Effect Of Seat Belt Use Research Articles

Investigating the role of health belief model on seat belt use for front seat passengers on urban and rural roads

What makes a vehicle user buckle up? Considering the strong effect of seat belt use in reducing injuries and fatalities in a vehicle crash, we investigated the role of the health belief model on seat belt use among front-seat passengers on urban and rural roads. A questionnaire based on the theory components was randomly distributed in public areas of Sari, Iran. Structural equation model was used to test the study hypotheses. The results revealed that anticipated severity and perceived susceptibility directly affected seat belt use on urban roads, whereas perceived barriers had a reverse effect on seat belt use on urban roads. Perceived barriers with an indirect and perceived susceptibility with a direct effect, played an essential role in explaining seat belts use on rural roads. Outcomes of this study extend the knowledge of seat belts use behavior among front seat passengers by introducing new factors of potential influence, which could lead to practical solutions aimed to enhance seat belts utilization among these vehicle users and decrease the rate of injuries and fatalities in road crashes.

Does gender make a difference? Seatbelt use and the risk of severe injuries among drivers hospitalized in Level-1 trauma centers

BackgroundA considerable proportion of hospitalized trauma patients are due to motor vehicle crashes. While the safety implications of seatbelt use in reducing severe injuries and fatalities are well established, and while it is argued that females are underrepresented in safety vehicle tests, it is unclear whether seatbelts have equally benefitted drivers of either gender. Previous studies have not, to the best of our knowledge, tested moderation effect of seatbelt use on the association between gender and crash-related injury. MethodsWe performed a retrospective cohort study using data drawn from the National Trauma Registry database, 2008–2018, to determine the role of car driver's gender as a predictor of injury outcome following a road traffic crash resulting in hospitalization. Modified Poisson regression models were applied controlling for age, ethnicity, seatbelt use, impact type, road type, and year of hospitalization. Effect modification of the gender-injury outcome associations was tested for belt-restraint status using multiplicative interaction terms. ResultsThere was no evidence for a modification effect of the gender-seatbelt and injury associations, indicating that males are at greater risk for injury, independent of seatbelt use. The relative risk (RR) for a male driver to sustain severe injuries was approximately two fold the injury risk of female drivers (RR = 1.9, 95%CI: 1.6–21). The corresponding RRs for severe head and torso injuries were 2.5 (95%CI: 2.0–3.2) and 1.8 (95%CI: 1.5–2.2), respectively. ConclusionsThe results suggest that seatbelts provide equal injury protection for drivers of both genders; yet, males are at a greater risk to sustain severe injuries regardless of seatbelt use. This finding points to the possibility that risk-taking behaviors contribute to gender specific disparities and should be the focus of targeted interventions by health professionals and policymakers.

The Effects of Body Mass Index and Seatbelt Use on Pediatric Chest and Abdominal Injuries after Motor Vehicle Collisions.

Motor vehicle collisions (MVCs) are a major cause of pediatric morbidity and mortality. However, the effect of body mass index (BMI) and seatbelt use on thoracic injuries and outcomes in pediatric patients with rib fractures remains unexplored. We aim to assess how seatbelt use and BMI affect thoracic injuries and outcomes in pediatric patients who sustained ≥3 rib fractures following an MVC. The Trauma Quality Improvement Program (TQIP) database (2013-2017) was queried for pediatric patients (8-17years and >4feet 9inches tall) admitted secondary to MVCs, with ≥3 rib fractures and all non-thoracic Abbreviated Injury Scale ≤2. Patients were then divided by Injury Severity Score (ISS) into low (<15) and intermediate-severe (≥15) groups, which were further subdivided according to seatbelt use and BMI. Logistic and linear regression was performed to assess the effects of seatbelt use and BMI on outcomes. Seatbelt compliance varied from 39.6 to 50.7%. Belted patients (intermediate-severe ISS) had a reduced hospital length of stay (HLOS), intensive care unit length of stay(ICU-LOS), and mechanical ventilation time but had increased odds of splenic laceration vs. unbelted patients (aOR = 2.46, 95% CI: 1.03-5.93, P = .044). Obese patients (low ISS) had lower incidences of hemothorax, pneumothorax, pulmonary contusion, splenic laceration, and liver injury compared to normal-weight patients. Overweight patients (intermediate-severe ISS) had a significantly reduced ICU-LOS vs. normal-weight patients (β = -.17, 95% CI: -.33,-.01, = .041). Seatbelt use may improve outcomes for pediatric MVC patients with ≥3 rib fractures. Higher BMI may be associated with reduced thoracic injury and decreased ICU-LOS. Effective educational initiatives are needed to increase pediatric seatbelt compliance.

