The determinants of motorcyclists helmet use: Urban arterial road in Khon Kaen City,Thailand

IntroductionCurrently, Thailand incurs the highest death toll of motorcyclists in the world. The aim of this study was to explore the factors influencing helmet use of motorcyclists in Khon Kaen City, Thailand by using the Logistic regression analysis.MethodThe samples, consisting of 27,977 riders and 6,947 riding passengers, were collected by CCTV installed at several signalized intersections along urban arterial roads.ResultsThe observation results reveal that only 67% of motorcyclists wore the helmets. The analysis results reveal that the helmet use of motorcyclists was significantly associated with the riding status, number of passengers, apparent age, motorcycle class, time of day, the presence of police booths at intersections and, especially, red light running behavior. The riders tended to wear helmets at 2.7 times higher rates than passengers. Adult motorcyclists tended to wear the helmets at 2.8 times higher rates than children. The motorcyclists riding the motorcycles over 125 cc tended to wear the helmets 1.9 times higher than those riding motorcycles under 125 cc. The motorcyclists riding in the morning and the afternoon tended to wear the helmets 5.0 and 3.8 times higher than in the evening. The motorcyclists riding through intersections with police booths tended to wear the helmets 2.2 times higher than those riding through intersection without police booths. However, the red light running riders intend to wear the helmets 0.6 times less than the legal riders.ConclusionsThe outcome of this study could determine the factors influencing motorcyclist's helmet use.Practical ImplicationsIt will be useful for a development of 100% helmet use program designed to lessen the fatality of motorcyclists along the urban arterial roads.     

Severity and patterns of injury in helmeted vs. non-helmeted motorcyclists in a rural state

Introduction: Under current law in our rural state, there is no universal requirement for motorcyclists to wear helmets. Roughly 500 motorcycle crashes are reported by the state each year and only a fraction of those riders wear helmets. We sought to determine the difference in injury patterns and severity in helmeted versus non-helmeted riders. Methods: Retrospective review (2014–2018) of a single level 1 trauma center’s registry was done for subjects admitted after a motorcycle collision. Demographic, injury and patient outcome data were collected. Patients were stratified by helmet use (n = 81), no helmet use (n = 144), and unknown helmet use (n = 194). Statistical analysis used Student’s t-test or Pearson’s χ² p-value ≤0.05 as significant. State Department of Transportation data registry for state level mortality and collision incidence over the same time period was also obtained. Results: Of the 2,022 state-reported motorcycle collisions, 419 individuals admitted to our trauma center were analyzed (21% capture). State-reported field fatality rate regardless of helmet use was 4%. Our inpatient mortality rate was 2% with no differences between helmet uses. Helmeted riders were found to have significantly fewer head and face injuries, higher GCS, lower face, neck, thorax and abdomen AIS, fewer required mechanical ventilation, shorter ICU length of stay, and had a greater number of upper extremity injuries and higher upper extremity AIS. Conclusions: Helmeted motorcyclists have fewer head, face, and cervical spine injuries, and lower injury severities: GCS and face, neck, thorax, abdomen AIS. Helmeted riders had significantly less mechanical ventilation requirement and shorter ICU stays. Non-helmeted riders sustained worse injuries. Practical Applications: Helmets provide safety and motorcycle riders have a 34-fold higher risk of death following a crash. Evaluating injury severities and patterns in motorcycle crash victims in a rural state with no helmet laws may provide insight into changing current legislation.     

