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Safety helmet use rate and child pillion riders’ characteristic in Selangor
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MRR No. 121
Safety Helmet Use Rate and Child Pillion

Riders’ Characteristics in Selangor
Noor Faradila Paiman

Mohd Hafzi Md Isa
Zulhaidi MohdJawi
Aqbal Hafeez Ariffin
Mohd Syazwan Solah
Mohd Khairudin Rahman
Azhar Hamzah
Khairil Anwar Abu Kassim
Noor Faradila Paiman

Mohd Hafzi Md Isa
Zulhaidi Mohd Jawi
Aqbal Hafeez Ariffin
Mohd Syazwan Solah
Mohd Khairudin Rahman
Azhar Hamzah
Khairil Anwar Abu Kassim
MIROS © 2013. All rights reserved.
Published by:
Malaysian Institute of Road Safety Research (MIROS)

Lot 125-135, Jalan TKS 1, Taman Kajang Sentral,
43000 Kajang, Selangor Darul Ehsan, Malaysia.
Perpustakaan Negara Malaysia Cataloguing-in-Publication Data
Safety helmet use rate and child pillion riders’ characteristic in Selangor /
Noor Faradila Paiman ... [et al.]
(Research report ; MRR No. 121)
Bibliography: p. 24
ISBN 978-967-5967-30-6
1. Helmets--Standards--Malaysia. 2. Children’s accidents--Prevention.
3. Traffic safety and children. I. Noor Faradila Paiman. II. Series.
687.43218
Printed by : Malaysian Institute of Road Safety Research
Font type : Myriad Pro Light

Size : 11 pt / 15 pt
DISCLAIMER
None of the materials provided in this report may be used, reproduced or transmitted, in any form or by any means,
electronic or mechanical, including recording or the use of any information storage and retrieval system, without
written permission from MIROS. Any conclusion and opinions in this report may be subject to reevaluation in the
event of any forthcoming additional information or investigations.
Safety Helmet Use Rate and Child Pillion Riders’ Characteristics in Selangor
Contents
Page
List of Tables iv
List of Figures v
Terminologies and Abbreviations vi
Contributors vii
Acknowledgement ix
Abstract xi
1.0 Introduction 1
2.0 Literature Review 5

2.1 Child Injury Scenario in Member States of South East Asia (SEA)
Region 5
2.2 Differences in Injury Patterns between Children and Adults 6
2.3 Anthropometric and Biomechanical Differences between
Children and Adults 7
2.4 Safety Precautions for Child Pillion Riders 9
3.0 Methodology 10
3.1 Sample and Site Selection 10
3.2 Defining Variables 11
3.3 Data Analysis 13
4.0 Result and Discussion 14

4.1 Sample Characteristics 14
4.2 Characteristics of Motorcycle Riders 14
4.3 Characteristics of Child Pillion Riders 16
4.4 Prevalence of Helmet Use: Riders vs Child Pillion Riders 18
4.5 Single and Multiple Child Pillion Riders in Relation to Site Location
and Rider’s Gender 19
5.0 Conclusion/Recommendation 21
References 23
iii
List of Tables
Page
Table 1 Comparison of motorcycle rider regulations 2

Table 2 Distribution of child (<14 years old) deaths by cause in SEA region 5
Table 3 Mortality rates due to major causes of injury per 100,000
children by sex in the SEA Region 6
Table 4 Demographics of the motorcycle rider being observed 15
Table 5 Demographics of the child motorcycle child pillion rider being
observed 17
Table 6 Single and multiple child pillion riders 18
Table 7 Demographics relationship between rider and pillion rider for
safety helmet use compliance 20
Table 8 Single and multiple child pillion riders by location of school and
gender of rider 21
iv
List of Figures
Page
Figure 1 Multiple child pillion riders 3

Figure 2 Sitting position’s definition 13
v
Terminologies and Abbreviations
Adult Other than a child.
Child Definition of child as used by the United Nations

Convention on the Right of the Child, Article 1 which
states that “a child means every human being below
the age of 18 years” (United Nations 1989). However, in
this research, the child is defined as a person of age 15
years old and below; according to Malaysian laws, the
minimum age to apply for a motorcycle driving license
is 16 years old.
CHOP Conference Children’s Hospital of Philadelphia Annual Conference.
Day time The time between sunrise and sunset (7:00 a.m.–7:00 p.m.).
Pillion rider A person who sits on passenger seat of a motorcycle.
Rider A person who is riding a motorcycle.
Side car Vehicle with three wheels asymmetrically arranged in

relation to longitudinal median plane with engine CC >
50 cm3 and max design speed > 50 km/h.
vi
Acknowledgement
The authors would like to express their sincerest appreciation

