Fall 2009 Editorial

All things must come to an end. This is the final edition of Headlines, the newsletter of the World Health Organization Helmet Initiative.

There are several reasons why publication of Headlines is ending, however, the major one has been the Helmet Initiative is a victim of its own success! In the past 17 years, there has been a dramatic change in attitudes towards bicycle and motorcycle helmets. In 1991, when the Helmet Initiative began, using a bicycle helmet or motorcycle helmet wasn’t very common. Then, only motorcycle riders in Europe wore helmets regularly. In Asia and the SE Asian Peninsula and Latin America, almost no motorcycle riders wore helmets. In most counties, few children – and even fewer adults – wore bicycle helmets. There were no laws requiring riders to wear bicycle helmets.

The idea for the Helmet Initiative came about in 1991 when several of the WHO Collaborating Centers for violence and injury prevention decided to join together and work on a common project to prevent injuries. Since bicycles and motorcycles were used worldwide and helmets had been shown to reduce serious head injury and even death for bicycle and motorcycle riders, we felt that a project to promote the use of bicycle and motorcycle helmets would be appropriate. And so the Initiative was born.

During the 17 years of existence of the Helmet Initiative, people have begun wearing helmets. Health and transport officials started talking about the benefits of wearing helmets. Policy changes to promote helmet wearing were made. In the South East Asia and Western Pacific regions these changes were dramatic. In Vietnam, helmets were designed for use in tropical climates, manufactured and distributed throughout the region. Universal helmet wearing laws were created and old laws were enforced in Thailand, Indonesia, Malaysia, and Vietnam. In Latin America, countries like Columbia and Mexico have enforced existing laws, resulting in dramatic declines in head injury rates. In the United States, Canada, the United Kingdom, Sweden, and Norway, bicycle helmet use became widespread, first for children, then for adults. This happened because of vigorous helmet promotion activities and by using mandatory laws. Now, throughout the world, helmets are a common sight everywhere. They’re just something that’s done – part of the riding equipment. Even professional bicycle racers are wearing helmets when they race.

We know a lot about the basics of helmets. We know they’re effective. We know that wearing laws – that are enforced impartially – increase helmet use. We know the effectiveness of peer pressure, helmet subsidies and giveaway schemes in increasing helmet use. We’ve developed helmet designs that are inexpensive and work, and they can be manufactured and worn in the tropics. We’re on the right track!

But in spite of the huge global increase in helmet wearing, we can’t celebrate yet. In many African and Latin American countries, helmets are worn infrequently. In the United States of America, motorcycle helmet use is decreasing as fewer states require helmet wearing. In Asia, although helmet use has been increasing, recent research shows that constant promotion and enforcement of laws are necessary in order to keep these wearing rates up. In Africa, few countries have policies in place that promote helmet wearing. Motorcycle taxi passengers and operators in some African cities suffer alarming injury rates because there are no helmet laws.

We appreciate your comments, contributions and encouragement through the past 17 years. We hope that you will continue to rely on science-based policy to promote helmets. Although we will discontinue publishing Headlines, the need to continue to promote use of helmets for all bicycle and motorcycle riders must go on. It is up to you to continue the efforts.

Thanks for your support and best of luck to you!

Philip L. Graitcer
Facilitator, WHO Helmet Initiative

United States: Repeal of Helmet Laws Compromise Safety
In the United States, for the past 40 years, there has been an ever changing pattern of helmet laws. Although each state develops and enforces its own traffic safety laws, the federal government has, at times, influenced state law making by requiring the inclusion of mandatory motorcycle helmet laws as a condition for receiving highway funding from the federal government. Since the 1970s, federally mandated requirements for states’ helmet laws have been changed several times. At present, no federal regulation exists requiring states to have mandatory helmet laws. As a result, many states have changed their helmet laws, either abolishing them or requiring helmets for only certain groups of riders. At present 20 states and the District of Columbia have universal motorcycle helmet laws. Four states – Colorado, Illinois, Iowa, and New Hampshire – have no helmet wearing requirement, and 26 states require only certain riders to use helmets. read more

U.S: Comparing Helmeted and Unhelmeted Motorcyclists
The State of Texas has had an on again, off again relationship with its universal motorcycle helmet laws. In 1968, a universal law was passed, and all motorcyclists and their passengers wore helmets. In 1977, this law was repealed. In 1989, a universal helmet law was again passed. In 1997, the universal law was again repealed, and helmets were not required if the operator was over 21 years old and had successfully completed a motorcycle safety course or was covered by a health insurance plan providing at least $10,000 in medical benefits for injuries incurred as a result of a motorcycle crash. read more

United States: Another look at helmet effectiveness using a trauma data base
Over 1,000 U.S. trauma centres and hospitals contribute patient data to the National Trauma Data Bank (NTDB). That means there are over 2 million patient records in it; more than 76,000 of them are motorcycle-related injuries. Croce and his colleages at the University of Tennessee Health Science Center in Memphis examined the motorcycle injury data and produced an analysis of what may be the largest motorcycle injury database to date. read more

United States: What works to reduce motorcycle injury?
Numerous studies have examined the effectiveness of alcohol and traffic policies in reducing automobile crashes and fatalities in the USA. Only a few studies have looked at the impact of state-specific policies on motorcycle safety. read more

Nigeria: Commercial motorcycle operators and passengers often injured
In Benin City, as in many cities in Nigeria, commercial motorcycle operators provide a valuable transportation service for many citizens. But, as Nzegwu and his colleagues at the University of Benin Teaching Hospital have shown, the risks of morbidity and mortality for both the operators and the passengers appear to be great. read more

New Zealand: Changing patterns of bicycle injuries
During the period, 1982-86, a childhood injury surveillance system was operated at the Whakatane Hospital Emergency Department in the Eastern Bay of Plenty in New Zealand. read more