Role of motorcycle type in fatal motorcycle crashes

IntroductionMotorcycles vary in design and performance capability, and motorcyclists may select certain motorcycle types based on driving preferences. Conversely, motorcycle performance capability may influence the likelihood of risky driving behaviors such as speeding. Both mechanisms may affect fatal crash risk when examined by motorcycle type. Although it was not possible to estimate the effect of each mechanism, the current study analyzed fatal crash data for evidence of motorcycle type differences in risky driving behaviors and risk of driver death.MethodsStreet legal motorcycles were classified into 10 types based on design characteristics and then further grouped as cruiser/standard, touring, sport touring, sport/unclad sport, supersport, and all others. For each motorcycle type, driver death rates per 10,000 registered vehicle years and the prevalence of fatal crash characteristics such as speeding were analyzed. Differences among motorcycle types concerning the effect of engine displacement were examined using Poisson regression.ResultsOverall, driver death rates for supersport motorcycles were four times as high as those for cruiser/standard motorcycles. Fatally injured supersport drivers were most likely to have been speeding and most likely to have worn helmets, but least likely to have been impaired by alcohol compared with drivers of other motorcycle types. The patterns in driver factors held after accounting for the effects of age and gender. Increased engine displacement was associated with higher driver death rates for each motorcycle type.ConclusionStrong effects of motorcycle type were observed on driver death rates and on the likelihood of risky driving behaviors such as speeding and alcohol impairment. Although the current study could not completely disentangle the effects of motorcycle type and rider characteristics such as age on driver death rates, the effects of both motorcycle type and rider age on the likelihood of risky driving behaviors were observed among fatally injured motorcycle drivers.Impact on IndustryCertain motorcycle designs, particularly supersport motorcycles, are associated with increases in risky driving behaviors and higher driver death rates. At present, there are no proven countermeasures for this situation. However, existing countermeasures such as helmet laws and automated speed enforcement could have a substantial benefit.     

Are helmet laws protecting young motorcyclists?

PROBLEM: The trend in state mandatory motorcycle helmet laws is away from universal coverage to partial coverage statutes that require only young riders to wear a helmet. Among partial coverage states substantial variation exists in this age requirement. How effective are motorcycle helmet laws at reducing young motorcyclist fatalities? METHOD: The dependent variable is the number of motorcyclist fatalities 15-20 years of age. Fixed effects negative binomial regression models are estimated using panel data for all 50 states and Washington DC, for the period 1975-2004. RESULTS: Universal helmet laws are associated with fatality rates that are 31% lower among motorcyclists 15-20 years of age. In contrast, partial coverage laws targeting young motorcyclists are statistically unrelated to a reduction in the fatality rates of this age group. DISCUSSION: The long-term consequence of the move away from universal helmet laws will be an increased level of risk faced by young motorcyclists. In many states, mandatory motorcycle helmet laws are not protecting even young riders.     

Adolescent noncompliance with age-specific versus universal US motorcycle helmet laws: Systematic review and meta-analysis

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.     

The effects of a mandatory motorcycle helmet law on helmet use and injury patterns among motorcyclist fatalities

BACKGROUND: The National Highway Traffic Safety Administration (NHTSA) has found that motorcycle helmets are 37% effective in preventing death and 65% effective in preventing brain injuries in a crash. Unfortunately, in 1995 Congress lifted federal sanctions against states without helmet laws and since then there have been a number of primary motorcycle helmet laws repealed or weakened. More lives could be saved and serious injuries avoided if there was increased helmet use throughout the United States. METHODS: This study analyzed helmet use and injury patterns among motorcycle riders in the United States involved in fatal crashes from 1995 through 2003 and compared the results between states with and without a primary helmet law. Age, sex, injury severity and helmet use are some of the variables obtained from the Fatality Analysis Reporting System (FARS). RESULTS: In the 20 states and the District of Columbia, which currently have a primary helmet law, 84.0% of fatally injured riders were wearing a helmet. In the 27 states with a secondary helmet law, 36.2% of fatalities used a helmet, and in the remaining three states with no law at all, helmet use dropped to 17.6%. In the two states (Arkansas and Texas) that changed from a primary helmet law to a secondary helmet law in 1997, helmet use decreased from 78.2% in 1996 to 31.7% in 2000. CONCLUSION: If all states were to enact a primary motorcycle helmet law, helmet use would dramatically increase while decreasing the number of motorcyclist head injuries and fatalities. IMPACT ON INDUSTRY: The results of this study will hopefully persuade law makers to enact primary helmet laws in all states throughout the nation. Helmet manufacturers can use this data to design more comfortable helmets while also improving upon the protective qualities of these safety devices.     

