Restraints for young kids on motorcycles: potential harms likely outweigh the benefits

The transport of young children on motorcycles is a concern in many low- and middle-income countries. A 2015 World Health Organization report speculated about the potential value of safety restraints ("safety harness") that strap the child to the adult rider and aim to prevent young children from slipping off motorcycles. Although the WHO report recommended that the concept should be evaluated before adoption, India recently became the first country to mandate the use of child safety harnesses. Epidemiological data from India show that children rarely slip off motorcycles. In contrast, crashes of motorcycles that are carrying young children are far more common. In a crash, a child who is tethered to an adult is likely to sustain more severe injuries because of the adult's mass and movement during impact. Therefore, the risks posed by harnesses to children may far exceed their benefits. Policies promoting these devices will likely create a false sense of safety among parents that could increase the transport of young children on motorcycles and in more risky conditions. India's policy mandating their use should be discontinued until more evidence is available. We call for urgent reconsideration and redirection of attention toward evidence-based strategies to protect children in traffic.