Background Appropriate motorcycle helmet use can reduce the risk of death by 40% and severe injury by 70% in the event of a crash. Motorcycle use has increased in Mexico in recent years, less is known about the prevalence of helmet use—an important first step in advocating for change.

Aims/Objectives/Purpose To quantify the prevalence of motorcycle helmet use in three Mexican cities (Guadalajara-Zapopan, León, and Cuernavaca) within the context of ongoing road safety initiatives.

Methods Serial roadside observations were conducted by investigators from the Instituto Nacional de Salud Pública in Mexico and the Johns Hopkins International Injury Research Unit in November 2010, and June, and December 2011. Observations were done at randomly selected intersections with functioning traffic lights across varied days, times, and direction of travel.

Results/Outcomes A total of 6990 motorcycle users were observed: 94% were males, 89% were aged 18 years or older, and 90% were motorcycle drivers. Helmet use was higher among drivers than passengers (78.4% vs 55.2%, p<0.01) and among males than females (77.1% vs 59.4%, p<0.01). The overall prevalence of proper motorcycle helmet use was 76.1%; use was highest (p<0.01) in León (90.3%), followed by Cuernavaca (75.8%). Overall, helmet use among children <10 years was 48.3%, compared to ∼75% in older individuals.

Significance/Contribution to the Field Roadside observations indicate motorcycle helmet use in three Mexican cities needs to be improved. Since motorcycle use is increasing in Mexico, targeted interventions are necessary to impact this preventable cause of death and injury.