Lower Seat Belt Use Research Articles

Environmental and Psychosocial Factors Affecting Seat Belt Use Among Turkish Front-Seat Occupants in Ankara: Two Observation Studies

Objective. Low seat belt use rate among car occupants is one of the main problems contributing to low driver and passenger safety in Turkey, where injury and fatality rates of car occupants are very high in traffic crashes. The present article consists of two observation studies, which were conducted in Ankara. The first study aimed at investigating environmental factors and occupant characteristics affecting seat belt use among front-seat occupants, and the objective of the second study was to investigate the relationship between driver and front-seat passenger seat belt use. Method. In the first study, 4, 227 front-seat occupants (drivers or front seat passengers) were observed on four different road sides and, in the second study 1, 398 front seat occupants were observed in car parks of five different shopping centers in Ankara. In both observations, front-seat occupants' seat bet use (yes, no), sex (male, female), and age (< 30 years, 30–50 years, > 50 years) were recorded. Results. The data were analyzed using chi-square statistics and binary logistic regression techniques. Results of the first study showed that seat belt use proportion among observed front seat occupants was very low (25%). Being female and traveling on intercity roads were two main factors positively related to use a seat belt among front-seat occupants. High correlations between seat belt use of the drivers and front-seat passengers were found in the second study. Conclusions. Overall, low seat belt use rate (25%) among the front-seat occupants should be increased urgently for an improved driver and passenger safety in Turkey. Seat belt campaigns especially tailored for male front-seat occupants and for the front-seat occupants traveling on city roads are needed to increase seat belt use rates among them. Also, both drivers and passengers may have an important role in enforcing seat belt use among themselves.

Predictors of seatbelt use in American Indian motor vehicle crash trauma victims on and off the reservation

Objectives American Indians (AI's) have the lowest rate of seatbelt use in the nation, putting them at significant risk for motor vehicle crash (MVC) morbidity and mortality. This study compares seatbelt use in victims of level one trauma crashes presenting from on and off AI reservations. Predictors of seatbelt use were evaluated as well. We hypothesized that AI's in crashes on a reservation would have lower rates of seatbelt use, even compared to AI's in crashes from off the reservation. Methods This is a retrospective cohort study of consecutive MVC victims presenting to a level one trauma facility in Phoenix, Arizona from July 2003 to June 2005. Inclusion criteria were age >11 and transported directly from the crash; struck pedestrians were excluded. Inter-facility transports were also excluded, as these patients would likely represent a sicker population, possibly introducing bias. Characteristics of those patients (sex, race, location of crash, alcohol and seatbelt use) were analyzed in univariate and multivariate logistic regression. Results Data were collected on 2339 patients. Three hundred ninety-two were excluded, leaving 1947 (83%) available for analysis. AI's had lower rates of seatbelt use compared to all other races. Additionally, AI's on a reservation were less likely to wear seatbelts than those off a reservation (25.9% versus 42.7%). However, when tested in a multivariate analysis with alcohol as a covariate, race and location became insignificant. Low seatbelt use by AI's on the reservation was primarily associated with alcohol use. Conclusion In this analysis, alcohol, rather than race or location, is the overriding predictor of seatbelt use. This study compared patients that were in crashes, and only those triaged to a level one trauma facility. If we assume unbelted passengers are more severely injured, this would bias our results. The application of these data may help direct future public service efforts to increase seatbelt use in target populations.

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.

The use of technology to address patterns of risk among teenage drivers

Introduction The crash risk of teens is high, with fatal crash rates of teen drivers higher than any other age group. New approaches to reduce teen traffic fatalities are clearly needed. Method A possible approach to reduce the incidence of teen driver crashes and fatalities is through the use of vehicle-based intelligent driver support systems. To be most effective, the system should address the behaviors associated with an overwhelming number of teen fatal crashes: speed, low seatbelt use, and alcohol impairment. In-vehicle technology also offers an opportunity to address the issue of inexperience through enforcement of certain Graduated Driver’s License provisions. Results To fully understand the capability of such technologies, there should be a concerted effort to further their development, and human factors testing should take place to understand their effects on the driver. Impact If successfully implemented, a Teen Driver Support System (TDSS), such as the one described here, could significantly decrease the number of teens killed in traffic crashes.