to the Director-General of the Malaysian Institute of Road
Safety Research (MIROS), and the Director of Vehicle Safety
and Biomechanics Research Centre, for providing the grant
in conducting this project, VS102020 and extending their full
support in producing this report. Our deepest gratitude goes
to all the stakeholders involved, partners, reviewers, relevant
agencies/companies, research participants, our editor, Mr Tan
Choon Yeap, Akmalia Shabadin and Rohayu Sarani from Statistical
Consultation Clinic who have worked hard, contributed
their invaluable ideas, inputs, energy and time towards the
production of this report. The authors would also like to express
special thanks to the team members and research assistants
for their help and contribution in completing the project. They
are Muhammad Ridzuan Md Abd Basah, Fazli Yusof, Wan Amin
Ridzuan Wan Draman and Hisham Ali.
vii
Abstract
Cross-sectional observation surveys among 6 to 12 years

old child pillion riders were carried out at 17 different speed-
restricted school safety zones. The objectives of the survey are
to study the current safety helmet use compliance rate among
motorcycle rider in relation to child pillion rider; to study the
prevalence of safety helmet use among children pillion rider and
number of child pillion riders carried per motorcycle in relation to
their sitting position; and to determine the relationship between
child pillion riders’ physical sizes and their legs positioning. A total
of 712 riders and 915 school children were captured in videos
representing 10% of the whole selected schools’ populations
travelling to and fro from schools by motorcycle. Safety helmet
use rate among motorcycle riders was 66.8% while for child
pillion riders was 14.7%. The riders were 11.7 times as likely to use
safety helmet as compared to child pillion riders. Safety helmet
use rates among male (75.5%) and female riders (52.5%) had
statistical significant difference where male riders were 2.7 times
more prone to use safety helmet (χ2 = 35.98, p<0.001).
Safety helmet use rates of 16.3% and 13.2% were also observed for
male and female child pillion riders respectively. The difference
observed was not statistically significant (p=0.191). It was
observed that 65.8% of female riders and 59% of male riders were
carrying more than one child pillion rider. While 70.8% was found
to carry only one child pillion rider, 26.1% had two child pillion
riders and 2.8% carried more than three child pillion riders on a
motorcycle. Safety helmet use by motorcyclists on the route to
school is generally low. To increase its prevalence, there is a need
for public awareness campaigns on the safety benefits of safety
helmets use. Furthermore, issues such as ergonomic and the
motorcycle design should be given due priority. There are quite
a number of children riding motorcycle but has no flat surface
ix
to safely rest their foot for support. Thus, the motorcycle design
engineers need to cater for the requirements by considering the
difference in sizes between an adult and child pillion riders for
example, to equip motorcycle with more “flexible” gadget such as
a suitable foot peg.
x
1.0 Introduction
Carrying child pillion riders on motorcycles has become a norm

in this country. Usually parents or guardians bring their children
to school, for leisure or even for long trip journey. In Malaysia,
motorcycle fatal crashes (60%) warrant a high degree of concern.
This is increasing the exposure to the risk of road crashes and may
increase casualty. The available statistical data relating to the road
crash involving motorcyclist from 2005–2007 in Malaysia shows
that there were 25% of children below 16 years old pillion riders
involved in road crashes (MROADS 2011). In 2008, according to
the Malaysian Institute of Road Safety Research (MIROS 2011),
road crashes in Malaysia have killed 410 lives of children aged
between one and 15 years old and another 2,797 children
suffered serious and light injuries.
Child motorcyclists are the highest children victims involved in

road crash in this country. This is due to the potential vulnerability
of child pillion riders and the possibility of injuries caused by road
crashes. In Malaysia, in 1999 alone, general insurers paid RM 1.67
billion or an average of RM 4.6 million a day on motorcycle claims
due to road crashes (Kareem 2003). It is now recognised that road
traffic crashes represent a major public health problem due to
the high number of victims involved and the seriousness of the
consequences for themselves and their families.
There are several questions arise regarding the issue of child

motorcycle pillion riders. For instance,
• How many children aged less than 16 years regularly

travelled as motorcycle pillion riders?
• What is the appropriate age limit for a child to ride as a
pillion rider on a motorcycle?
1
• Is there any existing legislation that limits the number of

pillion riders carried on a motorcycle?
• What regulations relate to the safety of motorcycle pillion
riders?, and
• What plans are available to improve the safety of
motorcycle pillion riders?
In answering those questions, Azhar et al. (2009) had done a

comprehensive review of regulations and policies on motorcycle
rules which revealed that very few countries specified the
minimum age of a child riding as a pillion rider on a motorcycle.
Additionally, the definition of child physical requirements to
ride as pillion rider is also rarely available. As shown in Table 1,
motorcycle pillion rider’s age limitation is not commonly set in
the regulations.
Table 1 Comparison of motorcycle rider regulations (Azhar et al. 2009)
Safety helmet use

Country No. of pillion riders Pillion riders’ age limit
requirement
Malaysia Only 1 pillion rider allowed No requirement Yes
Vietnam No requirement No requirement Yes
US, 4 states No requirement Varies from >5 to >8 years Yes
Sit astride and should keep

