Prevalence and factors associated with effective helmet use among motorcyclists in Mysuru City of Southern India

Factors associated with nonuse of helmet among motorcyclists sustaining road traffic accidents

Background

Road traffic accidents (RTAs) remain a prominent cause of mortality and morbidity worldwide. Wearing a helmet while riding a motorbike can significantly minimize injury severity and fatality. This study aimed to identify the factors associated with the use and nonuse of helmets among motorized two-wheelers.

Methods

This observational study was conducted on victims of RTAs who presented to the emergency department of a hospital in Eastern India. Data were collected through a semi-structured questionnaire from March 2021 to December 2021. The data on sociodemographic details of the victims and various extrinsic and intrinsic factors associated with the nonuse of helmets were collected and analyzed.

Results

A total of 346 patients were included. The prevalence of helmet use was 35.7%, and most young adults were helmet nonusers (32.31 ± 12.3 vs. 37.1 ± 12.3, P = 0.15). The pillion riders, alcohol abuse, lower educational levels, and riding on municipal/panchayat roads were associated with statistically significant (P < 0.05) nonuse of helmets. The injury severity score was significantly higher in helmet nonusers (13.20 ± 6.44 vs. 11.23 ± 6.01, P = 0.004). Among the extrinsic factors, fewer traffic checkpoints (P < 0.001), visibility issues (P = 0.02), and use of ear pods (P = 0.01) were significant factors for the nonuse of helmets. In the intrinsic factors, traveling short distances (P < 0.001) and forgetfulness (P < 0.01) were significant factors for the nonuse of helmets.

Conclusions

Traveling short distances, forgetfulness, and fewer traffic check posts are significantly associated with the nonuse of helmets among motorcyclists. Traveling on village or municipality roads and alcohol abuse is significantly associated with helmet nonuse.

Prevalence and patterns of helmet use among motorized two-wheelers: findings from a large observational study in an Indian metropolis

Motorized two-wheeler users account for 45% of road fatalities in 2021 in India. Correct helmet use decreases the risk of fatalities, but information about the prevalence of correct helmet use is limited in the Indian context. This study aims to assess the prevalence of helmet use and factors associated with correct helmet use among motorized two-wheeler users in Bengaluru city, India. This observational cross-sectional assessment was conducted in a random-representative sample of 98021 motorized two-wheelers sampled from 15 intersections. Helmet use and other information were collected by trained Field Data Collectors via hand-held tablet devices and the KoBo collect application, following a globally used checklist. The prevalence of helmet use (all types) was 88% among riders and pillion together and 92.4% among riders. However, the prevalence of correct helmet use is 38% among riders, and non-standard helmet use is 27%. This study reveals a correct helmet use gap in Bengaluru city. The study recommends the need to shift enforcement, messaging, and intervention focus towards correct helmet use and the implementation of routine population-based surveillance for helmet use in the city.

A qualitative study to explore traffic police personnel perceptions towards road safety behaviour among young riders in Manipal, India

Road crash injuries are significant public health issues in many low-and middle-income countries. Every year more than 1.35 million people lose their lives due to road crashes, making it one of the leading causes of death worldwide. In 2021, 1.19 million road traffic deaths occurred worldwide. Globally, India accounts for the second-largest number of fatal road traffic crashes. Riders in the age range of 18-25 years contribute to 41.4% of India's total road crash victims. An in-depth understanding of the current traffic density, violations, and behaviours of young riders is essential for enforcement agencies, in particular, the traffic police personnel. Their perspective is relevant as they have a unique position to judge and evaluate the riding behaviours and the efficiency of the existing intervention programmes. Furthermore, their suggestions can be highly effective in developing evidence-based risk reduction programmes. The present study was conducted in Manipal, which is a locality of Udupi district in Karnataka province of Southwestern India. Seventeen in-depth interviews were conducted from October 2018 to January 2019 among traffic police personnel. Thematic analysis was done using ATLAS.ti 8 software to identify, analyse, and report themes within the data. Respondents revealed that in recent times Manipal roads have become unsafe for young riders. Factors such as speeding, using a mobile phone while riding, reckless riding, and overtaking from the wrong side were the main reasons for road traffic crashes. Interventions like the installation of traffic barricades, closed-circuit television cameras, speed breakers, and signboards at the crash hotspots, together with strict enforcement of traffic laws, were suggested by the respondents to reduce crashes. The study findings highlight the importance of traffic police personnel's views in understanding the various determinants for road crashes observed among young riders. Future research can be taken up in other settings with broader age group involvement for the target population. There is a need to establish a coordination committee that can locally organize awareness programmes involving all the stakeholders on road safety to increase the level of risk perception and reduce crashes.

