Effect of Wearing a Helmet on the Occurrence of Head Injuries in Motorcycle Riders in Benin: A Cohort-nested Case-control Study

Abstract Background : In Benin, motorcycles are the main means of transport for road users and are involved in more than half of accidents. This study aims to determine the effect of wearing a helmet on reducing head injuries in road accidents in Benin. Methods : This cohort-nested case-control study took place in 2020 and focused on road trauma victims. The sample consisted of 242 cases for 484 controls. A logistic regression model was performed. Results: Fewer of the subjects with a head injury were wearing a helmet at the time of the accident 69.8% (95% CI = 63.6 - 75.6) compared to those without a head injury 90.3% (95% CI = 87.3 - 92.8). Adjusting for the other variables, subjects not wearing helmets were at greater risk of head injuries (OR = 3.8, 95% CI (2.5 - 5.7)); the head injury rating was 2.0 (95% CI = 1.2 - 3.2) times higher in subjects who were fatigued during the accident than among those who were not and 2.1 (95% CI = 1.2 - 3.3) times higher than in subjects with no medical history. Conclusion : Failure to wear a helmet exposes motorcyclists to the risk of head injuries during accidents. It is important to increase awareness and better target such initiatives at the subjects most at risk.