Enforcement Of Seat Belt Laws Research Articles

Education, incentive, and engineering-based interventions to promote the use of seat belts.

Education, incentive, and engineering-based interventions to promote the use of seat belts.

Seat belt laws and prevalence of use among high school students in the United States

To examine the association between state seat belt laws and the prevalence of seat belt use among a nationally representative sample of teenagers in the United States, taking into consideration state-specific child restraint laws that could affect teenagers of different ages. Data were from the 2019 state Youth Risk Behavior Survey. We estimated prevalence ratios using modified Poisson regression with robust variance estimates to evaluate associations between state seat belt laws and seat belt use. Among, 81,929 high school students under 18 from 36 states, 56% always wore a seat belt when someone else was driving. Relative to students in states with secondary enforcement of seat belt laws, students living in states with primary enforcement were 5% more likely (aPR=1.05, 95% CI: 0.99, 1.11), and students covered by a child restraint law were 6% more likely to always wear a seat belt (aPR=1.06, 95% CI: 0.99, 1.12) after adjusting for age, sex, race/ethnicity, and graduated driver licensing laws. States with secondary seat belt enforcement should consider upgrading seat belt laws to potentially improve the prevalence of seat belt use among adolescents, potentially reducing injuries and deaths due to motor vehicle crashes.

Influence of seat belt use behavior and road traffic crash experience on the use of child restraint systems: A step further

Seat belts and child restraint systems (CRS) are important in-car safety components capable of preventing serious injuries and death in the event of a car crash. Low rates of seat belt and CRS use persist globally, particularly in the Kingdom of Saudi Arabia (KSA). In an effort to better understand and subsequently improve seat belt and CRS use rates, this study analyzed the factors influencing seat belt and CRS use behavior in the Eastern Province (EP) of KSA, including the connection between seat belt and CRS use and road traffic crash experience.This cross-sectional study was based on a survey of 3,421 male and female participants regarding their seat belt and CRS use behavior. Respondents were classified into four CRS use categories: cautious, helplessly negligent, ignorantly negligent, and deliberately negligent. Chi-squared tests were used to determine significant associations among seat belt use, seat belt belief, prior crash experience, CRS use, and demographic variables. Multinomial nominal logistic regression was used to estimate the odds ratios for classification in one of the three negligent vs. cautious CRS use categories as a function of demographic variables, prior road traffic crash experience, and belief in and use of seat belts.Results of this study indicated a modest improvement in the rate of seat belt use in KSA’s EP, however, a significant proportion of respondents reported only sometimes or never using their seat belt. A significant proportion of respondents were also classified in one of the three negligent CRS use categories. Respondents who reported using a seat belt sometimes or never were 2.67, 2.60, and 3.48 times more likely to be categorized as deliberately negligent, ignorantly negligent, or helplessly negligent in their CRS use, respectively, than respondents who reported always using their seat belts. Respondents who reported being previously involved in a car crash or a near crash were also more likely to be classified in one of the three negligent CRS use categories than respondents who reported no prior road traffic crash experience. Previous involvement in a car crash was also found to be associated with lower seat belt and CRS use rates.These findings suggest a need for increased seat belt law enforcement by the KSA’s Traffic Police Department, as well as additional seat belt and CRS use awareness campaigns targeting individuals with prior road traffic crash experience by the KSA’s Ministry of Communications through the Road Transport Department. This study can serve as a reference for future studies that aim to understand the factors and implications related to seat belt use and belief, CRS use, and road traffic crash experience.

Epidemiology of pediatric trauma in the Kingdom of Bahrain: a national pediatric trauma registry pilot study

