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Motorcycle rider conspicuity and crash related injury: case-control study

BMJ 2004; 328 doi: (Published 08 April 2004) Cite this as: BMJ 2004;328:857
  1. Susan Wells, senior lecturer in epidemiology (s.wells{at},
  2. Bernadette Mullin, public health physician1,
  3. Robyn Norton, professor of public health3,
  4. John Langley, director of injury prevention research unit4,
  5. Jennie Connor, senior lecturer in epidemiology1,
  6. Rod Jackson, professor of epidemiology1,
  7. Roy Lay-Yee, assistant research fellow2
  1. 1Section of Epidemiology and Biostatistics, School of Population Health, Private Bag 92019, University of Auckland, Grafton Road, Auckland 1, New Zealand
  2. 2Centre for Health Services Research and Policy, School of Population Health, University of Auckland
  3. 3Institute for International Health, University of Sydney, Sydney, NSW, Australia
  4. 4University of Otago, Otago, New Zealand
  1. Correspondence to: S Wells
  • Accepted 3 December 2003


Objective To investigate whether the risk of motorcycle crash related injuries is associated with the conspicuity of the driver or vehicle.

Design Population based case-control study.

Setting Auckland region of New Zealand from February 1993 to February 1996.

Participants 463 motorcycle drivers (cases) involved in crashes leading to hospital treatment or death; 1233 motorcycle drivers (controls) recruited from randomly selected roadside survey sites.

Main outcome measures Estimates of relative risk of motorcycle crash related injury and population attributable risk associated with conspicuity measures, including the use of reflective or fluorescent clothing, headlight operation, and colour of helmet, clothing, and motorcycle.

Results Crash related injuries occurred mainly in urban zones with 50 km/h speed limit (66%), during the day (63%), and in fine weather (72%). After adjustment for potential confounders, drivers wearing any reflective or fluorescent clothing had a 37% lower risk (multivariate odds ratio 0.63, 95% confidence interval 0.42 to 0.94) than other drivers. Compared with wearing a black helmet, use of a white helmet was associated with a 24% lower risk (multivariate odds ratio 0.76, 0.57 to 0.99). Self reported light coloured helmet versus dark coloured helmet was associated with a 19% lower risk. Three quarters of motorcycle riders had their headlight turned on during the day, and this was associated with a 27% lower risk (multivariate odds ratio 0.73, 0.53 to 1.00). No association occurred between risk and the frontal colour of drivers' clothing or motorcycle. If these odds ratios are unconfounded, the population attributable risks are 33% for wearing no reflective or fluorescent clothing, 18% for a non-white helmet, 11% for a dark coloured helmet, and 7% for no daytime headlight operation.

Conclusions Low conspicuity may increase the risk of motorcycle crash related injury. Increasing the use of reflective or fluorescent clothing, white or light coloured helmets, and daytime headlights are simple, cheap interventions that could considerably reduce motorcycle crash related injury and death.


  • Contributors SW was mainly responsible for the statistical analysis, interpreting the data, and writing the paper. RJ, RN, BM, and JL were mainly responsible for the study design, and BM was responsible for data collection. RJ, RN, BM, and JL contributed to writing the paper. RJ, JC, and RL-Y contributed to the statistical analysis, interpreting the data, and writing the paper. RJ is the guarantor.

  • Funding Health Research Council of New Zealand (HRC) and the Accident Rehabilitation and Compensation Insurance Corporation (ACC). BM was the recipient of an HRC Training Fellowship. The Injury Prevention Research Centre and the Injury Prevention Research Unit were both jointly funded by the HRC and ACC at the time of the study.

  • Competing interests None declared.

  • Ethical approval The study was approved by the Northern Regional Health Authority Ethics Committee.

  • Accepted 3 December 2003
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