Determinants of Head and Neck Injuries among Commercial Motorcyclists in Kisumu County, Kenya

Abstract

Motorcycle-related injuries remain a significant public health concern in low- and middle-income countries. This study assessed factors associated with head and neck injuries among commercial motorcyclists in Kisumu County, Kenya.A community-based analytical cross-sectional study assessed socio-demographic, behavioral and cognitive determinants of head and neck injuries among 375 commercial motorcyclists in Kisumu County selected through cluster sampling. The lifetime prevalence of head and neck injuries was 5.9%. Most respondents were male (95.7%), aged 25–34 years (44.2%), and had secondary education (51.3%). Inconsistent helmet use was significantly associated with injury at bivariate level (χ² = 10.88, p = 0.012), with riders who never wore helmets having higher crude odds of injury (OR = 4.18; 95% CI: 1.27–13.79). However, this association did not remain statistically significant in the multivariate model, likely due to confounding by riding experience and small cell sizes in the never-use category, as reflected by the wide confidence interval. Multivariate logistic regression showed that riders with more than 6 years of riding experience had significantly increased odds of injury (AOR = 6.39, 95% CI: 1.75–23.37, p = 0.005), suggesting cumulative occupational exposure and possible risk normalization. Overall, riding experience emerged as the only independent predictor of head and neck injuries, while socio-demographic variables and overall knowledge scores were not significant. The findings suggest that behavior-focused interventions and strengthened helmet law enforcement remain important, but prolonged occupational exposure should be prioritized in injury prevention strategies.