Mandatory Seat Belt Research Articles

Mandatory seatbelt laws and traffic fatalities: A reassessment

AbstractUsing data from the Fatality Analysis Reporting System for the period 1983–1997, Cohen and Einav (Review of Economics and Statistics 2003; 85[4]: 828–843) found that mandatory seatbelt laws were associated with a 4–6% reduction in traffic fatalities among motor vehicle occupants. After successfully replicating their two‐way fixed effects estimates, we (1) add 22 years of data (1998–2019) to capture additional seatbelt policy variation and observe a longer post‐treatment period, (2) employ the interaction‐weighted estimator proposed by Sun and Abraham (2021) to address potential bias due to heterogeneous and dynamic treatment effects, and (3) estimate event‐study models to investigate pre‐treatment trends and explore lagged post‐treatment effects. Consistent with Cohen and Einav (2003), our updated estimates show that primary seatbelt laws are associated with a 5 to 9% reduction in fatalities among motor vehicle occupants. Estimated effects of secondary seatbelt laws are smaller in magnitude and sensitive to model choice.

Is There Racial Bias in the Enforcement of Primary Seat Belt Laws? Evidence from Veil of Darkness Tests

Abstract State mandatory seat belt laws have become stricter over time, allowing for a vehicle to be stopped solely for a suspected seat belt infraction. While effective in reducing traffic fatalities, this additional discretion may also come with the possibility of increased racial targeting. Using individual-level traffic stop data, I combine recent advances in the Veil-of-Darkness test with a difference-in-difference identification strategy to estimate whether primary seat belt laws are associated with changes in the racial composition of seat belt stops. Results indicate that under primary seat belt enforcement, a black individual is 1.138–1.222 times more likely than a white individual to be stopped for a seat belt violation under the good visibility of daylight compared to the poor visibility of darkness. These additional stops end mostly in warnings, suggesting the law is used to increase the number of pretextual stops made, specifically on black drivers.

Investigating the trend of road traffic fatalities in Malawi using Mann-Kendall statistic

Fatalities due to road accidents remain a major challenge worldwide. In the recent years, Malawi, one of the developing African countries with a total population of about 19 million has also been witnessing a very high fatality rate [of about 31 crash deaths per 100,000 population in 2016] compared to most of its neighbours in the region. This seems to be continuously increasing even with several intervention measures, such as, speed and alcohol impairment laws, and laws for mandatory seatbelt and helmet use. In view of this, the study attempted to investigate the trend of road fatalities in Malawi, such that effectiveness of the existing measures can be established. For this, archived crash data of road fatalities between years 2000–2021 were used to undertake intervention and trend analyses. The method of Cumulative Summation was used to identify intervention points in the series, followed by the Mann-Kendall statistic (τ) to determine the trend during the intervened period using the non-parametric Rank-Sum test to support the findings. The results showed that the trend has been decreasing in the early years of legislating policy measures [2000–2012] and, thereafter [2013–2021], increased significantly [τ = 0.8333]. This suggests that there was acceptance of the measures by the motorists/public in the early years of implementation [2000–2012], which might have been overshadowed by vehicle population growth and weak enforcement mechanism that have seen the trend increasing lately. The study therefore suggests that there is still a scope to review the intervention measures in their effective implementation as well as regular monitoring.

Mandatory Seatbelt Laws and Traffic Fatalities: A Reassessment

Mandatory Seatbelt Laws and Traffic Fatalities: A Reassessment

Mandatory Seatbelt Laws and Traffic Fatalities: A Reassessment

Mandatory Seatbelt Laws and Traffic Fatalities: A Reassessment

Injury prediction algorithm for rear‐seat occupants in advanced automatic crash notification systems

An advanced automatic crash notification (AACN) system can predict the injuries of a vehicle's occupants when the vehicle is involved in a collision accident. The rear-seat occupants are at significant risk in collision accidents owing to an inferior protection system and the absence of mandatory seat belt laws. However, only a few studies have focused on the injury prediction for rear-seat occupants, which can be used in AACN system. Therefore, an injury prediction algorithm is proposed for rear-seat occupants. Initially, a rear-seat occupant simulation model is established and verified and the relationship between the head, neck, and chest injury levels and velocity variation is examined. Then, a rear-seat occupant injury prediction algorithm is developed and AACN terminal is constructed to analyse the effects of the algorithm. The comparison of the obtained results with actual accident data validated that the proposed algorithm can effectively evaluate the injury levels of rear-seat occupants. The study findings can enhance the prediction accuracy of all occupants’ injury levels based on their positions inside the vehicle and improve the efficiency of rescue operations, particularly in the case of rear-seat occupants.

