Italy: Motor Scooter Riders and Helmets

Look at any tourist photos of Rome from the 1960s, and you’ll see beautiful fountains, pigeon-filled city squares, and lots of Italians on Vespa motor scooters. Today, you’ll still see the same beautiful street scenes, but now more than 90% of motor scooter riders are wearing helmets. That’s according to a new report by Giuseppe La Torre and his colleagues that examined head injury differences before and after the passage of a universal helmet wearing law (1).

Up to March, 2000, only motor scooter riders under 18 years were required to wear helmets. Since then, a universal law has been in effect that requires that all drivers wear helmets.

La Tore’s team used motor scooter injury data from the Emergency Department of a teaching hospital, comparing injury rates, demographic data, and injury severity during periods before, immediately after, and 3-6 months after the passage of the universal helmet law.

Their results showed significant changes. Helmet wearing increased from about 15% before the law to 97%  immediately after passage. Helmet use dropped to 90% six months later.  Head injury rates also declined, dropping from 25.65/10,000 person-years to 21.15/10,000 person-years immediately after- and 8.88/10,000 person-years 3-6 months after passage of the law. The most dramatic rates of change occurred in the those riders aged over 30 years. During those same periods before and after the law, however, the incidence rate of all injuries actually increased by about 50% with injuries to the extremities increasing proportionately more than other injuries. But these injuries may have been less severe – the average length of hospital stay declined from 7.1 to 5.6 days.

The authors believe that their study has confirmed that the law had its desired impact. Helmets reduced head trauma among two-wheeled riders. In Italy, non-helmeted riders were 2-4 times more likely to sustain head trauma than helmeted motor scooter riders. Their study also showed that the helmet law also had a great impact on helmet wearing – increasing usage to above 90%.

In spite of the success of the law, there remain research and policy questions: What kind of public education and police enforcement efforts will be needed to sustain high rates of helmet wearing? Is linking violations of helmet wearing laws to deduction of points from the driver’s licence a good strategy for law reinforcement? What kind of behavioural reinforcement should be undertaken?

(1) Giuseppe LT, VanBeeck E, Guiliano B, Walter R. Head injury resulting from scooter accidents in Rome: differences before and after implementing a universal helmet law. Eur J of Public Health (Advance publication, March 29, 2007). doi10.1093/eurpub/ckm028

back to Headlines