Abstract
The dispersion of motorcycle related injuries and deaths might be a result of disparity in motorcycle helmet use. This study uses national roadside survey data, injury sentinel surveillance data and other national data sets in 2010 of Thailand, a country with high mortality related to motorcycle injuries, to explore the disparity in helmet use, explanatory factors of the disparity. It also assessed potential agreement and correlation between helmet use rate reported by the roadside survey and the injury sentinel surveillance. This report revealed helmet use rate of 43.7%(95% CI:43.6,43.9) nationwide with the highest rate (81.8%; 95% CI: 44.0,46.4) in Bangkok. Helmet use rate in drivers (53.3%; 95% CI: 53.2,53.8) was 2.5 times higher than that in passengers (19.3%; 95% CI:18.9,19.7). In relative terms (highest-to-lowest ratio,HLR), geographical disparity in helmet use was found to be higher in passengers (HLR=28.5). Law enforcement activities as indicated by the conviction rate of motorcyclists were significantly associated with the helmet use rate (spline regression coefficient = 3.90, 95% CI: 0.48,7.33). Together with the finding of HLR for conviction rate of 87.24, it is suggested that more equitable improvement in helmet use could be achieved by more equitable distribution of the police force. Finally, we found poor correlation (r=0.01; p value = 0.76) and no agreement (difference = 34.29%; 95% CI:13.48%, 55.09%) between roadside survey and injury sentinel surveillance in estimating helmet use rate. These findings should be considered a warning for employing injury surveillance to monitor policy implementation of helmet use.
Highlights
Road traffic injuries (RTIs) have been increasing in many regions of the world in contrast to declining trends in highly motorized countries [1]
Making use of road-side surveys on helmet use, injury sentinel surveillance and other relevant datasets, this report aims to shed some lights on inequity in helmet use and factors associated with it, and the discrepancy between helmet use rates which were estimated by the survey data and the surveillance data in Thailand
Our model suggested that the ln(conviction rate) was linearly correlated with helmet use rate (t = 2.27, p = 0.026) by increasing 1 unit of ln(conviction rate) would increase helmet use rate of 3.9%
Summary
Road traffic injuries (RTIs) have been increasing in many regions of the world in contrast to declining trends in highly motorized countries [1]. At the area level, accumulated evidence supports an association between economic deprivation and low population density and severe RTIs after taking account for the Concerning reduction of RTIs, the body of evidence supports legislative measures on safety behaviors like helmet use, seat belt use, and compliance to speed limits [9,10]. RTIs in highly motorized countries mostly involve car drivers, whereas they are motorcycle riders in certain countries of Asia, e.g., Thailand and Vietnam [10,12]. In contrast to the argument of White et al [11], legislative measures for helmet use applies only on certain assigned routes and national roads in Vietnam which resulted in 6 times the prevalence on inner-city roads [13]
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