PT  - JOURNAL ARTICLE
AU  - Road Traffic Injuries Research Network Multicenter Study Collaborators
AU  - Williams Ackaah
AU  - Francis Afukaar
AU  - Williams Agyemang
AU  - Trinh Thuy Anh
AU  - A R Hejar
AU  - Ghaffar Abdul
AU  - Gopalkrishna Gururaj
AU  - Hidalgo-Solórzano Elisa
AU  - Híjar Martha
AU  - Adnan A Hyder
AU  - Cristina Inclán-Valadez
AU  - Subramaniam Kulanthayan
AU  - Robyn Norton
AU  - Wilson Odero
AU  - Eme T Owoaje
AU  - Margie Peden
AU  - Krishnan Rajam
AU  - Junaid Abdul Razzak
AU  - Adesola Oluwafunmilola Sangowawa
AU  - Jawaid Shah
AU  - Pham Le Tuan
AU  - Radin Umar RS
AU  - Nguyen Thi Van Anh
AU  - Marc Van der Putten
AU  - Nitaya Vajanapoom
AU  - Nuntavarn Vichit-Vadakan
AU  - Kaviyarasu Yellappan
AU  - James Yu
TI  - The use of non-standard motorcycle helmets in low- and middle-income countries: a multicentre study
AID  - 10.1136/injuryprev-2012-040348
DP  - 2013 Jun 01
TA  - Injury Prevention
PG  - 158--163
VI  - 19
IP  - 3
4099  - http://injuryprevention.bmj.com/content/19/3/158.short
4100  - http://injuryprevention.bmj.com/content/19/3/158.full
SO  - Inj Prev2013 Jun 01; 19
AB  - Background The use of non-standard motorcycle helmets has the potential to undermine multinational efforts aimed at reducing the burden of road traffic injuries associated with motorcycle crashes. However, little is known about the prevalence or factors associated with their use. Methods Collaborating institutions in nine low- and middle-income countries undertook cross-sectional surveys, markets surveys, and reviewed legislation and enforcement practices around non-standard helmets. Findings 5563 helmet-wearing motorcyclists were observed; 54% of the helmets did not appear to have a marker/sticker indicating that the helmet met required standards and interviewers judged that 49% of the helmets were likely to be non-standard helmets. 5088 (91%) of the motorcyclists agreed to be interviewed; those who had spent less than US$10 on their helmet were found to be at the greatest risk of wearing a non-standard helmet. Data were collected across 126 different retail outlets; across all countries, regardless of outlet type, standard helmets were generally 2–3 times more expensive than non-standard helmets. While seven of the nine countries had legislation prohibiting the use of non-standard helmets, only four had legislation prohibiting their manufacture or sale and only three had legislation prohibiting their import. Enforcement of any legislation appeared to be minimal. Interpretation Our findings suggest that the widespread use of non-standard helmets in low- and middle-income countries may limit the potential gains of helmet use programmes. Strategies aimed at reducing the costs of standard helmets, combined with both legislation and enforcement, will be required to maximise the effects of existing campaigns.