Helmet utilisation and its associated factors among motorcyclists in northern Ghana: an analytical cross-sectional survey

BACKGROUND

Motorcycle crashes are a major source of road traffic deaths in northern Ghana. Helmet use has been low. The last time it was formally assessed (2010), helmet use was 30.0% (34.2% for riders and 1.9% for pillion riders). We sought to determine the current prevalence of helmet use and its associated factors among motorcyclists in northern Ghana.

METHODS

Cross-sectional observations of motorcycle helmet use were conducted among 3853 motorcycle riders and 1097 pillion riders in the Northern Region at 12 different locations near intersections, roundabouts and motorcycle bays. Modified Poisson regression was used to assess the factors associated with helmet use.

RESULTS

The prevalence of helmet use was 22.1% overall: 26.7% among motorcycle riders and 5.7% among pillion riders. On the multivariable regression analysis, the prevalence of helmet use among motorcycle riders was 69% higher during the day compared with the night, 58% higher at weekend compared with weekday, 46% higher among males compared with females, but it was 18% lower on local roads compared with highways, 67% lower among young riders compared with the elderly and 29% lower when riding with pillion rider(s).

CONCLUSION

Despite small increases in motorcycle helmet use among pillion riders, helmet use has declined overall over the past decade. Immediate actions are needed to promote helmet use among motorcyclists in northern Ghana. This calls for a multisectoral approach to address the current low helmet use, targeting young riders, female riders, pillion riders, evening riding and riding on local roads.

The prevalence of helmet use in motorcyclists around the world: a systematic review and meta-analysis of 5,006,476 participants

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.

Perceptions, barriers, and strategies regarding helmet use by female pillion riders in Pakistan: A qualitative study

INTRODUCTION

Despite the existence of a national motorcycle helmet law that applies to both riders and pillion riders, the use of helmets among female pillion riders is low in Pakistan. This study aimed to explore perceptions, barriers, and strategies related to helmet use by female pillion riders.

METHODS

Data was collected from nine focus group discussions held with female pillion riders and male riders working at the Aga Khan University. Focus group discussions were transcribed verbatim and checked for accuracy before being imported into NVivo2. Transcriptions were analyzed using a thematic analysis approach.

RESULTS

Four overarching themes emerged, including: (1) motorcycle as mode of transportation, (2) law on helmet use and its enforcement, (3) barriers to helmet use among female pillion riders, and (4) strategies to improve helmet use among female pillion riders. Female participants never wore a helmet or considered wearing it even though "safety" was the most important benefit of helmet usage expressed. The motorcycle is an economical mode of transportation for families, particularly those in the middle and lower socioeconomic groups. Helmet laws are not strictly enforced for pillion riders, including females. Possible barriers to helmet use among female pillion riders included discomfort in wearing a helmet, uninvited attention from others, concerns about physical appearance, and substandard quality and design of helmets. Suggested strategies for implementing helmet use among female pillion riders encompassed awareness generation through media, complementary distribution of helmets, strict law enforcement in the form of fines, and the influence of religious leaders regarding social norms and cultural barriers.

CONCLUSION

Motorcycles are a risky mode of transport, and there are several social and cultural barriers regarding helmet use by female pillion riders. Enforcing helmet laws for female pillion riders, raising awareness about helmet laws, and making helmet use among pillion riders a norm are some essential steps to take to promote helmet use among female pillion riders in Pakistan.

