The validity of self-reported helmet use among motorcyclists in India

Background: Motorcyclists are the most vulnerable vehicle users in India. Nopublished study has assessed the validity of self-reported estimates of helmetuse in India. The objectives of this study were to assess helmet use by comparingobserved and self-reported use and to identify factors influencing use amongmotorcyclists in Hyderabad, India.Methods: Population-based observations were recorded for 68 229 motorcyclistsand 21 777 pillion riders (co-passengers). Concurrent roadside observations andinterviews were conducted with 606 motorcyclists, who were asked whether they“always wear a helmet”. Multivariate logistic regression analyses were conductedto determine factors influencing helmet use.Results: In the population-based study, 22.6% (n = 15,426) of motorcyclists and1.1% (n = 240) of pillion riders (co-passengers) were observed wearing helmets. Inroadside interviews, 64.7% (n = 392) of the respondents reported always wearinga helmet, 2.2 times higher than the observed helmet use (29.4%, n = 178) inthe same group. Compared with riders aged ≥40 years, riders in the age groups30–39 years and 18–29 years had respectively 40% (95% confidence interval[CI]: 0.4 to 1.0, P < 0.05) and 70% (95% CI: 0.2 to 0.5, P < 0.001) lower odds ofwearing a helmet after controlling for other covariates. Riders with postgraduateor higher education had higher odds of wearing a helmet (adjusted odds ratio[OR]: 4.1, 95% CI: 2.5 to 6.9, P < 0.001) than those with fewer than 12 grades ofschooling. After adjusting for other covariates, younger riders also had 40% (95%CI: 0.3 to 0.9, P < 0.05) lower odds of self-reporting helmet use, while those withpostgraduate or higher education had 2.1 times higher odds (95% CI: 1.3 to 3.3,P < 0.01) of reporting that they always wear a helmet. Police had stopped only2.3% of respondents to check helmet use in the three months prior to the interview.Conclusion: Observed helmet use is low in Hyderabad, yet a larger proportion ofmotorcyclists claim to always wear a helmet, which suggests that observationalstudies can provide more valid estimates of helmet use. Interview findings suggestthat a combination of increased enforcement, targeted social marketing andincreased supply of standard helmets could be a strategy to increase helmet usein Hyderabad.

Pattern of motorcycle-related injuries in Tehran, 1999 to 2000: a study in 6 hospitals

We studied motorcycle-related injuries in Tehran from 23 August 1999 to 21 September 2000 in 6 hospitals. Data were obtained from the trauma registry and questionnaires completed by trained physicians. Of a total of 8500 patients with trauma injuries, 1332 were motorcyclists, with a male to female ratio of 15:1. Of these, 1226 patients were driving the motorcycle at the time of the accident and 75 were pillion passengers. Crashes involving another vehicle were the commonest kind of accident [72.5%]. Helmet use was noted in only 8.6% of cases. There were 28 fatalities and head injuries were the prominent cause of death. Of those who died, none had been wearing a helmet at time of the crash. Only 2.7% of helmeted riders sustained a head injury, compared with 11.2% of riders without a helmet. The commonest musculoskeletal injury was fracture: tibial fracture with 509 cases [49.8%] comprised the largest proportion