Prevalence rates of helmet use among motorcycle riders in a developed region in China

This study aimed to determine the prevalence rates of helmet use, and of correct helmet use (chinstrap firmly fastened) among motorcycle riders and their passengers in Zhongshan, Guangdong Province, China. A cross-sectional survey involving direct observation of motorcycle riders was conducted at 20 randomly selected intersections. A total of 13,410 motorcycles were observed during a 10-day period in February 2009. The overall prevalence of helmet use was 72.6% (95% CI: 71.8–73.3%) among drivers and 34.1% (95% CI: 32.7–35.5%) among pillion passengers. The prevalence of correct use was 43.2% (95% CI: 42.4–44.0%) and 20.9% (95% CI: 19.8–22.1%) for drivers and passengers respectively. The helmet wearing rate on city streets was almost 95%, however city riders were more likely than rural riders to wear non-motorcycle helmets while riding. In multivariate analyses, factors associated with increased helmet use included riding on city streets, male gender, being a driver, carrying less passengers and riding a registered motorcycle. The results indicated enforcement and education activities need to be strengthened with respect to both helmet use and helmet quality, especially in rural areas, in order to improve wearing rates.     

Mobile phone use among motorcyclists and electric bike riders: A case study of Hanoi,Vietnam

Motorcyclist injuries and fatalities are a major concern of many developing countries. In Vietnam, motorcycles are involved in more than 70% of all road traffic crashes. This paper aims to explore the prevalence and factors associated with mobile phone use among motorcyclists and electric bike riders, using a case study of Hanoi, Vietnam. A cross-sectional observation survey was undertaken at 12 sites, in which each site was surveyed during a two-hour peak period from 16:30 to 18:30 for two weekdays and one weekend day. A total of 26,360 riders were observed, consisting of 24,759 motorcyclists and 1601 electric bike riders. The overall prevalence of mobile phone use while riding was 8.4% (95% CI: 8.06–8.74%) with calling having higher prevalence than screen operation: 4.64% (95% CI: 4.39–4.90%) vs. 3.76% (95% CI: 3.52–3.99%) respectively. Moreover, the prevalence of mobile phone use was higher among motorcyclists than electric bike riders: 8.66% (95%CI: 8.30–9.01%) vs. 4.43% (95% CI: 3.40–5.47%) respectively. Logistic regression analyses revealed that mobile phone use while riding was associated with vehicle type, age, gender, riding alone, weather, day of week, proximity to city centre, number of lanes, separate car lanes, red traffic light duration, and police presence. Combining greater enforcement of existing legislations with extensive education and publicity programs is recommended to reduce potential deaths and injuries related to the use of mobile phones while riding.     

Association between cannabis use and non-traffic injuries

Background

This study aimed to assess the association between cannabis use and unintended non-fatal injuries other than those caused by road crashes.

Methods

Cross-sectional data were collected from a nationwide sample of 27,934 subjects surveyed in 2005 in Spain: 14,699 persons aged 15–34 years and 13,235 aged 35–64 years. Logistic regression was used to obtain odds ratios (OR) between patterns of cannabis use and frequency of non-traffic injuries, adjusted for sociodemographic factors and for the use of alcohol, tobacco and other drugs.

Results

Cannabis use in the last 12 months was associated with a higher frequency of injuries (OR = 1.4; 95% CI: 1.2–1.7). The OR in older adults (35–64 year age group) was 1.8 and 1.3 in younger people (15–34 year age group). The strongest associations found were between weekly use of cannabis and injuries from knocks and bumps (OR = 5.1; 95% CI 2.9–8.9) and those occurring outside work (OR = 3.0; 95% CI 1.8–4.9) in the older adult population.

Conclusion

Although our analysis did not control for behavioural factors, cannabis use is independently associated with an increased frequency of non-traffic injuries, especially in the older adult population. These associations emphasise the need to carry out longitudinal studies addressing the causal links between cannabis use and unintended injuries.     

Does wearing helmets reduce motorcycle-related death? A global evaluation

Background

The high risk of injury and death of motorcycle riders is a major global health problem. This study aimed to evaluate the effect of helmet wearing on motorcycle riders’ death rates on a global level.