UK Only 1 pillion rider allowed Yes
both feet on the foot pegs
Australia No requirement ≥8 years, unless in a side car Yes
Furthermore, children’s size safety helmets are readily available

in Malaysia. However, the minimum size available is 57 cm in
diameter which may not satisfactorily suitable for the size of the
head of children who are younger than seven years old. Recent
survey conducted by MIROS researchers on the Standard Child
Helmet Compliance found that there are few other prominent
issues requiring immediate attention (Azhar et al. 2009). Firstly,
there is an obvious practice of multiple child pillion riders riding
2
on a motorcycle, as reflected in Figure 1. Secondly, there are cases

where the physical size of children may not be suitable to ride
as pillion riders because their legs could not reach the foot peg
or their arms reach are too short to firmly hold onto the rider in
front to have the needed support. Another concern would be
the habit of carrying pillion riders in front of the rider which has
a tendency to distract the motorcyclist. However, scientifically,
there is very little evidence to support these hypotheses and the
area could be understudied.
Figure 1 Multiple child pillion riders
3
Thus, the objectives of this study are as follow:
• to study the current safety helmet use compliance rate

among motorcycle rider in relation to child pillion rider;
• to study the prevalence of safety helmet use among child
pillion rider and number of child pillion rider carried on a
motorcycle in relation to their sitting position; and
• to determine the relationship between the child pillion
riders’ physical sizes and their legs positioning.
4
2.0 Literature Review
2.1 Child Injury Scenario in Member States

of South East Asia (SEA) Region
Children and older people (60 years and above) are often
considered as vulnerable road users (Kareem 2003). Data
collected around SEA region revealed that road traffic injuries
were the second highest reason of children death (Table 2). In
addition, WHO (2008) reported that road traffic injuries are the
highest cause of child mortality rate whereby boys recorded 9.6
while girls 5.1 injury per 100,000 children death (Table 3). These
findings are parallel with other studies which supported that
road traffic injuries are the leading cause of mortality and severity
among children worldwide and the burden mostly affects low
and middle income countries (Jaung et al. 2009; Krug et al. 2000;
Nantulya and Reich 2003).
Table 2 Distribution of child (<14 years old) deaths by cause in SEA region
Causes Percentage
Other unintentional injuries 53%
Intentional self-harm 2%
Interpersonal violence 3%
Other intentional injuries 1%
Road traffic injuries 12%
Poisoning 3%
Falls 5%
Burns 9%
Drowning 12%
Source: The Global Burden of Disease (2004 update)
5
Generally, it is known that motorcyclist is of a high risk group and

susceptible to high velocity injury and multiple traumas. They are
relatively more exposed to road hazards, therefore are more prone
to injury than those travelling in any other mode of transportation
which has protection “shell” such as cars and buses. Children, as
vulnerable as they are, are at greater risk of sustaining significant
severe injuries when involved in motorcycle crashes.
Table 3 Mortality rates due to major causes of injury per 100,000 children by
sex in the SEA Region
Types of injury Boys Girls Total

Road traffic injuries 9.6 5.1 7.4
Drowning 7.1 5.2 6.2
Burns 3.3 9.1 6.1
Falls 3.0 2.4 2.7
Source: World report on child injury prevention, Geneva, WHO (2008)
2.2 Differences in Injury Patterns between

Children and Adults
Head injuries are very common in children and are the leading
cause of disability and death. At least 80% of children died with
multiple traumas have significant head injuries as compared
with 50% of adults (Walker et al. 1985). Head injuries are more
common in children due to several factors:
• the head-body ratio is much greater;

• the brain of the child, especially in early childhood, which is
less myelinated and hence is easier to be injured; and
• the cranial bones are thinner and offer less protection to
the brain.
In piglets, age has an effect on the response and recovery of the

brain to focal impact and rotational load (Abrogast et al. 2003). If
human follows the same principles and patterns, then it may be
possible that brain damage increases with age when subjected
to external loads. In other words, when significantly loaded, the
6
brains of children can adapt and recover better from injury than
the brains of adults. However, studies show that children’s skulls
are only 1/8 as strong as that of adults (Near Infrared Imaging
2011). Thus, children are much more vulnerable to injury through
deformation and fracture of the skull, which can injure the brain.
If this hypothesis is acceptable, then children’s safety helmet
needs to be designed differently in order to be more effective in
reducing brain injury.
For the cervical spine injuries, it is rare in children under 12 years

old because of their greater mobility and elasticity of the cervical
spine (Henrys et al. 1977). Children bend their necks at higher
vertebral levels than adults, and their vertebral joints are flatter so
they don’t restrict forward motion as much as in adults. In another
study, it is reported that spine injuries stand out as the most
severe in paediatric cervical spine (Abrogast et al. 2003). Since
cervical spine injuries may be related to the impact to the heads,
then this issue is relevant to safety helmet design standards.
2.3 Anthropometric and Biomechanical