The Impact of Seat Belt Use in Pregnancy on Injuries and Outcomes After Motor Vehicle Collisions

BackgroundSeat belt use during motor vehicle collisions (MVCs) has been shown to alter adults’ intra-abdominal injury patterns, although the effect of seat belt use in pregnant women is unclear. The objective of this study was to determine the impact of seat belt use in pregnancy on injuries and outcomes after MVCs. MethodsPatients injured by MVCs were identified from the National Trauma Data Bank (2007-2014). The exclusion criteria were transfer from an outside hospital, male or unspecified sex, missing restraint data, and nonchildbearing age. Demographics, clinical/injury data, pregnancy status, seat belt use, and outcomes were collected. Study groups were dichotomized by pregnancy status with subgroup analysis by seat belt use. Univariate/multivariate analyses compared outcomes and determined predictors of seat belt use. ResultsAfter exclusions, 162,964 women were included, of which 680 (<1%) were pregnant. Intra-abdominal injuries during pregnancy did not vary according to seat belt use (P > 0.05). Unrestrained pregnant women were more injured (Injury Severity Score: 13 versus 7, P < 0.001), more likely to need emergent operation (14% versus 10%, P < 0.001), and had a longer hospital stay (6 versus 4 d, P = 0.012) than restrained counterparts. On multivariate analysis among pregnant women, seat belt use was associated with age ≥25 y (odds ratio: 2.033, P = 0.001). The lack of restraint use was associated with the position in the passenger seat (odds ratio: 0.521, P = 0.001). ConclusionsSeat belt use in pregnancy does not alter abdominal injury patterns but is associated with lower injury severity, reduced need for emergent surgery, and shortened hospital stay. Public health interventions emphasizing the importance of seat belts could be focused on younger patients and vehicle passengers to reach the high-risk pregnant subset.

Seatbelt use and risk of major injuries sustained by vehicle occupants during motor-vehicle crashes: a systematic review and meta-analysis of cohort studies

BackgroundIn 2004, a World Health Report on road safety called for enforcement of measures such as seatbelt use, effective at minimizing morbidity and mortality caused by road traffic accidents. However, injuries caused by seatbelt use have also been described. Over a decade after publication of the World Health Report on road safety, this study sought to investigate the relationship between seatbelt use and major injuries in belted compared to unbelted passengers.MethodsCohort studies published in English language from 2005 to 2018 were retrieved from seven databases. Critical appraisal of studies was carried out using the Scottish Intercollegiate Guidelines Network (SIGN) checklist. Pooled risk of major injuries was assessed using the random effects meta-analytic model. Heterogeneity was quantified using I-squared and Tau-squared statistics. Funnel plots and Egger’s test were used to investigate publication bias. This review is registered in PROSPERO (CRD42015020309).ResultsEleven studies, all carried out in developed countries were included. Overall, the risk of any major injury was significantly lower in belted passengers compared to unbelted passengers (RR 0.47; 95%CI, 0.29 to 0.80; I2 = 99.7; P = 0.000). When analysed by crash types, belt use significantly reduced the risk of any injury (RR 0.35; 95%CI, 0.24 to 0.52). Seatbelt use reduces the risk of facial injuries (RR = 0.56, 95% CI = 0.37 to 0.84), abdominal injuries (RR = 0.87; 95% CI = 0.78 to 0.98) and, spinal injuries (RR = 0.56, 95% CI = 0.37 to 0.84). However, we found no statistically significant difference in risk of head injuries (RR = 0.49; 95% CI = 0.22 to 1.08), neck injuries (RR = 0.69: 95%CI 0.07 to 6.44), thoracic injuries (RR 0.96, 95%CI, 0.74 to 1.24), upper limb injuries (RR = 1.05, 95%CI 0.83 to 1.34) and lower limb injuries (RR = 0.77, 95%CI 0.58 to 1.04) between belted and non-belted passengers.ConclusionIn sum, the risk of most major road traffic injuries is lower in seatbelt users. Findings were inconclusive regarding seatbelt use and susceptibility to thoracic, head and neck injuries during road traffic accidents. Awareness should be raised about the dangers of inadequate seatbelt use. Future research should aim to assess the effects of seatbelt use on major injuries by crash type.