Methods

Data for motorcycle riders were collected from 70 countries. These data included motorcycle-related death rates per 100 000 population, helmet non-usage percentage, Gross National Income per capita (GNI), number of registered motorized 2–3 wheelers, the effectiveness of law enforcement in each country, and whether there was standards for helmets use or not. Correlations between studied variables were done using Pearson correlation. Multiple linear regression models were used to define factors affecting motorcycle-related death rates.

Results

The correlation between motorcycle-related death rate and helmet non-usage, was almost significant (p = 0.056, r = 0.28). Helmet non-usage percentage was significantly correlated with GNI (p < 0.0001, r = −0.61) and effectiveness of the law (p < 0.0001, r = −0.73). A multiple linear regression model which was highly significant (adjusted R-squared = 0.3, F = 6.69, p < 0.001) has shown that helmet non-usage percentage (p = 0.003), motorcycle per person ratio (p = 0.01) and the presence of helmet standards (p = 0.05) were positively associated with motorcycle-related death rates. A simple linear regression model between helmet usage and road traffic death rate has shown that for each 10% increase in helmet usage, one life per 1 000 000 inhabitants can be saved per year.

Conclusion

Helmet non-usage percentage was the most significant factor affecting motorcyclists’ death rate. Wearing a motorcycle helmet reduces the risk of death from a motorcycle crash. Enforcement of motorcycle helmet laws should be effectively supported by motorcycle safety programs.     

Trends in head injuries associated with mandatory bicycle helmet legislation targeting children and adolescents

Background

Bicycling related head injuries (HIs) can be severe. Helmet use reduces head injury risk; however, there are few controlled studies of the effect of helmet legislation. We conducted this study to investigate changes in HIs after bicycle helmet legislation targeting those <18 in Alberta, Canada in 2002.

Methods

Bicyclist and pedestrian (control) HI rates and HIs as a proportion of all injuries were compared for the three years (1999–2001) before and four years (2003–2006) after bicycle helmet legislation in three age groups (children: <13, adolescents: 13–17, and adults: 18+).

Results

There were 41,270 ED visits and 2782 hospitalizations for bicyclists and 9836 ED visits and 2029 hospitalizations for pedestrians (excluding the legislation year 2002). The rate of ED HIs declined for child bicyclists and child pedestrians, while the rate of non-HIs declined in adult bicyclists and child pedestrians. The rate of hospitalized HIs declined in child bicyclists and all ages of pedestrians while non-HI rates declined for child and adult pedestrians. Non-HI rates for adolescent and adult bicyclists increased. After adjusting for sex and location, the proportion of ED bicycle HIs declined by 9% (APR = 0.91; 95% CI: 0.86, 0.95) in children, was unchanged among adolescents and increased in adults (APR = 1.08; 95% CI: 1.01, 1.15). The proportion of bicycle HI related hospitalizations decreased by 30% (APR = 0.70; 95% CI: 0.55, 0.90) in children, 36% (APR = 0.64; 95% CI: 0.49, 0.84) in adolescents and 24% (APR = 0.76; 95% CI: 0.63, 0.91) in adults. There were no observed changes in the proportion of pedestrian HIs resulting in ED visits or hospitalizations.

Interpretation

Our data indicate significant declines in the proportion of child bicyclist ED HIs and child, adolescent and adult bicyclist HI hospitalizations. This is in contrast to no significant trends in the proportion of ED or hospitalized HIs among pedestrians and the unexpected increases in the proportion of ED HIs for adult bicyclists. Comparing bicyclist and pedestrian trends in the proportion of child and adolescent HIs suggests a bicycle helmet legislation effect.     

Novice riders and the predictors of riding without motorcycle protective clothing

Background

While helmet usage is often mandated, few motorcycle and scooter riders make full use of protection for the rest of the body. Little is known about the factors associated with riders’ usage or non-usage of protective clothing.

