Department of Pediatrics, McMaster Children's Hospital, Master University, 1280 Main St W., Hamilton, ON, Canada L8S 4K1; Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Suite E8132, Baltimore, MD 21205, United States.
Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Suite E8132, Baltimore, MD 21205, United States.
Injury. 2022 Jul;53(7):2478-2484. doi: 10.1016/j.injury.2022.03.038. Epub 2022 Mar 25.
Road traffic injuries are the leading cause of death in children over age five. Most of these deaths occur in low- and middle-income countries. Vulnerable road users, such as motorcyclists and their passengers, are at higher risk. Helmets have significantly decreased morbidity and mortality for motorcyclists; however, they are often unused. The second phase of the Bloomberg Philanthropies Initiative for Global Road Safety was launched in 2015 to improve road safety in 10 cities. This study focuses on child passenger helmet use data from that study to understand the prevalence of helmet use and factors that are associated with helmet use.
The 10 cities selected were Accra, Addis Ababa, Bandung, Bangkok, Bogota, Fortaleza, Ho Chi Minh City, Mumbai, Sao Paulo, and Shanghai. Eight rounds of roadside observational data were collected from February 2015 to April 2019. Observers noted correct child motorcycle passenger helmet use and other site observations including weather patterns, traffic volume, and road surface conditions. A multivariable Poisson regression model was used to examine correct helmet use trends over time. A multivariable logistic regression model was fitted for correct child passenger helmet use in all cities controlling for weather, observation time, number of passengers, and driver's correct helmet use.
This dataset contained 99,846 motorcycle child passenger observations across the 10 cities. The highest prevalence of correct child passenger helmet use was in Sao Paulo at 97.33%. Six cities had under 25% correct helmet use for child passengers. Examining helmet use over time, only five cities had a significant increase, four cities had no change, and Ho Chi Minh City demonstrated a decrease. In the multivariable regression model, child passengers had higher odds of wearing helmets in adverse weather conditions, early mornings, if the driver wore a helmet, and if there were fewer passengers.
The prevalence of correct child passenger helmet utilization shows large variation globally and is concerningly low overall. Enhanced enforcement in combination with media campaigns may have contributed to increasing helmet use prevalence over time. Further research is needed to understand reasons for low child passenger helmet use in most cities.
道路交通伤害是 5 岁以上儿童死亡的主要原因。这些死亡大多发生在中低收入国家。摩托车手及其乘客等弱势道路使用者风险更高。头盔显著降低了摩托车手的发病率和死亡率；然而，它们经常未被使用。彭博慈善基金会全球道路安全倡议的第二阶段于 2015 年启动，旨在改善 10 个城市的道路安全。本研究重点关注该研究中儿童乘客头盔使用数据，以了解头盔使用的普遍性和与头盔使用相关的因素。
选择的 10 个城市为阿克拉、亚的斯亚贝巴、万隆、曼谷、波哥大、福塔莱萨、胡志明市、孟买、圣保罗和上海。从 2015 年 2 月到 2019 年 4 月，进行了 8 轮路边观察数据收集。观察员记录了正确使用儿童摩托车乘客头盔和其他站点观察结果，包括天气模式、交通量和道路表面状况。使用多变量泊松回归模型来检查随时间变化的正确头盔使用趋势。在所有城市中，针对天气、观察时间、乘客人数和驾驶员正确使用头盔，使用多变量逻辑回归模型拟合正确使用儿童乘客头盔的情况。
本数据集包含 10 个城市的 99846 次摩托车儿童乘客观察结果。儿童乘客正确使用头盔的比例最高的城市是圣保罗，为 97.33%。有 6 个城市的儿童乘客头盔使用率低于 25%。随着时间的推移检查头盔使用情况，只有 5 个城市显著增加，4 个城市没有变化，胡志明市显示出下降趋势。在多变量回归模型中，如果天气条件恶劣、清晨、驾驶员戴头盔或乘客较少，儿童乘客戴头盔的可能性更高。
全球范围内正确使用儿童乘客头盔的比例差异很大，总体上令人担忧。随着时间的推移，加强执法和媒体宣传可能有助于提高头盔使用率。需要进一步研究以了解大多数城市儿童乘客头盔使用率低的原因。
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