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.

Prevalence of and factors associated with self-reported noncompliance with mandatory seatbelt-use law while driving among adults in Kuwait

ObjectivesThis cross-sectional study assessed the prevalence of self-reported noncompliance with mandatory seatbelt-use law and examined the factors associated with noncompliance with seatbelt-use while driving in adult working population in Kuwait.MethodsDuring October 2017, 822 adults aged 21–60 years from 11 government ministries and departments were enrolled in this study. Data were collected using a pre-tested, structured, and self-administered questionnaire. We computed the prevalence of self-reported noncompliance with mandatory seatbelt-use law while driving and evaluated the factors associated with noncompliance with seatbelt-use law while driving using a multivariable log-binomial regression model. The adjusted prevalence ratios (PR) and corresponding 95% confidence intervals (CI) were computed using model’s parameters’ estimates.ResultsOf 822 participants, 64.4% were females, 56.6% were 21 to 30 years old, 86.5% were Kuwaitis, and 70.3% had college and/or university level education. The prevalence of self-reported noncompliance with mandatory seatbelt-use law while driving was 55.5%, whereas the prevalence of noncompliance with self-reported mandatory use seatbelt as a passenger was 80.9%. Multivariable log-binomial regression model showed that after adjusting for the influence of other variables in the model, participants were more likely to be noncompliers with mandatory seatbelt law while driving, if they believed that seatbelt does not protect against injuries during road traffic crashes (RTC) (adjusted PR = 1.20; 95% CI: 1.06–1.37; p = 0.004) or if they were ever fined for not wearing seatbelt (adjusted PR = 1.34; 95% CI: 1.24–1.47; p < 0.001). Furthermore, participants were significantly more likely to be noncompliers with mandatory seatbelt law while driving, if they were unaware of implemented mandatory seatbelt law in Kuwait (adjusted PR = 1.11; 95% CI: 1.04–1.19; p = 0.003).ConclusionsThe prevalence of noncompliance with mandatory seatbelt-use law in the adult working population of Kuwait is considerably high. Being unaware of mandatory seatbelt use law, belief that seatbelt does not protect during RTC, and having ever been fined in the past for not having seatbelt on while driving were significant predictors of noncompliance with seatbelt-use law. These results warrant the focused mass education and rigorous enforcement of seatbelt-use law while driving. These strategies are likely to enhance the adherence to seatbelt-use law and minimize RTCs related injuries and mortality among adult drivers in this and other similar settings in the region. If implemented, future studies may look at the impact of such interventions on RTCs related frequency and severity of injuries in this and other similar settings.

Injury patterns of mass casualty incidents involving high-speed passenger ferries presenting to accident and emergency departments in Hong Kong: a retrospective review

BackgroundAccidents involving high-speed passenger ferries have the potential to cause mass-casualty incidents (MCIs), yet there is a lack of relevant studies available to inform hospital disaster preparedness planning. ObjectiveThe objective was to study the injury patterns and outcomes of MCI victims involved in high-speed passenger ferry accidents in Hong Kong waters. MethodsA retrospective study was conducted from 1 January 2005 to 31 December 2015. All MCIs involving high-speed passenger ferries were captured from the Marine Department of Hong Kong. Victims of all age who were sent to the accident and emergency departments (A&Es) of seven public hospitals around Victoria Harbour, including three trauma centres, were identified from electronic disaster registries of the study hospitals. Data on injury patterns and outcomes were extracted from medical records with the Injury Severity Score (ISS) calculated for each victim. The Kruskal-Wallis test was used to compare medians of the ISS across different mechanisms of injury. Multivariable logistic regression was performed to identify independent predictors for major trauma (ISS≥16). ResultsDuring the study period, eight MCIs involving high-speed passenger ferries were reported and 512 victims (median age: 44 years, age range: 2–85 years) were sent to the study hospitals. The A&E triage categories were Cat 1, 3.1%; Cat 2, 4.3%; Cat 3, 19.3%; Cat 4, 72.9%; and Cat 5, 0.4%, respectively. The median ISS was 1.0 (interquartile range: 1.0–2.0). Fourteen victims (2.7%) had an ISS≥16 and age was the only independent predictor for major trauma (OR 1.06, p = 0.025, 95% CI 1.01–1.11). Trauma call was activated at A&E for 11 victims. In total, 100 victims (19.5%) were admitted to the study hospitals, including 19 (3.5%) and 15 (2.9%) who required surgery and intensive care unit stay, respectively. Eleven victims (2.1%) died, mostly due to drowning. ConclusionMCIs involving high-speed passenger ferries can result in a sudden surge in demand for both A&E and in-patient care, though the majority of victims may have minor injuries. Better access to lifejackets and mandatory seatbelt use may help to reduce injuries and deaths.