Methods

Novice riders were surveyed prior to their provisional licence test in NSW, Australia. Questions related to usage and beliefs about protective clothing, riding experience and exposure, risk taking and demographic details. Multivariable Poisson regression models were used to identify factors associated with two measures of usage, comparing those who sometimes vs rarely/never rode unprotected and who usually wore non-motorcycle pants vs motorcycle pants.

Results

Ninety-four percent of eligible riders participated and usable data was obtained from 66% (n = 776). Factors significantly associated with riding unprotected were: youth (17–25 years) (RR = 2.00, 95% CI: 1.50–2.65), not seeking protective clothing information (RR = 1.29, 95% CI = 1.07–1.56), non-usage in hot weather (RR = 3.01, 95% CI: 2.38–3.82), awareness of social pressure to wear more protection (RR = 1.48, 95% CI: 1.12–1.95), scepticism about protective benefits (RR = 2.00, 95% CI: 1.22–3.28) and riding a scooter vs any type of motorcycle. A similar cluster of factors including youth (RR = 1.17, 95% CI: 1.04–1.32), social pressure (RR = 1.32, 95% CI: 1.16–1.50), hot weather (RR = 1.30, 95% CI: 1.19–1.41) and scooter vs motorcycles were also associated with wearing non-motorcycle pants. There was no evidence of an association between use of protective clothing and other indicators of risk taking behaviour.

Conclusions

Factors strongly associated with non-use of protective clothing include not having sought information about protective clothing and not believing in its injury reduction value. Interventions to increase use may therefore need to focus on development of credible information sources about crash risk and the benefits of protective clothing. Further work is required to develop motorcycle protective clothing suitable for hot climates.     

Alcohol- or drug-use disorders and motor vehicle accident mortality: A retrospective cohort study

A large body of research has linked alcohol consumption and motor vehicle accidents (MVAs), but far fewer studies have estimated the risk of MVA fatality among drug users. Our study addresses this gap. We identified cohorts of individuals hospitalized in California from 1990 to 2005 with ICD-9 diagnoses of methamphetamine- (n = 74,170), alcohol- (n = 592,406), opioids- (n = 68,066), cannabis- (n = 47,048), cocaine- (n = 48,949), or polydrug-related disorders (n = 411,175), and these groups were followed for up to 16 years. Age-, sex-, and race-adjusted standardized mortality rates (SMRs) for deaths due to MVAs were generated in relation to the California general population. Standardized MVA mortality ratios were elevated across all drug cohorts: alcohol (4.5, 95% CI, 4.1–4.9), cocaine (3.8, 95% CI, 2.3–5.3), opioids (2.8, 95% CI, 2.1–3.5), methamphetamine (2.6, 95% CI, 2–3.1), cannabis (2.3, 95% CI, 1.5–3.2) and polydrug (2.6, 95% CI, 2.4–2.9). Males and females had similar MVA SMRs. Our large, population-based study found elevated risk of MVA mortality across all cohorts of individuals with alcohol- or drug-use disorders. Given that illicit drug users are often unaware of or misperceive the impacts of drug use on safe driving, it may be important for health-service or public-health interventions to address such biases and improve road safety.     

Public attitudes towards motorcyclists’ safety: A qualitative study from the United Kingdom

The aim of the reported research was to examine the perceptions of road user safety amongst different road users and examine the link between attitudes, empathy and skill in motorcycle safety behaviour. Motorcyclists were perceived by the study participants, members of the public at four different locations at the UK (including motorcyclists and non-motorcyclists), as a group be at a high risk of accidents on the road. This was due to perceived behavioural characteristics of motorcyclists – who were viewed as ‘thrill seekers’ – as well as observed behaviours on the road. This, coupled with the physical vulnerability and excessive speeds, meant that motorbike driving was considered by the study participants as the least safe form of road use. There was broad agreement that motorcycling was dangerous as a whole, but not all motorcyclists were necessarily risky riders. The issue of ‘competitive space’ emerged between car drivers and motorcyclists in particular and it was suggested that there was a lack of mutual awareness and considerations between the two groups. Generally, greatest empathy comes from drivers who are motorcyclists themselves. Engineering, education, enforcement interventions were investigated. These were aimed at two main areas: normalising safer driving behaviours for motorcyclists and increasing awareness of bikes for motorists—particularly in relation to reducing speed limits at urban junctions. Finally, the idea of risk mapping and reduced speed limits on rural roads was seen as potentially effective—particularly as certain motorcyclists highlighted that they changed their riding behaviours by increasing speed and taking greater risks on these roads.     

