Helmets

Motorcycle helmets reduce the risk of head injury by 60% and death by 42%.

helmet

Photo credit: Anatoliy Rakhimbayev

Why are motorcycle helmets important?

  • Deaths from motorized two-wheel vehicles (motorcycles, motorized scooters, etc) are disproportionately high compared to other vehicles. Head injuries resulting from motorcycle accidents cause severe morbidity. Helmets can help reduce deaths and head injuries resulting from motorcycle crashes.  

Do motorcycle helmets work?

  • Motorcycle helmets reduce the risk of head injury by 60% and death by 42%.

Equity: Do they work in the disadvantaged?

  • Motorcycle use is increasing in low and middle income countries. This review included studies conducted in four low and middle income countries and found motorcycle helmets to be effective.

Intervention Delivery

  • All but one of the included studies were observational and collected motorcycle crash or hospital data.

Population and Setting

  • Most participants were from high income countries (Austria, Australia, Belgium, France, Germany, Greece, Italy, Japan, Sweden, UK, US) but four studies were based in low- and middle-income countries (China, India, Indonesia, Thailand)

  • Study participants were mainly identified from hospitals (those presenting following motorcycle accidents), linking data from police reports to hospital data, and databases such as routinely collected information (e.g. the Fatal Accident Reporting System in the US) and trauma databases. One study recruited college students to participate.

Summary of Findings [SOF] Table:

Patient or population: drivers aged 14 and up
Settings: low-, middle-, and high-income countries
Intervention: Helmet
Comparison: No helmet

Outcomes

Anticipated absolute effects

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Without helmet

With helmet (95% CI)

 

 

 

 

 

 

Death (unadjusted)

5.86 per 100

2.38 fewer (from 1.51 to 3.08 fewer)

OR 0.58 (0.46-0.73)

18,588 (16)

Moderate

Head injury (unadjusted)

40.1 per 100

18.98 fewer (from 18.15 to 20.25 fewer)

OR 0.40 (0.37-0.42)

25,892 (18)

Moderate

Adverse Events:

About quality of evidence (GRADE)
High quality (High): Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality (Moderate): Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality (Low): Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality (Very low): We are very uncertain about the estimate.

1. Risk of selection bias and lack of control for confounders.



 

Relevance of the review for disadvantaged communities

Motorcycle helmets reduce the risk of head injury by 60% and death by 42%.
This review included studies conducted in four low and middle income countries and found motorcycle helmets to be effective in reducing death and injury.

Findings

Interpretation

Equity – Which of the PROGRESS groups examined

 

Motorcycle helmets can effectively prevent deaths and head injuries due to motorcycle crashes.

Helmets are effective. However, the availability of helmets does not guarantee their use. Helmet legislation can increase helmet use rates.

The review does not report subgroup analyses by age or sex.

The review is unable to determine whether there are differences in effectiveness of helmets for male or female or older or younger drivers. It is likely that helmets have the same effectiveness assuming other factors, such as speed, are the same.

Most of the included studies were conducted in high income countries; however, 4 studies were in low/middle income countries.

Motorcycle helmets are likely effective in all countries.

Equity Applicability

 

This review found that helmets can prevent death and head injuries due to motorcycle crashes.

More research is needed to determine the effectiveness of motorcycle helmet legislation in increasing helmet use rates to prevent death and head injury from crashes.

Cost-equity

 

The review does not report on the cost effectiveness of motorcycle helmets.

Motorcycle helmets need to be available at a reasonable cost to the driver to ensure their purchase.

Monitoring & Evaluation for PROGRESS Groups

 

Few of the studies reported on differences in effectiveness depending on the type of helmet

More research is needed to determine whether there are differences in effectiveness depending on the type of helmet.

Few of the included studies examined the helmets to verify the quality of the helmets and whether they met safety standards.

Policymakers implementing helmet legislation in both high and low/middle income countries should take measures to ensure that helmets available meet safety standards and are of high enough quality to prevent head injuries and death and prevent the use of lower cost but sub-standard helmets.

Comments on this summary? Please contact Jennifer Petkovic.