BackgroundA pediatric trauma registry for the Kingdom of Bahrain would be a novel public health tool for the Bahraini health system. The aim of this study was to explore the epidemiology of pediatric trauma at the national level by describing the distribution of pediatric injury in the Kingdom, and quantifying the burden of injury shouldered by the study population.MethodsThis multicenter observational cross-sectional study was conducted in Bahrain using data from the Pediatric Trauma Registry (PTR), which was a short-term paper-based prospective trauma registry that collected data over a three-month period in 2018. PTR was based in the pediatric emergency departments (ED) of the three national referral hospitals in the Kingdom. By simultaneously collecting data from all three trauma hospitals in the country, it was assumed that during the data collection period all major pediatric trauma patients in the country would be captured by the study, and that the data collected would provide national estimates of trauma. Inclusion criteria for the study was any individual under the age of 14, that arrived at the ED seeking care for intentional and unintentional injuries.ResultsA total of 1328 patients were included in the study. Sixty-nine percent of patients were treated and discharged from the ED, 30.5% were admitted to the hospital, admitted for surgery, or seen by a specialist, and 0.5% were declared deceased. The percentage of patients documented as unrestrained during Motor Vehicle Collisions (MVC) was 92.3%, and amongst those involved in MVC, 12% were ejected from the cabin of the vehicle.ConclusionsThere are significant implications that this study holds for policy implementation and practice surrounding injury prevention in the Kingdom of Bahrain. Low seatbelt utilization and the high proportion of ejection amongst MVC victims warrant immediate public health policy implementation, including enforcement of seat belt laws, strengthening of the traffic court system, and awareness campaigns for MVC prevention. Additionally, pediatric drowning prevention programs centered on constant adult supervision, pool isolation fencing, personal flotation devices, and swimming education should be created to address the mortality attributable to drowning in this study.

A statistical analysis of the correlates of compliance and defiance of seatbelt use

With the intent to frame policy recommendations for enhancing the state of road safety, this study employed a binary logit regression approach to examine the factors associated with the compliance/defiance of seatbelt use among drivers of different vehicle types in Islamabad. To this end, a questionnaire survey was conducted to collect data on the respondents’ seatbelt use, demographic characteristics, driving behavior, past penalization history, and perceived effectiveness of enforcement of seatbelt laws. The study results revealed that there is a lower likelihood of wearing seatbelt among male drivers, taxi drivers, drivers with a low level of education, drivers with no crash or injury history, drivers that violate speed limits and are never penalized on seatbelt violation, and drivers with no seatbelt reminder installed in their vehicles. Respondents who believed that there is low effectiveness of the enforcement of seatbelt laws had the highest impact on seatbelt use whereas, the presence of seatbelt reminders in the vehicle had the least impact on seatbelt use. The findings of this study suggest the need for awareness campaigns for taxi drivers with the intent to educate them about the potential benefits of using a seatbelt in the case of a crash event; improved awareness and strict vigilance of male drivers; strict enforcement of posted speed limits and seatbelt laws; legislation for the mandatory installation of a seatbelt in all the new vehicles, and organizing mass outreach campaigns to improve the overall safety environment. Most importantly and widely applicable to the developing world, this study necessitates a depiction of strong resolve on the part of government agencies regarding the strict enforcement of seatbelt laws. Given a substantial difference in the social, cultural, and legislative outfit of the developed and developing worlds, factors influencing the compliance/defiance of seatbelt use among drivers differ significantly. It is, therefore, important to explore the local contributory factors as the results are not necessarily transferable across the regions.

Barriers to the enforcement of mandatory seat belt laws in Ghana: an exploratory study.

Road traffic accidents claim millions of lives every year across the world. Fortunately, effective safety and preventive measures such as routine maintenance of vehicles and roads and the use of seat belts exist. Yet, authorities in some countries fail to enforce laws on these measures. One of the barriers to compliance with traffic laws is poor enforcement. Using a cross-sectional study design, we explored the barriers to the enforcement of mandatory seat belt laws in Ghana. We employed an open-ended key informant interview guide to interview 26 staff of the Motor Traffic and Transport Department of the Ghana Police Service, National Road Safety Authority and the Driver and Vehicle Licensing Authority. The interviews which lasted between 30 and 45 min per session were analysed through a thematic approach facilitated by ATLAS.ti. The findings showed that the barriers to the enforcement of seat belt laws mentioned by the participants were institutional factors (inadequate resources and logistics and inability to enforce vehicle safety standards) political factors (external interference and lack of consensus on seat belt law implementation) and human factors (poor public attitudes and non- recognition of road safety as both individual and collective responsibility). The enforcement of road safety laws could be enhanced by adequately resourcing officers, addressing external interference of police duties and empowering officers to perform their duties without fear or favour. These findings are also useful in continuous public education and enhanced enforcement of the seat belt laws.