Traffic safety among motorcyclists in Norway: A study of subgroups and risk factors

Although it is widely recognized that motorcyclists have a particularly high accident risk, our knowledge of the mechanisms producing this accident risk is incomplete. The aims of the present paper are to identify subgroups of motorcyclists with a particularly high accident risk and to identify the relevant risk factors at work. The study presented in this paper relies both on a questionnaire (N = 3356) relating rider characteristics, behaviors and accident risk, and analyses of fatal motorcycle accidents (ca. 100) from 2005 to 2008 in Norway. The results reveal that riders of racing replica bikes (sport bikes), and riders younger than 19 years, including especially youths (16–17 years) riding light motorcycles (≤125 cm³), are subgroups of Norwegian motorcyclists with particularly high accident risks. Analysis of fatal motorcycle accidents reveals that about half of the fatal accidents involve sport bikes. Nearly all fatal accidents with sport bikes involved excessive speed. The combination of low age, low experience, risky behavior and “unsafe” attitudes seems to be a particular potent risk factor for Norwegian motorcyclists.     

Motorcycle-related injuries in the United Arab Emirates

Objectives

To study the anatomical distribution, severity, outcome, and age by nationality of hospitalized motorcycle-related injured patients in Al-Ain, United Arab Emirates so as to improve preventive measures.

Methods

All motorcycle riders involved in a road traffic collision and admitted to Al-Ain Hospital for more than 24 h or who died in hospital after arrival were studied. Patient data were retrieved from Al-Ain Hospital Trauma Registry. Data had been prospectively collected during four and half years (March 2003–October 2007). Demography of patients, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), Hospital stay, mortality, nationality, time, day of week, and month of occurrence were analyzed.

Results

There were 95 patients (93 males). Mean (SD) age was 29.8 (11.5) years. 35% were United Arab Emirates (UAE) nationals. Upper limbs were most frequently involved (54%) followed by lower limbs (48%), head (41%), and face (30%). On arrival at hospital, median (range) ISS was 4.5 (1–36) and median (range) GCS was 15 (3–15). Mean (range) hospital stay was 8.8 (1–79) days. 14 patients (15%) were admitted to the Intensive Care Unit. In-hospital mortality was 6%. UAE national victims were significantly younger and had more abdominal injuries than expatriates, who had lower limb injuries.

Conclusions

The most common mechanism of motorcycle crashes was hitting a moving vehicle. Young UAE national motorcyclists are at a higher risk of being injured compared with non UAE nationals. This may be due to risk-taking behavior of young motorcyclists who are mainly riding for leisure. Extremities were the most common injured body region. Severe head injury was the main cause of death. This signifies the need for effective application of motorcycle helmet law in the UAE along with other preventive measures that might include increasing the licensing age.     

Understanding on-road practices of electric bike riders: An observational study in a developed city of China

Although millions of electric bikes (E-bikes) operate in China and many associated deaths and injuries have been reported, E-bikers’ on-road practices are poorly characterized and few direct observational studies have been performed. This study aims to describe riding behaviors among E-bikers and to investigate factors influencing these practices to inform injury prevention. In March 2012, a cross-sectional observational study was conducted at 14 randomly selected intersections in Suzhou during a 7-day period. A pro-forma observation checklist was used to collect data on road riding practice. Adjusted Odds Ratios (OR) and 95% Confidence Intervals (CI) to assess the likelihood of specific riding practices among E-bikers were evaluated using mixed-effects logistic regression. Among 18,150 E-bikers observed, 37.6% rode E-bikes with cycling pedals, 86.0% of E-bikes were registered, 26.6% did not comply with the road rules, and 41.1% wore at least one safety item. The overall prevalence of carrying passengers, riding in a motor vehicle lane, running red lights, riding in opposite directions (i.e., facing oncoming traffic), mobile phone use, and helmet use were 12.4% (95%CI: 11.9–12.9%), 1.9% (95%CI: 1.7–2.1%), 4.8% (95%CI: 4.5–5.1%), 3.4% (95%CI: 3.1–3.7%), 0.4% (95%CI: 0.3–0.5%), and 9.0% (95%CI: 8.5–9.4%), respectively. Male E-bikers was associated with increased helmet use and riding in motor vehicle lanes, whereas riding a registered E-bike was associated with reduced likelihood of carrying passengers. This study demonstrates common road rule violations and low helmet use among E-bikers and supports the urgent need to develop additional regulations and behavioral interventions to improve safety practice among E-bikers in China.     