Modeling of Compliance Behavior of Motorcyclists to Proper Usage of Safety Helmets in Malaysia

A questionnaire study was carried out in Kajang, Malaysia on the compliance behavior of motorcyclists in relation to the proper usage of safety helmets. A total of 500 respondents were interviewed and the data analyzed using logistic regression method. Six variables were found to be significant at 5 percent level (p < 0.05): age, gender, distance of travel, location of travel, riders practice and perception of police enforcement. Compliance to the proper usage of safety helmet was higher for motorcyclists 21 years of age and above, female riders and pillion passengers, travelling in town areas, categorized as having good practices, who are able to predict enforcement activities and travelling a distance of 2 km and above.     

Examination of factors associated with use rates after transition from a universal to partial motorcycle helmet use law

Objectives: Motorcycle riders account for a disproportionately high number of traffic injuries and fatalities compared to occupants of other vehicle types. Though research has demonstrated the benefits of helmet use in preventing serious and fatal injuries in the event of a crash, helmet use has remained relatively stable in the United States, where the most recent national estimates show a 64% use rate. Use rates have been markedly lower among those states that do not have a universal helmet law for all riders. In 2012, the state of Michigan repealed its longstanding mandatory helmet use law. In order to gain insights as to the effects of this legislative change, a study was conducted to examine short-term changes in helmet use and identify factors associated with use rates.

Methods: A statewide direct observation survey was conducted 1 year after the transition from a universal helmet law to a partial helmet law. A random parameters logistic regression model was estimated to identify motorcyclist, roadway, and environmental characteristics associated with helmet use. This modeling framework accounts for both intravehicle correlation (between riders and passengers on the same motorcycle) as well as unobserved heterogeneity across riders due to important unobserved factors.

Results: Helmet use was shown to vary across demographic segments of the motorcyclist population. Use rates were higher among Caucasian riders, as well as among those age 60 and above. No significant difference was observed between male and female riders. Use was also found to vary geographically, temporally, and with respect to various environmental characteristics. Geographically, helmet use rates tended to be correlated with historical restraint use trends, which may be reflective of riding environment and general differences in the riding population. To this end, rates were also highly variable based upon the type of motorcycle and whether the motorcyclist was wearing high-visibility gear.

Conclusions: The study results demonstrate the short-term reduction in helmet use following transition from a universal to partial motorcycle helmet law. The reduction in use is somewhat less pronounced than has been experienced in other states, which may be reflective of general differences among Michigan motorcyclists because the state has also generally exhibited higher use rates of seat belts and other forms of occupant protection. The study results also highlight potential target areas for subsequent education and public awareness initiatives aimed at increasing helmet use.     

Are motorcycles really “donorcycles”? Examining organ donation rates between unhelmeted and helmeted motorcyclists

Introduction: Motorcycles are colloquially referred to as “donorcycles” among medical staff. However, the actual impact of helmet laws and helmet use on organ donation is unknown. Michigan’s 35-year-old universal helmet law (UHL) was repealed in April 2012 and replaced by a partial-helmet law. We hypothesized that there would be an increase in organ donation rates from unhelmeted motorcyclist fatalities. Methods: Michigan's Gift of Life Michigan organ donation database was queried from April 2008 through May 2015 in conjunction with the Michigan Trauma Quality Improvement Program database from the same time period. All in-hospital motorcycle crash fatalities were examined. Results: A three-fold increase was found in the rate of organ donation for unhelmeted motorcyclists compared to helmeted motorcyclists (p = 0.006). Motorcycle crash fatalities tended to be younger in age after the UHL repeal with an average age of 32.8 years versus 40.8, however, this finding was not statistically significant (p = 0.071). Additionally, there was no significant difference in organ donation rates pre-UHL repeal (2008–2012) versus post-repeal (2012–2015). Conclusions: This is the first study to demonstrate an increased rate of organ donation among unhelmeted motorcyclist fatalities compared to helmeted rider fatalities. There was no significant increase in the rate of organ donation following the Michigan UHL repeal. However, we identified that some motorcycle crash fatalities were from illegally unhelmeted riders in the past, prior to the repeal. Practical Application: Unhelmeted motorcyclists are three times more likely than helmeted riders to become organ donors, possibly due to the well documented increase in severe traumatic brain injuries in this population. From a public health perspective, helmets should be required for all motorcyclists and efforts to advocate in favor of helmet legislation should be supported by trauma systems and health professionals.     