Seat Belt Use to Save Face: Impact on Drivers’ Body Region and Nature of Injury in Motor Vehicle Crashes

Background: Seat belt use is the single most effective way to save lives and reduce injuries in motor vehicle crashes. However, some case reports described seat belt use as a double-edged sword because some injuries are related to seat belt use in motor vehicle crashes. To comprehensively understand the effects of seat belt use, we systemically investigated the association between seat belt use and injuries based on anatomic body region and type of injury in drivers involved in motor vehicle crashes.Methods: The injury information was obtained by linking crash reports with hospital discharge data and categorized by using the diagnosis codes based on the Barell injury diagnosis matrix. A total of 10,479 drivers (≥15 years) in passenger vehicles involved in motor vehicle crashes from 2006 to 2011 were included in this study.Results: Seat belt use significantly reduced the proportions of traumatic brain injury (10.4% non-seat belt; 4.1% seat belt) and other head, face, and neck injury (29.3% non-seat belt; 16.6% seat belt) but increased the proportion of spine: thoracic to coccyx injury (17.9% non-seat belt; 35.5% seat belt). Although the proportion of spine: thoracic to coccyx injury was increased in drivers with seat belt use, the severity of injury was decreased, such as fracture (4.2% with seat belt use; 22.0% without seat belt use). Furthermore, the total medical charges decreased due to the change of injury profiles in drivers with seat belt use from a higher percentage of fractures (average cost for per case $26,352) to a higher percentage of sprains and/or strains ($1,897) with spine: thoracic to coccyx injury.Conclusion: This study provide a comprehensive picture for understanding the protective effect of seat belt use on injuries based on anatomic body region and type of injury in drivers involved in motor vehicle crashes.

The Effect of Seatbelt Use in Frontal/Side/Rear Collisions

The Effect of Seatbelt Use in Frontal/Side/Rear Collisions

Independent Effect Of Seat Belt Use On Motor Vehicle-Related Health Outcomes: A National Study

Independent Effect Of Seat Belt Use On Motor Vehicle-Related Health Outcomes: A National Study

Injury Mechanism Analysis for Casualty in Frontal Collision and Effect of Seatbelt Use

Injury Mechanism Analysis for Casualty in Frontal Collision and Effect of Seatbelt Use

Estimating the Impact of Seat Belt Use on Traffic Fatalities: Empirical Evidence from Canada

This study contributes to the literature by using provincial data in Canada between 1980 and 1996 to analyze the effect of seat belt use on traffic fatalities. Empirical estimates from first stage instrumental-variables regressions suggest that the enactment of mandatory seat belt laws is significantly associated with an increase in average seat belt use, while corresponding estimates from second stage regressions imply that a 1 percent increase in average seat belt use is correlated with a 0.17–0.21 percent drop in vehicle-occupant fatalities. These results suggest that roughly 17 percent of the observed decline in vehicle-occupant fatalities is attributable to the enactment of mandatory seat belt legislation and the corresponding increase in seat belt use.

