Effectiveness Of Seat Belts Research Articles

Outcome of Seatbelt Education and Safety Program Among Teenagers.

Despite the effectiveness of seatbelts, concerns persist about compliance, especially among teenagers. Survey data from a local high school and registry data from a level 1 trauma center were used to observe seatbelt and motor vehicle accident trends. The survey data was analyzed to gauge student's sentiments on seatbelt education. The trauma center data was analyzed to identify characteristics and trends among teenage motor vehicle accidents. Social media was the most common strategy selected for seatbelt safety awareness. Random seatbelt checks performed over 4 months revealed seatbelt compliance rates of 90%, 93.55%, and 96.94% after education intervention. Trauma center data showed that lack of seatbelt usage resulted in greater morbidity. These findings emphasize the need for targeted interventions. This study provides insights into creating effective education campaigns that can be used to enhance safety belt compliance and potentially reduce injury.

The effect of seatbelt pre-tensioners and load limiters in the reduction of MAIS 2+, MAIS 3+, and fatal injuries in real-world frontal crashes

Contemporary research has pointed out that while newer cars are contributing to the decrease of AIS2+ and AIS3+ injuries in several body regions, this effect is not shown for thoracic injuries like rib or sternal fractures. The objective of this study is to assess the effectiveness of advanced seat belt systems incorporating pre-tensioners and load limiters in the prevention of fatal, AIS2+ and AIS3+ injuries overall and then focus only on the head-face-neck and thoracic areas. Data from the NASS CDS database between 2000 and 2015 was augmented with specific vehicle information taken from NHTSA’s NCAP tests to identify the characteristics of the seat belt of each vehicle involved in a collision. Multivariate logistic regressions were developed to assess the likelihood of injuries for belted front seat occupants in frontal impacts. The presence of pre-tensioners and load limiters with a low load limiter (<4.5 kN) was significantly associated with a decreased risk of fatal and AIS3+ in the whole body (OR = 0.31 (p < 0.05) and OR = 0.70 (p < 0.1)), while high load limiters were significant in the prevention of fatal injuries (OR = 0.42). These effects should be considered always in combination with the delta-v of the collision, as the interaction term between delta-v and advanced seat belt features was significant. In the crashes considered, the model predicted a higher risk of injury for women compared to men, controlling for other occupant and crash factors. Impacts with a slightly oblique component increased the risk of injury compared to pure frontal impacts. After controlling for the presence of pre-tensioners and load limiters, the vehicle model year variable was found to be insignificant in any of the regression models. This study shows that the real-world effectiveness of advanced seat belts still requires further analysis. Other effects like age or impact direction might be more influential in the injury outcome than these seat belt features.

Effects of Seat Belts and Shock Absorbers on the Safety of Racing Car Drivers

This paper aimed to study the behavior of a body (dummy) that was in a race car in the event of a frontal collision with a wall in order to see what loads were acting on the dummy. Based on a complex car model, equipped with two safety system seat belts and a shock absorption system, the behavior of the dummy was obtained following frontal collision of the car–dummy assembly. The accelerations were obtained at different points of the dummy’s body and the force that appeared on the seat belts were determined. The Gibbs–Appell method was used to assess the response of the system based on the equations of motion in a problem involving shocks. This paper demonstrates that the revisited old principle of mechanics can offer an interesting and convenient means to obtain results in a short time. FEM and Altair Hyperworks software II was used to model the system. It can be used to determine whether a seat belt is able to work if it has defects during use, such as scratches, cigarette burns or animal bites.

Effectiveness of seatbelts in mitigating traumatic brain injury severity.

Effectiveness of seatbelts in mitigating traumatic brain injury severity.

Correlation between frontal crash occupant impact velocities and occupant injury indices reflecting the effect of airbags and seat belts

Correlation between frontal crash occupant impact velocities and occupant injury indices reflecting the effect of airbags and seat belts

Preventive effects of seat belts on traumatic brain injury in motor vehicle collisions classified by crash severities and collision directions.

