Barriers And Factors Influencing Helmet Usage Among Bike Riders In Salem, India : A Cross-Sectional Study

Abstract

Introduction: Motorcycle road injuries constitute a public health emergency. Helmets are crucial in preventing deaths and head injuries. The WHO estimates 1.19 million road deaths every year, with motorcyclists being extremely susceptible. In spite of legislation, helmet use is low in most regions, such as Tamil Nadu, India. Salem, a high-risk crash area, has persistently low use, which requires investigation into compliance factors. Objective: To estimate the proportion of effective helmet users and identify the barriers and factors influencing helmet-wearing behaviour among bike riders in Salem, India. Materials and Methods: A cross-sectional study was conducted in Salem, Tamil Nadu, using purposive sampling approach, selecting five study locations. Data were collected with 512 randomly selected motorcyclists. Observers recorded helmet-wearing patterns, while structured interviews assessed knowledge, attitudes, and factors influencing helmet use. Effective helmet use was defined as wearing a standard full-face helmet with a properly fastened chin strap. Data were analysed using SPSS Version 28, with proportion tests, bivariate analysis, and logistic regression. Results: 63.1% of participants were using helmet but effective helmet use was observed in just 27.9% of helmet users.Key barriers included discomfort (13.5%), inconvenience (12.2%), and concerns about hair and appearance (8.8%). Significant predictors of non-compliance included female gender, lower education, rural residence, and absence of prior fines (p < 0.001). Conclusion: Despite existing regulations, helmet compliance and effective helmet use remain low in the observed participants. Strengthening enforcement, raising awareness, and promoting proper use of helmets are essential for improving compliance and reducing road traffic injuries.