 years. Twenty-five percent were using standard helmets at the time of accident, 43% had no cranio-facio-cervical injury except very mild skin abrasions, and 23% had facial injury, including skin lacerations needing sutures, two nasal bone fractures, and no maxillofacial damage. Among the patients using standard helmets, 44% had head injuries which needed to be taken care of (mostly nonoperatively), while 61% using nonstandard helmets had head trauma (P > 0.05). The other variables did not reach a significant value affecting the use of either standard or nonstandard helmets in prevention of craniofacial damages. Conclusion: This pilot analysis (comprising the data from 100 cases of motorcycle accidents) could not demonstrate statistically significant differences in injury patterns of different types of helmets and variants influencing their respective use. However, it can lead the way for further analysis of larger and more comprehensive head trauma databases regarding factors contributing to the issue of head injury.
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Affiliation(s)
- Abbas Amirjamshidi
- Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Kardamanidis K, Martiniuk A, Ivers RQ, Stevenson MR, Thistlethwaite K. Motorcycle rider training for the prevention of road traffic crashes. Cochrane Database Syst Rev 2010:CD005240. [PMID: 20927741 DOI: 10.1002/14651858.cd005240.pub2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Riding a motorcycle (a two-wheeled vehicle that is powered by a motor and has no pedals) is associated with a high risk of fatal crashes, particularly in new riders. Motorcycle rider training has therefore been suggested as an important means of reducing the number of crashes, and the severity of injuries. OBJECTIVES To quantify the effectiveness of pre- and post-licence motorcycle rider training on the reduction of traffic offences, traffic crash involvement, injuries and deaths of motorcycle riders. SEARCH STRATEGY We searched the Cochrane Injuries Group Specialised Register, CENTRAL (The Cochrane Library 2008, Issue 3), TRANSPORT, MEDLINE, EMBASE, CINAHL, WHOLIS (World Health Organization Library Information System), PsycInfo, LILACS (Latin American and Caribbean Health Sciences), ISI Web of Science: Social Sciences Citation Index (SSCI), ERIC, ZETOC and SIGLE. Database searches covered all available dates up to October 2008. We also checked reference lists of relevant papers and contacted study authors in an effort to identify published, unpublished and ongoing trials related to motorcycle rider training. SELECTION CRITERIA We included all relevant intervention studies such as randomised and non-randomised controlled trials, interrupted time-series and observational studies such as cohort and case-control studies. DATA COLLECTION AND ANALYSIS Two review authors independently analysed data about the study population, study design and methods, interventions and outcome measures as well as data quality from each included study, and compared the findings. We resolved differences by discussion with a third review author. MAIN RESULTS We reviewed 23 studies: three randomised trials, two non-randomised trials, 14 cohort studies and four case-control studies. Five examined mandatory pre-licence training, 14 assessed non-mandatory training, three of the case-control studies assessed 'any' type of rider training, and one case-control study assessed mandatory pre-licence training and non-mandatory training. The types of assessed rider training varied in duration and content.Most studies suffered from serious methodological weaknesses. Most studies were non-randomised and controlled poorly for confounders. Most studies also suffered from detection bias due to the poor use of outcome measurement tools such as the sole reliance upon police records or self-reported data. Small sample sizes and short follow-up time after training were also common. AUTHORS' CONCLUSIONS Due to the poor quality of studies identified, we were unable to draw any conclusions about the effectiveness of rider training on crash, injury, or offence rates. The findings suggest that mandatory pre-licence training may be an impediment to completing a motorcycle licensing process, possibly indirectly reducing crashes through a reduction in exposure. It is not clear if training (or what type) reduces the risk of crashes, injuries or offences in motorcyclists, and a best rider training practice can therefore not be recommended. As some type of rider training is likely to be necessary to teach motorcyclists to ride a motorcycle safely, rigorous research is needed.