Click it or give it: Increased seat belt law enforcement and organ donation.

Laws mandating that individuals wear a seat belt have the presumed goal of reducing motor vehicle accident fatalities, but the prevailing view is that they may reduce the number of organs available. I provide a conceptual model identifying mechanisms whereby the law could either increase or decrease organ donation. Exploiting variation across states and time in the adoption of primary seat belt enforcement, I investigate these mechanisms and estimate the effect of the law on the supply of organs. The law increases seat belt usage and decreases motor vehicle accident fatalities, which translates to a sizeable reduction in the number of motor vehicle accident-based organ donors. In contrast, the law is not associated with changes in the number of organ donors from nonmotor vehicle accident-based sources and is robust to controlling for hospital-specific effects. The effects are concentrated within organs expected to be most negatively impacted by the seat belt. Although primary enforcement represents a net-gain to society in terms of lives saved, the negative impact on organ donation suggests further emphasis be placed on policies aimed at increasing the availability of organs.

Would Stronger Seat Belt Laws Reduce Motor Vehicle Crash Deaths?: A Semi-Bayesian Analysis.

For policy questions where substantial empirical background information exists, conventional frequentist policy analysis is hard to justify. Bayesian analysis quantitatively incorporates prior knowledge, but is not often used in applied policy analysis. We combined 2000-2016 data from the Fatal Analysis Reporting System with priors based on past empirical studies and policy documents to study the impact of mandatory seat belt laws on traffic fatalities. We used a Bayesian data augmentation approach to combine information from prior studies with difference-in-differences analyses of recent law changes to provide updated evidence on the impact that upgrading to primary enforcement of seat belt laws has on fatalities. After incorporating the evidence from past studies, we find limited evidence to support the hypothesis that recent policy upgrades affect fatality rates. We estimate that upgrading to primary enforcement reduced fatality rates by 0.37 deaths per billion vehicle miles traveled (95% posterior interval -0.90, 0.16), or a rate ratio of 0.96 (95% posterior interval 0.91, 1.02), and increased the proportion of decedents reported as wearing seat belts by 7 percentage points (95% posterior interval 5, 8), or a risk ratio of 1.18 (95% posterior interval 1.13, 1.24). Bayesian methods can provide credible estimates of future policy impacts, especially for policy questions that occur in dynamic environments, such as traffic safety.

An investigation of state population characteristics that moderate the relationship of state seat belt law and use in the United States

ObjectivesPrimary enforcement laws have been shown to be effective methods for increasing seat belt use at the state level. MethodThis study investigates state differences in the effectiveness of primary enforcement laws by assessing whether a state's academic achievement, health ranking, economic prosperity, violent crime rates, government effectiveness, gender distribution, or proportion of rural roads moderate the relationship between those laws and seat belt compliance rates. ResultsAggregate state-level academic achievement, health ranking, government effectiveness, and proportion of rural roads uniquely moderated the seat belt use differences between primary and secondary enforcement states. ConclusionsThis evidence suggests that cultural, social, and demographic differences among regions may be important factors in explaining state-level differences in the effectiveness of primary enforcement of seat belt laws.

Use of Seat Belt and Enforcement of Seat Belt Laws in Pakistan

Objectives: Traffic crashes are a leading cause of deaths and injuries in Pakistan. The World Health Organization (WHO) estimates that approximately 30,131 people die in road crashes annually on Pakistani roads (WHO 2013). The use of seat belts can be effective in reducing road crash fatalities in Pakistan but under existing seat belt laws, seat belt use is mandatory only for drivers and is limited to specific vehicles and roads. Primarily, this study was aimed to measure seat belt use rates among Pakistani vehicle occupants. It was meant to investigate the factors influencing the compliance behavior of seat belt use among vehicle drivers. The second objective was to gauge the enforcement of seat belt laws and their effectiveness in Pakistan.Methods: A first ever national survey was conducted for the systematic recording of seat belt use rates among Pakistani drivers and front passengers on 5 different kinds of roads. Factors influencing compliance with seat belt use were gauged through a questionnaire for 5 different kinds of roads. Commitment level of different traffic police organizations to enforce seat belt laws was also measured through their previous year's enforcement data.Results: Average seat belt use rates were 20% with the highest on motorways (53%) and the lowest on rural roads (5%). Unawareness of the law/usefulness, seat belt not fitted, discomfort, forgetfulness, low speed, and careless attitude were major reasons for noncompliance with seat belt laws among Pakistani drivers. Seat belt use rates were directly proportional to law enforcement strength and the National Highways and Motorways Police (NH&MP) showed maximum enforcement on M-2. There is a dire need to revise existing seat belt laws in order to raise seat belt use rates in Pakistan.

