The George Institute For Global Health
United Kingdom

Motorcycle Helmet Use and Risk Factors for Helmet Non-use among Motorcyclists in China

Project status: 

There are more drivers and motorcyclists on the roads than ever, and safety of these motorists is becoming more important in countries around the world. This study identified the prevalence of non-standard helmets among motorcyclists using helmet.

The difference in the costs between standard, safe helmets and non-standard helmets was calculated to help understand the motivation of those who are not using standard helmets. Other factors that were identified included legislation around manufacturing, importing and selling non-standard helmets.


The aim of the study was to firstly determine the prevalence of motorcycle helmet use, including both the quality of helmets used and proper helmet wearing, and secondly, to identify factors associated with motorcyclists not wearing helmets and not properly wearing standard helmets in China.

A roadside observational study was conducted. Two sessions (summer and winter) of roadside observations and interviews were conducted at 18 randomly selected sites in Guigang Prefecture of Guangxi Region, China, in 2002.

The data collected included:

  • Helmet use status
  • Demographic variables
  • Characteristics of motorcyclist and motorcycle
  • Knowledge, attitudes and beliefs towards helmet use, legislation and enforcement, and helmet cost

Unconditional multivariate logistic regression was undertaken to determine the predictors of helmet non-use, including substandard helmet use and improper helmet use.


Two-thirds of helmets worn were substandard4,852 motorcyclists were observed and 4,768 (98.3%) agreed to be interviewed, of whom 3,785 were motorcycle riders and 983 were pillion passengers.

  • Just over half (56%) of the motorcyclists wore helmets
  • Two thirds of helmets used were substandard
  • Only 18.4% wore standard helmets and 16.4% wore standard helmets properly

Predictors of helmet non-use and improper helmet use included rural primary roads, highways, early morning / evening, never married, high school, residence in rural area, pillion passenger, non-license, small engine size, less knowledge on helmet use, and negative attitude / beliefs about helmet use.


Proper helmet use campaigns need to be launched in China, as standard helmet use and proper helmet use rates are extremely low. The campaigns should target peasants, blue-collar workers, and unlicensed drivers.

Driver training courses need to be revised to foster positive knowledge, attitudes, and beliefs about helmet use.

Regulations should be modified to prescribe the standard of helmets and the mode of wearing them. Regulation enforcement should be strengthened, especially in rural areas, and in early mornings and evenings.

Production and sale of quality helmets should be monitored regularly and helmet makers and distributors must be certified.

The findings of the study will be used to develop intervention strategies, as part of a proposed community-based study, the Shantou Motorcycle Helmet Study, in order to promote proper helmet use and reduce motorcycle injuries.


  • Junhua Zhang
  • Sing Kai Lo

Related unit: Injury