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Affiliation(s)
- Katina Kardamanidis
- The George Institute for Global Health, PO Box M201 Missenden Road, Sydney, NSW, Australia, 2050
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20
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Oluwadiya KS, Kolawole IK, Adegbehingbe OO, Olasinde AA, Agodirin O, Uwaezuoke SC. Motorcycle crash characteristics in Nigeria: implication for control. ACCIDENT; ANALYSIS AND PREVENTION 2009; 41:294-298. [PMID: 19245888 DOI: 10.1016/j.aap.2008.12.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2008] [Revised: 11/14/2008] [Accepted: 12/14/2008] [Indexed: 05/27/2023]
Abstract
Despite being the second most common cause of road traffic injuries (RTIs) in Nigeria, no study had examined the peculiarities of motorcycle crash site characteristics in Nigeria. We examined and interviewed 363 motorcycle RTI patients in three tertiary hospitals in southwest Nigeria. All the motorcycles are small with capacities between 80 and 125cm3. 68.9% of the patients sustained their injuries while working or going to work and 23.4% on their way to school. 176 (48.5%) of the crashes were with moving vehicles and in 83 (22.3%) cases, either the motorcycle or the other vehicle is moving against the traffic. 37.8% of all crashes occurred at junctions with no roundabout versus 5% at junctions with roundabout. Some risky practices of the patient included carrying more than 2 persons (15.02%), travelling without headlight at night (31.7%) and not wearing helmets (96.5%). This study showed that risky behavior among motorcycle riders, chaotic traffic and road design faults accounted for most of the motorcycle crashes. The implications for the prevention and control of motorcycle injuries were discussed.
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Affiliation(s)
- K S Oluwadiya
- Department of Surgery, Ladoke Akintola University of Technology (LAUTECH) Teaching Hospital, Osogbo, Osun State, Nigeria.
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21
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Hung DV, Stevenson MR, Ivers RQ. Barriers to, and factors associated, with observed motorcycle helmet use in Vietnam. ACCIDENT; ANALYSIS AND PREVENTION 2008; 40:1627-1633. [PMID: 18606299 DOI: 10.1016/j.aap.2008.05.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2007] [Revised: 04/14/2008] [Accepted: 05/08/2008] [Indexed: 05/26/2023]
Abstract
This study investigated barriers to, and factors associated with, observed motorcycle helmet use among motorcyclists in Hai Duong Province, Vietnam. The findings highlighted an array of factors associated with observed helmet use namely, support for universal helmet legislation and a positive attitude towards what might be perceived as negative attributes of helmet use such as inconvenience and discomfort in hot weather. As well, older age (greater than 25 years in age), riding on a compulsory road, being a driver, trips of greater than 10 km, higher levels of education (having a university degree and higher) were found to be key determinants of helmet use. Despite over 95% of motorcyclists disagreeing with the statement that wearing a helmet does not reduce the severity of head injury in a crash, most motorcyclists believed that helmets did not need to be worn for a short trip. Overall, only 23% of motorcyclists were observed wearing a helmet. The authors conclude that efforts to increase helmet use need to focus on the necessity for universal helmet legislation in association with identifying solutions to reduce the negative attitudes towards helmet use.
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Affiliation(s)
- Dang Viet Hung
- The George Institute for International Health, The University of Sydney, Missenden Road, Sydney, NSW 2050, Australia.
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La Torre G, Van Beeck E, Bertazzoni G, Ricciardi W. Head injury resulting from scooter accidents in Rome: differences before and after implementing a universal helmet law. Eur J Public Health 2007; 17:607-11. [PMID: 17400541 DOI: 10.1093/eurpub/ckm028] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To estimate the incidence rates and related determinants of head injuries before and after the implementation of a new universal helmet law in Italy. METHODS The investigation took place in the Emergency Room of the Accident and Emergency Department, Teaching Hospital 'Umberto I', Rome, in 1999 (before the new law), and 2000 (two periods after the new law). Personal data, injury circumstances, helmet use, others involved in injury and health data, were collected. Incidence rates by time period were calculated and differences between groups were analysed. Logistic regression models were conducted to assess the association between head trauma and potential determinants. RESULTS The incidence rate of all injury among scooter riders rose from 64.36/10,000 person-years before the new law (1999) to 98.05/10,000 person years afterwards. The incidence rate of head trauma among scooter riders showed an opposite trend, i.e. a decrease from 26.65/10,000 person-years (1999) to 8.88/10,000 person-years in the second post-legislation period. Helmet use among injured scooter riders rose from 5% before the new law to 90% afterwards. Helmet use is a protective factor for being a patient with head trauma, in all the periods considered (OR 0.24-0.44). After implementation of the new law, age (18+) showed a protective effect as well (OR 0.42-0.44). CONCLUSION Helmet use has a protective effect on head trauma among scooter riders. One year after implementing a universal law, helmet use has increased substantially and a sharp reduction in head trauma among persons older than 18 years could be observed.
