Introduction In many developing countries, multiple riders are present on motorcycles; with varying degrees of helmet legislation compliance. Sri Lankan injury surveillance records determined 44.8% of the road injuries involved motorcycles. In collaboration with the Ministry of Health, an observational study of three cities was conducted to assess patterns of helmet usage among adults/children. Mandatory motorcycle helmet legislation for adults is present in Sri Lanka; no formal paediatric legislation exists.
Methods Injury data was analysed for types/causes related to motorcycles. A three-city observational study was conducted, during peak travel times. Riders were categorised for age, gender, helmet usage/type.
Results 2194 motorcycles with 3309 riders were observed. Most riders were adults (86.97%) with 12.87% children. Adult helmet use was 97%, while child usage was 31%. 92% of women wore helmets compared to 97% of men. The capital Colombo and Kurnegala had higher usage with 92% and 88%; Puttalam 70%. 81% wore open face helmets. Results were shared with the Trauma Secretariat for advocacy and public health policy.
Conclusions Despite high helmet usage by adults, the majority of children are not wearing motorcycle helmets, increasing the risk of severe injury. In Asia, families often travel on motorcycles with infants, children and other family members, yet no formal WHO recommendations have been issued regarding paediatric motorcycle helmet usage. More research is needed to assess why helmets are not being used on children, availability and standards of helmets. Data must be used for advocacy, legislation and education.
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