Legislation and Enforcement to Increase Motorcycle Helmet Use: Synthesis of Existing Systematic Reviews

Motorcycles are a popular mode of transport in many low- and middle- income countries (LMICs); in some of these regions they account for up to 70% of vehicles on the road [1]. For this reason, it is important that motorcyclists in these countries are well protected. Head injuries are the leading cause of motorcycle-related death for riders, so it is essential that they wear a high quality, properly fitted helmet in order to decrease their risk of serious injury or death [2]. Research has shown that wearing a helmet can reduce an individual’s risk of dying by 42% and their risk of sustaining a serious injury by 69% [3].
To conclude, the synthesis of results from existing systematic reviews on the effectiveness of mandatory motorcycle helmet laws revealed an average motorcyclist fatality reduction of 26% and an average motorcyclist injury reduction of 27% post-implementation. The average fatality and injury reductions differed when looking only at results from LMICs; the average motorcyclist fatality reduction in LMICs was 16% (CMF 0.84, 95% confidence interval 0.61 to 1.16) and the average injury reduction was 39% (CMF 0.61, 95% confidence interval 0.44 to 0.85). However, these estimates were based on fewer studies and had larger confidence intervals compared to the results from HICs. Although LMICs are the main target audience for the Road Safety Calculator, the current evidence available for the effects of mandatory helmet laws in LMICs is limited and lacks the consensus seen in results from HICs. Therefore, the research team recommends using the CMFs calculated for all income levels, which are 0.74 for motorcyclist fatalities (95% confidence interval 0.72 to 0.76) and 0.73 for motorcyclist injuries (95% confidence interval 0.56 to 0.94).