C. Pathak1, S. Siddiqui2, S. Sagar3, M. Swaroop1 1Feinberg School Of Medicine – Northwestern University,Chicago, IL, USA 2Johns Hopkins University School Of Medicine,Baltimore, MD, USA 3The All India Institute Of Medical Sciences,New Delhi, India, India
Introduction: Helmet usage laws have been a cornerstone in preventing and minimizing injuries in motorized two-wheeled (MTW) vehicle accidents. In 1988, India passed the Motor Vehicle Act nationally, making it mandatory for MTW riders to wear helmets. In 1999, the Act was challenged as undermining religious expression in the New Delhi High Court and an exemption was passed, allowing women and Sikhs to ride pillion without wearing helmets. These exemptions made the law difficult to enforce. In a study conducted of MTW pillions in New Delhi in 2011, 58.7% were helmeted and 41.3% were unhelmeted. In 2014, the New Delhi government revised the exemption requiring all MTW riders to wear helmets, with fewer exemptions. The purpose of this study was to determine the prevalence of helmet usage in MTW vehicle riders in New Delhi, India following the revision of the exemption.
Methods: An observational video study was conducted to determine the prevalence of helmet usage in MTW riders in New Delhi, India. At least twenty-five minutes of traffic video was recorded in the morning rush hour, mid-day and evening rush hour from June 15 to June 25, 2016 at four representative intersections in the city: Rajiv Chawk Circle and Barakhambha road, AIIMS Trauma Center and Mahatma Ghandi road, India Gate C Hexagon, and Safdarjung Hospital and Mahatma Gandhi road intersections. The video recordings were analyzed for the number of MTW riders, gender, approximate age (adult or child), and helmet usage by two reviewers who are versed in Indian culture.
Results: A total of 12,625 MTW riders were observed on video. Of those, 88% (11,121) were male, 10% (1198) were female and 2% (237) were children. Compared to the 2011 study, the percentage of MTWs who used helmets increased from 88.4% to 93% for males, p<0.001 and from 0.6% to 45% for females, p<0.001. While the percentage of women who were helmeted increased from the 2011 study, there remained a significant difference, p<0.0001, in the percentage of males and females that were helmeted. Of the children observed, only 6% were helmeted. However, there are no data points for comparison from the 2011 study for children.
Conclusion: Since the revision of the exemption, there has been an increase in male and female MTWs using helmets. While males already demonstrated a high rate of helmet usage, the rate of increase in helmet usage by women has been dramatic. Overall, however, the rate of helmet usage for women remains low, at 45%. Additionally, helmet usage in children remains exceptionally low at 6%. While the change in mandatory helmet laws is a significant factor in influencing an increase in overall helmet usage, additional factors including improved media and public educational campaigns, law enforcement, and shifting cultural norms may affect usage as well. Barriers to helmet usage by women and children need to be studied further to improve the rate of helmet usage in these populations.