Helmets and traffic injury outcomes: Findings from a setting lacking legislation on proper wearing and quality assessment

Abstract

Objective: We assessed the effectiveness of helmet wearing for improving traffic injury outcomes in a setting lacking legislations on proper wearing and quality assessment of helmets. Methods: The study included motorcycle riders from Karachi, Pakistan, who were involved in a road traffic crash between 1 January 2007 and 30 September 2013. We estimated likelihoods of death and severe injury in riders wearing helmets compared to those not wearing them. Results: Only 6% (n = 6,092) of the 109 210 riders wore helmets. Helmet wearing was about 1% in pillion riders, women, and children. About 2% of riders died (n = 1,949) and 15% (n = 16,051) were hospitalized. About a third of riders (n = 37,439, 34%) suffered from head injuries, 30% (n = 33,130) had facial injuries, 46% (n = 50,264) had extremity injuries, and 61% (n = 67,094) had external body injuries. Those wearing helmets were less likely to die (adjusted odds ratio [aOR] = 0.37, 95% confidence interval [CI] = 0.28–0.50) or sustain a severe head injury (aOR = 0.70, 95% CI = 0.55–0.89) than others. The preventive effects however disappeared in high-impact collisions, e.g. heavy vehicles, head-on. Conclusion: Helmets effectively reduced the likelihood of deaths and serious head injuries in the injured motorcyclists in Pakistan. Improving legislation and enforcement could help further prevent deaths and serious head injuries in Pakistan and similar settings.

Keywords

• developing country
• motorcycle
• traffic accident