Exploring Ghanaian commercial drivers’ intentions to wear a seat belt

Wearing a seat belt reduces a person’s risk of serious injury and death during a road traffic crash. Ghana has mandatory seat belt laws. Despite this, only a few commercial drivers wear a seat belt. This study aimed to gain an understanding of the factors associated with the intention to wear a seat belt in a sample of commercial drivers in the Greater Accra Region of Ghana. Drivers of passenger-carrying minibuses (N = 303) completed an interviewer-administered questionnaire based on the theory of planned behaviour. Structural equation modelling (SEM) showed that attitudinal beliefs about seat belt use were positively associated with the intention to wear a seat belt. Normative beliefs and perceived control beliefs were not associated with the intention to wear a seat belt. The results demonstrate that commercial drivers in the Greater Accra Region seem to possess attitudinally-controlled intentions, such that road safety campaigns that target the antecedents of attitude formation and activation may strengthen behavioural beliefs about seat belt use intentions. Having positive attitudes towards seat belt use should be considered by the National Road Safety Commission as an important starting point for seat belt use safety interventions. For example, seat belt use interventions for commercial drivers that combine education with the use of intelligent seat belt reminders (loud sound or light displays) may strengthen positive attitudes towards seat belt use.

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.

Elderly road collision injury outcomes associated with seat positions and seatbelt use in a rapidly aging society-A case study in South Korea.

IntroductionAging has long been regarded as one of the most critical factors affecting crash injury outcomes. In South Korea, where the elderly population is projected to reach 35.9% by 2050, the implications of an increasing number of elderly vehicle users on road safety are evident. In this research, the confounding effect of occupant age in a vehicle in terms of seat position and seatbelt use was investigated. In addition, elderly occupants were divided into a younger-old group aged between 65 and 74 years and an older-old group aged 75 years and older in an effort to assess whether the conventional elderly age standard of 65 years should be reconsidered.MethodsA multinomial logit framework was adopted to predict two-level injury severity using collision data between 2008 and 2015. Predictor variables included gender, age group, seat position, seatbelt, road type, road slope, road surface, road line, and type of vehicle. Five models, a base model with no interactions and four interaction models which were combinations of age group, seatbelt use and seat position, were devised and evaluated.ResultsWith no interacting term, age was the most prominent predictor. Elderly occupants were most likely to suffer from severe injury without a seatbelt in all seat positions, and the use of a seatbelt reduced this likelihood the most in the elderly group as well. Front passenger seats had the highest risk to elderly occupants, while the driver seat was statistically insignificant. When the elderly group was divided into the younger-old group and the older-old group, the older-olds were found to be much more vulnerable compared to the younger-olds. In particular, older drivers were five times more likely to suffer a severe injury without a seatbelt.ConclusionsThe degree of injury severity of elderly occupants was reduced the most with the use of a seatbelt, demonstrating the importance of using seat restraints. The sharp increase in the risk of injury of the older-old group suggests that the age standard of 65 years as the elderly group with regard to traffic safety may require reconsideration due to the growing number of elderly vehicle users on the road. Our results provide practical evidence with which to formulate new safety policies, including mandatory seatbelt use, driving age limits and insurance pricing.