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Pileggi C, Bianco A, Nobile CGA, Angelillo IF. Risky behaviors among motorcycling adolescents in Italy. J Pediatr 2006; 148:527-32. [PMID: 16647418 DOI: 10.1016/j.jpeds.2005.11.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2005] [Revised: 09/19/2005] [Accepted: 11/03/2005] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To investigate the relationship between risky behaviors and motorcycling in adolescents in Italy. STUDY DESIGN A questionnaire was administered to a random sample of 1000 adolescents attending randomly selected public secondary schools to assess personal characteristics and lifestyle; motorcycle and helmet use; behavior while driving a motorcycle; traffic-related accidents, and receipt of tickets. RESULTS Of the 894 responders, 54% and 29.2% routinely use the helmet as driver or passenger, respectively. Routine helmet use was higher among males, current smokers, alcohol drinkers, and those who reported that at least one close friend used a helmet. Motorcycling after consuming alcohol was higher in males, in current smokers, and in those who used cell phones and were tired while driving. An accident in the past year occurred in 25.7% of riders and was significantly higher in those who used cell phones while driving and in those who were interested in learning about motorcycle use. Adolescents who reported always motorcycling over the speed limit were at lower risk of smoking, talking with the passenger, and using a cell phone while driving. Being male, being older, learning about motorcycle use from someone outside the family, talking with a passenger, and using a cell phone while driving increased the risk of receiving a ticket. CONCLUSIONS Educational programs, legislative measures, and policies to reduce risk behaviors in adolescents who use motorcycles are needed.
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Affiliation(s)
- Claudia Pileggi
- Hygiene, Medical School, University of Catanzaro Magna Graecia, Catanzaro, Italy
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Baldi S, Baer JD, Cook AL. Identifying best practices states in motorcycle rider education and licensing. JOURNAL OF SAFETY RESEARCH 2005; 36:19-32. [PMID: 15752480 DOI: 10.1016/j.jsr.2004.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2004] [Revised: 08/31/2004] [Accepted: 11/03/2004] [Indexed: 05/24/2023]
Abstract
PROBLEM After decreasing to a historic low in 1997, motorcycle crash-related fatalities are increasing. Although causes remain unclear, motorcycle rider education and licensing play key roles in reducing motorcycle crashes and injuries. Yet, little is known about what constitutes effective rider training and licensing. This study develops a model of best practices in motorcycle rider education and licensing and combines primary and secondary data to identify states that most closely adhere to this model. Evidence on the validity of the model is also examined. METHOD States were rated along three areas of best practices: (a) program administration; (b) rider education; and (c) licensing based on 2001 data collected for a National Highway Traffic Safety Administration (NHTSA)-sponsored study. RESULTS Results indicate wide variation in states' adherence to best practices; several states meet most, others very few. When the areas of best practices are considered separately, a state tends to behave similarly on all three. Initial evidence supports the validity of the model, with high best practices states having the lowest rates of motorcycle fatalities. IMPACT ON TRAFFIC SAFETY As motorcycle-related crashes increase and state and federal support for rider education programs diminishes, it is critical that states identify deficiencies in their program and learn from successful states about efficient, cost-effective strategies for increasing best practices in motorcycle rider education and licensing.
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Affiliation(s)
- Stéphane Baldi
- American Institutes for Research, 1000 Thomas Jefferson St., NW, Washington, DC 20007, USA.