Age and engine displacement are associated with unsafe motorcycle rider actions

Background: Our goal was to examine the relationship between age and engine displacement in cubic centimeters (CCs) and crash responsibility. Methods: Male motorcyclists, aged 16–94, involved in a fatal crash in the United States (1987–2015) who tested negative for both drugs and alcohol were included. Employing a case control design, cases had committed one or more Unsafe Motorcyclist Actions (UMAs), the proxy measure of responsibility; controls had no UMAs recorded. Odds ratios were computed via multinomial regression examining the effect of motorcyclists’ age and motorcycle displacement (up to 1500 CCs, in 250 CC increments) on crash responsibility by any UMA and top three individual UMAs committed. Results: A total of 19,166 motorcyclists met our inclusion criteria. Increased displacement was observed in older motorcyclists and in more recent crashes. Fifty-six percent of motorcyclists committed one or more UMAs (n = 10,743). The top three individual UMAs were: Speeding (35%, n = 6,728), Weaving (24%, n = 3,269), and Erratic Operation (6%, n = 1,162). Odds ratios for committing any UMA were the greatest for riders on 750 CC motorcycles, followed closely by 500 and 1000 CC motorcycles. By 1250 CCs the effect of displacement on rider crash responsibility (any UMA) was no longer statistically significant. Typically, younger ages (e.g., 20–30) on motorcycles with 500–1000 CCs were associated with the highest odds of either speeding, weaving, or erratic riding compared to similar aged riders on 250 CC motorcycles. Exceptions were observed, for example riders at 70 years of age on 1500 CCs having higher odds of speeding than younger riders on equivalent CC motorcycles. Conclusion: Education and legislative measures should be considered. Educationally, the development of training interventions focusing on control, stability, and breaking differences with more powerful motorcycles (750 to 1250 CCs) is needed. Legislatively, licensing tiers could be employed based on displacement and educational requirements. Education and legislative measures could help to curb the trend seen between high-powered motorcycles and crash responsibility.     

The role of sales of new motorcycles in a recent increase in motorcycle mortality rates

INTRODUCTION: The National Highway Traffic Safety Administration (NHTSA) has reported that mortality rates from crashes among motorcycle riders in the United States increased from 21.0 per 100 million motorcycle miles traveled in 1997 to 38.4 per 100 million motorcycle miles traveled in 2003. At the same time, annual domestic sales of new, on-road motorcycles increased from 247,000 in 1997 to 648,000 in 2003. METHOD: This study used data from the NHTSA Fatality Analysis Reporting System and annual sales figures for on-road motorcycles to determine if newer motorcycles were more likely to be involved in fatal crashes and if fatal crashes involving newer motorcycles could account for the mortality increase after 1997. RESULTS: Mortality rates were 7.9, 8.1, 5.4, and 2.9 per 10,000 motorcycles sold for motorcycles <1, 1-3, 4-6, and 7-11 years old, respectively, from 1994 to 2003. Assuming complete registration, the number of motorcycles sold during the 2000-2003 time period accounted for 42.4% of the total number of motorcycles registered in 2003. Motorcycles sold during 2000-2003 were associated with 52.5% of all motorcycle deaths in 2003. The increase in the number of deaths associated with motorcycles less than four years old between 1997 and 2003 accounted for 78.1% of the total increase in motorcyclist deaths over this time period. CONCLUSIONS: Two possible explanations for the association between high sales volumes and mortality rates are: (a) increased exposure from more extensive use of motorcycles when they are new; and (b) inexperience with motorcycle riding or with specific motorcycles. IMPACT ON INDUSTRY: This study suggests that the deaths of growing numbers of motorcyclists are a consequence of the financial success of the motorcycle industry.     