This study aimed to measure the preventive effect of seat belt on traumatic brain injury (TBI) and to compare the effect according to the crash severities and collision directions. Korea In-Depth Accident Study (KIDAS) has collected vehicle and demographic data on injured occupants involved in motor vehicle collisions (MVCs) who visited three emergency medical centers for calendar years 2011-2016. Primary and secondary end points were TBI (abbreviated injury score 2+) and in-hospital mortality. Crush extent (CE) was classified into 1-2, 3-4, 5-6, and 7-9 according to the crash severity. We calculated adjusted odds ratios (ORs) of seat belts and CE for study outcomes and developed an interaction model in each collision direction using multivariate logistic regression analysis. Of the 2,245 occupants who were injured in MVCs, 295 (13.1%) occupants sustained TBI. In univariate analysis, old age, unbelted status, lateral collision, and higher CE were factors associated with TBI in MVCs. Occupants with belted status was less likely to have TBI and in-hospital mortality compared with those with unbelted status [AORs (95% CI) 0.48 (0.37-0.62) and 0.49 (0.30-0.81), respectively]. In interaction analysis, preventive effects of seat belts on TBI from MVCs were retained within CE 5-6 in frontal MVCs and within CE 1-2 in near side lateral MVCs, and those of seat belts on in-hospital mortality were reserved within CE 3-4 in frontal and rollover MVCs. The preventive effects of seat belts on TBI and in-hospital mortality are preserved within a limited crash severity in each collision direction.

The assessment of airbag deployment and seatbelt use in preventing facial injuries.

This study aimed to determine the effectiveness of airbags and seatbelts in the prevention of facial fractures and slight facial injuries in relation to the speed and kinetic energy experienced in frontal collisions. All cases of vehicle occupants who had been in frontal collisions and had subsequently been examined in the Institute for Emergency Medical Assistance and the Clinical Center of Montenegro in 2017 were analyzed. There were 29 cases of facial fractures (Group 1), 35 cases of slight facial injuries (including nondisplaced nasal fractures) (Group 2), and 26 cases of occupants who had suffered no facial injuries (control Group 3). In all assessed cases all of the subjects had been wearing a seatbelt and the airbag had deployed at the time of impact. A frontal collision is defined as a collision in which the principal force acts within a range of 90° from the longitudinal axis of the vehicle. Using the mass and the speed of the vehicles, the total kinetic energy (KE) of all frontal collisions being analyzed was calculated. The cut-off value of total KE in frontal collisions that were associated with either facial fractures or slight facial injury was estimated using a receiver operating characteristic (ROC) curve. The cut-off amounts of KE were then used to calculate the barrier equivalent velocity (BEV). The BEV for a vehicle of average mass was estimated to be 55.7km/h (34.6 mph) in Group 1, and 49.2km/h (30.6 mph) in Group 2. Airbags and seatbelts are effective in preventing facial injuries in vehicles of average mass that are traveling at speeds under 49.2km/h (30.6 mph) at the point of impact, but they do not protect from facial fractures when the vehicle speed exceeds 55.7km/h (34.6 mph).

Effect of seat belt and head restraint on occupant’s response during rear-end collision

Current neck injury criteria used to evaluate whiplash injuries are based on the kinematics or kinetics of the occupant’s head and neck during rear impacts. The occupant’s response is affected by many factors including impact severity, seat design and occupant related factors such as gender and posture. Most of the current finite element models are concerned with modeling the head and neck, ignoring the interaction of the seat with the occupant during rear collision. In this work the Global Human Body Model Consortium (GHBMC) finite element model was used to study these interaction effects with emphases on the effect of seat belt, headrest and seat stiffness on the occupant’s response during rear-end collisions and evaluate the response using three neck injury criteria. The study shows the dramatic importance of the occupant’s seat restraint and head rest upon occupant safety. Specifically, the occupant ramping during rear impacts can be prevented by using the seat belt. Furthermore, the headrest reduces the head displacement and rotation. Our work further reveals that the head displacement reduction can lead to higher moments, axial and shear forces at the neck, especially for cases involving poorly adjusted or stiffer headrest.

How would increasing seat belt use affect the number of killed or seriously injured light vehicle occupants?