Self-reported seatbelt use, United States, 2002–2010: Does prevalence vary by state and type of seatbelt law?

ProblemMotor-vehicle crashes are a leading cause of death in the United States. Seatbelts are highly effective in preventing serious injury and death in the event of a crash. Not all states have primary enforcement of seatbelt laws. MethodsData from the 2002, 2006, 2008, and 2010 Behavioral Risk Factor Surveillance System were used to calculate prevalence of seatbelt use by state and type of state seatbelt law (primary vs. secondary enforcement). Results and discussionSelf-reported seatbelt use among adults in the United States increased steadily between 2002 and 2010, with the national prevalence reaching 87% in 2010. Overall, seatbelt use in 2010 was 9 percentage points higher in the states with primary enforcement laws than in the states with secondary enforcement laws (89% vs. 80%). Impact on industry: Primary enforcement seatbelt laws and enhanced enforcement of seatbelt laws are proven strategies for increasing seatbelt use and reducing traffic fatalities.

RTAS—Case fatality rate, crash injury rate and motor vehicles: Time trends between a developed and developing country

Introduction: RTCs (road traffic collisions) are one of the most common preventable causes of death and disability worldwide, and a major public health problem in developing countries. We aim to investigate changes in numbers of motor vehicles, case fatality rate and crash injury rate over 10 years in the UK and Sri Lanka, and factors affecting this relationship. Method: We utilised audit of government records and patient directed questionnaires (ethical approval obtained in both countries). Factors, e.g. environmental causes, visual impairment, pedestrian factors, wearing seatbelts, speed of vehicles, whether fatigued at accident were investigated. Results were analysed using percentages and chi squared analysis. Results: We demonstrated numbers of motor vehicles have risen in both countries; crash injury rates rising in the UK whilst remaining stable in Sri Lanka and case fatality rate decreasing in both countries. 325 patients took part in the survey at the Sri Lankan end, with 83 at the UK end. Number of motor vehicles was higher in the UK yet the case fatality rate, but not crash injury rate was greater in Sri Lanka. Results including environmental causes, e.g. poor lighting were worse in Sri Lanka as was, visual impairment lack of seatbelt usage and speed of vehicles, which may contribute towards the higher case fatality rate. The majority of results were significantly different between the two countries. Discussion: We discuss how factors investigated may impact on differences in case fatality, crash injury rate and number of motor vehicles between the two countries and propose recommendations to reduce case fatality and crash injury rates, e.g. target ‘vulnerable’ groups, e.g. young males for risk prevention, adequate lighting of roads both within/outside city limits, reflective clothing to be worn by vulnerable road user groups, enforcement of seatbelt laws and regular eyesight checks. Keywords: Road traffic collisions; Epidemiology; Developing country; Developed country

Effectiveness of Media and Enforcement Campaigns in Increasing Seat Belt Usage Rates in a State with a Secondary Seat Belt Law

Objective: In 2005, in terms of seat belt usage rates, Nevada ranked third nationally and first among states with secondary seat belt use enforcement laws in the United States. An effective combination of a media-based education and enforcement campaign helped in this regard. The objective of this article is to document the effectiveness of enforcement and media-based education and outreach campaigns on the seat belt usage rates in Nevada, a state with a secondary seat belt usage law Methods: Observational data on seat belt usage and passenger fatality data are used to evaluate the effectiveness of enforcement campaigns and media-based education and outreach campaigns. Data based on observations of about 40,000 vehicles in each of the years 2003 to 2005 were analyzed. Results: Statistical analyses show that a significant increase in seat belt usage rates among both drivers and passengers for both genders resulted from the accompanying the media and enforcement campaigns. Conclusions: The results from this study indicate that effective and well-planned media/enforcement campaigns can have a significant impact on seat belt usage rates even in a state where the enforcement of seat belt laws can only be as a secondary violation. They validate and expand on findings from other efforts documented in the literature. These results demonstrate that, if coordinated properly, media and enforcement campaigns work very effectively in increasing seat belt usage rates even in states with secondary seat belt laws.