Motorcycle safety among motorcycle taxi drivers and nonoccupational motorcyclists in developing countries: A case study of Maoming,South China

Objective: An increasing number of motorcycle taxis have been involved in traffic crashes in many developing countries. This study examines the characteristics of both motorcycle taxi drivers and nonoccupational motorcyclists, investigates the risks they pose to road safety, and provides recommendations to minimize their risks.

Methods: Based on the data collected from a questionnaire survey of 867 motorcycle taxi drivers and 2,029 nonoccupational motorcyclists in Maoming, South China, comparisons were made to analyze differences of personal attributes, attitudes toward road safety, and self-reported behavior of the 2 groups.

Results: Results of the chi-square tests show that not only motorcycle taxi drivers but also nonoccupational motorcyclists in Maoming held poor attitudes toward road safety and both groups reported unsafe driving behavior. There is much room for improving local road safety education among all motorcyclists in Maoming. Yet, motorcycle taxi drivers were more likely to pose road safety risks than nonoccupational motorcyclists under some circumstances, such as speeding late at night or early in the morning, not requiring passengers to wear helmets, and running a red light. The results of the binary logistic regression model show that possessing a vehicle license for a motorcycle or not was the common significant predictor for unsafe driving behavior of motorcycle taxi drivers and nonoccupational motorcyclists. Therefore, enforcement against all motorcyclists not showing vehicle licenses for their motorcycles should be stepped up.

Conclusion: Motorcycle safety is largely poor in Maoming. Therefore, efforts to improve motorcycle safety should be strengthened by targeting not only motorcycle taxi drivers but also nonoccupational motorcyclists.     

Risky behaviors and helmet use among young adolescent motorcyclists in Southern Thailand

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.     

Exposure factors of Victoria's active motorcycle fleet related to serious injury crash risk

Objective: The purpose of this study was to describe the nature and extent of current powered 2-wheeler (PTW) risk exposures in order to support future efforts to improve safety for this mode of transport.

Methods: A cross-sectional analysis of the control arm of a population-based case-control study was conducted. The control sample was selected from 204 sites on public roads within 150 km of the city of Melbourne that were locations of recent serious injury motorcycle crashes. Traffic observations and measurements at each site were sampled for a mean of 2 h on the same type of day (weekday, Saturday, or Sunday) and within 1 h of the crash time. Photographs of passing riders during this observation period recorded data relating to characteristics of PTWs, age of riders, travel speed of PTWs and all vehicles, time gaps between vehicles, visibility, and protective clothing use.

Results: Motorcycles and scooters represented 0.6% of all traffic (compared with 4% of all vehicle registrations). Riders were significantly more likely to have larger time gaps in front and behind when compared to other vehicles. The average travel speed of motorcycles was not significantly different than the traffic, but a significantly greater proportion were exceeding the speed limit when compared to other vehicles (6 vs. 3%, respectively). The age of registered owners of passing motorcycles was 42 years. Over half of riders were wearing dark clothing with no fluorescent or reflective surfaces. One third of motorcyclists had maximum coverage of motorcycle-specific protective clothing.

Conclusions: A very low prevalence of motorcyclists combined with relatively higher rates of larger time gaps to other vehicles around motorcycles may help explain their overrepresentation in injury crashes where another vehicle fails to give way. An increased risk of injury in the event of a crash exists for a small but greater proportion of motorcyclists (compared to other vehicle types) who were exceeding the speed limit. An apparent shift toward older age of the active rider population may be reducing injury crash risk relative to exposure time. There is significant scope to improve the physical conspicuity of motorcyclists and the frequency of motorcycle specific protective clothing use. These results can be used to inform policy development and monitor progress of current and future road safety initiatives.     

