Background Two-wheeler users accounted for 37% of 1,33,201 persons killed in road crashes in India in year 2019, implying need to strengthen helmet use

Aims To estimate helmet use patterns among two-wheeler users in Bengaluru city; to conduct data-driven advocacy to highlight the problem of non-standard helmet use and seek stricter implementation of standard helmet use.

Methods Between December-2021 – February-2022, we collected Helmet use data across 15 randomly sampled representative locations in Bengaluru city, using a multistage sampling technique. Trained investigators recorded helmet use data using standardized handheld android tablet devices. Helmet use were defined as Standard helmet (fully strapped full-face helmet) and non-standard helmets (unstrapped, inappropriate sizes and types). Each site was observed at different time intervals to capture the varying traffic volume and weather. We performed descriptive analysis to estimate the proportions and patterns of helmet use, and binary logistic regression to estimate the odds of standard helmet use, by select covariates. Ethics approvals was obtained from NIMHANS and JH-IIRU.

Results We observed 98021 two-wheeler users. Overall helmet use was 92% but standard helmet use was just 24%. Nearly 26% of riders and 20% of pillion used cap helmets (low grade non-standard helmet). The odds of standard helmet use were 1.18 times among persons aged 18+ years and 3.3 times among males. Advocacy programmes were held with Police triggered sensitization drive to deter use of cap helmets.

Conclusion Despite the high coverage of helmet use, standard helmet use is significantly low among two-wheeler users, specifically among youth. Widespread use of cap helmets is alarming as they offer no protection against head injuries. We strongly advocate the need for data-driven programmes to reinforce the use of a standard, helmet use.

Learning Outcomes Large scale evidence-based data using robust assessment are useful to advocate for standard helmet use, sensitize traffic police department and the public, leading to stricter enforcement. However such efforts need to be repeatedly and consistently implemented to allow evidence-based policy revisions and enforcement activities for improving standard helmet use.

Support – Project funded by Johns Hopkins International Injury Research Unit (JH-IIRU)