Differences between Children and Adults
Children and adults have plenty of differences in term of

anthropometry and body build up. The most prevalent would be
the size, shape and biomechanics. From University of Michigan
- Transportation Research Institute (UMTRI), data presented in
CHOP Conference (2003), Klinich pointed out that a child’s head
size undergoes rapid development from born till the age of four
years old. The size reaches 90% of an adult’s at four years old
and 95% by the age of 12 (Abrogast et al. 2003). This finding is a
relevant input for the design of children safety helmet.
Additionally, the data also shows that at the same age of four and
12 years old, the neck size for children is respectively 75% and
85% of the adults’ size and tend to be weaker with regards to
muscle strength but has a higher level of stretch ability (Abrogast
et al. 2003). These characteristics create a less respective forward
7
motion for children’s neck relative to that of adults’ and give more
flexibility for the neck to bend. These attributes are some of the
potential factors to be considered when determining safety
helmet mass.
Consequently, adult sized safety helmets can obscure children’s

vision and would not fit properly on their heads. For a child, the
adult sized motorcycle’s safety helmet may actually rest on the
shoulder and the head may not fit snugly into the safety helmet.
Even the chinstrap will not secure the safety helmet properly as
chinstrap anchor points are placed to fit adult’s anatomy. They are
likely to be too low and too far forward for children’s head and it
will be loose on their head; worst of all, it may come off in a crash.
Children’s injury limit need to be assessed seperately and not

using adults’ injury levels. Children’s injury limits are more
complicated because they need to be assessed as a function of
age. The age consideration is very important because children’s
anthropometric and biomechanical limits are different at every
stage of age. To the best of the authors’ knowledge there was
no study done with regard to relationship between children age
and body size with the suitability of riding as pillion rider on a
motorcycle. However, there was a study done on children bicycle
with regards to their body sizes. Thus the suitability of children
riding pillion on a motorcycle is not known. For bicycle, handle
bar would affect the spinal posture as well as the load imposed
on the back or neck area and therefore may result in discomfort in
these areas (Laios and Giannatsis 2010). Due to wide variance in
anthropometric dimensions between children and adult and also
among the children themselves, the suitability of children riding
as pillion rider on motorcycle need to be reviewed.
8
2.4 Safety Precautions for Child Pillion

Riders
According to YouClaim, an insurance company from the United

Kingdom (U.K.), most general safety precautions for child pillion
riders are clearly prescribed in the laws. The followings are some
of the general safety precautions:
• there must be an actual pillion seat;
• the foot pegs must be easily reached by the child’s feet;
• the child must be able to grip the rider, the bar or the
pillion hand-holds easily;
• an appropriate, well-fitting safety helmet must be worn by
the child; and
• a full license, i.e. not a provisional license, must be held by
the rider.
In addition to this, other safety precautions which are strongly

advisable by YouClaim to prevent the child from injury suffering
in a motorcycle crash include:
• the child should wear a full and proper protective clothing;
• a high visibility clothing should be worn by both adult rider
and child pillion rider;
• the journeys are kept short and that stops and breaks are
made regularly;
• the child is mature and responsible enough to understand
the behaviour required while riding pillion rider; and
• the rider fully appreciate the impact on performance and
handling of a child pillion rider.
9
3.0 Methodology
3.1 Sample and Site Selection
This study was conducted between June and November 2010

and covered all nine districts in Selangor state. Data collection
in every district was carried out by an assigned team member.
The study’s subjects from every district were selected by the
Multistage Sampling Method with the following criteria.
i) Three primary schools in a rural setting were selected
comprising one National Primary School (SR Kebangsaan),
one National Type Chinese Primary School (SRJK Cina)
and one National Type Tamil Primary School (SRJK Tamil).
ii) Three primary schools in an urban setting were also
selected comprising one SR Kebangsaan, one SRJK Cina
and one SRJK Tamil.
A total of 17 primary schools were selected randomly according

to rural and urban area setting which was based on the school’s
classification by the Ministry of Education. Schools with the
highest number of students were nominated for data collection
according to cluster under each stratified areas. This is due to the
higher possibility of meeting relevant respondents. All primary
schools’ students comprising standard 1 to 6 (age from 7 to 12
years old), either going to school or coming back from school by
motorcycle were captured as the sample for this study.
This study, based on observation survey was conducted to

determine the characteristics of child pillion riders in the state of
Selangor. All observation sites were established at a non-curved
road segment along the main road of primary school main
entrance. At each site, two trained observers, including researchers,
10
observed and recorded all the passing-by motorcycles which

carry child pillion rider/riders. Then, the observers would fill out
and complete the observation form and subsequently record the
following variables for analysis:
• number of riders;
• goods carried;
• gender of riders (male or female);
• age of riders (adult or child); and
• use of safety helmet.
The above observation does not include riders who were not
seated on their own (namely; babies or infants). The Observation
form used was adapted from MUARC study (Clark 2009) to suit
our local environment. These observations were conducted
between 12:00 p.m. to 2:00 p.m. during the weekdays (Monday
to Thursday). Traffic from both directions was observed for each
site within the period of time set. Additional day will be allocated
if the required numbers of observations were not obtained.
3.2 Defining Variables
The following variables were observed for both the rider and
the child pillion rider during data harvesting from the captured
videos.
i) Estimated age of child pillion rider.
ii) Gender of child pillion rider.
iii) Position of each child pillion rider.
iv) Compliance of safety helmet use.
v) Use of protective clothing.
vi) Use of conspicious clothing.
vii) Switch-on motorcycle headlight during day time.
viii) Number of person on motorcycle.
11
It was noted that the child pillion riders’ age were hard to be
determined due to the variation in body sizes. This is because this
study was carried out using road observational method, not one-
to-one interview. On top of that some of the recorded videos
were not clear as the video resolutions were not in high definition
mode. As such the researchers had lost some valuable data such
as riders’ age and tightening of chinstrap.
Child pillion rider’s variables consist of the following:

i) gender of child pillion rider;
ii) safety helmet use compliance;
iii) child pillion rider’s sitting position; and
iv) child pillion rider’s leg resting position.
As shown in Figure 2, child pillion rider’s sitting position comprises:

i) front (FP);
ii) middle (MP); and
iii) back (BP).
Front (FP) is defined by the child pillion rider’s sitting in front of

the rider. Middle (MP) is defined by the child pillion rider’s sitting
position which is between the rider and the rear most pillion
rider. The back (BP) sitting position is defined as the rearmost
child pillion rider riding the motorcycle.
The leg resting position comprised three variables, namely, ‘in

basket’, ‘hanging’ and ‘on foot peg’. ‘In basket’ is defined by leg
resting in the basket available in front of a motorcycle. ‘Hanging’
is defined as the leg of child pillion rider who does not have any
flat surface for support. This could happen to a smaller size pillion
rider and also to one of the pillion riders when carrying more
than one pillion rider.
12
Rider and 1 Rear child pillion rider (BP) Rider and 1 Front child pillion rider (FP)
Rider and 1 FP , 1 Middle child pillion Rider and 1 FP , 2 MP and 1 BP

rider (MP) and 1 BP
Figure 2 Sitting position’s definition
3.3 Data Analysis
Recorded videos were extracted and relevant data were entered

into a database using Microsoft Excel. The prevalence of safety
helmet use (with 95% confidence intervals, CI) for both riders and
child pillion riders were determined for subgroups based on sex,
and location using simple cross-tabulations. Statistical analysis
was performed using SPSS software (SPSS Inc.). Comparisons
between groups were tested using analysis of variance (ANOVA)
for continuous outcome variables, and with Chi-square tests
for categorical outcome variables. P values for inclusion to and
exclusion from the models were set at 0.05, and the likelihood-
ratio test was used to test for significance.
13
4.0 Result and Discussion
4.1 Sample Characteristics
A total of 701 motorcycle riders and 913 child pillion riders

from all the 17 locations were observed. From the observation,
436 riders (62.2%) were men and 265 (37.8%) were women. A
total of 913 students were captured in the videos representing
10% of the selected schools’ total populations to and fro from
school by motorcycle. The number recorded in Selangor
was small because most of the parents are working, thus
do not send and pick up their children from schools. Thus,
transportation facility offered by transport agency such as
buses and vans are preferred by parents. Furthermore, most
of the schools provide additional classes for students who will
be taking major examinations at the end of each year. Since
this observation took place only from 12:00 p.m. to 2:00 p.m.,
the researchers have missed those students who were having
additional classes. These were the reasons for the sample
size to be small. Nevertheless, the number of observations is
adequate for this study.
4.2 Characteristics of Motorcycle Riders
As shown in Table 4, 33.2% of the observed riders did not

comply with the safety helmet use regulation. It is known that
the introduction of the safety helmet law has led to a 30%
reduction in motorcycle deaths (WHO 2008). However, the
safety helmet use among riders is found to be low in this study.
Safety helmets provide the best protection from head injury for
cyclist and motorcyclists who are involved in traffic crashes. Non-
compliance to safety helmet use increases the risk of head injury
14
for motorcycle riders by a factor of three (3), and safety helmets

use reduces fatal and serious head injuries by between 20% to
45% (WHO 2004).
Table 4 Demographics of the motorcycle riders being observed
Variables Frequency Percentage (%)

Riders’ gender
Male 437 62.3
Female 264 37.7
Location
Urban 382 54.5
Rural 319 45.5
Riders safety helmet use compliance
Yes 468 66.8
No 233 33.2
Brightness of riders upper garments
Yes 290 41.4
No 411 58.6
Running headlights during the day
On 390 55.6
Off 311 44.4
Motorcycle plate
L 7 1.0
P 25 3.6
None 669 95.4
Riders footwear
Shoes 159 22.7
Sandals 542 77.3
Furthermore, low motorcycle conspicuity, which is the inability

of the motorcyclist to be seen by other road users, is thought
to be an important factor associated with the risk of motorcycle
crashes (William 1979; Wells et al. 2003).
In Table 4, it could be seen that the number of riders who wore

