Effective factors of improved helmet use in motorcyclists: a systematic review

Abstract

Background Road traffic injuries (RTI) are one of the most prominent causes of morbidity and mortality, especially among children and young adults. Motorcycle crashes constitute a significant part of RTIs. Policymakers believe that safety helmets are the single most important protection against motorcycle-related injuries. However, motorcyclists are not wearing helmets at desirable rates. This study systematically investigated factors that are positively associated with helmet usage among two-wheeled motorcycle riders. Methods We performed a systematic search on PubMed, Scopus, Web of Science, Embase, and Cochrane library with relevant keywords. No language, date of publication, or methodological restrictions were applied. All the articles that had evaluated the factors associated with helmet-wearing behavior and were published before December 31, 2021, were included in our study and underwent data extraction. We assessed the quality of the included articles using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for observational studies. Results A total of 50 articles were included. Most evidence suggests that helmet usage is more common among drivers (compared to passengers), women, middle-aged adults, those with higher educations, married individuals, license holders, and helmet owners. Moreover, the helmet usage rate is higher on highways and central city roads and during mornings and weekdays. Travelers of longer distances, more frequent users, and riders of motorcycles with larger engines use safety helmets more commonly. Non-helmet-using drivers seem to have acceptable awareness of mandatory helmet laws and knowledge about their protective role against head injuries. Importantly, complaint about helmet discomfort is somehow common among helmet-using drivers. Conclusions To enhance helmet usage, policymakers should emphasize the vulnerability of passengers and children to RTIs, and that fatal crashes occur on low-capacity roads and during cruising at low speeds. Monitoring by police should expand to late hours of the day, weekends, and lower capacity and less-trafficked roads. Aiming to enhance the acceptance of other law-abiding behaviors (e.g., wearing seat belts, riding within the speed limits, etc.), especially among youth and young adults, will enhance the prevalence of helmet-wearing behavior among motorcycle riders. Interventions should put their focus on improving the attitudes of riders regarding safety helmets, as there is acceptable knowledge of their benefits.

Prevalence of motorcycle accidents among food delivery drivers and its relation to knowledge, attitudes, and practices in urban areas in Bangkok, Thailand

“…However, in our study, it is found that most FDDs wear a helmet properly while riding a motorcycle, attach the chinstrap to the helmet, and adjust it snugly while riding the motorcycle. Our study agrees with previous studies that the attitude that helmets cannot be protective correlated with not always wearing helmets [ 34 ]. In addition, most of them did not practice drinking alcohol before going out to deliver food.…”

Unveiling the road to safety: Understanding the factors influencing motorcycle accidents among riders in rural Chiang Mai, Thailand

“…It's interesting to note that non-helmeted riders have acceptable knowledge about the advantages and protective functions of helmets as well as the importance of wearing them [ 9 ]. It is challenging for authorities to enforce helmet use when riding since people often have acceptable knowledge and awareness.…”

“…It is challenging for authorities to enforce helmet use when riding since people often have acceptable knowledge and awareness. Several factors were found to positively influence helmet usage, such as riding on highways, long distances, helmet ownership, larger engine sizes, helmet prices, and the legal regulations [ 9 , 30 ]. To increase the use of helmets, public policy may therefore begin by focusing on those protective factors.…”

“…Although there was a difference in engine capacity between the accident and non-accident groups, this difference was not substantially connected with accidents when confounders were adjusted. Even larger engines were protective variables for wearing helmets [ 9 ], but several studies revealed that heavy engines were related to more incidence and serious crashes [ 10 , 11 ]. It can be due to the heavier weight, larger size, and greater potential power, speed, and momentum [ 44 ].…”

“…Three aspects of contributing variables to motorcycle accidents are vehicle factors [ [9] , [10] , [11] ] (engine capacity and vehicle visibility), environmental factors (road, weather, light, etc. ), and personal factors [ [12] , [13] , [14] , [15] , [16] , [17] , [18] ] (risky behavior, attitude, gender, age, etc.).…”