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McGwin G, Whatley J, Metzger J, Valent F, Barbone F, Rue LW. The Effect of State Motorcycle Licensing Laws on Motorcycle Driver Mortality Rates. ACTA ACUST UNITED AC 2004; 56:415-9. [PMID: 14960987 DOI: 10.1097/01.ta.0000044625.16783.a9] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the association between motorcycle licensing and operation regulations and motorcycle mortality rates in the United States during 1997 through 1999. METHODS A population-based ecologic study was used. RESULTS Lower mortality rates were observed in states with the following motorcycling requirements: skill test for a motorcycle permit (rate ratio [RR], 0.76; 95% confidence interval [CI], 0.69-0.84), driver training (RR, 0.80; 95% CI, 0.74-0.86), longer duration of learner's permits (95-190 days [RR, 0.86; 95% CI, 0.79-0.95] and >190 days [RR, 0.87; 95% CI, 0.81-0.93], three or more learner's permit restrictions (RR, 0.78; 95% CI, 0.73-0.84), and a full helmet law (RR, 0.76; 95% CI, 0.71-0.81). CONCLUSION Specific motorcycle licensure policies appear to be associated with lower mortality rates.
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Affiliation(s)
- Gerald McGwin
- Secction of Trauma, Burns and Surgical Critical Care, Division of General Surgery, Departmnet of Surgery, School of Medicine, Birmingham, Alabama 35294-0016, USA.
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Ichikawa M, Chadbunchachai W, Marui E. Effect of the helmet act for motorcyclists in Thailand. ACCIDENT; ANALYSIS AND PREVENTION 2003; 35:183-189. [PMID: 12504139 DOI: 10.1016/s0001-4575(01)00102-6] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVES This study investigated the effect of the helmet act for motorcyclists on increasing helmet use and reducing motorcycle-related deaths and severe injuries in Thailand. METHODS Data were derived from a trauma registry at the Khon Kaen Regional Hospital in the northeast Thailand. Helmet use and outcome in motorcycle crashes were compared 2 years before (1994-1995) and after (1996-1997) enforcement of the helmet act. During the study period, there were 12002 injured motorcyclists including 129 death cases in the municipality of Khon Kaen Province who were brought to the regional hospital. RESULTS After enforcement of the helmet act, helmet-wearers increased five-fold while head injuries decreased by 41.4% and deaths by 20.8%. Those who had head or neck injuries or died were less likely wearing a helmet. Compliance of helmet use was lower at night. Fatality of injured motorcyclists did not significantly decrease in the post-act period and among helmet-wearers. CONCLUSION Enforcement of the helmet act increased helmet-wearers among motorcyclists but helmet use did not significantly reduce deaths among injured motorcyclists. Motorcyclists should be instructed to properly and consistently wear a helmet for their safety.
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Affiliation(s)
- Masao Ichikawa
- Department of Community Health, School of International Health, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
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Hotz GA, Cohn SM, Popkin C, Ekeh P, Duncan R, Johnson EW, Pernas F, Selem J. The impact of a repealed motorcycle helmet law in Miami-Dade County. THE JOURNAL OF TRAUMA 2002; 52:469-74. [PMID: 11901321 DOI: 10.1097/00005373-200203000-00009] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To study the impact of helmet nonuse in motorcycle crashes after the repeal of a mandatory helmet law in the state of Florida. METHODS We prospectively studied all patients evaluated at the University of Miami/Jackson Memorial Medical Center from July 1, 2000, through December 31, 2000, involved in motorcycle crashes, and compared them with those seen during the same time period the year before the helmet law change. RESULTS In 1999, before the repeal of the helmet law, there were 52 cases evaluated at our center compared with 94 after the law change. Helmet usage decreased from 1999 (83%) to 2000 (56%). The number of brain injuries (Abbreviated Injury Scale score > or = 2) during this same time period increased from 18 to 35, and the number of fatalities from 2 to 8. CONCLUSION The repeal of a motorcycle helmet law significantly increased the number and severity of brain injuries admitted to our trauma center.
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Affiliation(s)
- Gillian A Hotz
- Department of Neurological Surgery, University of Miami School of Medicine, Miami, Florida, USA
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