bright upper garment (41.4%) is lower than riders wore dark
shirts (58.6%). Running headlights during the day which was
recorded in this study was low. This study found out that only
55.6% had turned on their motorcycles’ headlights as compared
to study conducted by Radin Umar (2005) whereby nearly 90%
of motorcyclists complied with the running headlights during
15
the day. Day time use of headlights had been proven to enhance
the conspicuousness of motorcycle riders hence it showed a
significantly decreased in day time conspicuity related accidents
by about 29% (Radin Umar 2005; Hardy 2011).
This study also highlighted the usage of proper footwear

among motorcycle riders. It is obviously shown in Table 4 that
the majority of motorcycle riders (about 77.3%) did not wear
shoes while riding. This finding concurs with the previous study
(Radin et al. 1996) which shows that 53% of Malaysian riders were
observed to wear sandals or slippers during raining days and this
can be seen in the high injuries to victims’ ankle and foot. Jeffers
et al. (2004) also revealed that motorcycle crashes continue to
be a source of severe injury, especially to the foot. Unsuitable
or inadequate footwear such as slippers and sandals could be
a hazardous practice for motorcyclist due to interference when
shifting gears or in the worst case rider’s foot could be stuck
at the brake lever when applying foot brake. Even though this
injury has been associated with low mortality, they still require
the assessment and immediate treatment to prevent death or
permanent disability.
4.3 Characteristics of Child Pillion Riders
Table 5 shows the characteristics of child motorcycle pillion

riders being observed. Out of the 913 child pillion riders being
observed, 48.5% are male and 51.5% are female. Safety helmet use
compliance is very low among child pillion riders. The number of
children use safety helmet to school is only 134 (14.7%).
Of the total numbers of observed child pillion riders’ sitting

location, 93% of them occupied the seat behind the rider–
classified in this study as Back (BP – rearmost child pillion rider,
73.6%) and Middle (MP – any child pillion rider between rider
and BP, 19.2%). There were 66 (7.2%) observed child pillion riders
occupying the front “seat”.
16
Table 5 Demographics of the child motorcycle pillion rider being observed
Variables Total Percentage (%)

Child pillion rider’s gender
Male 443 48.5
Female 470 51.5
Safety helmet use compliance
Yes 134 14.7
No 779 85.3
Child pillion rider’s sitting position
Front (PF) 66 7.2
Middle (PM) 175 19.2
Back (PB) 672 73.6
Child pillion rider’s leg position
In basket 52 5.7
Hanging 320 35.0
Foot peg 541 59.3
In addition, the observation for the child pillion rider’s leg

position is straightforwardly related to the sitting position. Child
pillion rider being seated in the front usually put their leg in the
basket (the floor of the basket being the foot rest). Child pillion
riders at the rear (BP) and middle (MP) were observed to have
their legs hanging or resting on the foot peg. In the case of two
or more child pillion riders behind the rider, it was observed that
the back child pillion riders (BP) occupy the foot peg more often.
Therefore, the observation for leg position follows the same
pattern of sitting position with leg on the foot peg and hanging
were 59.3% and 35%, respectively.
Of the observed motorcycles, 502 (71.6%) had one child pillion

rider, 179 (25.5%) had two child pillion riders, and 20 (2.9%) had
more than three child pillion riders as shown in Table 6. Exclusive
to this research, there was one occasion of a rider carried four child
pillion riders was detected, which made up the total occupants
for a motorcycle to five.
17
Table 6 Single and multiple pillion riders
Variable Frequency Percentage (%)

Multiple child pillion rider
No 502 71.6
Yes
Two pillions riders 179 25.5
Three or more pillion riders 20 2.9
4.4 Prevalence of Safety Helmet Use: Riders

vs Child Pillion Riders
Table 7 shows that the estimated total rate of safety helmet use
compliance for riders and child pillion rider were 66.8% and
14.7%, respectively. The observed difference on the rate of safety
helmet use among riders and child pillion rider was statistically
significant (χ2 = 460; p < 0.001). Generally, riders were 11.7 times
as likely to use safety helmet as compared to child pillion rider.
However, the rate of helmet use compliance was low as compared
to observation carried out during Ops Sikap conducted by MIROS
during Chinese New Year (CNY) 2012, whereby the helmet
compliance rate was reported higher than 90% (Azzuhana, In
press). The low compliance rate was most probably due to the
observation areas which were conducted within school vicinity.
Since most of the observed schools were located near residential
areas, it is assumed that the riders and the child pillion riders
tend not to use helmet due to short distance travelled from their
house to school, and vice versa. As a result, the compliance rate of
helmet use might be affected, hence, recorded low.
In Selangor, the safety helmet use rate for riders was higher than
the child pillion riders as in accordance with other studies (Ackaah
and Afukaar 2010; Hung et al. 2006; Skalkidou et al. 1999). In other
countries such as Ghana, there is a general perception that only
riders are required to use safety helmet. Their motorcycle riders
are not well informed of the safety helmet legislation. However,
Malaysia differs from those countries whereby majority of the
18
population is aware of the safety helmet law but unfortunately

