|Year : 2016 | Volume
| Issue : 2 | Page : 43-47
Motorcycle accident mortality in Lagos, Nigeria: Impact of a traffic law
Festus Edobor Emiogun, Francis Adedayo Faduyile, Sunday Sokunle Soyemi, Olugbenga Olaide Oyewole
Department of Pathology and Forensic Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
|Date of Web Publication||9-Aug-2017|
Francis Adedayo Faduyile
Department of Pathology and Forensic Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos
Source of Support: None, Conflict of Interest: None
Introduction: The use of the motorcycles for commercial purposes has been associated with a high rate of road traffic injuries and mortality in Nigeria. This study is to examine the effects of newly introduced traffic laws on the mortality rate as well as pattern of injury following the enforcement of the laws.
Methodology: This is a 4-year retrospective autopsy study of motorcycle accident deaths in Lagos State University Teaching Hospital, Ikeja. The study period was divided into two parts; 2 years before the law, August 2010–July 2012 and 2 years after the law, August 2012–July 2014. The anatomical location of the injuries as well as the cause of death of the patients was extracted from the register and the data were analyzed using SPSS version 20. Test for statistical significance was set as P < 0.05.
Results: There were 128 motorcycle death autopsies recorded during the period of study with 96 cases (75%) before the law and 32 cases (25%) after the law. The frequency of head injury was 39.8% before the law and 43.6% after the law. The proportion of road traffic accident deaths due to motorcycle crashes was from 23.4% before the law to 11.2% after the law.
Conclusion: Head injury is the most frequent anatomical region of injury in both periods. There is a 3-fold decrease in the proportion of death from motorcycle crashes following the enforcement of the traffic law.
Keywords: Autopsy, head injury, motorcycle, road traffic accident, traffic laws
|How to cite this article:|
Emiogun FE, Faduyile FA, Soyemi SS, Oyewole OO. Motorcycle accident mortality in Lagos, Nigeria: Impact of a traffic law. Afr J Trauma 2016;5:43-7
|How to cite this URL:|
Emiogun FE, Faduyile FA, Soyemi SS, Oyewole OO. Motorcycle accident mortality in Lagos, Nigeria: Impact of a traffic law. Afr J Trauma [serial online] 2016 [cited 2017 Aug 19];5:43-7. Available from: http://www.afrjtrauma.com/text.asp?2016/5/2/43/212629
| Introduction|| |
Riding of motorcycle in Nigeria was mainly for personal transportation for the low-income earners in the past, but with the economic downturn experienced in the country from the 1980s coupled with population rise in the cities at that time, the use of motorcycle popularly referred to as “Okada” for commercial transportation began to gain popularity., The poor state of the roads in the country and the inefficiency of the public transportation system as well as worsening vehicular congestion and increasing unemployment are major reasons for the thriving motorcycle transport industry.
Increasing use of motorcycles for private and commercial purposes has also been reported in other African countries such as Ghana, Uganda, and South Africa.,, In contrast, in developed countries, the use of motorcycles is mostly for leisure and for sports.
Because of the increased use of the motorcycles for commercial purposes within a very short period, proper training and licensure were not possible for most riders. This is coupled with the fact that laws to control the use of motorcycles for commercial use were not in existence.
Mortality due to road traffic injuries in Africa is among the highest in the world, it accounts for 28.3 deaths/100,000 population. In Nigeria, the population burden of road traffic accident (RTA) is estimated to be 41/1000 population, and motorcycle injuries account for over half of road traffic injuries.
Motorcyclists are particularly vulnerable to injury because there is little or no protection provided in the event of a crash.
In August 2012, the government of Lagos State, Southwest Nigeria, passed into law a bill banning the use of motorcycles on many major roads and bridges across the state. The law also prohibits motorcycle riders below 18 years of age as well as prescribing the use of a standardized protective helmet for all riders and pillion passengers. Issues of licensure and regulation of maximum number of passengers allowed on a motorcycle, restriction of pregnant women, and children below the age of 12 years from riding as pillion passengers on motorcycles and the prevention of use of motorcycles for haulage are also addressed by the law. The state government adduced the high rate of motorcycle accidents as one of the reasons for the legislation.
