Exploring the Economics of Motorcycle Helmet Laws — Implications for Low and Middle-Income Countries

Abstract

This paper reviews economic evaluations of motorcycle helmet interventions in preventing injuries. A comprehensive literature review focusing on the e fectiveness of motorcycle helmet use, and on mandatory helmet laws and their enforcement was done. When helmet laws were lifted between 1976-80, 48 states within the USA experienced a cost of $342,047 per excess fatality of annual net savings. Helmet laws in the USA had a benefit-cost ratio of 1.33 to 5.07. Taiwan witnessed a 14% decline in motorcycle fatalities and a 22% reduction of head injury fatalities with the introduction of a helmet law. In Thailand, where 70-90% of all crashes involve motorcycle, after enforcement of a helmet law, helmet-use increased five-fold, the number of injured motorcyclists decreased by 33.5%, head injuries decreased by 41.4%, and deaths decreased by 20.8%. There is considerable evidence that mandatory helmet laws with enforcement alleviate the burden of tra fic injuries greatly. For low and middle-income countries with high rates of motorcycle injuries, enforced, mandatory motorcycle helmet laws are potentially one of the most cost-e fective interventions available. Asia Pac J Public Health 2007; 19(2): 16—22.

Keywords

Economic evaluation cost-benefit analysis road tra fic injuries motorcycle helmet laws.

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References

Mathers C. , Stein C. , Ma Fat D. , Rao C. , Inoue M. , Tomijima N. , et al. The Global Burden of Disease 2000: Version 2, Methods and Results (GPE discussion paper No. 50). Geneva: Global Progra me on Evidence for Health Policy, World Health Organization , 2002. Available at: http://www.who.int/evidence . Accessed 1 July 2005.

Mu ray C. , Lopez A. Global Burden of Disease and Injuries. Cambridge, MA: Harvard University Press; 1996.

WorldHealthOrganization. WorldHealthReport1998 . Geneva, Switzerland: WHO; 2000.

World Health Organization. Injury: A Leading Cause of the Global Burden of Disease. Geneva, Switzerland: WHO; 1999.

Mohan D. Tra fic safety and health in Indian cities. J Transport and Infrastructure 2002; 9: 79— 92.

United States General Accounting O fice. Highway Safety: Motorcycle Helmet Laws Save Lives and Reduce Costs to Society . Washington, DC: US GAO; 1991.

Preusser F. , Hedlund J. , Ulmer R. Evaluation of Motorcycle Helmet Law Repeal in Arkansas and Texas. Preusser Research Group, Inc.; September 2000.

Watson G. , Zador P. , Wilks A. Helmet use, helmet use laws, and motorcyclist fatalities. Am J Public Health 1981; 71: 297-300.

National Highway Tra fic Safety Administration. Report to Congress February 1996: Benefits of Safety Belts and Motorcycle Helmets: Based on data from The Crash Outcome Data Evaluation System (CODES). Washington, DC: Department of Transportation; 1996.

10.

National Highway Tra fic Safety Administration. Tra fic Safety Facts 2000. Washington, DC: Department of Transportation; 2000.

11.

Hartunian N. , Smart C. , Willemain T. , Zador PL The economics of safety deregulation: lives and dollars lost due to repeal of motorcycle helmet laws. J Health Polit Policy Law 1983; 8: 76-98.

12.

Watson G. , Zador P. , Wilks A. The repeal of helmet use laws and increased motorcyclist mortality in the United States, 1975-1978. Am J Public Health 1980; 70: 579-85.

13.

McSwain N. The Impact of Re-enactment of Motorcycle Helmet Laws in Louisiana. Proceedings of the 29th Conference of American Association of Automotive Medicine; Illinois: American Association of Automotive Medicine; 1985: 425-46.

14.

Guillen Grima F. , Aguinaga Ontoso I. , Aguinaga Ontoso E. Helmet use by drivers and passengersofmotorcyclesin Pamplona (Spain), 1992. Eur J Epidemiol 1995; 11: 87-9.

15.

Tsai MC , Hemenway D. E fect of mandatory helmet laws in Taiwan. Inj Prev 1999; 5: 290-291.

16.

Royal Malaysian Police. Statistical Report Road Accidents Malaysia — 1997. Tra fic Branch, Bukit Aman, Kuala Lumpur: PNMB Publishers ; 1998.

