Helmet use among adolescent motorcycle and moped riders - Rome, Italy, 1994

Morbidity and Mortality Weekly Report, April 19, 1996

Reported by. P Baldaccini, MC Biagioli, M Boscolo Nata, M Cassiani, M Cavinato, VA Caporale, M Chironna, A Ciglia, RM Conforti, P Fermani, P Gallo, L Gardenghi, G Giostra, F Giurdanella, F Grippi, P Lopalco, E Lorenzo, E Martini, G Maugeri, F Michieleffo, A Monti, PA Napoli, B Niccoli, A Petrucci, M Portera, S Raspanti, G Rimenti, G Ripabelli, A Romano, A Sanguedolce, R Sestili, F Sforza, AR Silvestri, G Silvestri, A Stelia, BO Tchangmena, F Terragni, L Trezzi, R Trigilio, D Viviani, Field Epidemiology Training Program; P Dargenio, A infuso, T Manfredi-Selvaggi, A Niccolini, G Salamina, S Salmaso, L Sodano, F Taggi, S Viviani, National Institute of Health, Rome, Italy. Div of Tuberculosis Elimination, National Center for HIV STD, and TB Prevention (proposed),, Div of Unintentional injury Prevention, National Center for Injury Prevention and Control, CDC.

Editorial Note: Although motorcycles and mopeds are an inexpensive mode of individual transportation, in most countries, they are associated with the greatest risks for transportation-related injuries (1). Per vehicle mile, motorcycle drivers are approximately 20 times more likely than passenger-car occupants to die in a motor-vehicle crash (2). in the United States, head injuries occur in approximately 53% of motorcycle-related deaths (3). Motorcycle helmets are 46%-85% effective in reducing the incidence of severe, serious, and critical head injuries (4) and 29% effective in reducing fatalities (5). In addition, nonhelmeted riders who are injured have been more likely to require ambulance service; be admitted to a hospital; incur higher hospital charges; require neurosurgery, intensive care, rehabilitation, and long-term care; and sustain permanent disabilities (4).

Laws requiring helmets for population subgroups (such as the one applying to moped users in Italy) are substantially less effective than laws requiring universal helmet use (4) and are difficult to enforce. In the United States, helmet laws that apply to population subgroups (i.e., persons aged [greater than or equal to]18 years) result in helmet use of 42%-59%. In comparison, in states with universal helmet laws, up to 99% of riders use helmets (4,6).

The findings in this report are subject to at least two limitations. First, only six schools were included in the survey, all in the central part of Rome. Although the three types of schools were included in the survey to ensure the representation of students of different academic achievement levels and different socioeconomic strata, participants probably were not representative of all students in Rome. Second, because self reported data often overestimate use of safety devices, actual helmet use probably was less than that reported (7).

To improve the enforcement of laws related to mopeds, license plates for mopeds are now mandatory. Although this requirement should decrease the number of mopeds carrying more than one person, underenforcement of age-specific helmet use is expected to remain a problem. Results of this survey have been provided to the Ministry of Transport in support of extending helmet use to all moped users in Italy. in addition, the results were used to prepare a health-education leaflet, produced jointly by the ministries of health and education, on the importance of helmet use that was distributed to high school students throughout Italy.