Effect of Seat Belt Use on Road Accidents in Thailand

This research was conducted to investigate the factors influencing seat belt use in Thailand. An additional aim was to analyze the effect of seat belt use in motor vehicle crashes with the use of injury data from hospitals. Significant factors influencing seat belt use were determined through field observations and a questionnaire survey. Seat belt use was observed to be higher in passenger cars than in pickups; lower seat belt use was observed for females, and drivers’ use of seat belts was considerably higher than that of front seat passengers and passengers in the rear seat position. Statistical analysis from the questionnaire survey found that the sex, age, education, income, vehicle type, seating position, seat belt installation, and average travel time and the interaction between age and seating position, education and income, and vehicle type and seating position significantly affect seat belt use. Probability of survival and severity index analysis found that unbelted car users could have a severity rate 67.5% higher than those who are belted. From the odds ratio analysis, car users who are unbelted have a higher fatality risk than those who are belted, as shown in the odds ratio 1.54. Fatality reduction analysis shows that with seat belt use, 35 of every 100 crash fatalities could be prevented. This study shows that by maximizing seat belt use, lives lost due to road crash injuries could be reduced annually.

Click it or Pay It

This study investigated the association of seat belt use with occupant characteristics and the effect of seat belt use on occupant injuries and hospital costs for treatments. Data from the Kansas Trauma Registry were used for the analysis; from these, data related to crash victims who were occupants of motor vehicles were extracted. According to the analysis results, the overall seat belt usage among hospitalized highway crash victims was 43%, significantly lower than the observed Kansas seat belt usage rate. Young hospitalized occupants were less likely to wear seat belts, while older crash victims were reported to have the highest recorded seat belt usage rate. A majority of the hospitalized occupants were males, and their seat belt usage was lower than that of female occupants. Occupants who sustained less severe injuries had a higher seat belt usage rate than severely injured occupants. A univariate analysis showed possible association between seat belt usage and occupant age, gender, and injury severity. The mean hospital charge for an unrestrained occupant was about $68,000, while that value for a restrained occupant was about $51,000. Length of stay in an intensive care unit and the injury severity score were also higher for unrestrained occupants. On the basis of the analysis results, it was confirmed that unrestrained occupants have higher odds of being fatally injured than restrained occupants.

The Effect of Seat Belt Use on the Cervical Electromyogram Response to Whiplash-Type Impacts

Objective The objective of this study was to determine the effect of a standard 3-point lap-and-shoulder seat belt and car seat on the electromyogram (EMG) response of the cervical muscles to increasing low-velocity impacts in comparison with that of a rigid seat and 5-point restraint. Methods Seventeen healthy volunteers were subjected to rear, frontal, right and left lateral and bilateral anterolateral, and posterolateral impacts with an acceleration varying from 4.4 to 16.8 m/s 2 while in a car seat with lap-and-shoulder seat belt. Results For rear-end impacts, whether straight on, right posterolateral, or left posterolateral, all muscles generated 50% or less of the maximal voluntary contraction (MVC) EMG. In straight-on rear impacts, the sternocleidomastoid was symmetrically the most active; however, in posterolateral impacts, the sternocleidomastoid contralateral to impact direction was more active than its counterpart. For a right lateral impact, at the highest acceleration, the left splenius capitis generated 47% of its MVC and the left trapezius did 46% of its MVC. In a left lateral impact, the right splenius capitis generated 48% of its MVC and the right trapezius did 57% of its MVC. In a straight-on frontal impact, the left trapezius generated 35% of its MVC and the right trapezius did 48% of its MVC. In a left anterolateral impact, the right splenius generated 60% of its MVC and the right trapezius did 66% of its MVC. Similarly, in a right anterolateral impact, the contralateral splenius muscle increased its activity to 52% of its MVC and the left trapezius was at 52% of its MVC. Conclusions Compared with previously reported impact studies with a rigid seat and 5-point harness, the use of a 3-point lap-and-shoulder seat belt with a standard car seat did not appear to adversely affect cervical muscle response. In very-low-velocity and low-velocity impact experiments, seat belt and seat type may not significantly alter cervical EMG and kinematics.