There is a dearth of studies to determine the effect of the newly introduced traffic laws on road traffic mortality; hence, this study is to examine the effects of the traffic laws on the mortality rate as well as pattern of injury following the enforcement of the laws.
| Methodology|| |
This was a 4-year retrospective study of motorcycle accident deaths in Lagos State University Teaching Hospital (LASUTH), Ikeja. LASUTH is a foremost tertiary institution in Lagos, Southwest Nigeria, located in Ikeja administrative zone of Lagos and provides medical services to inhabitants of Lagos, Nigeria's commercial capital as well as contiguous states. In Lagos State, deaths from accidents are reportable and bodies of victims are deposited in the LASUTH morgue which is the main designated center for coroner's autopsies. All deaths due to motorcycle accidents, being coroner's cases are usually accompanied by a duly signed order from a coroner, requesting for an autopsy to be performed on the body.
On examining, the impact of the Lagos State road traffic law August 2012, the study period was divided into two parts, 2 years before the enactment and enforcement of the law (August 2010–July 2012) and 2 years after the law (August 2012–July 2014). Relevant information was recovered from the autopsy registers, the autopsy reports, hospital case notes where applicable, extract from police diary, and from relatives of the deceased. The confidentiality of the identity of the subjects was maintained. The pattern of injuries seen at postmortem examination was also documented in terms of the anatomical location of the injuries as well as the cause of death. The data were analyzed using SPSS version 20 (IBM SPSS, Illinois, Chicago, USA) and were presented as tables, percentages, and bar chart. Test for statistical significance was set as P < 0.05.
| Results|| |
During the 4-year period between August 2010 and July 2014, there were 128 motorcycle death autopsies recorded. Of this number, 96 cases (75%) were recorded before the law and 32 cases (25%) occurred after the law, resulting in a ratio of 3:1 [Table 1].
|Table 1: Total numbers of Motorcycle accident deaths before and after the enactment of the traffic law in Lagos state|
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[Table 2] shows that head injury was the most frequent anatomical region of injury both before and after the enactment and enforcement of the Lagos State traffic law. There is no statistical difference between pattern of injuries before and after the enforcement of the law (P > 0.05). There is a slight increase in the frequency of head injury from 39.8% before the law to 43.6% after the law (P = 0.304); and reduction of abdominal injuries from 10.4% to 5.9% (P = 0.036).
|Table 2: Regional pattern of injuries before and after the lagos state traffic law|
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[Table 3] shows that there was a reduction in the proportion of death from RTA due to motorcycle crashes from 23.4% to 11.2% following the introduction of the traffic law (P = 0.001).
|Table 3: Proportions of Motorcycle deaths in relation to All RTA cases before and after the law|
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| Discussion|| |
The study showed that a total of 96 cases (75%) were recorded before the law and 32 cases (25%) were seen after the law, with a ratio of 3:1. This shows that deaths due to motorcycle accident injuries at autopsy in LASUTH reduced by one-third (33%) following the enactment and enforcement of the Lagos State road traffic law that provided for the prohibition of the use of motorcycle on all major roads and bridges in the state, mandatory helmet use by riders, and pillion passengers on motorcycles among sundry issues. This outcome is comparable to a federal road safety law introduced in Spain, in the fall of 1992, which made helmet use mandatory for all two-wheel vehicle riders and pillion passengers. The legislation in Spain resulted in a 25% reduction in mortality from motorcycle accidents. The reduction in motorcycle accident-related mortality following the enactment and enforcement of the Lagos traffic law seen in this study may be due to the fact that there were fewer motorcycles on the roads because of the ban and so the rate of accident generally reduced as a consequence. In addition, operators of motorcycles in areas not affected by the ban, mostly in the suburban areas, and the few categories of riders who were exempted from the law, such as cooperate dispatch riders, road safety corps riders, military, and police escort bikers were perhaps more compliant with helmet use and this may have resulted in a reduction in the number of fatality of motorcycle accidents.