Motorcyclist perception response time in stopping sight distance situations

One of the most effective engineering measures is the provision of an exclusive motorcycle lane that separates motorcycles from other mixed traffic to reduce traffic congestion and motorcycle crashes. Even though the existing exclusive motorcycle lanes in Malaysia reduced the incidents of motorcycle crashes with other vehicles, the design of this special motorcycle lane was based on a cross reference between a bicycle track and a highway. Thus, a suitable design guide is yet to be developed for the geometrical design of a proper and safer exclusive motorcycle lane. Safe stopping sight distance (SSD) has been recognized as a criterion for road design and should be taken into account. Motorcyclist perception response time (PRT) is the time from detection object until the rider reduces motorcycle speed in braking action is an essential component of motorcycle SSD. Two road experiments were conducted to obtain empirical values of motorcycle PRT to expected and unexpected objects. In the expected condition, 89 motorcyclists applied brake as quickly as possible following activation of a light beside the road. In the unexpected condition, 16 riders responded by braking in response to an obstacle that appeared suddenly in their lane. The mean PRT to expected and unexpected object is 0.71 s and 1.25 s respectively. The 85th percentile PRT to unexpected object is 2.12 s. This study found that most riders are capable of responding to an unexpected object along the roadway in 2.5 s or less. Therefore, PRT of 2.5 s is an appropriate value for motorcycle lane geometric design.     

Florida's weakened motorcycle helmet law: effects on death rates in motorcycle crashes

OBJECTIVES: Effective July 1, 2000, Florida's universal helmet law was amended to exclude riders ages 21 and older with insurance coverage providing at least 10,000 US dollars in medical benefits for injuries sustained in a motorcycle crash. Observed helmet use in Florida was reported to have declined from nearly 100% in 1998, before the law change, to 53% after. This study examined the effects of the law change on the likelihood of death, given involvement in a motorcycle crash. METHODS: Rates of motorcyclist deaths per crash involvement in Florida for 2001-2002 (after the law change) were compared with those for 1998-1999 (before the law change). Before/after death rate ratios (95% CIs) were examined, and logistic regression models estimated the effect of the helmet law change on the odds of death in a crash, while controlling for rider gender, age, and seating position, and number of vehicles. RESULTS: The motorcyclist death rate increased significantly after the law change, from 30.8 to 38.8 deaths per 1,000 crash involvements. Motorcyclist death rates increased for single- and multiple-vehicle crashes, for male and female operators, and for riders of all ages including those younger than 21. After controlling for gender and age, the likelihood of death given involvement in a motorcycle crash was 25% higher than expected after the law change. It is estimated that 117 motorcyclist deaths could have been avoided during 2001-2002 if Florida's universal helmet law had remained in place. CONCLUSIONS: This study provides evidence of the life-saving benefits of universal helmet laws. The results also suggest that age-specific helmet laws are not effective in protecting the youngest drivers. This is not surprising, as these laws are largely unenforceable.     

Risk factors for motorcycle loss-of-control crashes

Objective: The present article identifies and assesses the effect of critical factors on the risk of motorcycle loss-of-control (LOC) crashes.

Method: Data come from a French project on road crashes, which include all fatal road crashes and a random sample of 1/20th of nonfatal crashes in France in 2011, based on police reports. A case–control study was carried out on a sample of 903 crashes for 444 LOC motorcycle riders (case) and 470 non-LOC and nonresponsible motorcycle riders (control). The sample was weighted due to the randomization of nonfatal crashes. Missing values were imputed using multiple imputation.