Primary Enforcement of Mandatory Seat Belt Laws and Motor Vehicle Crash Deaths

Policies that allow directly citing motorists for seat belt non-use (primary enforcement) have been shown to reduce motor vehicle crash deaths relative to secondary enforcement, but the evidence base is dated and does not account for recent improvements in vehicle designs and road safety. The purpose of this study was to test whether recent upgrades to primary enforcement still reduce motor vehicle crash deaths. In 2016, researchers used motor vehicle crash death data from the Fatal Analysis Reporting System for 2000-2014 and calculated rates using both person- and exposure-based denominators. Researchers used a difference-in-differences design to estimate the effect of primary enforcement on death rates, and estimated negative binomial regression models, controlling for age, substance use involvement, fixed state characteristics, secular trends, state median household income, and other state-level traffic safety policies. Models adjusted only for crash characteristics and state-level covariates models showed a protective effect of primary enforcement (rate ratio, 0.88, 95% CI=0.77, 0.98; rate difference, -1.47 deaths per 100,000 population, 95% CI= -2.75, -0.19). After adjustment for fixed state characteristics and secular trends, there was no evidence of an effect of upgrading from secondary to primary enforcement in the whole population (rate ratio, 0.98, 95% CI=0.92, 1.04; rate difference, -0.22, 95% CI= -0.90, 0.46) or for any age group. Upgrading to primary enforcement no longer appears protective for motor vehicle crash death rates.

Do Seat Belt Laws Still Work? Replication and Re-Evaluation of Recent Evidence

Recent work suggests that mandatory seatbelt laws are associated with lower motor vehicle accident mortality, but it is unclear whether this is due to increased enforcement. We study this association using 2001-2010 US data on traffic fatalities among individuals ages 10 and over and we test the robustness of unstated assumptions by replicating and extending prior work. Using Poisson regression adjusted for state-level traffic safety policies (seat belt laws, blood alcohol laws, speed limits), miles traveled, and median income, we replicate the covariate-adjusted association seen in prior work (Rate Ratio [RR]=0.80, 95%CI 0.74,0.87). Further adjustment for state and time fixed effects showed no evidence of a causal effect (RR=1.00, 95%CI 0.95,1.06). We find little evidence that seatbelt laws reduce traffic fatalities, and prior work was confounded by general improvements in other environmental determinants of motor vehicle accident mortality. Replications studies have the potential to increase the integrity of research findings.

정부의 정보 보안 대책 법제화의 사전 효과성 분석 방법

In order to ensure that all firms are cyber-secure, many governments have started to enforce the implementation of various security measures on firms. Prior to the implementation, however, it is vague whether government enforced security measures will be effective for mitigating cyber-security risks. By applying a method for estimating the effectiveness of a mandatory seatbelt law in reducing fatalities from motor vehicle accidents, this study develops an ex ante evaluation method that can approximate the effectiveness of a government enforced security measure in reducing country-wide or industry-wide cyber-security risks. Using data obtained from the Korean Internet and Security Agency, this study then explores how to employ the developed method to assess the effectiveness of a specific security measure in mitigating cyber-security risks, if enforced by the government, and compares the effectiveness of various security measures. The comparison shows that compulsory security training has the highest effectiveness.

Investigating Peltzman effects in adopting mandatory seat belt laws in the US: Evidence from non-occupant fatalities

This study investigates the Peltzman effects in adopting mandatory seat belt laws in the US. According to the Peltzman offsetting effect theory, seat belt laws make drivers feel more secure and drive more aggressively, which could cause additional crashes and fatalities. A set of panel data containing 50 US states and the District of Columbia for the years from 1983 to 1997 are analyzed using such panel data techniques as fixed effects and instrument variables. Fixed effects consider both dimensions of states and time while instruments variables are proposed to reduce the endogeneity problem. Most data were collected as part of a previous research project. The fatality rate of non-occupants, which refer to pedestrians and cyclists on the road rather than drivers and passengers in the vehicle, is chosen as the dependent variable. The Peltzman effects are identified especially in the situation when the primary enforcement is directly introduced to a state. Moreover, sensitivity analyzes on seat belt laws and seat belt usage are conducted to check the robustness of the results on Peltzman effects. Furthermore, the dynamics of Peltzman effects is examined by constructing variables that represent the amount of time seat belt laws have been implemented in a state. The Peltzman effects are found to fade away over time, which could be a reason many previous studies failed to identify the Peltzman offsetting effects caused by seat belt laws.