Seat Belt Law Enforcement and Racial Disparities in Seat Belt Use

Numerous reports have documented a lower prevalence of seat belt use among blacks in the United States, compared with whites. Limited data suggest that black-white disparities in states with primary seat belt laws (motorists can be stopped and cited solely for violating a seat belt law) are less marked than in states with secondary laws (motorists can be cited for violating a seat belt law only if stopped for another offense). Data from the Fatality Analysis Reporting System were analyzed in 2005 to compare seat belt use among 11,574 blacks and 73,639 whites aged 16 or more years killed in crashes from 1999 to 2003 in 33 states with a primary or secondary adult seat belt law and annual reporting of race for 80% or more of decedents. After stratification of states by type of seat belt law, logistic regression was used to calculate odds ratios and 95% confidence intervals (CIs) for seat belt use among blacks, relative to whites, with adjustment for age, gender, seat position, urban/rural region, and income. Odds ratios and 95% CIs for seat belt use among blacks were 1.05 (0.97-1.13) and 0.89 (0.83-0.95), in primary- and secondary-law states, respectively. Black-white disparities in seat belt use were mitigated in states with primary seat belt laws. Only 24 states have primary laws. Enacting primary laws in other states might reduce or eliminate racial disparities in seat belt use.

Seatbelt Law Enforcement and Motor Vehicle Crash Fatalities Among Blacks and Whites in Louisiana and Mississippi

Seatbelt laws save lives. Primary enforcement (allowing citations solely for seatbelt nonuse) is a more effective means of saving lives, yet seven southern states have no primary laws, due in part to concern about racial profiling. Non-Hispanic, black:white (B:W), occupant motor vehicle crash mortality rate ratios (MRRs) were compared across the 15 to 64 age range over two time periods in two demographically comparable southern states (Louisiana and Mississippi). From 1992 to 1994 (when neither state had primary law) to 1996 to 1998 (when Louisiana had primary law) B:W MRRs were 0.73 (95% confidence interval = 0.61, 0.88) and 0.72 (0.60, 0.86) in Louisiana and 1.01 (0.9, 1.12) and 1.22 (1.10, 1.35) in Mississippi. Successful opposition to primary seat belt enforcement may have the unintended effect of producing racial disparities in motor vehicle crash mortality that adversely affects blacks.

Race and seatbelt law enforcement: health policy in search of descriptive epidemiology

Primary enforcement of state seatbelt laws (motorists can be stopped and cited solely for seatbelt nonuse) more effectively prevents motor vehicle crash injuries than does secondary enforcement (motorists can be cited only if stopped for another offense). Enactment of primary laws in most states has been hampered by concern that enforcement would engender racial profiling, but little is known about racial differences in seatbelt law enforcement. To explore racial profiling in relation to state seat belt laws, we analyzed data from telephone interviews performed by the U.S. Department of Transportation with a national probability sample of motorists in 2000. The study population comprised 466 black and 3117 white drivers residing in 12 primary law states and 13 secondary law states from which there were five or more black survey participants. As a measure of profiling, race-specific seatbelt violation citation histories were compared for all motorists stopped by police in the preceding year who had not been wearing seatbelts at the time. Logistic regression was used in computation of prevalence odds ratios (OR) and 95% confidence intervals (95% CI) with and without stratification by type of state seatbelt law. For all states collectively, among blacks and whites stopped while not wearing seatbelts, blacks were nearly three times as likely to be cited exclusively for violating a seatbelt law (OR = 2.8; 95% CI = 1.0, 8.1). Stratification by state law, however, indicated that in primary law states blacks were nearly four times as likely as whites to be cited only for a seatbelt law violation (OR = 3.7, 95% CI = 0.8, 16.7), whereas in secondary law states blacks were more than three times less likely to be cited only for seatbelt law violations (OR = 0.32, 95% CI = 0.1, 2.0). Although these findings were based on a small size and confidence intervals were wide, they suggest that primary seatbelt laws may lead to racial profiling.

