Motorcycle protective clothing: Protection from injury or just the weather?

Background: Apart from helmets, little is known about the effectiveness of motorcycle protective clothing in reducing injuries in crashes. The study aimed to quantify the association between usage of motorcycle clothing and injury in crashes. Methods and findings: Cross-sectional analytic study. Crashed motorcyclists (n = 212, 71% of identified eligible cases) were recruited through hospitals and motorcycle repair services. Data was obtained through structured face-to-face interviews. The main outcome was hospitalization and motorcycle crash-related injury. Poisson regression was used to estimate relative risk (RR) and 95% confidence intervals for injury adjusting for potential confounders. Results: Motorcyclists were significantly less likely to be admitted to hospital if they crashed wearing motorcycle jackets (RR = 0.79, 95% CI: 0.69-0.91), pants (RR = 0.49, 95% CI: 0.25-0.94), or gloves (RR = 0.41, 95% CI: 0.26-0.66). When garments included fitted body armour there was a significantly reduced risk of injury to the upper body (RR = 0.77, 95% CI: 0.66-0.89), hands and wrists (RR = 0.55, 95% CI: 0.38-0.81), legs (RR = 0.60, 95% CI: 0.40-0.90), feet and ankles (RR = 0.54, 95% CI: 0.35-0.83). Non-motorcycle boots were also associated with a reduced risk of injury compared to shoes or joggers (RR = 0.46, 95% CI: 0.28-0.75). No association between use of body armour and risk of fracture injuries was detected. A substantial proportion of motorcycle designed gloves (25.7%), jackets (29.7%) and pants (28.1%) were assessed to have failed due to material damage in the crash. Conclusions: Motorcycle protective clothing is associated with reduced risk and severity of crash related injury and hospitalization, particularly when fitted with body armour. The proportion of clothing items that failed under crash conditions indicates a need for improved quality control. While mandating usage of protective clothing is not recommended, consideration could be given to providing incentives for usage of protective clothing, such as tax exemptions for safety gear, health insurance premium reductions and rebates.