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25 AUGUST 2006 | GENEVA - Each year about 1.2 million people die as a result of road traffic crashes, and millions more are injured or disabled. Most of the deaths are preventable. In many low-income and middle-income countries, users of two-wheelers - particularly motorcyclists - make up more than 50% of those injured or killed on the roads. Head injuries are the main cause of death and disability among motorcycle users, and the costs of head injuries are high because they frequently require specialized medical care or long-term rehabilitation.
Wearing a helmet is the single most effective way of reducing head injuries and fatalities resulting from motorcycle and bicycle crashes. Wearing a helmet has been shown to decrease the risk and severity of injuries among motorcyclists by about 70%, the likelihood of death by almost 40%, and to substantially reduce the costs of health care associated with such crashes.
The World Health Organization (WHO) is intensifying efforts to support governments, particularly those in low-income and middle-income countries, to increase helmet use through a new publication, Helmets: a road safety manual for decision-makers and practitioners.
The manual is a follow-up to the World report on road traffic injury prevention, published in 2004 by WHO and the World Bank, which provided evidence that establishing and enforcing mandatory helmet use is an effective intervention for reducing injuries and fatalities among two-wheeler users. The manual has been produced under the auspices of the UN road safety collaboration, in collaboration with the Global Road Safety Partnership, the FIA Foundation for the Automobile and Society, and the World Bank, as one of a series of documents that aim to provide practical advice on implementing the recommendations of the World Report.
The importance of increasing helmet use follows dramatic growth in motorization around the world, largely from increasing use of motorized two-wheelers, particularly in Asian countries. In China, for example, motorcycle ownership over the last ten years has increased rapidly. In 2004 it was estimated that more than 67 million motorcycles were registered in the country, and approximately 25% of all road traffic deaths were among motorcyclists and their passengers.
"We want to make helmet use a high priority for national public health systems," says Dr. Anders Nordström, Acting Director-General of WHO. "We need to stress not only the effectiveness of helmets in saving lives, but the fact that helmet programmes are good value for money. Countries will recoup their investment in these programmes many times over through savings to their health care systems, as well as savings to other sectors."
Many countries have succeeded in raising rates of helmet use through adopting laws that make helmet use compulsory, enforcing these laws, and raising public awareness about the laws, as well as the benefits of helmet use. This new helmet manual draws on such examples.
In Thailand, for instance, 80% of the 20 million registered motorized vehicles are motorcycles. In 1992, when helmet use was not mandatory, 90% of deaths resulting from traffic injuries were among motorcycle users, almost all due to head injuries. Legislation passed in the north-eastern province of Khon Kaen to make helmet use mandatory, supported by enforcement and publicity programmes, led to a 40% reduction in head injuries among motorcyclists and a 24% drop in motorcyclist deaths within the two years
This new manual provides technical advice to governments on the steps needed to assess current helmet use, and then design, implement and evaluate a helmet use programme. The manual addresses specific issues pertinent to many low-income and middle-income countries, such as:
What can be done to protect the large number of children who ride as passengers on their parents' motorcycles?
Are there financial disincentives in place that make helmets unaffordable and thus reduce their use, for example, sales tax, or import duties that could be removed by governments in efforts to increase helmet use?
How can enforcement be consistent and effective when resources are constrained? Should countries aim to implement a comprehensive helmet law, or is it more appropriate to phase in a law, in order to allow the traffic police to manage the new responsibility?
The manual will be implemented in a number of countries over the next two years, starting in the ASEAN region through the Global Road Safety Partnership’s GRSI initiative, but extending to cover countries from Africa, Latin America and the Middle East.
In addition to the publication of this manual, WHO has also established a network of experts working to increase helmet use, and supports helmet programmes directly in its country work on road safety.