The study, however, showed that there was no change in the pattern of injuries before and after the law (P = 0.451). The head and neck, lower extremity, and chest in that order remained the major anatomical regions of injuries sustained by motorcycles accident victims. The head remained the major region of injury after the traffic law, with even a slight increase from 39.8% before the law to 43.6% after the law although not statistically significant (P = 0.304). This finding may indicate that there was probably poor compliance with helmet use in spite of the law that made it mandatory. After the law, some of the victims may have used nonstandard helmets or they failed to strap the helmet over the chin. They simply placed the helmet on the head like a cap just to avoid being apprehended by the law enforcement agents rather than as a compliance with a safety measure. Even in the setting of the use of standard protective helmet, head injury may still be inevitable. It was postulated by Cooter et al. that the use of a full face helmet may transmit the force of impact to the base of the skull through the mandibular rami, thereby increasing the risk of basal skull fracture during a motorcycle accident. Carrasco et al. also observed that despite obligatory helmet use in Brazil, head trauma was still the most common injury found. We further suggested that the dynamics in a motorcycle crash are so aggressive that even the use of helmet is not enough to protect against brain damage. There has been a large number of research studies published which address the effectiveness of mandatory helmet laws. Most of these studies have concluded that motorcycle helmets are effective in preventing fatal injuries. There are helmet laws in Ghana, Uganda, Brazil, Iran, Thailand, Scotland, India, and Spain.,,,,,,, In the United States, each state has its respective helmet law. As of May 2012, 19 states and the District of Columbia had universal laws and 28 states had a partial law and 3 states had no helmet law. In Nigeria, a federal law that made helmet use mandatory was repealed in 1979 but was reenacted in 2006., In 1980, after the repeal of the law, Asogwa reported that only 34% of motorcycle riders in Nigeria used crash helmets. In the federal law, the main emphasis is the use of crash helmet, but the Lagos State laws are more elaborate, which in addition placed other restrictions which included categories of pillion passenger that can be carried, the ban of some types of motorcycles on dual carriage ways and bridges and speed restriction.,
Adetunji and Aloba in their study opined that the irrational behavior of commercial motorcyclists on urban roads indicates inadequate training and illegal possession of driving license as well as the inability of the police to enforce traffic rules and regulations among this category of transporters in urban centers in Nigeria. All these have led to traffic accidents in urban centers in developing countries. They further concluded that, with the exception of Lagos State and part of the federal territory, there is a little or no serious government policy addressing the operations of commercial motorcyclists with a view to cutting down the rate of motorcycles accidents in urban centers in Nigeria and they advocated for the review of the processes of possession of driving license and enforce compliance by commercial motorcyclists who are operating in the cities.
Olakulehin et al. in their study on the helmet use among motor cycle riders revealed the overall prevalence of helmet use to be 4.3% among the riders and 1.4% among the pillion rider. They concluded that poor compliance with the use of helmets among motorcyclists exists; hence, the need to enforce law on use of helmet and educational programs such as media enlightenment should be intensified to enhance the use of helmet.
Within a period of 2 years before the traffic law, a total of 411 RTA autopsies were recorded, out of which 96 cases, 23.4% were from motorcycle accidents. Similarly, out of the 286 RTA death autopsies done during a period of 2 years after the law, 32 cases were due to motorcycle accidents which represent 11.2%. There is, therefore, a reduction in the proportion of deaths from RTA that is due to motorcycle crashes from 23.4% to 11.2% after the enactment and subsequent enforcement of the Lagos State road traffic law (P = 0.001).
The state government used special task forces comprising Kick Against Indiscipline staff, Lagos State Traffic Management Authority staff as well as the police force to ensure compliance of the law and ensuring arrest of defaulters and seizure of their motorcycles. The very strict enforcement of the restriction on the use of motorcycle on major roads and bridges in Lagos as provided for in the traffic law resulted in a drastic reduction in the number of motorcycles on the roads and consequently a reduction in the rate of motorcycle accident deaths.
| Conclusion|| |
The enactment and subsequent enforcement of a road traffic law in Lagos in the year 2012 resulted in a 3-fold decrease in the number of deaths resulting from injuries sustained in motorcycle accidents. There were, however, no significant changes in the pattern of injuries sustained in those accidents in the era before and after the law.
The gains achieved by the Lagos State government by reducing mortality from motorcycle accidents by 3-fold with the use of instrument of law and enforcement is highly laudable and must be sustained.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3]