Effect of wearing a helmet on the occurrence of head injuries in motorcycle riders in Benin: a case-control study

Dos Santos, Bella Hounkpe; Ahanhanzo, Yolaine Glele; Kpozehouen, Alphonse; Daddah, Donatien; Lagarde, Emmanuel; Coppieters, Yves · 2021 · Crossref

DOI: 10.1186/s40621-021-00311-3

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Summary

This study investigates the impact of helmet usage on the incidence of head injuries among motorcycle riders in Benin, a country where motorcycles are the primary mode of transport and involved in over half of all traffic crashes. Motivated by the high burden of road traffic injuries in West Africa and the enforcement of a helmet mandate since 2014, the research aims to quantify the protective effect of helmets and identify other factors influencing head injury occurrence. The researchers conducted a case-control study in 2020, drawing data from the TraumAR database, which comprised road trauma victims recruited from five hospitals across Benin between July 2019 and January 2020. The final sample included 242 cases (motorcyclists with head injuries) and 484 controls (motorcyclists without head injuries). Data collection involved prospective questionnaires administered to patients or caregivers, supplemented by medical records. The study analyzed four groups of independent variables: socio-demographic and economic factors, personal history, behavioral factors (including helmet use, fatigue, and distraction), and road/environmental conditions. Statistical analysis utilized a descending step-by-step binary logistic regression model to assess associations, adjusting for potential confounders. The results demonstrated a significant association between helmet use and head injury risk. Only 69.8% of cases were wearing helmets at the time of the crash, compared to 90.3% of controls. After adjusting for other variables, motorcyclists not wearing helmets had an odds ratio (OR) of 3.8 (95% CI: 2.5–5.7) for sustaining head injuries compared to those who did. Additionally, driving while fatigued or drowsy increased the risk of head injury by 1.9 times (95% CI: 1.2–3.3), while having no medical history was associated with a 2.0 times higher risk (95% CI: 1.2–3.3). Other significant factors included poorer visibility conditions and crashes with no antagonist. Socio-demographic variables such as age, gender, and ethnicity did not show significant associations with head injury occurrence in the multivariate analysis. The study concludes that failure to wear a helmet significantly exposes motorcyclists to the risk of head injuries during crashes. The findings confirm the efficacy of helmet use in reducing head trauma severity and incidence in the Beninese context. The authors emphasize the need for increased awareness campaigns and targeted interventions, particularly focusing on high-risk behaviors such as fatigue and non-compliance with helmet laws, to mitigate the burden of road traffic injuries.

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Topics

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• helmet protective
• cyclist safety

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• Empirical Findings: crash risk outcomes