The expected effects of increasing seat belt use on the number of killed or seriously injured (KSI) light vehicle occupants have been estimated for three scenarios of increased seat belt use in Norway, taking into account current seat belt use, the effects of seat belts and differences in crash risk between belted and unbelted drivers. The effects of seat belts on fatality and injury risk were investigated in a meta-analysis that is based on 24 studies from 2000 or later. The results indicate that seat belts reduce both fatal and non-fatal injuries by 60% among front seat occupants and by 44% among rear seat occupants. Both results are statistically significant. Seat belt use among rear seat occupants was additionally found to about halve fatality risk among belted front seat occupants in a meta-analysis that is based on six studies. Based on an analysis of seat belt wearing rates among crash involved and non-crash involved drivers in Norway it is estimated that unbelted drivers have 8.3 times the fatal crash risk and 5.2 times the serious injury crash risk of belted drivers. The large differences in crash risk are likely to be due to other risk factors that are common among unbelted drivers such as drunk driving and speeding. Without taking into account differences in crash risk between belted and unbelted drivers, the estimated effects of increasing seat belt use are likely to be biased. When differences in crash risk are taken into account, it is estimated that the annual numbers of KSI front seat occupants in light vehicles in Norway could be reduced by 11.3% if all vehicles had seat belt reminders (assumed seat belt wearing rate 98.9%), by 17.5% if all light vehicles had seat belt interlocks (assumed seat belt wearing rate 99.7%) and by 19.9% if all front seat occupants of light vehicles were belted. Currently 96.6% of all (non-crash involved) front seat occupants are belted. The effect on KSI per percentage increase of seat belt use increases with increasing initial levels of seat belt use. Had all rear seat occupants been belted, the number of KSI front seat occupants could additionally be reduced by about 0.6%. The reduction of the number of KSI rear seat occupants would be about the same in terms of numbers of prevented KSI.

Data linkage: An untapped resource for reducing serious traffic injuries in fast developing countries.

Reliable high quality traffic safety data has been essential for monitoring, developing and evaluating strategies to reduce the burden of injuries from traffic injuries. Information is often available in many different sources including police reports, ambulance/emergency medical service (EMS) run data, emergency department(ED) and hospital data, and mortality data from death certificates or medical examiner/coroner systems. However while each of these data systems has their own strengths and weakness, none can provide a comprehensive picture of traffic related injuries. Hospital trauma center records for example have extensive information on injuries and related medical problems but lack details on the mechanism of injury and crash and roadway characteristics. Often medical data cannot even distinguish drivers from pedestrians. Police or insurance crash reports on the other hand have considerable detail on the crash and circumstances surrounding it but have very poor data on the actual injuries sustained or their severity. This impedes targeting of prevention strategies towards serious injuries and fatalities. This presentation will use examples from current work on data linkage to demonstrate the value of linking traffic record data and explore how this approach can greatly advance traffic medicine and road safety in fast developing countries. In the United States linkage of crash data and medical data has been important for many traffic safety programs. One example is Maryland’s Crash Outcome Data Evaluation System (CODES) that uses probabilistic methodology to link police crash records to injury outcome records. CODES was established in an effort to improve highway safety through the use of linked motor vehicle crash data collected from police, EMS, hospitals (emergency department or inpatient admissions), and death certificates. This linked data have been used for a variety of statewide studies such as of injured motorcyclists, effectiveness of seat belts at preventing injuries, studies of older drivers, an analysis of mismatch collisions, geographic analysis of pedestrian injuries, patterns of injury in frontal collisions, costs and consequences of lower extremity injuries, the safety of newer vehicles, and the impact of casino gambling on alcohol-related crashes. A new project seeks to overcome the serious lack of reliable routine data on drug involvement in fatal crashes by linking detailed toxicology data from medical examiners with the Fatality Analysis Reporting System (FARS) in a sentinel group of states. Similar data linkage is also used in other countries such as a New Zealand study estimating underreporting of serious injuries by police reports. An Australian study noted that workers compensation datasets can identify most serious cases of occupational traffic injuries but lack valuable information on the circumstances and risk factors contributing to work-related crashes. Through linkage to police crash reports the study was able to identify high risk groups such as heavy vehicle drivers and the role played by fatigue and speeding. Many fast developing countries also have useful crash reports either from police or insurance reports. However only through linkage with medical data can their full potential for reducing the burden of serous traffic injuries be realized?