Results: Road alignment and surface conditions, human factors, and motorcycle type played important roles in motorcycle LOC crashes. Riding in a curve was associated with a 3-fold greater risk of losing control of motorcycle than riding in a straight line. Poor road adhesion significantly increased the risk of losing control; the risk increased more than 20-fold when deteriorated road adhesion was encountered unexpectedly, due to loose gravel, ice, oil, bumps, road marking, metal plates, etc. For motorcyclists, riding with a positive blood alcohol concentration (over or equal to the legal limit of 0.5 g/L) was very dangerous, often resulting in losing control. The risk of LOC crash varied for different types of motorcycle: Riders of roadsters and sports bikes were more likely to have an LOC crash greater than that of riders of basic or touring motorcycles. In addition, LOC risk increased with speed; a model using the square of the traveling speed showed better fit than one using speed itself.

Conclusion: The LOC crash factors related to riders, vehicles, and road infrastructure identified here were expected but were rarely identified and taken simultaneously into account in previous studies. They could be targeted by countermeasures to improve motorcyclist safety.     

Bicycle helmet use among persons 5 years and older in the United States, 2012

IntroductionIn 2013, injuries to bicyclists accounted for 925 fatalities and 493,884 nonfatal, emergency department-treated injuries in the United States. Bicyclist deaths increased by 19% from 2010 to 2013. The greatest risk of death and disability to bicyclists is head injuries. The objective of this study was to provide estimates of prevalence and associated factors of bicycle riding and helmet use among children and adults in the United States.MethodCDC analyzed self-reported data from the 2012 Summer ConsumerStyles survey. Adult respondents (18 + years) were asked about bicycle riding and helmet use in the last 30 days for themselves and their children (5 to 17 years). For bicycle riders, CDC estimated the prevalence of helmet use and conducted multivariable regression analyses to identify factors associated with helmet use.ResultsAmong adults, 21% rode bicycles within the past 30 days and 29% always wore helmets. Respondents reported that, of the 61% of children who rode bicycles within the past 30 days, 42% always wore helmets. Children were more likely to always wear helmets (90%) when their adult respondents always wore helmets than when their adult respondents did not always wear helmets (38%). Children who lived in states with a child bicycle helmet law were more likely to always wear helmets (47%) than those in states without a law (39%).ConclusionsDespite the fact that bicycle helmets are highly effective at reducing the risk for head injuries, including severe brain injuries and death, less than half of children and adults always wore bicycle helmets while riding.Practical applicationStates and communities should consider interventions that improve the safety of riding such as policies to promote helmet use, modeling of helmet wearing by adults, and focusing on high risk groups, including Hispanic cyclists, occasional riders, adults, and children ages 10 to 14.     

Bicycle helmet use among children in the United States: The effects of legislation, personal and household factors

Introduction

Children ages 5-14 years have the highest rate of bicycle-related injuries in the country. Bicycle helmets can prevent head and brain injuries, which represent the most serious type of bicycle-related injury.

Objectives

This paper compares children's bicycle helmet use to that estimated from an earlier study, and explores regional differences in helmet use by existing helmet legislation.

Methods

This study was a cross-sectional, list-assisted random-digit-dial telephone survey. Interviews were completed by 9,684 respondents during 2001-2003. The subset with at least one child in the household age 5-14 years (2,409 respondents) answered questions about bicycle helmet use for a randomly selected child in their household.

Results

Almost half (48%) of the children always wore their helmet, 23% sometimes wore their helmet, and 29% never wore their helmet. Helmet wearing was significantly associated with race, ethnicity, and child age but was not associated with the sex of the child. Other significant predictors of use included household income, household education, census region, and bicycle helmet law status. Statewide laws were more effective than laws covering smaller areas. The proportion of children who always wore a helmet increased from 25% in 1994 to 48% in 2001-2002. Significant increases in helmet use from 20% to 26% were seen among both sexes, younger (5-9 years) and older (10-14 years) children, and in all four regions of the country.

Conclusions

While there has been substantial progress in the number of children who always wear their helmets, more than half do not. Further progress will require using a combination of methods that have been shown to successfully promote consistent helmet use. Impact on industry: minimal.