The country is observing the
National Road Safety Week from 4th February
(Monday) to 10th February (Sunday). The
aim is to increase public awareness about traffic rules including the
importance of wearing helmets and seat belts.
A Harm Reduction conference was organized by Heart
Care Foundation of India (HCFI) at Maple Hall, India Habitat Centre, New Delhi
on January 30, 2019. Harm reduction strategies for important public health
issues were discussed, including helmets and seat belts.
A consensus statement was also released. The
recommendations with regard to helmets and seat belts are as follows:
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Helmets and harm reduction
Preventing head injuries by wearing a bicycle helmet
reduces the risk of brain injury. A 2009 systematic review of five
case-control studies found that helmets provide a 63 to 88 percent reduction
in the risk of head, brain, and severe brain injuries and a 65 percent
reduction of injuries to the upper and mid-face for bicyclists of all
ages. Helmets provide similar protection for crashes involving motor
vehicles and other causes (70 percent). In children (<15 years of age),
wearing a helmet reduces the risk of head injury by 63 percent and of loss of
consciousness by 86 percent.
Pregnancy Belt
Pregnant women should wear three-point seat belts
during pregnancy. The lap belt is placed across the hips and below the uterus;
the shoulder belt goes between the breasts and lateral to the uterus.
Although there are case reports of maternal and foetal injuries resulting
from seat belt use, the overall effect is that seat belts provide
significantly more benefit than risk to the mother and foetus in the event of
collision.
Recommendations
·
Zero tolerance for not wearing helmets and seat belts.
·
Govt should be asked to bring in laws for mandatory cycle helmets, seat belts
for back seat passengers, seat belt for bus drivers.
·
Awareness should be created about quality of helmets.
·
Children below < 5 years old should not be allowed to sit in the front
seat of a car. Car seats for children to be mandatory.
·
In the back seat of a car, the middle seat should always have a seat belt as
the person seated in the middle is most at risk.
·
The importance of helmets and seat belts should be taught in schools.
·
Children from schools in high risk areas should be made to wear helmets while
crossing the roads.
Suggested Reading
1.
Attewell RG, et al. Bicycle helmet efficacy: a meta-analysis. Accid Anal Prev
2001; 33:345.
2.
Maimaris C, et al. Injury patterns in cyclists attending an accident and
emergency department: a comparison of helmet wearers and non-wearers. BMJ
1994; 308:1537.
3.
Thompson RS, et al. A case-control study of the effectiveness of bicycle
safety helmets. N Engl J Med 1989; 320:1361.
4.
Thompson DC, et al. Effectiveness of bicycle safety helmets in preventing
head injuries. A case-control study. JAMA 1996; 276:1968.
5. Thomas
S, et al. Effectiveness of bicycle helmets in preventing head injury in
children: case-control study. BMJ 1994; 308:173.
6. Spaite
DW, et al. A prospective analysis of injury severity among helmeted and
non-helmeted bicyclists involved in collisions with motor vehicles. J Trauma
1991; 31:1510.
7.
McDermott FT, et al. The effectiveness of bicyclist helmets: a study of 1710
casualties. J Trauma 1993; 34:834.
8. Persaud
N, et al. Nonuse of bicycle helmets and risk of fatal head injury: a
proportional mortality, case-control study. CMAJ 2012; 184:E921.
9.
Thompson DC, et al. Helmets for preventing head and facial injuries in
bicyclists. Cochrane Database Syst Rev 2009; :CD001855.
10. Kaushik R, et al.
Pediatric bicycle-related head injuries: a population-based study in a county
without a helmet law. Inj Epidemiol 2015; 2:16.
11. Schieber RA, et al.
Effect of a state law on reported bicycle helmet ownership and use. Arch
Pediatr Adolesc Med 1996; 150:707.
12. Klinich KD, et al. Fetal
outcome in motor-vehicle crashes: effects of crash characteristics and
maternal restraint. Am J Obstet Gynecol 2008; 198:450.e1.
13. Motozawa Y, et al.
Effects of seat belts worn by pregnant drivers during low-impact collisions.
Am J Obstet Gynecol 2010; 203:62.e1.
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Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical
Associations in Asia and Oceania
(CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Past National President IMA
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