Forensic medical aspects of traffic accident reconstruction

Injuries and fatalities occur in all forms of transportation. Numerically, road traffic accidents account for the great majority worldwide. Special questions (especially from the forensic medical point of view) are associated with maritime and flight crashes, when bodies are heavily mutilated and severely decomposed (concerning i. e. identification). – Post mortem radiological investigations are of special value (especially body scanning, pm CT, so called virtual autopsy). The pattern of injuries, toxicological findings, and trace evidence vary considerably and the whole scale of forensic medical analyses is required. This concerns for example: Pattern of injury of vehicle occupants, effect of seatbelts, vulnerability of children in vehicles, injuries to motorcyclists, pedal cyclists and pedestrians, cause of death, suicide and homicide, railway injuries and the special dynamics of other motorized transports. Concerning fitness to drive/pilot/navigate/work careful medical (i.e. concerning epilepsy), psychological (concerning psychiatric illness, substance abuse) and toxicological screenings and investigations are required. For example chronic alcoholism and drug dependence have to be evaluated (i.e. by segmented hair analysis). Such drivers are responsible for very severe crashes. According to the German law these persons are banned from driving motorized vehicles.

Effect of Restraining Devices on Facial Fractures in Motor Vehicle Collisions.

The aim of this systematic review is to summarize and critically evaluate the evidence for or against the effectiveness of restraining devices on facial fractures in motor vehicle collisions (MVCs).In a PubMed search, the search terms "facial bone fracture and seat belt," "facial bone fracture and air bag," and "facial bone fracture and restraining" were used. The authors abstracted the odds ratio (OR) and 95% confidence intervals (CIs) from each study. Weighted mean differences and 95% CIs were also calculated. The statistical analysis was performed with Review Manager (The Nordic Cochrane Centre).The authors found 30 potentially relevant articles, of which 6 articles met our inclusion criteria. Five studies were subgrouped, and a meta-analysis of these data suggested beneficial effects of seat belts on decreasing facial fractures in MVCs (n = 15,768,960, OR, 0.46, 95% CI = 0.35-0.60). Three studies were subgrouped, and a meta-analysis of these data suggested that there were beneficial effects of seat belts and air bags on decreasing facial fractures in MVCs (n = 15,768,021, OR, 0.59, 95% CI = 0.47-0.74). Four studies were subgrouped, and a meta-analysis of these data suggested there were no significant effects of an air bag on decreasing facial fracture in MVCs (n = 15,932,259, OR, 1.00, 95% CI = 0.72-1.39).A seat belt alone (OR, 0.46) or a seat belt and an air bag (OR, 0.59) were effective to decrease facial fractures in MVCs. However, air bags alone had no significant effect (OR, 1.00). In using air bags, seat belt should be applied together to prevent facial fractures in motor vehicle injuries.

Effect of restraining devices on eye injury in motor vehicle collisions.

The aim of this systematic review is to summarize and critically evaluate the evidence for or against the effectiveness of restraining devices on eye injury in motor vehicle collisions (MVCs).In a PubMed search, the search terms "eye injury and seatbelt," "eye injury and car belt," "eye injury and airbag," and "eye injury and restraining" were used. Among the 30 potentially relevant articles, 5 articles met our inclusion criteria. The odds ratio (OR) and 95% confidence intervals (CIs) from each study were abstracted. The statistical analysis was performed with Review Manager (The Nordic Cochrane Centre).Three studies were subgrouped, and a meta-analysis of these data suggested no significant effects of an airbag on increasing eye injury in MVCs (n = 10,123,954; OR, 1.10; 95% CI, 0.77-1.56). Two studies were subgrouped, and a meta-analysis of these data suggested that there are beneficial effects of seat belts on decreasing eye injury in MVCs (n = 43,057,271; OR, 0.50; 95% CI, 0.50-0.51).Seat belts were effective to decrease eye injuries in MVCs. However, airbags had no significant effect on an increase to eye injuries. When using airbags, seat belts should be used together.