17.

Kulanthayan S. , Umar RS , Hariza HA , Nasir MT , Harwant S. Compliance of proper safety helmet usage in motorcyclists. Med J of Malaysia 2000; 55: 0-4.

18.

Umar RS , Law TH Preliminary Evaluation of the Targeted Motorcycle Safety Program in Malaysia . Motorcycle Safety Program Ministry of Transport Malaysia: Road Safety Research Center Research Report 2/99; 1999.

19.

Ichikawa M. , Chadbunchachai W. , Marui E.E. fect of the helmet act for motorcyclists in Thailand. Accid Anal Prev 2003; 35(2): 183-9.

20.

ConradP. , BradshawYS , LamsudinR. , KasniyahN. , Costello C. Helmets, injuries and cultural definitions: motorcycle injury in urban Indonesia . Accid Anal Prev 1996; 28(2): 193-200.

21.

Brandt MM , Ahrns KS , Corpron CA , Franklin GA , Wahl WL Hospital cost is reduced by motorcycle helmet use. J Trauma 2002; 53(3): 469-71.

22.

ShankarBS , RamzyAI , Soderstrom CA , Dischinger PC , Clark CC Helmet use, pa terns of injury, medical outcome, and costs among motorcycle drivers in Maryland. Accid Anal Prev 1992; 24(4): 385-96.

23.

Rivara FP , Dicker BG , Bergman AB , Dacey R. , Herman C. The public cost of motorcycle trauma. J Am Med Assoc 1988; 260(2): 221-3.

24.

Muller, A. Evaluation of the costs and benefits of motorcycle helmet laws. Am J Public Health 1980; 70(6): 586-92.

25.

Rice D. , MacKenzie EJ Cost of Injury in the United States: A Report to Congress, 1989. San Francisco, CA. Institute for Health and Aging, University of California, and Injury Prevention Center, The Johns Hopkins University; 1989.

26.

Garbacz C.

Tra fic fatalities in Taiwan. J Transport Economics and

Policy 1989; 23: 317-327.

27.

Max W. , Stark B. , Root S. Putting a lid on injury costs: the economic impact of the California motorcycle helmet law. J Trauma 1998; 45(3): 550-6.

28.

Clotfelter C. , Hahn J. Assessing the national 55mph speed limit. Policy Sci 1978; 9: 281-294.

29.

Haworth N. , Ungers B. , Vulcan P. , Corben B. Evaluation of a 50 km/ h Default Urban Speed Limit for Australia. Monash University Accident Research Centre, Discussion Paper; 2001.

30.

VanMatre J. , Overstreet G. Motor vehicle inspection and accident mortality: A reexamination. Journal of Risk and Insurance 1982: 423-435.

31.

Fuchs V. Motor Vehicle Mortality and Compulsory Inspection of Vehicles. In: The Health Economy; Cambridge, MA: Harvard University Press; 1986: 169-180.

32.

Lave L. , Weber W. A benefit-cost analysis of auto safety features. Appl Econ 1970; 2: 265-275.

33.

United States General Accounting O fice. E fectiveness, Benefits and Costs of Federal Safety Standards for Protection of passenger Car Occupants. National Highway Tra fic Safety Administration, Department of Transportation; Report to the Co mittee on Co merce, United States Senate by the Comptroller General of the United States; Washington, DC: US General Accounting Office; 1976.

34.

Miller TR , Levy DT Cost-outcome analysis in injury prevention and control: eighty-four recent estimates for the United States. Med Care 2000; 38(6): 562-82.

35.

Peden M. , Scurfield R. , Sleet D. , Mohan D. , Hyder AA , Jarawan E. et al,( editors). World Report on Road Tra fic Injury Prevention. Geneva, Switzerland: WHO; 2004.

36.

Gold MR , Siegel JE , Russel LB , Weinstein MC , (editors). Cost-E fectiveness in Health and Medicine. New York: Oxford University Press; 1996.

37.

Zaza S. , Carande-Kulis VG , Sleet DA , et al. Methods for conducting systematic reviews of the evidence of e fectiveness and economic e ficiency of interventions to reduce injuries to motor vehicle occupants. Am J Prev Med 2001; 21: 23-30.