the rate of complying is still low for pillion, in the case of this
study is child pillion rider.
Safety helmet use rates among male (75.1%) and female riders
(53%) were found statistically significant. Male were 2.7 times
more prone to use safety helmet (χ2 = 36, p<0.001) as compared
to female. Nevertheless, this finding is not aligned with the
previous CNY 2012 study (Azzuhana, In press). Reason for such
difference might be due to the study area which were carried
out around the school vicinity. The finding suggested that travel
distance plays a significant role in determining the helmet use
compliance between male and female riders. Moreover, it is
assumed that female riders were mostly housewives who ride
motorcycle for sending and fetching their children to and from
school. On the other hand, male riders mostly travelled longer
distances from/to work place. As discussed in Akmalia (In press),
male respondents in Sabak Bernam drove significantly more
miles and trips as compared to female for their daily routine.
As shown in Table 7, safety helmet use rate of 16.3% and 13.2%

were observed for male and female child pillion rider, respectively.
The difference observed was not statistically significant. However,
child pillion rider sitting position plays a significant role in
determining the compliancy of safety helmet use. Furthermore,
there was a significant difference for child pillion rider safety
helmet use compliance according to sitting position. Children
who sit in the middle position (PM) are less likely to use safety
helmet.
Observations were also made at sites in the urban and rural areas.
There was a significant difference (χ2=5.1, p=0.024) in safety
helmet use between motorcycle riders within the urban (63.1%)
as compared to those in rural area (71.2%). It is unexpected that
the result of the safety helmet use within rural area is higher than
in urban area. This result contradicts the other studies (Ackhaah
and Afukaar 2010). The low compliance rate of safety helmet use
in urban area was due to the study environment whereby the trips
19
of the observation are dedicated to short distance trip i.e., trip

to and fro from school. Studies had proven that the compliance
rate of safety helmet use increases as the travel distance increases
(Kulanthayan et al. 2000).
Table 7 Demographics relationship between rider and child pillion rider for safety helmet use compliance
Safety helmet use

compliance Total
Variables Statistical significant Odd Ratio
no.
Yes (%) No (%)
Position of occupant
Rider 468 (66.8) 233 (33.2) 701 χ2 = 460, 1d.f., p<.001 11.7 (9.2-14.9)
Child pillion rider 134 (14.7) 779 (85.3) 913
Rider
Male 328 (75.1) 109 (24.9) 437 χ2 = 35.98, 1d.f., p<.001 2.7 (1.9-3.7)
Female 140 (53.0) 124 (47.0) 264
Child pillion rider
Male 72 (16.3) 371 (83.7) 443 χ2 = 1.71, 1d.f., p=0.191 -
Female 62 (13.2) 408 (86.8) 470
Child pillion sitting position
Front (PF) 6 (9.1) 60 (90.9) 66 χ2 = 7.25, 1d.f., p=.007 5.7 (1.4-23.6)
Back (PB) 125 (18.6) 547 (81.4) 672 χ2 = 30.87, 1d.f., p<.001 0.76 (0.02-0.24)
Middle (PM) 3 (1.7) 172 (98.3) 175
Location
Urban 241 (63.1) 141 (36.9) 382 χ2 = 5.10, 1d.f., p=0.024 0.69 (0.50-0.95)
Rural 227 (71.2) 92 (28.8) 319
4.5 Single and Multiple Child Pillion Riders

in Relation to Site Location and Rider’s
Gender
Table 8 shows the number of riders carrying multiple pillion riders

according to location (urban and rural) and gender of rider (male
and female). Based on the observation, it was noted that the
percentage of multiple child pillion riders was higher in rural area
(31.0%) as compared to urban area (26.2%). The result, which is
as expected, concurs with authors’ opinion that there is a limited
transportation facility (e.g. school bus) available in the rural area
as compared to urban area. However, further analysis using the
Chi-square method shows that the difference was not statistically
20
significant because it exceeded the 0.05 level (χ2=2.02, p=0.156).

This means that there is no significant association between
presence of multiple child pillion riders and the location of school.
A similar analysis was also carried out to determine whether there

is an association between multiple child pillion riders with gender
of rider. Initial analysis of the data showed that the percentage of
multiple child pillion riders was higher for female riders (34.1%)
than male (24.9%). Nevertheless, the frequency of rider carrying
multiple child pillion riders was higher for male rider than female.
Analysis using Chi-square method yielded a Chi-square value of
6.78 which was significant at the 0.05 level (p=0.009). This shows
that there is a significant association between multiple child
pillion riders with gender of rider. The Odds Ratio (O.R.) value
showed that male rider was 1.6 times more likely to carry multiple
child pillion riders when compared to female rider. The outcome
from the O.R. value supported the results of the total frequency
distribution shown in Table 8 where the total number of male
rider observed was higher than female rider.
Table 8 Single and multiple child pillion riders by location of school and
gender of rider
Multiple child pillion riders