Tips and falls during electric-powered wheelchair driving: effects of seatbelt use, legrests, and driving speed

Corfman TA, Cooper RA, Fitzgerald SG, Cooper R. Tips and falls during electric-powered wheelchair driving: effects of seatbelt use, legrests, and driving speed. Arch Phys Med Rehabil 2003:84:1797–802. Objective To measure the response of a test dummy while traversing common obstacles encountered by users of electric-powered wheelchairs (EPWs) to determine whether optimal wheelchair fit, use of seatbelts, and driving speed affect the frequency and severity of EPW tips and falls. Design Repeated-measures comparison study. Setting Constructed environment both in and around a Veterans Affairs medical center. Participant A 50th percentile Hybrid II anthropometric test dummy (ATD) was used to simulate a person driving an EPW. Interventions The ATD was driven in 4 different EPWs over commonly encountered obstacles at speeds of 1 and 2m/s, with and without the use of a seatbelt, and at varying legrest heights. Main outcome measures The response and motion of the ATD were observed and recorded as no fall, loss of control (the ATD falls forward or sideways but remains in the EPW), the ATD falls out of the EPW, or the EPW tips completely. Results A total of 97 adverse events out of 1700 trials were recorded: 88 were losses of control (instability) and 9 were ATD falls. No complete tips of any EPW occurred. Univariate statistical analysis indicated a significant relationship between the adverse events and the use of seatbelts, legrest condition, and test obstacles ( P<.05). A mixed-model analysis confirmed the significant relationships between the adverse events and the use of seatbelts, legrest condition, and test obstacles ( P<.05). However, the mixed model indicated that (1) there was no significant relationship between the adverse events and driving speed and (2) no one obstacle was designated to be the most problematic. Conclusion Persons who use EPWs should use seatbelts and legrests while driving their EPWs, and clinicians should include common driving tasks when assessing the proper set-up of EPWs.

Effect of motor vehicle crashes on adverse fetal outcomes.

To assess the effect of maternal involvement in motor vehicle crashes on the likelihood of adverse pregnancy outcomes and to estimate the effect of seatbelt use in reducing the occurrence of those outcomes. Statewide motor vehicle crash, birth, and fetal death records from 1992 to 1999 were probabilistically linked. Logistic regression was used to compare the likelihood of adverse birth and fetal outcomes including low birth weight, prematurity, placental abruption, fetal distress, excessive bleeding, fetal death, and other complications among pregnant women in crashes and those not in crashes. Of 322,704 single live resident births, 8938 mothers (2.8%) experienced a crash during pregnancy. Pregnant women using seatbelts were not significantly more at risk for adverse fetal outcomes than pregnant women not in crashes. However, pregnant women who did not wear seatbelts during a crash were 1.3 times more likely to have a low birth weight infant than pregnant women not in a crash (95% confidence interval [CI] 1.0, 1.6) and twice as likely to experience excessive maternal bleeding than belted pregnant women in a crash (95% CI 1.0, 4.2). Forty-five of 2645 fetal deaths were linked to a motor vehicle crash, with unbelted pregnant women 2.8 times more likely to experience a fetal death than belted pregnant women in crashes (95% CI 1.4, 5.6). Pregnant women should be counseled to wear seatbelts throughout pregnancy and reduce crash risk.

Effect of Motor Vehicle Crashes on Adverse Fetal Outcomes

In Brief OBJECTIVE To assess the effect of maternal involvement in motor vehicle crashes on the likelihood of adverse pregnancy outcomes and to estimate the effect of seatbelt use in reducing the occurrence of those outcomes. METHODS Statewide motor vehicle crash, birth, and fetal death records from 1992 to 1999 were probabilistically linked. Logistic regression was used to compare the likelihood of adverse birth and fetal outcomes including low birth weight, prematurity, placental abruption, fetal distress, excessive bleeding, fetal death, and other complications among pregnant women in crashes and those not in crashes. RESULTS Of 322,704 single live resident births, 8938 mothers (2.8%) experienced a crash during pregnancy. Pregnant women using seatbelts were not significantly more at risk for adverse fetal outcomes than pregnant women not in crashes. However, pregnant women who did not wear seatbelts during a crash were 1.3 times more likely to have a low birth weight infant than pregnant women not in a crash (95% confidence interval [CI] 1.0, 1.6) and twice as likely to experience excessive maternal bleeding than belted pregnant women in a crash (95% CI 1.0, 4.2). Forty-five of 2645 fetal deaths were linked to a motor vehicle crash, with unbelted pregnant women 2.8 times more likely to experience a fetal death than belted pregnant women in crashes (95% CI 1.4, 5.6). CONCLUSION Pregnant women should be counseled to wear seatbelts throughout pregnancy and reduce crash risk. Unrestrained pregnant women in motor vehicle crashes are at greater risk for adverse pregnancy events than restrained pregnant women.

