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Motorcycle-Related Fatalities: A Systematic Review and Structured Narrative Synthesis
Athina Tousia1, Nikolaos Kalogrias2, Konstantinos Katsos1
1Department of Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, Athens, GRC.
Cureus
|August 8, 2026
Summary
Motorcycle crash fatalities are often linked to non-helmet use and substance impairment. Key interventions include helmet laws, substance abuse prevention, and targeted education for vulnerable road users.
Area of Science:
- Road Safety
- Traumatology
- Public Health
Background:
- Two-wheeler fatalities represent a substantial global road traffic burden.
- Despite existing safety measures, mortality rates, particularly in low- and middle-income countries, remain alarmingly high.
Purpose of the Study:
- To systematically review and synthesize factors contributing to fatal outcomes in motorcycle crashes.
- Identify modifiable risk factors to inform targeted intervention strategies.
Main Methods:
- Systematic literature search across PubMed, Scopus, and Web of Science (2014-2026).
- Inclusion of observational studies (cohort, case-control, cross-sectional) on fatal motorcycle crashes.
- Narrative synthesis of extracted data on helmet use, substance involvement, demographics, and injury patterns, assessed using Joanna Briggs Institute methodology.
Main Results:
- Sixty-five studies globally identified common factors in fatal motorcycle incidents.
- Non-helmet use, alcohol/substance involvement, and male riders aged 15-45 were significantly associated with mortality.
- Elderly victims also showed high mortality, indicating a bimodal age distribution of risk.
Conclusions:
- Motorcycle fatalities result from multiple, often modifiable, behavioral and environmental factors.
- Effective interventions require comprehensive strategies including enhanced helmet legislation, substance abuse programs, infrastructure enhancements, and tailored education campaigns for high-risk demographics.