Barriers to, and factors associated, with observed motorcycle helmet use in Vietnam

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.     

The frequency and predictors of helmet use among Iranian motorcyclists: A quantitative and qualitative study

Objective

This study examines the rate of helmet use and identifies barriers and facilitators of wearing helmets among Iranian motorcyclists. A mixed-method approach was used, including a structured seasonal survey with specific observations of a random sample of 6010 riders and qualitative methods that included 29 in-depth interviews and seven focus groups (n = 31).

Results

Only 10% of motorcyclists wear a standard helmet while riding. However, another 23% of motorcyclists used non-standard or partial helmets that covered only part of the head and do not prevent head trauma injuries effectively. We observed only 2 of 264 child passengers and 22 of 1951 adult passengers wearing helmets. Almost no one used protective pants or clothing made to be more visible in traffic. Themes emerged from qualitative interviews and were grouped into three main categories: (1) helmet characteristics; (2) social and cultural factors; and (3) personal and psychological factors.

Conclusion

Overall, the motorcyclists in our study believed that wearing a safety helmet protects them against serious injuries or death during a crash; however, only a small percentage of the motorcyclists used safety helmets. National intervention programs addressing motorcycle safety should aim to overcome barriers to and promote facilitators of helmet use, including providing inexpensive standard helmets, banning manufacturing/using unsafe partial or dummy helmets, as well as enforcing helmet use on a consistent basis.     

Risk factors for fatal road traffic accidents in Udine, Italy.

In the Province of Udine, Northeast Italy, mortality from road accidents is 37% higher than in the country as a whole. To identify the major risk factors for fatal crashes in this area, we analyzed the Police reports of 10,320 road traffic accidents that occurred from 1991 to 1996. Logistic regression was used to evaluate the association of characteristics of drivers and accidents with accident severity. The risk of involvement in fatal rather than non-fatal accidents was lower among females than among males (odds ratio (OR) = 0.65; 95% confidence interval (95% CI), 0.53-0.80). Compared with subjects < 30 years of age, subjects aged > or = 65 had a significantly increased risk of fatal injury as pedestrians (OR = 10.87; 95% CI, 4.45-26.54), car drivers (OR = 1.85; 95% CI, 1.08-3.18), moped riders (OR = 3.53; 95% CI, 1.42-8.78), and bicycle riders (OR = 7.72; 95% CI, 2.56-23.29). In accidents that occurred from 1:00 to 5:00 h the risk of death was higher than from 6:00 to 11:00 h among pedestrians (OR = 8.88; 95% CI, 2.58-30.52), car drivers (OR = 4.95; 95% CI, 3.09-7.95), motorcycle riders (OR = 13.44; 95%CI, 2.54-71.05) and moped riders (OR = 8.76; 95% CI, 2.42-31.69). Risk of death among pedestrians, car drivers, moped, and bicycle riders was also significantly increased on roads outside the urban center. Driver's injury was strongly associated with lack of use of seat belts (OR = 13.27; 95% CI, 9.39-18.74, for fatal injury; OR = 2.49; 95% CI, 2.17-2.86, for non-fatal injury). Simple interventions focused on protecting the weakest road users and based on law enforcement, behavioral change and environmental modification might result in reducing the significant excess of road traffic accident mortality found in the study area.     

