Wednesday, January 2, 2008

Helmets in Malaysia

Malaysian Helmet Initiatives is a consortium of university, governmental (Ministry of Health, Department of Road Safety, etc) and non-governmental organizations that promote the use of motorcycle and bicycle helmets. The program is being supported by research funds and corporate bodies.
Motorcycles are a common means of transport both in urban and rural areas. Motorcycle helmet legislation was introduced in the year 1980. It was the first law to mandate the use of a consumer good which met national safety standards. For religious reasons, the law exempted those wearing turbans or other headgear from wearing helmets. Since the introduction of the law, a decrease in the number of motorcycle injuries was noted. (1) In recent years, research showed that though a majority of motorcyclists in urban areas wore helmets, they did not fasten the straps correctly. (2) If a helmet is not fastened correctly, it would dislodge from the head during a crash or fall, rendering the head susceptible to injuries. A multimedia campaign was organized by the Road Safety Council to educate the public on correct wearing of a motorcycle helmet.
Compliance to helmet legislation in rural areas is of major concern and needs to be addressed since about 70% of motorcycle fatalities occur in rural areas. The issue of very young children being carried (without protection) on motorcycles, especially in rural areas raises the need for adequate public transportation as an important strategy in the prevention of motorcycle injuries.
In recent years, the government made the motorcycle helmet standards more stringent because of higher speed of travel of vehicles on the road. Manufacturers of motorcycle helmets agreed to the new standards after a survey of standards of helmets from retail outlets showed noncompliance.
Bicycle fatalities constitute about 4% of road fatalities in Malaysia. Majority of these fatalities are associated with head injuries, occur in rural areas and involve persons of all ages.
The use of bicycle helmet was rare in Malaysia, till the 1990s. The first program was started as a research project in 1995 under the Intensification of Research in Priority Areas Scheme (IRPA) scheme of the government. Programs were targeted at rural children and a school-based program was chosen for ease of follow up for compliance. The programs involved all relevant sectors in the Road Safety Council at state and district levels.
School children who rode the bicycle to school were trained in helmet use. Parents and students gave written consent and students pledged to use the helmet at all times when they rode their bicycles. Compliance to helmet use was assessed by the students themselves and school authorities. Monthly assessment was made unannounced for six months either at school starting or ending times. Students were given a standard questionnaire for reporting any involvement in crashes. Compliance ranged from 31% to 98% and depended on commitment from children and school authorities. Reasons for non-compliance negative included negative peer pressure lack of storage places in schools for helmets, lack lustre colour of helmets, etc.
Lessons learned included charging the children a small co-payment the helmets (not to give helmets free), choice of trendy colours and design for helmets, arranging storage places for helmets in schools, involving community partners in programs and obtaining ongoing commitment from schools. Lessons learnt from earlier programs were implemented in subsequent programs. Many schools expanded their programs. Two recreational bicycle tours were organized as a road show for bicycle helmet use. At least one bicycle helmet program has been implemented in each of the nine states of Peninsular Malaysia.
State road safety and health authorities have implemented several programs. Since the first program in 1995, a total of about 4,000 students in 50 schools (involving 11 states) and about 200 teachers have been involved in the program. One child was involved in a crash but escaped unhurt since he was wearing his helmet.
The government is making considerable efforts to improve public transportation to curtail the rapid increase in number of motorcycles, especially in rural areas, where the majority of fatal motorcycle crashes occur. Though a motorcycle helmet law was enacted, constant monitoring is necessary to ensure compliance. Helmet standards need to reviewed with time to cope with increasing speed of travel.
The Malaysian Helmet Initiatives is an excellent example where many sectors work together to prevent head injuries.
References
Supramaniam V, Belle V, Sung J. Fatal motorcycle accidents and helmet laws inPeninsular Malaysia. Accident Analysis & Prevention. 1984;16:157-162
R.Krishnan, Hamidah Karim, “Research to prevent Injuries”, World Health Forum, World Health Organization, 1998, 19 (2) : 39 - 41

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