Visible Helmet Presence Among Motorcycle Riders and Passengers at a Thai University: A CCTV-Based Cross-Sectional Observational Study.

Motorcycle-related injuries remain a major public health concern in Thailand, particularly among adolescents and young adults, yet evidence on actual helmet-related behavior in university settings remains limited. This study assessed visible helmet presence among motorcycle riders and passengers at a Thai university using real-world CCTV observations. A cross-sectional observational study was conducted at a large private university in Thailand using CCTV footage from two campus gates over seven consecutive days during peak commuting periods (07:00-09:00 and 16:00-18:00). Motorcycle-user observation events were coded for visible helmet presence, rider/passenger role, university affiliation, and time of observation. Descriptive statistics, chi-square tests, and 95% confidence intervals were used. A total of 19,363 motorcycle-user observation events were recorded. Overall visible helmet presence was 18.8% (3646/19,363). Visible helmet presence was 21.8% (1956/8985) among student riders, 3.1% (230/7505) among student passengers, 58.6% (1299/2217) among staff riders, and 24.5% (161/656) among staff passengers. Morning observation periods showed higher values than evening periods across most groups. Visible helmet presence was low overall and especially low among student passengers. These findings should be interpreted as event-based estimates rather than person-based prevalence or verified protective helmet use, and they support universities as priority settings for targeted road-safety interventions.