The culpability of drivers killed in New Zealand road crashes and their use of alcohol and other drugs

Over a period of five years, blood samples were taken from 1046 drivers killed as a result of a motor vehicle crash on New Zealand roads. These were analysed for the presence of alcohol and a range of both illicit drugs and psychoactive medicinal drugs. Driver culpability was determined for all crashes. The control group of drug- and alcohol-free drivers comprised 52.2% of the study population. Drivers positive for psychoactive drugs were more likely to be culpable (odds ratio (OR) 3.5, confidence interval (CI) 95% 2.4–5.2) than the control group. Driver culpability exhibited the expected positive association with alcohol use (OR 13.7, 95% CI 4.3–44) and with combined alcohol and cannabis use (OR 6.9, 95% CI 3.0–16). There was only a weak positive association between cannabis use (with no other drug) and culpability (OR 1.3, CI 95% 0.8–2.3). Furthermore, the OR for drivers with blood tetrahydrocannabinol (THC) concentrations greater than 5 ng/mL was lower (OR 1.0, CI 95% 0.4–2.4) than drivers with blood THC concentrations less than 2 ng/mL (OR 3.1, CI 95% 0.9–10). This is inconsistent with results reported by other studies where a significant increase in crash risk was found with blood THC levels greater than 5 ng/mL. In this study, there were very few drivers who had used a single drug, other than cannabis or alcohol. Therefore, from this study, it is not possible to comment on any relationship between opioid, stimulant or sedative drug use and an increased risk of being killed in a crash for the drivers using these drugs. The results from a multivariate analysis indicate that driver gender, age group and licence status, (P = 0.022, P = 0.016, P = 0.026, respectively), the type of vehicle being driven (P = 0.013), the number of vehicles in the crash (P < 0.001), the blood alcohol concentration of the driver (P < 0.001) and the use of any drug other than alcohol and cannabis (P = 0.044), are all independently associated with culpability.     

Mortality from road traffic accidents in Switzerland: longitudinal and spatial analyses

Road traffic accidents (RTA) are an important cause of premature death. We examined socio-demographic and geographical determinants of RTA mortality in Switzerland by linking 2000 census data to RTA mortality records 2000–2005 (ICD-10 codes V00–V99). Data from 5.5 million residents aged 18–94 years, 1744 study areas, and 1620 RTA deaths were analyzed, including 978 deaths (60.4%) in motor vehicle occupants, 254 (15.7%) in motorcyclists, 107 (6.6%) in cyclists, and 259 (16.0%) in pedestrians. Weibull survival models and Bayesian methods were used to calculate hazard ratios (HR), and standardized mortality ratios (SMR) across study areas.Adjusted HR comparing women with men ranged from 0.04 (95% CI 0.02–0.07) in motorcyclists to 0.43 (95% CI 0.32–0.56) in pedestrians. There was a u-shaped relationship with age in motor vehicle occupants and motorcyclists. In cyclists and pedestrians, mortality increased after age 55 years. Mortality was higher in individuals with primary education (HR 1.53; 95% CI 1.29–1.81), and higher in single (HR 1.24; 95% CI 1.05–1.46), widowed (HR 1.31; 95% CI 1.05–1.65) and divorced individuals (HR 1.62; 95% CI 1.33–1.97), compared to persons with tertiary education or married persons. The association with education was particularly strong for pedestrians (HR 1.87; 95% CI 1.20–2.91). RTA mortality increased with decreasing population density of study areas for motor vehicle occupants (test for trend p < 0.0001) and motorcyclists (p = 0.0021) but not for cyclists (p = 0.39) or pedestrians (p = 0.29). SMR standardized for socio-demographic and geographical variables ranged from 82 to 190.Prevention efforts should aim to reduce inequities across socio-demographic and educational groups, and across geographical areas, with interventions targeted at high-risk groups and areas, and different traffic users, including pedestrians.     

