Balancing injury prevention and infection risk in helmet sharing, By Johnson, Obi & Khalifa

…the benefits of helmet use outweigh the potential risks of lethal infection, especially when proper hygiene practices are followed. It is important to continue advocating for helmet use, while ensuring that appropriate cleaning and maintenance protocols are in place. Governments and private sector actors should implement best practices for helmet hygiene and maintenance, raising awareness and educating the public to ensure the safe and effective use of helmets.

Helmets have long been recognised as a vital tool in the fight against head injuries. From cycling and motorcycling to sports and construction work, helmets are fundamental in preventing traumatic brain injuries, skull fractures, and fatalities. The importance of helmet use is well-documented, with substantial evidence supporting its effectiveness in saving lives. According to a study of the Johns Hopkins Bloomberg School of Public Health, implementing proven road safety interventions, including helmet use, can prevent between 25 per cent and 40 per cent of all deaths from road traffic injuries worldwide. Specifically, increased motorcycle helmet use could prevent over 50,000 deaths per year.

Yet, despite the clear protective benefits of helmets, there is a growing concern about the potential public health risks associated with sharing them. Due to economic constraints, helmet-sharing is common in many low- and middle-income countries (LMICs), including those in Africa. This practice, however, can introduce significant health risks, particularly the transmission of infectious microorganisms.

Shared helmets can become vectors of a variety of infections, including bacterial ones such as methicillin-resistant Staphylococcus aureus (MRSA), fungal infections like ringworm, and parasitic infestations such as head lice. Research in Nepal revealed that shared helmets can harbour diverse microorganisms, including drug-resistant bacteria. Similarly, another study from Chennai, India, found that helmets used by multiple individuals contained significant bacterial and fungal contamination levels. These studies underscore the importance of regular disinfection to prevent the spread of infections through shared helmets.

In Lagos, Nigeria, researchers found that shared motorcycle helmets harboured antibiotic-resistant bacteria, such as Staphylococcus aureus, Bacillus anthracis, and Escherichia coli. This highlights the epidemiological significance of shared helmets as potential sources of antibiotic-resistant infections. These findings emphasise the urgent need for stringent hygiene practices to protect users from health risks.

…regular cleaning and disinfection protocols for shared helmets are essential. Disinfectant sprays specifically designed for helmets have been shown to reduce bacterial colonies effectively. In LMICs, where resources may be limited, adopting cost-effective and accessible hygiene solutions is vital. Regularly cleaning helmets with locally available disinfectants can significantly lower the risk of infection.

As such, how do we balance the undeniable life-saving benefits of helmet use with the potential risks of infection from shared helmets? The answer lies in implementing effective hygiene practices and effective public health interventions.

First, regular cleaning and disinfection protocols for shared helmets are essential. Disinfectant sprays specifically designed for helmets have been shown to reduce bacterial colonies effectively. In LMICs, where resources may be limited, adopting cost-effective and accessible hygiene solutions is vital. Regularly cleaning helmets with locally available disinfectants can significantly lower the risk of infection. Simple hygiene interventions, such as regular cleaning with soap and water, have effectively reduced microbial presence on helmets in studies conducted in Nairobi, Kenya.

Second, disposable or personal helmet liners can significantly enhance hygiene by providing a barrier between the user’s head and the helmet. These liners can be easily replaced or washed, minimising the risk of infection. Encouraging personal cloth coverings can be an effective alternative in settings where disposable liners may not be economically feasible. Such coverings made from affordable, locally available materials, ensure both cost-effectiveness and accessibility.

Third, educating users about the risks of infection and proper maintenance practices is essential. Awareness campaigns can promote regular cleaning and responsible sharing practices, ensuring that users understand the importance of hygiene. Leveraging community health workers and the local media can help disseminate this crucial information effectively. In a study on motorcycle helmet use in LMICs, education campaigns targeting riders through local radio stations and community meetings significantly improved helmet hygiene practices and compliance.

Balancing the benefits and risks of helmet use requires a comprehensive approach that incorporates effective hygiene measures. Helmets are essential for injury prevention, but they must be kept clean and properly maintained to prevent the transmission of infectious diseases. As Dr Abdulgafoor M. Bachani of the Johns Hopkins Center for Injury Research and Policy emphasises, “Helmets play a vital role in protecting individuals from head injuries.

Finally, regular inspection and maintenance of helmets ensure they remain in good condition and free from harmful microorganisms. Organisations should implement routine checks and cleaning protocols to maintain helmet safety. Integrating these practices into existing community health initiatives can enhance compliance and effectiveness. Local health volunteers could incorporate periodic checks into broader public health campaigns, ensuring helmet hygiene is maintained alongside other community health measures.

Balancing the benefits and risks of helmet use requires a comprehensive approach that incorporates effective hygiene measures. Helmets are essential for injury prevention, but they must be kept clean and properly maintained to prevent the transmission of infectious diseases. As Dr Abdulgafoor M. Bachani of the Johns Hopkins Center for Injury Research and Policy emphasises, “Helmets play a vital role in protecting individuals from head injuries. However, we must also recognise the importance of hygiene in preventing infections.” By implementing regular cleaning and maintenance protocols, we can ensure that helmets provide maximum protection, without posing additional health risks.

In conclusion, the benefits of helmet use outweigh the potential risks of lethal infection, especially when proper hygiene practices are followed. It is important to continue advocating for helmet use, while ensuring that appropriate cleaning and maintenance protocols are in place. Governments and private sector actors should implement best practices for helmet hygiene and maintenance, raising awareness and educating the public to ensure the safe and effective use of helmets. By doing so, we can reduce traffic injuries and infection risks.

Ambulai Johnson is a faculty research associate, Simon Patrick Obi is a researcher, and Banda A. Khalifa is a public health physician and PhD student, all at the Johns Hopkins Bloomberg School of Public Health.