Variables Total no. Statistical significant
Yes (%) No (%)
Location of school
Urban area 100 (26.2) 282 (73.8) 382 χ2 = 2.02, 1 df, p=0.156
Rural area 99 (31.0) 220 (69.0) 319
Gender of rider
Male 109 (24.9) 328 (75.1%) 437 χ2 = 6.78, 1 df, p=0.009
Female 90 (34.1) 174 (65.9) 264 Odds Ratio = 1.6 (1.114, 2.174)
21
5.0 Conclusion/Recommendation
This study was aimed to capture the safety helmet use rate
among rider and child pillion rider, and the relationship between
child pillion riders’ characteristics and the number of child pillion
riders carried at any one time.
Since the introduction of safety helmet regulation in 1971 for

motorcyclist, the accumulated evidence is overwhelming that
safety helmet use reduces motorcyclist fatalities, injuries, and
treatment costs. The price for these benefits is that motorcyclist,
including child pillion rider, should use a safety helmet and fasten
it properly. The proper use of a safety helmet may seen to benefit
only the motorcyclist, but in actual fact failure to use a safety
helmet properly may result in injury or fatality to the motorcyclist,
especially among children, which will also affect other people
directly or indirectly, including the family members, other road
users and also the society at large.
It is surprising that the result of this study showed that the

safety helmet use rate was relatively low even though with the
implementation of the safety helmet regulation. The study also
showed that, about 30% of the child pillion riders carried at
any one time was not complying with the existing regulation.
Thus, it is recommended that the existing law related to safety
helmet compliance and the number of child pillion rider carried
be enforced more effectively. It is also suggested that public
campaigns as well as educational programmes be conducted
regularly to enhance the awareness level of safety helmet use
compliance and the consequences of carrying multiple child
pillion riders among motorcyclist.
Besides that, the issue such as ergonomic and the motorcycle’s

design should be given due priority to allow children to be
22
safely carried on a motorcycle. In fact, ergonomically, design

of equipments should suit every user. But in reality, due to the
variability within the population, most designs are suited to
only 95% of the population. As for this study, with regards to
child pillion rider, the current design of motorcycle foot peg is
only suitable for those who have the adequate height. Thus, the
motorcycle design engineers need to consider the difference
sizes between adult and children. For example, to equip
motorcycle with “flexible” foot peg. On top of that, due to wide
variance in anthropometric dimensions between children and
adult, it warrants a revision of the law on the suitability of children
riding as pillion rider by including the age limit.
23
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Book · January 2013

Noor Faradila Paiman Mohd Hafzi Md Isa

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Zulhaidi Mohd Jawi Aqbal Hafeez Ariffin

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Human Factors & Ergonomics Research @ MIROS View project

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Safety Helmet Use Rate and Child Pillion

Noor Faradila Paiman

Noor Faradila Paiman

Malaysian Institute of Road Safety Research (MIROS)

Perpustakaan Negara Malaysia Cataloguing-in-Publication Data

Printed by : Malaysian Institute of Road Safety Research

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2.0 Literature Review 5

4.0 Result and Discussion 14

Table 1 Comparison of motorcycle rider regulations 2

Figure 1 Multiple child pillion riders 3

Terminologies and Abbreviations

Adult Other than a child.

Child Definition of child as used by the United Nations

CHOP Conference Children’s Hospital of Philadelphia Annual Conference.

Pillion rider A person who sits on passenger seat of a motorcycle.

Rider A person who is riding a motorcycle.

Side car Vehicle with three wheels asymmetrically arranged in

The authors would like to express their sincerest appreciation

Cross-sectional observation surveys among 6 to 12 years

Carrying child pillion riders on motorcycles has become a norm

Child motorcyclists are the highest children victims involved in

There are several questions arise regarding the issue of child

• How many children aged less than 16 years regularly

• Is there any existing legislation that limits the number of

In answering those questions, Azhar et al. (2009) had done a

Table 1 Comparison of motorcycle rider regulations (Azhar et al. 2009)

Safety helmet use

Malaysia Only 1 pillion rider allowed No requirement Yes

Vietnam No requirement No requirement Yes

US, 4 states No requirement Varies from >5 to >8 years Yes

Sit astride and should keep

Australia No requirement ≥8 years, unless in a side car Yes

Furthermore, children’s size safety helmets are readily available

on a motorcycle, as reflected in Figure 1. Secondly, there are cases

Figure 1 Multiple child pillion riders

Thus, the objectives of this study are as follow:

• to study the current safety helmet use compliance rate

2.0 Literature Review

2.1 Child Injury Scenario in Member States

Generally, it is known that motorcyclist is of a high risk group and

Types of injury Boys Girls Total

2.2 Differences in Injury Patterns between

• the head-body ratio is much greater;

In piglets, age has an effect on the response and recovery of the

For the cervical spine injuries, it is rare in children under 12 years

2.3 Anthropometric and Biomechanical

Children and adults have plenty of differences in term of

Consequently, adult sized safety helmets can obscure children’s

Children’s injury limit need to be assessed seperately and not

2.4 Safety Precautions for Child Pillion

According to YouClaim, an insurance company from the United

In addition to this, other safety precautions which are strongly

3.1 Sample and Site Selection

This study was conducted between June and November 2010