The Effect of Seatbelt Use on Injury Patterns, Disposition, and Hospital Charges for Elders

Objective: To study the relationships between seatbelt use and injury patterns, hospital charges, morbidity, and mortality in elder motor vehicle crash victims. Methods: A retrospective review of individuals at least 65 years old presenting to an urban emergency department (ED) after a motor vehicle crash. Results: Over a two‐year period, 339 patients had documentation of seatbelt use or non‐use at the time of the crash. Of these, 241 (71%) patients had been wearing a seatbelt and 98 (29%) had not. Elders not using seatbelts were more likely to require hospitalization (29% unbelted vs. 17% belted) and had a higher mortality rate. Injury patterns were different in the two groups. Emergency department charges were significantly different between belted and unbelted elders ($351 vs. $451, p = 0.01) and head computed tomography (CT) utilization was higher in the unbelted group (25.6% vs 12.7%, p = 0.005). Conclusions: Improved seatbelt compliance in elders can reduce injuries, hospitalization rates, ED charges, and mortality resulting from motor vehicle crashes.

The effect of seatbelt use on injury patterns, disposition, and hospital charges for elders.

To study the relationships between seatbelt use and injury patterns, hospital charges, morbidity, and mortality in elder motor vehicle crash victims. A retrospective review of individuals at least 65 years old presenting to an urban emergency department (ED) after a motor vehicle crash. Over a two-year period, 339 patients had documentation of seatbelt use or non-use at the time of the crash. Of these, 241 (71%) patients had been wearing a seatbelt and 98 (29%) had not. Elders not using seatbelts were more likely to require hospitalization (29% unbelted vs. 17% belted) and had a higher mortality rate. Injury patterns were different in the two groups. Emergency department charges were significantly different between belted and unbelted elders ($351 vs. $451, p = 0.01) and head computed tomography (CT) utilization was higher in the unbelted group (25.6% vs 12.7%, p = 0.005). Improved seatbelt compliance in elders can reduce injuries, hospitalization rates, ED charges, and mortality resulting from motor vehicle crashes.

Injury severity in motor vehicle occupants.

We performed a retrospective analysis of injury severity and the effect of seat belt use with findings from forensic autopsies of 50 persons who had died in motor vehicle accidents. From autopsy findings and accident reports, the abbreviated injury scale (AIS) and the injury severity score (ISS) were calculated and analyzed epidemiologically. Among unrestrained occupants, drivers usually sustained more severe chest and abdominal injuries. Furthermore, three-point seat belts significantly decreased the severity of drivers' chest and abdominal injuries. Our results may be useful for forensic pathologists and clinicians and for mechanical engineers who investigate new safety devices for vehicle occupants.

Effects of North Carolina's mandatory safety belt law on children.

To assess the effect of the North Carolina law mandating that all front seat passengers use a safety belt on children 4 through 15 years of age. North Carolina collision reports, completed by local police or the state highway patrol for crashes with greater than $500 worth of damage, were analyzed using time series analysis on the monthly percentage of deaths and serious injuries between January of 1980 and February of 1994. Following the 1985 implementation of the law, children 4 to 15 years of age experienced a 42% decline in deaths and serious injuries. The mandatory safety belt law in North Carolina has been associated with a decline in deaths and serious injuries. Additional research in needed to assess the seat belt behaviors of this age group as well as the specific effects of seat belt use using outcome measures more precise than those available in police crash reports.