Change in Velocity and Energy Dissipation on Impact in Motor Vehicle Crashes as a Function of the Direction of Crash: Key Factors in the Production of Thoracic Aortic Injuries, Their Pattern of Associated Injuries and Patient Survival A Crash Injury Research Engineering Network (CIREN) Study

To examine the effect of change in velocity (MV) and energy dissipation (IE) on impact, above and below the test levels for federal motor vehicle crash (MVC) safety standards, on the incidence of aortic injury (AI) and its mortality and associated injury patterns in frontal (F) and lateral (L) MVCs. Comparison of 80 AI and 796 non-AI patients of AIS=3. Eight hundred seventy-six MVC adult drivers or front-seat passengers (552 F and 324 L) evaluated by 10 Level I CIREN study Trauma Centers together with vehicle and crash scene engineering reconstruction. Patient seatbelt and/or airbag use correlated with clinical or autopsy findings. In AI, 63% of cases were dead at the scene and only 16% survived to leave hospital. The relation between IE dissipated in the MVC and the DeltaV on impact was exponential as DeltaV increased, but the rise in IE for a given DeltaV was greater in LMVC than in FMVC (p <0.05). A more rapid rise in IE/DeltaV occurred above the mean DeltaV of 48 +/- 19.7 kph (30 mph) in FMVC and above the mean DeltaV of 36 +/- 16.2 kph (23 mph) in LMVC. As DeltaV increased above these means, 65% of 46 FMVC aortic injuries (AIs) and 64% of 34 LMVC AIs occurred. In AI patients there was evidence of focusing of the point of IE impact on the upper chest with a higher incidence of rib1-4 fractures than in non-AI (p <0.01) and more brain, heart, lung and spleen injuries (p <0.01) consequent to lower seatbelt use (p <0.01), but LMVC also had more pelvic fx (p <0.05). Airbags + seatbelts in FMVC and seatbelts in LMVC reduced mortality (p <0.05) Comparison of AI incidence in three successive 4-year vehicle model year periods showed a progressive decrease as new safety devices were introduced (p < 0.05). The implications for AI of the focused IE at the upper chest suggest a probable mechanism for MVC AI with the pressurized aortic arch acting as the long arm of a lever system with the fulcrum at the subclavian artery, producing maximum torsional strain at the short arm of the isthmus where 75% of the AIs occurred. AI mortality is also influenced by the associated injuries. To develop more effective safety systems to prevent AI, MVC safety testing with airbags and seatbelts should be carried out at DeltaVs of 1 SD above means for FMVC and LMVC.

Situational Factors in Seat Belt Use by Teenage Drivers and Passengers

Drivers with high crash risk such as teenagers have relatively low seat belt use, which contributes to their injuries. This article addresses whether belt use is lower in driving situations with higher crash risk (such as when teenagers transport passengers), further contributing to the problem. Belt use was investigated in a variety of situations among fatally injured drivers and their passengers, using 1995-99 data from the Fatality Analysis Reporting System. For drivers of all ages, belt use was lower at night and with alcohol present. For teenagers, but not adults, driver belt use decreased with increasing number of passengers. Driver belt use was lowest when teenage drivers were transporting passengers in their twenties, and many of these crashes involved driver alcohol use. Driver belt use was highest when teenage drivers were transporting passengers age 30 and older, many of whom could be parents. Passenger belt use also decreased among teenagers as the number of passengers in the vehicle increased. Transporting passengers up to age 29 should be restricted in graduated licensing systems, and restrictions should not be waived unless a licensed passenger older than that is present. Most existing passenger restrictions do not conform to this.

Self-reported risk-taking behaviors and hospitalization for motor vehicle injury among active duty Army personnel

Background: Motor vehicle crashes are a leading cause of injury in the Army. Behaviors increasing risk for motor vehicle crashes are also prevalent, but research has not linked these behaviors directly to injury outcomes (e.g., hospitalizations). Methods: To evaluate the relationship between behavior and motor vehicle crash injuries, 99,981 Army personnel who completed Health Risk Appraisal surveys in 1992 were followed for up to 6 years. Cox proportional hazards modeling was used to evaluate speeding, seat belt use, drinking patterns, and demographics. Results: A total of 429 soldiers were hospitalized for motor vehicle injury. Unadjusted analyses revealed that heavy drinking, drinking and driving, speeding, low seat belt use, younger age, minority race/ethnicity, and enlisted rank were significantly associated with motor vehicle injury, but neither smoking nor gender was. Multivariate models showed a significant trend of increasing injury risk with younger ages. Soldiers under age 21 were injured almost five times more often than those over age 40 (HR 4.89, 2.56–9.33). Also associated with risk for hospitalizations were minority race (HR 1.78, 1.46–2.18), heaviest drinkers versus abstainers (HR 1.81, 1.11–2.94), and seat belt use of 50% or less versus 100% (HR 1.40, 1.07–1.85). Although nonsignificant, there was evidence of an age–drinking interaction where the difference in injury risk between those older and those younger than 21 was greatest at low alcohol consumption levels. Conclusions: Modifiable risk factors associated with motor vehicle injuries include heavy drinking and low seat belt use. Programs targeting these behaviors that meet the needs of young and minority soldiers are needed. The high density of young, at-risk soldiers residing in base housing may provide a unique opportunity for a residential intervention program.