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Taiwan has one of the highest motorcycle use rates in the world; there are 11 million motorcycles in a total population of 22 million people. Motorcycles account for 74% of all motor vehicles, and for almost half of all motor vehicle related deaths (the denominator includes pedestrian fatalities). 1 By contrast, in the United States, motorcycles account for fewer than 2% of all motor vehicles and 8% of all motor vehicle related deaths. 2
Motorcycles are also a principal cause of non-fatal injuries in Taiwan. For example, traffic injuries account for 69% of all cases of traumatic brain injury and motorcycle injuries account for 64% of traffic related cases of traumatic brain injury. 3
In the mid-1990s, Taiwan was one of the few Asian countries without a helmet use law. In January 1994, a six month pilot program-a helmet use persuasion policy-was adopted by the police in one jurisdiction, Taipei City. The program led to an increase in helmet use rates in that city, from 21% in January 1994 to 79% in May 1994. 3 A comparison of Taipei City injury rates from July 1993 to December 1993 with injury rates from January 1994 to June 1994 showed a decline in motorcycle fatalities by 40% and a reduction in motorcycle head injury hospitalization by 30%. 3 The pilot program ended in June 1994.
Three years later, on 1 June 1997, after much legislative debate, mandatory helmet use for motorcyclists became the national law in Taiwan.
The law dramatically increased helmet use. Island-wide observations were undertaken at fixed intersections in each of three cities, representing northern, central, and southern Taiwan (Taipei City, Taichung City, and Tainan) in 1997, between 5 pm and 7 pm on various days of the week. Over 22 000 cyclists were observed in March, April, and May before the law, and over 15 000 cyclists were observed in July, after the law. Results indicate that the percentage of helmet use among motorcycle riders in these three areas increased from 30% to 98% after the law was introduced. 4
The law did not reduce the number of licensed cyclists. Nationwide, the number of licensed cyclists increased from 8.7 million in 1996 to 9.1 million in 1997 to 9.7 million in 1998.
The present...