Differences in outcomes of mandatory motorcycle helmet legislation by country income level: A systematic review and meta-analysis

by Jacob R. Lepard, Riccardo Spagiari, Jacquelyn Corley, Ernest J. Barth élemy, Eliana Kim, Rolvix Patterson, Sara Venturini, Megan E. H. Still, Yu Tung Lo, Gail Rosseau, Rania A. Mekary, Kee B. Park BackgroundThe recent Lancet Commission on Legal Determinants of Global Health argues that governance can provide the framework for achieving sustainable development goals. Even though over 90% of fatal road traffic injuries occur in low- and middle-income countries (LMICs) primarily affecting motorcyclists, the utility of helmet laws outside of high-income settings has not been well characterized. We sought to evaluate the differences in outcomes of mandatory motorcycle helmet legislation and determine whether these varied across country income levels. Methods and findingsA systematic review and meta-analysis were completed using the PRISMA checklist. A search for relevant articles was conducted using the PubMed, Embase, and Web of Science databases from January 1, 1990 to August 8, 2021. Studies were included if they evaluated helmet usage, mortality from motorcycle crash, or traumatic brain injury (TBI) incidence, with and without enactment of a mandatory helmet law as the intervention. The Newcastle –Ottawa Scale (NOS) was used to rate study quality and funnel plots, and Begg’s and Egger’s tests were used to assess for small study bias. Pooled odds ratios (ORs) and their 95% confidence intervals (CIs) were stratified by high-income countries (HICs) versus LMICs using th...
Source: PLoS Medicine - Category: Internal Medicine Authors: Source Type: research