Recommendations of the Expert Group on Preventing Motorcycle Injuries in Children
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1 Recommendations of the Expert Group on Preventing Motorcycle Injuries in Children
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3 All Member States in the WHO South-East Asia (SEA) Region are low- and middle-income countries. In the SEA Region, the motorcycle is prevalently used as a family vehicle with children routinely transported as passengers. The current scenario is very alarming with motorcycles accounting for 50%-82% of registered vehicles in the Member States of the Region (except in the case of Bhutan 18%) and motorcycle riders (drivers and passengers) accounting for the largest proportion of road traffic injuries and deaths in several Member States. A motorcyclist is 26 times more likely to die in a crash per vehicle mile travelled in comparison with motorist. The increasing use of motorcycles and the injuries and deaths by its use in the South-East Asia Region is of great concern to Member States. This was also expressed by the delegates at the Sixty-third Session of the WHO Regional Committee for the South-East Asia (2010). Children, since the age of less than one year old, are reported to be severely injured in motorcycle crashes in the Member States of the SEA Region. Hence, the problem is even more alarming. Prevention of motorcycle injuries among the children in the developing world, particularly in the SEA Region, is impeded by limitations of knowledge, absence of reliable estimates of the current level of injuries, and perceptions of the community about injuries. WHO-SEARO in collaboration with the Trauma and Critical Care Centre, Khon Kaen Regional Hospital (a WHO Collaborating Centre on Injury Prevention and Safety Promotion), Khon Kaen, Thailand, organized an Expert Group Meeting on Preventing Motorcycle Injuries in Children from 21 to 23 December 2010 in Bangkok, Thailand. Experts from different sectors in the SEA Region, including biomechanics, epidemiologists, policy and law-enforcement officers, Recommendations of the Expert Group on Preventing Motorcycle Injuries in Children, December 2010, Bangkok, Thailand 3
4 orthopedists, traumatologists, psychosociologists, paediatricians, police and transport engineers, and others attended the meeting. Two among these are also members of the WHO Expert Advisory Panels and Committees. The experts made technical presentations, shared information and evidences on the problem. The expert group reviewed all available evidences on motorcycle-related issues in children and road traffic injuries (epidemiology, biomechanics, child development, psychosocial aspects, legislations in the high-income countries that produce motorcycles) along with existing safety measures focusing on motorcycle use in the SEA Region. The group provided recommendations in preventing motorcycle injuries in children to the Member States as follows, enunciated through the Bangkok Call for Action: 4
5 Bangkok Call for Action on Preventing Motorcycle-related Injuries in Children Participants at the Expert Group Meeting on Preventing Motorcycle Injuries in Children held on December 2010 at Bangkok, Thailand, Recalling the United Nations General Assembly Resolution A/RES/58/289 on Improving Global Road Safety, World Health Assembly Resolutions WHA57.10 on Road Safety and Health, and Resolution of the WHO Regional Committee for South-East Asia SEA/RC63/R2 on Injury Prevention and Safety Promotion, and the World Report on Child Injury Prevention, Taking Note of the report Make Roads Safe: A New Priority for Sustainable Development, from the Commission for Global Road Safety which links road safety with sustainable development and which calls for increased resources for road safety, a new commitment for road infrastructure assessment and a Global Ministerial Conference on road safety under the auspices of the United Nations, Expressing their concern at the continued increase in road traffic fatalities and injuries among children (defined as all persons less than 18 years old) as passengers and drivers of motorcycles (defined as all motorized two-wheeled vehicles powered by any source of energy) in the Member States of the SEA Region, Noting that data from some Member States of the SEA Region indicate injuries associated with use of motorcycles (including children as pedestrians) constitute a significant proportion of injuries due to all causes among children, Noting that motorcycles are relatively unsafe vehicles for transportation of children, And noting with concern that children also sustain serious and fatal injuries as motorcycle drivers, Recognizing that there is a demand for improvement in designs of currently available helmets especially in the matter concerning ventilation, Recognizing that not all Member States in SEA Region have developed standards for helmets suitable for children under six years, Recommendations of the Expert Group on Preventing Motorcycle Injuries in Children, December 2010, Bangkok, Thailand 5
6 Noting that urgent action is needed to prevent road traffic injuries and fatalities among children as motorcycle riders, REAFFIRM that all the concerned sectors health, transport, law enforcement, education, vehicle manufacturers and civil society should jointly participate in programmes to reduce the burden of motorcycleassociated road traffic morbidity and mortality on an urgent basis by improving methods of data collection and analysis, initiating research on risk factors associated with motorcycle user injuries, implementing and evaluating known road safety interventions, undertaking research to develop road safety measures uniquely suited to the SEA Region, and improving pre-hospital and trauma care systems in the Region, ENCOURAGE Member States, including international and regional financial institutions, to lend financial, technical and political support, as appropriate, to agencies for their efforts to improve the safety of children transported on motorcycles, RECOMMEND that: a. b. c. d. e. f. The minimum age for award of motorcycle driving license be restricted to persons older than 18 years in all countries; All agencies implement and enforce laws effectively regarding helmet wearing, driving under the influence of alcohol, and speed control, and modification of motorcycles after sale; Assistance to law-enforcement agencies be provided by all sectors of the society; Awareness be disseminated to all stakeholders regarding dangers of transporting children younger than five years of age on motorcycles, and that at present head protection devices for children less than two years old are not available; Member States encourage cooperation among themselves for harmonization of standards for helmets especially designed for children with extra provisions in standards for issues such as conspicuity; Member States consider the mandatory provision of two helmets (including the possibility of helmets for children) along with sale of motorcycles, and placing of warnings on motorcycles regarding carriage of children; 6
7 g. h. i. Governments at the national, provincial and municipal levels should consider policies concerning neighbourhood schools and public transport facilities (including for free or subsidy for the same) that would obviate the need for transporting children on motorcycles; Special attention be focused on accelerating research efforts for design of all helmets with better ventilation, lighter weight and visibility, and for improving helmet designs for children under five years of age. WHO should: (1) (2) (3) (4) (5) provide technical support to Member States in implementing the above recommendations; support experience sharing among Member States in progressing with the activities to prevent child motorcycle injuries; collaborate with Member States in improving data collection and analysis systems for identifying, monitoring and evaluating child injury prevention, especially in relation to motorcycles; encourage research that expands the evidence base for interventions to prevent child motorcycle injuries and mitigate their consequences in the context of each country in the SEA Region; and facilitate strengthening of enforcement strategies among law enforcement agencies, especially the police department, in the SEA Region. Recommendations of the Expert Group on Preventing Motorcycle Injuries in Children, December 2010, Bangkok, Thailand 7
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