Preventive Effects of Seat Belt on Clinical Outcomes for Road Traffic Injuries.

Proper seat belt use saves lives; however, the use rate decreased in Korea. This study aimed to measure the magnitude of the preventive effect of seat belt on case-fatality across drivers and passengers. We used the Emergency Department based Injury In-depth Surveillance (EDIIS) database from 17 EDs between 2011 and 2012. All of adult injured patients from road traffic injuries (RTI) in-vehicle of less than 10-seat van were eligible, excluding cases with unknown seat belt use and outcomes. Primary and secondary endpoints were in-hospital mortality and intracranial injury. We calculated adjusted odds ratios (AORs) of seat belt use and driving status for study outcomes adjusting for potential confounders. Among 23,698 eligible patients, 15,304 (64.6%) wore seat belts. Driver, middle aged (30-44 yr), male, daytime injured patients were more likely to use seat belts (all P < 0.001). In terms of clinical outcome, no seat belt group had higher proportions of case-fatality and intracranial injury compared to seat belt group (both P < 0.001). Compared to seat belt group, AORs (95% CIs) of no seat belt group were 10.43 (7.75-14.04) for case-fatality and 2.68 (2.25-3.19) for intracranial injury respectively. In the interaction model, AORs (95% CIs) of no seat belt use for case-fatality were 11.71 (8.45-16.22) in drivers and 5.52 (2.83-14.76) in non-driving passengers, respectively. Wearing seat belt has significantly preventive effects on case-fatality and intracranial injury. Public health efforts to increase seat belt use are needed to reduce health burden from RTIs.

Influences of Initial Forward Speed, Ground Stiffness on Seat-Belt Restraint Effectiveness in Rollover of Engineering Vehicle

A simulation model of a certain wheel loader is established to assess the restraint effectiveness of seat belts in 90° rollover accident along slope. The restraint effectiveness of seat belts for 95th percentile human body models are simulated which wearing lap belt, three-point belt and harness at a certain speed, and the influences of initial velocity and ground stiffness are analyzed. The results show that under a certain forward speed and same ground stiffness, wearing the harness can make the operator completely restrained in the operators seat comparing with the other belts, the head excursion is smallest, and it can reduce the risk of the head striking hazardous features of the cab interior. Under the same restraint system, the dummy's injury risk is inconsistent with change of initial speed. The harness can all provide the best restraint for the operator under different forward speeds and ground stiffness.

Motor vehicle safety during pregnancy.

Motor vehicle crashes during pregnancy are the leading cause of traumatic fetal mortality and serious maternal injury morbidity and mortality in the United States, injuring approximately 92,500 pregnant women each year. Little is known about the circumstances surrounding these crash events and the maternal characteristics that may increase women's vulnerability to crash-related injuries during pregnancy. Even less is known about the effects of crashes on fetal outcomes. Crash simulation studies using female anthropomorphic test devices and computational models have been conducted to better understand the mechanisms of maternal and fetal injuries and death resulting from motor vehicle crashes. In addition, several case reports describing maternal and fetal outcomes following crashes have been published in the literature. Only a few population-based studies have explored the association between motor vehicle crashes and adverse maternal and/or fetal outcomes and even fewer have examined the effectiveness of seat belts and/or airbags in reducing the risk of these outcomes. This paper reviews what is presently known about motor vehicle crashes during pregnancy, their effects on maternal and fetal outcomes, and the role of vehicle safety devices and other safety approaches in mitigating the occurrence and severity of maternal crashes and subsequent injuries. In addition, this paper suggests interventions targeted towards the prevention of crashes during pregnancy.