Restraint Use and Injury Patterns of Young Drivers and Passengers Admitted to Hospitals in New South Wales, Australia

Australians aged 17 to 25 years who travel in cars have a high risk of death and injury in crashes despite mandatory seat belt laws, graduated licensing programs for young drivers, and stringent enforcement. This analysis examined characteristics and injury outcomes of occupants aged 17 to 25 years injured in crashes in New South Wales, Australia. The study focused on restraint use. A linked hospital and police record data set for car occupants admitted to hospitals between 2005 and 2007 was used. Descriptive techniques were used to compare the characteristics of injured occupants of ages 17 to 25 years with those of older occupants and logistic regression was used to test the associations. Only 87% of injured young adults were wearing seat belts. Young adults were more likely than were their older counterparts to be in severe crashes, crashes that involved loss of control, crashes that involved single and older vehicles, and crashes when they were seated in the rear. Young adults also had more head, abdominal or lower torso, and neck injuries and fewer thoracic injuries than did older occupants. Young females were more likely to have been in newer vehicles and less likely to have been in more severe crashes than were young males. Young females also had fewer head injuries and more abdominal or lower torso injuries than young males had. Greater effort is required to increase the use of restraints and modern vehicles among young adults, to encourage industry to improve rear passenger protection, and to increase understanding of the factors that underpin the high involvement of young people in single-vehicle and loss-of-control crashes.

Modeling the Impact of Rescinding Michigan's Primary and Secondary Seat Belt Laws on Death and Injury from Passenger Vehicle Crashes

Background: Seat belts are the most effective method of decreasing fatal and nonfatal motor vehicle crash injury. Advocacy groups have recently been successful in enacting repeals of mandatory motorcycle helmet laws in several states. In some states, this has prompted renewed efforts aimed at repealing mandatory seat belt laws.Purpose: To evaluate and quantify the potential impact of rescinding seat belt laws on annual crash-related fatalities, nonfatal injuries, and associated economic costs, using Michigan as a model, to inform the national debate.Methods: Proportional injury rates were calculated utilizing police-reported statewide passenger vehicle crash data from 1999 and 2002, where belt use rates approximate estimates associated with repeal of primary and secondary seat belt laws. Proportional rates were applied to the most recent year of crash data (2011) to estimate changes in statewide fatalities and nonfatal injuries. National cost estimates were applied to injury data to calculate associated economic costs.Results: Full repeal of the seat belt law is estimated to result in an additional 163 fatalities, 13,722 nonfatal injuries, and an associated societal cost of $1.6 billion annually. Repeal of the primary seat belt law only is estimated to result in an additional 95 fatalities, 9156 nonfatal injuries, and an associated societal cost of $1.0 billion annually.Conclusions: This analysis suggests that repealing the either the primary or full seat belt law would have a substantial and negative impact on public health, increasing motor vehicle crash related fatality, nonfatal injury, and associated economic costs.

The Effect of Mandatory Seat Belt Laws on Seat Belt Use by Socioeconomic Position

AbstractWe investigated the differential effect of mandatory seat belt laws on seat belt use among socioeconomic subgroups. We identified the differential effect of legislation across higher versus lower education individuals using a difference‐in‐differences model based on state variations in the timing of the passage of laws. We find strong effects of mandatory seat belt laws for all education groups, but the effect is stronger for those with fewer years of education. In addition, we find that the differential effect by education is larger for mandatory seat belt laws with primary rather than secondary enforcement. Our results imply that existing socioeconomic differences in seat belt use would be further mitigated if all states upgraded to primary enforcement.

The two images of economics: why the fun disappears when difficult questions are at stake?

The image of economics got somewhat puzzling after the crisis of 2008. Many economists now doubt that economics is able to provide answers to some of its core questions. The crisis was not so fun for economics. However, this not so fun image of economics is not the only image in the eyes of the general public. When one looks at economics-made-fun (EMF) books (e.g. Freakonomics, The Undercover Economist, etc.), economics seems to be an explanatory science which is able to provide interesting, unconventional, entertaining and enlightening explanations for almost every aspect of our lives. Isn't there a great contradiction between these two images of economics? Not necessarily. The present paper explicates why. Nevertheless, the paper also shows that EMF books run the risk of creating a false sense of understanding and explains how one should read the basic insights provided by EMF books to remove this risk. The paper contrasts the EMF version of the explanation of the effects of mandatory seat belt laws with actual research concerning the subject to illustrate its arguments.