Helmet Use Among Two-Wheeler Riders’ Road Accident Victims in Benin

Background

In Benin, some riders of two-wheeled vehicles still do not wear helmets, the main protection against head injuries in road accidents. The objective of this study is to describe the characteristics of two-wheeled users, and to determine the factors influencing helmet use among this group.

Methods

This is a prospective cross-sectional study of 977 two-wheeled road accident victims from a cohort. Proportions or means were calculated for the different variables. Statistical comparisons were made to test the association with helmet use. Logistic regression modelling was performed to identify factors associated with helmet use.

Results

Among all subjects, 81.1% [CI95% (78.5; 83.4)] wore a helmet. Factors explaining helmet use were female gender (OR = 2.8 [1.3–6.1]), purpose of trip (OR = 1.7 [1.1–2.6]), possession of health insurance (OR = 3.7 [1.3–10, 5]), having been driving for 15–20 years (OR = 2.6 [1.4–4.7]) or more than 20 years (OR = 3.4 [2.0–5.8]), good road conditions (OR = 3.1 [2.0–4.8]), and good visibility (OR = 1.9 [1.3–3.1]).

Conclusion

The factors influencing helmet use are gender, reason for travel, length of time as a driver, possession of health insurance, conditions, and visibility of the road on which the subject are driving. These factors are related to experience and appropriation of the notion of risk, but also related to the environment. To increase helmet use among two-wheelers, helmet awareness should take into account the individual factors found in this study. Enforcement actions should be strengthened, and the quality of the roads improved.

Barriers and factors associated with the use of helmets by Motorcyclists: A scoping review

Road Traffic Injuries (RTIs) have imposed a great global burden on public health. Motorcyclists and pedestrians comprise the most significant proportion of this burden. Several studies have demonstrated a link between helmet wearing and a decline in the impact of RTIs in motorcyclists. In this study, we aimed to review the barriers to helmet utilization by motorcyclists. This scoping review has been conducted in accordance with the guidelines for the systematic review of observational studies and the PRISMA Checklist. The search was conducted by using related keywords in EMBASE, PubMed, Scopus, and Cochrane Library. Four independent reviewers carried out the screening. The main outcomes of interest were barriers to helmet usage among motorcyclists, drawn from the finally included studies. Fifty-three records were selected for data extraction. According to these reports, the barriers and factors associated with helmet usage among motorcyclists were categorized into five entities as: legislations/enforcement strategies, helmet disadvantages (discomfort, visual/auditory blockage, and thermal dysregulation), risky behaviors (riding while drunk or high on drugs), sex and/or age factors, and the location and time of the injury event (rural vs. urban locations, day vs. night riding). From the perspective of policymakers, the findings of this review are of utmost importance and could be used in addressing the challenge of inadequate compliance with helmet use.

A Focus Group Study to Explore Risky Ridership among Young Motorcyclists in Manipal, India

Road crash injuries have emerged as a significant public health issue in many low and middle-income countries in recent years. In India, motorized two-wheelers comprise 70% of the vehicle population and are considered the most vulnerable road users. Road crash injury is common among the young-aged population leading to premature deaths. It is essential to understand risky riding behaviors to develop accurate, evidence-based risk reduction programmes that fit the target population’s characteristics and the intervention setting. The current study aims to improve the understanding of the typical characteristics of motorcycle crashes among young riders in India, primarily focusing on the prevalence and role of risky riding behaviors. Five focus group discussions with eight to ten participants in each group (N = 35) were conducted in Manipal, in the Karnataka state of Southwestern India. A thematic analysis was completed using MAXQDA software to identify, analyze, and report on themes within the data. Speeding, riding under the influence of alcohol, and the poor maintenance of motorcycles were indicated as leading causes of crashes. Furthermore, using mobile phones while riding, violations of the traffic rules, and helmet non-use were identified as other risky behaviors among young riders. Future research can be taken up in other settings for the target population. Generational awareness with the involvement of young riders, government authorities, university officials, and the Regional Transport Office can be initiated. Engaging young riders, government authorities, university officials, and the Regional Transport Office through behavioral interventions such as persuasive communication techniques, an active experimental approach (such as the use of a simulator), and regulating the licensing procedure can reduce the number of road crashes.