The prevalence of non-standard helmet use and head injuries among motorcycle riders

OBJECTIVES: This study examined the prevalence of non-standard helmet use among motorcycle riders following introduction of a mandatory helmet use law and the prevalence of head injuries among a sample of non-standard helmet users involved in motorcycle crashes. METHODS: Motorcycle rider observations were conducted at 29 statewide locations in the 2 years following the introduction of the mandatory helmet use law in January, 1992. Medical records of motorcyclists who were injured in 1992 for whom a crash report was available and for whom medical care was administered in one of 28 hospitals were reviewed. Chi-squares and analysis of variance were used to describe differences between groups. RESULTS: Prevalence of non-standard helmet use averaged 10.2%, with a range across observation sites from 0 to 48.0%. Non-standard helmet use varied by type of roadway, day of week, and time of day. Injuries to the head were more frequent and of greater severity among those wearing non-standard helmets than both those wearing no helmet and those wearing standard helmets. CONCLUSIONS: Non-standard helmets appear to offer little head protection during a crash. Future study is needed to understand the dynamics leading to head injury when different types of helmets are worn.     

Safety riding program and motorcycle-related injuries in Thailand

A retrospective cohort study was conducted in Thailand from 2007 to 2009 to evaluate the efficacy of a safety riding program in preventing motorcycle-related injuries. A training group of motorcyclists were certified by the Asia-Pacific Honda Safety Riding Program in either 30-h instruction (teaching skills, riding demonstration) or 15-h license (knowledge, skills, and hazard perception) courses. The control group consisted of untrained motorcyclists matched on an approximately 1:1 ratio with the training group by region and date of licensure. In total, there were 3250 subjects in the training group and 2963 in the control group. Demographic data and factors associated with motorcycle-related injuries were collected. Motorcycle-related injuries were identified using the Road Injuries Victims Protection for injuries claims and inpatient diagnosis-related group datasets from the National Health Security Office. The capture–recapture technique was used to estimate the prevalence of injuries. Multivariate analysis was used to identify factors related to motorcycle-related injuries. The prevalence of motorcycle-related injuries was estimated to be 586 out of 6213 riders (9.4%) with a 95% confidence interval (CI): 460–790. The license course and the instruction course were significantly associated with a 30% and 29% reduction of motorcycle-related injuries, respectively (relative risk 0.70, 95% CI: 0.53–0.92 and 0.71, 95% CI: 0.42–1.18, respectively). Other factors associated with the injuries were male gender and young age. Safety riding training was effective in reducing injuries. These training programs differ from those in other developed countries but display comparable effects. Hazard perception skills might be a key for success. This strategy should be expanded to a national scale.     

Health status recovery at one year in children injured in a road accident: A cohort study

Despite the frequency of traumatic injuries due to road accidents and potential importance of identifying children at risk of impaired recovery one year after a road accident, there is a lack of data on long-term recovery of health status, except in children with severe traumatic brain injury. The aim of the present study was to evaluate predictive factors of recovery in children one year after road traffic injuries. The prospective cohort study was composed of children aged <16 years, admitted to public or private sector hospitals in the Rhône administrative area of France following a road accident. Recovery of health status one year after the accident and information concerning quality of life and the consequences of the accident for the child or family 1 year after the accident were collected by questionnaire, usually completed by the parents. Victims were in majority male (64.6%) and had mild or moderate injuries (81.9% with Maximum Abbreviated Injury Scale (M-AIS) <3). One year after the accident, 75.0% of the mild-to-moderate and 34.8% of the severe cases estimated health status as fully recovered. After adjustment, severity score (M-AIS ≥ 3) and lower limb injury (AIS > 1) were associated with incomplete recovery of health status: weighted odds ratio (OR_w), 4.3 [95% confidence interval (95% CI), 1.3–14.6] and OR_w, 6.5 [95% CI, 1.9–21.7], respectively. Recovery status correlated significantly with quality of life physical scores (r = 0.46), especially body pain (r = 0.48) and role/social–physical (r = 0.50) and, to a lesser extent, quality of life psychosocial scores (r = 0.21). In a cohort of children injured in a road accident, those with high injury severity score and those with lower limb injuries are less likely to recover full health status by 1 year. Impaired health status was associated with a lower physical quality of life score at 1 year.