Factors associated with helmet use among motorcycle users in Karachi, Pakistan.
OBJECTIVE
Wearing a helmet is the single most effective measure for preventing head injuries in motorcycle users. The authors undertook this study to estimate compliance and determine reasons for noncompliance with helmet use among motorcyclists in their community.


METHODS
This was a cross-sectional survey of motorcyclists in three large randomly selected public-access parking spaces across Karachi, Pakistan's largest city. Questions covered personal demographics, frequency of helmet use, reasons for use or nonuse, and knowledge of local helmet laws. Analysis was based on frequencies and group comparisons using chi-square test or independent sample t-test.


RESULTS
Of the 300 (100% male) subjects, 169 (56%) reported using helmets regularly. Users listed injury prevention (78%) as the major reason for compliance, while nonusers listed physical discomfort (44%) and limited vision (25%) as the leading reasons for noncompliance. In univariate analysis, helmet users were significantly better educated than nonusers and were more likely to believe that helmets are protective (p = 0.002) and that passengers should also wear helmets (p < 0.001). The significance of these variables persisted in multivariate analysis. Several other variables (such as mean age, marital status, and knowledge of helmet laws) did not differ between users and nonusers.


CONCLUSIONS
Helmets are underused by motorcyclists in the authors' community. This study underscores the need for improved helmet design, public understanding, intense public education, and rigorous law enforcement in raising compliance with helmet use and minimizing the risk of preventable trauma.
Khan
Imran
I
Department of Neurology, Aga Khan University Hospital, Karachi, Pakistan.
Khan
Abdullah
A
Aziz
Fatima
F
Islam
Muhammad
M
Shafqat
Saad
S
D000328:Adult; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D009049:Motorcycles; D010154:Pakistan; D012307:Risk Factors; D014505:Urban Population