Factors influencing students’ usage of school bus seat belts: An empirical analysis of the Alabama pilot project

The Alabama State Department of Education and the Governor's Study Group on School Bus Seat Belts authorized and funded a research project to investigate the effects of lap-shoulder seat belts on Alabama school buses. This article performs an empirical analysis to address an important component of the study – factors that impact students’ decisions about wearing seat belts or not on school buses. Discrete choice modeling framework is applied to quantify relative influences of various factors. To obtain the disaggregate level information on individual student's characteristics and trip properties, a new data collection protocol is developed. Eleven variables are investigated and eight of them are found to have significant impacts. They are age, gender, the home county of a student, a student's trip length, time of day, presence and active involvement of bus aide, and two levels of bus driver involvement. The resulting model fits the data well and reveals several trends that have been overlooked or underestimated in the literature. The model can also be used to predict the change of seat belt usage rate caused by the change of impact factors. This is helpful in identifying the most cost-effective ways to improve compliance rate, which is critical to bring the added safety benefit of seat belts into effect. This article is the first to quantify relative impacts of a range of variables using rigorous statistical modeling techniques. This study will contribute to the literature and provide valuable insights to the practice of school transportation management.

Seatbelt effectiveness for rear seat occupants in full and offset frontal crash tests

In Japan, it became mandatory for rear seat occupants to wear seatbelts as of 2008. This paper summarises the results of full car crash tests for rear seat occupants, and compares the kinematics and injury risk to belted and unbelted rear sear occupants in order to show the effectiveness of seatbelts. Full-width rigid barrier and offset frontal impact tests were conducted using Hybrid III fifth percentile female and 3-year-old dummies in belted or unbelted conditions in the rear seat. In both full and offset frontal tests, the injury measures of the belted fifth female and 3-year-old dummies in the rear seat were relatively low because contact with the car interior was prevented by the seatbelt, although the head injury criterion and the chest deflection of the fifth female dummy were relatively large. In the tests with the fifth female dummy not belted, its knees and head made contact with the front seatback and the head of the front seat dummy, respectively. Due to this impact by the fifth female dummy, the injury measures of the driver dummy became high. The unbelted 3-year-old dummy moved in the passenger compartment, making contact with several locations in the car. These test results were comparable with accident analyses that show high injury risks to the chest of belted rear seat occupants, and high injury risks to the head and lower extremities in unbelted rear seat occupants.

Effectiveness of Seat Belts in Reducing Injuries: A Different Approach Based on KABCO Injury Severity Scale

This study uses the multiple logistic regression method to estimate the effectiveness of seat belts in reducing fatal and nonfatal injuries to occupants involved in motor vehicle crashes. Two vehicle groups – passenger cars, and other passenger vehicles that included vans and pickup trucks – were considered in estimating seat belt effectiveness values using highway crash data in Kansas. According to the results, the estimated effectiveness of seat belts in reducing fatal injuries is 56% for passenger car occupants and 61% for others. In passenger cars, seat belts are 53% and 55% effective in reducing incapacitating and non-incapacitating injuries, respectively. In the case of other passenger vehicles, corresponding values are found to be 52% and 51%.

The effects of airbags and seatbelts on occupant injury in longitudinal barrier crashes

Introduction Longitudinal barriers, such as guardrails, are designed to prevent a vehicle that leaves the roadway from impacting a more dangerous object while minimizing the risk of injury to the vehicle occupants. Current full-scale test procedures for these devices do not consider the effect of occupant restraints such as seatbelts and airbags. The purpose of this study was to determine the extent to which restraints are used or deployed in longitudinal barrier collisions and their subsequent effect on occupant injury. Methods Binary logistic regression models were generated to predict occupant injury risk using data from the National Automotive Sampling System / Crashworthiness Data System from 1997 through 2007. Results In tow-away longitudinal barrier crashes, airbag deployment rates were 70% for airbag-equipped vehicles. Compared with unbelted occupants without an airbag available, seat belt restrained occupants with an airbag available had a dramatically decreased risk of receiving a serious (MAIS 3+) injury (odds-ratio (OR) = 0.03; 95% CI: 0.004-0.24). A similar decrease was observed among those restrained by seat belts, but without an airbag available (OR = 0.03; 95% CI: 0.001- 0.79). No significant differences in risk of serious injuries were observed between unbelted occupants with an airbag available compared with unbelted occupants without an airbag available (OR = 0.53; 95% CI = 0.10-2.68). Impact on Industry This study refutes the perception in the roadside safety community that airbags rarely deploy in frontal barrier crashes, and suggests that current longitudinal barrier occupant risk criteria may over-estimate injury potential for restrained occupants involved in a longitudinal barrier crash.