Peer-reviewed article

Observational study of adherence to effective helmet use among parents and students who are dropped by two-wheeler to school.

Shyam Shukla, Neelima Sharma, Dhaval Shukla · 11 Mar 2026

Abstract

OBJECTIVES: Road traffic injuries (RTIs) are a major cause of morbidity and mortality among children and adolescents in India. Despite legislative mandates requiring helmet use for all motorized two-wheeler riders aged 4 years and older, adherence remains poor, particularly among children. This study aimed to assess the prevalence and patterns of helmet use among parents and children commuting to school on motorized two-wheelers through direct observation. METHODS: A cross-sectional observational study was conducted in October 2024 at 4 schools located on roads of differing traffic densities in southern Bangalore. Observations were made during morning drop-off hours recording helmet use among parents and their accompanying children using an online tally counter. Helmet use was categorized as proper helmet, cap helmet, or no helmet. Statistical analysis included chi-square tests for differences between parents and children and across schools, with odds ratios and 95% confidence intervals (CIs) calculated. RESULTS: A total of 785 parent riders and 966 child pillion riders were observed. Proper helmet use was recorded in 42.0% of parents and only 4.5% of children, while 33.3% of parents and 92.7% of children did not wear any helmet. No child was observed wearing a helmet when their parent did not. Children were 25.3 times less likely to wear a helmet than their parents (95% CI: 19.05-33.6). Significant inter-school variation was observed (p < 0.001), but differences were primarily in the distribution of proper versus cap helmets rather than overall helmet use. CONCLUSIONS: Helmet use among child pillion riders in Bangalore remains alarmingly low despite legal requirements. The study highlights a large gap between parent and child compliance, reflecting poor awareness, lack of enforcement, and limited availability of child-sized helmets. Strengthening enforcement, improving access to child helmets, and implementing school-based education and parent awareness programs are essential to enhance compliance and reduce preventable head injuries among children in India.