Experience from a multivenue program to increase the use of car restraints in Greece

Objectives To evaluate a multivenue educational campaign aimed at increasing the use of car restraints in Greater Athens, Greece. Methods From October 1997 to June 1998, the campaign was implemented by a road safety coalition comprising 50 governmental and non-governmental organizations, while during the same period, seat belt law enforcement was not intensified. A pre-intervention survey was conducted in the summer of 1996 among the occupants of 1400 passenger cars and a post-intervention survey was carried out in the summer of 1998 (2250 cars). Both surveys followed the same protocol, focusing on the availability and use of seat belts. The data from the two surveys were modeled through multiple logistic regression. Results The odds ratio of seat belt use was significantly higher in 1998 than in 1996 (1.8 with 95% confidence interval = 1.5-2.1). Improvement was evident in highway traffic and among 25-64 year-old car occupants, but it was minimal among rear seat passengers, younger occupants, and in low-speed city and suburban traffic. There is evidence from the 1998 surveys that among front seat occupants, those travelling in larger engine capacity cars, frequently equipped with airbags, were less likely to use seat belts, whereas seat belting was more frequent among occupants of newer car models. Conclusion An education and information campaign in a Southern European country resulted in increased prevalence of seat belt use. A more intensive and sustained effort is required, however, to increase seat belt use in low-speed traffic and among rear seat occupants.

Use of a Community Program to Increase Seat Belt Use Among Shopping Center Patrons in Charlotte, North Carolina

A community program was implemented at one mall and two shopping centers in Charlotte, North Carolina, to increase patron seat belt use in the context of an ongoing statewide seat belt law enforcement program, “Click It or Ticket.” The program consisted of feedback signs at mall and shopping center exits displaying patron seat belt use rates, posters providing information about the benefits (number of lives and amount of money saved) of the “Click It or Ticket” program and urging patrons to use their seat belts and check seat belt use rate information posted at mall exits, as well as flyers providing similar information as the posters. Following a baseline period, the program was implemented at Carolina Place Mall, whereas the other two retail centers remained in the baseline condition. The program then was introduced at Matthews Festival Center, followed by Town Center Plaza. Seat belt use among drivers increased significantly from a range of 73–74% to 83–85% at all three sites following introduction of the program. Belt use among right front passengers also increased, but this change was statistically significant at only one of the three sites. Resumption of the statewide “Click It or Ticket” enforcement program was not associated with further increases in seat belt use.

Effectiveness of a comprehensive multisector campaign to increase seat belt use in the greater Athens area, Greece. Hellenic Road Traffic Police Department.

This study assessed the effectiveness of a comprehensive campaign to increase seat belt use in Athens. In 1996 a survey focusing on seat belt use was undertaken among occupants of 1400 passenger cars. From October 1997 to June 1998 the campaign was implemented; during the campaign, seat belt law enforcement was not intensified. In 1998 another inspection survey of 2250 cars was undertaken. The program brought only a 6% increase in compliance, but there was an estimated gain of about 50 averted deaths and 1500 averted injuries. An intensive campaign to increase seat belt use, conducted in the absence of increased law enforcement, resulted in moderate gains.

Nonsanction seat belt law enforcement: A modern day tale of two cities

This paper describes the implementation and evaluation of a nonsanction seat belt law enforcement program in two experimental communities of contrasting size in a state with a mandatory belt law. The main ingredients of the program were seat belt “salutes,” public information and education, and limited use of inexpensive economic incentives. Driver shoulder belt use data collected before, during, and after the experimental programs, compared to similar data collected in a comparison community, showed the approach to be effective. While standard seat belt enforcement activities without incentives have been shown to be effective, many police departments, especially in smaller communities, are reluctant to make wholesale increases in seat belt citations. Although requiring some additional level of manpower and resources, a nonsanction approach to seat belt law enforcement can provide an alternate way of increasing belt use in these communities.