Seat Belt Laws 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.

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.

Visual Functions, Seatbelt Usage, Speed, and Alcohol Consumption Standards for Driving and Their Impact on Road Traffic Accidents.

The incidence of road traffic accidents (RTAs) is dramatically increasing worldwide. Consequently, driving and licensing authorities have instituted strict rules and regulations, such as vision standards, restrictions on drunk driving, seat belt usage, and speeding, for driving safety. This study aimed to summarize the global visual standards for driving license issuing and renewal and investigate the effect of driving safety laws on RTA-related death rates in different countries. The study gathered data on visual standards for driving licenses from reliable sources and extracted enforcement scores (drunk driving, seat belt usage, and speeding) and RTA-related death rates from the World Health Organization status report on road safety. The Wilcoxon test explored the association between visual standards and RTA-related death rates, while the Kruskal-Wallis test analyzed the relationship between visual functions and death rates, as well as driving safety enforcement scores and RTA-related death rates. The analysis was conducted on 71 countries and 50 states within the United States out of the 193 countries listed by the United Nations. It was found that 116 countries and states required a minimum VA range of 6/6-6/18, while 91 countries and states mandated a similar range for one-eyed drivers. VF testing for driving licenses was necessary in 77 countries and states. No significant association was observed between VA or VF testing and RTA-related death rates. However, countries that conducted more visual function tests demonstrated lower rates of RTA-related fatalities. Furthermore, RTA-related death rates were significantly associated with speeding, drunk driving, and seat belt laws. Implementing clear policies regarding vision requirements, maintaining strict rules, and promoting law enforcement on speeding, drunk driving, and seat belt usage are crucial for improving road safety. These measures should be prioritized by driving and licensing authorities worldwide to mitigate the escalating incidence of RTAs.

Paternalism in Historical Context: Helmet and Seatbelt Legislation in the UK.

Paternalism is a frequent source of anxiety and scholarly enquiry within public health. This article examines debate in the UK from the 1950s to the early 1980s about two quintessentially paternalistic laws: those making it compulsory to use a motorcycle helmet, and a car seatbelt. This kind of historical analysis, looking at change over time and the circumstances that prevent or enable such change, draws attention to two significant features: the contingent nature of that which is perceived as paternalistic and therefore objectionable, and the wide range of arguments that can be marshalled for and against. It suggests that paternalism became a particularly disruptive accusation in the UK of the 1970s in relation to seatbelts, thanks to the population that would be affected and the wider socio-political context. It also suggests that arguments about the social cost of death and injury on the roads, along with overt acceptance that some element of paternalism could be acceptable, proved influential-as was the sense of inevitability that 10 years of regular debate helped to create.

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.

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

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.

Motor Vehicle Crash and Hospital Charges in Front- and Rear-Seated Restrained and Unrestrained Adult Motor Vehicle Occupants.

There are reports that historically higher mortality observed for front- compared to rear-seated adult motor vehicle (MV) occupants has narrowed. Vast improvements have been made in strengthening laws and restraint use in front-, but not rear-seated occupants suggesting there may be value in expanding the science on rear-seat safety. Methods. A linked 2016–2017 hospital and MV crash data set, the Crash Outcomes Data Evaluation System (CODES), was used to compare characteristics of front-seated (n = 115,939) and rear-seated (n = 5729) adults aged 18 years and older involved in a MV crash in New York State (NYS). A primary enforced seat belt law existed for front-seated, but not rear-seated occupants. Statistical analysis employed SAS 9.4. Results. Compared to front-seated occupants, those rear-seated were more likely to be unrestrained (21.2% vs. 4.3%, p < 0.0001) and to have more moderate-to-severe injury/death (11.9% vs. 11.3%, p < 0.0001). Compared to restrained rear-seated occupants, unrestrained rear-seated occupants had higher moderate-to-severe injury/death (21.5% vs. 7.5%, p < 0.0001) and 4-fold higher hospitalization. More than 95% of ejections were unrestrained and had 7-fold higher medical charges. Unrestrained occupants’ hospital stays were longer, charges and societal financial costs higher. Conclusions. These findings extend the science of rear-seat safety in seriously injured rear-seated occupants, document increased medical charges and support the need to educate consumers and policy makers on the health and financial risks of adults riding unrestrained in the rear seat. The lack of restraint use in adult rear-seated motor vehicle occupants consumes scarce health care dollars for treatment of this serious, but largely preventable injury.

Assessment of Drivers and Passengers Seat Belt Compliances in Baghdad City

Baghdad city population is growing rapidly and soon it will reach 10 million, and this has increased the number of drivers on city streets which accompanied with the absence of adequate traffic enforcement and traffic control devices to match this increase. Current research main objective is to assess city drivers and passenger’s compliance to use seat belts as a safety precaution. The study consists of two main surveys conducted in the field considering gender, vehicle type, and other drivers characteristics. The first one consists of a questionnaire asking respondents to answer multiple choice questions about seat belt use and other questions associated with respondents’ demographics. Whereas second part involves observing seat belt use among city drivers and passengers at selected locations. Also, we sought information about seat belt use as a driver, front seat passenger, and rear seat passenger. Only 20% of the sample in field observational survey were wearing seat belt as a driver. Printed questionnaire reveals that only 12% are used to buckle up all the time, and 28% never use seat belt in their life, and the rest use seat belt occasionally. Seat belt rates for passengers were 5% only, and most passengers do not care about seat belts and many cars have disabled or malfunction seat belts. Four reasons for putting seat belt were considered and ranked as to avoid injuries, to avoid fines, to follow seat belt law, and wearing seat belt when people in the same car are wearing it.

Examining Seat Belt Use Habits in Wyoming: A Bayesian Hierarchical Logit Approach

Wyoming has one of the lowest seat belt law compliance rates in the United States. Understanding the factors associated with seat belt non-use is crucial for the development of appropriate mitigation measures that aid in increasing seat belt usage rates. In this study, Bayesian binary logistic regression models were developed to: i) investigate the factors associated with daytime seat belt non-use using observational survey data; and ii) assess the factors related to seat belt non-use in fatal crashes while accounting for possible intra-class correlation (effects of unobserved factors common to occupants in the same vehicle). The results indicated that males were less likely to use seat belts than females. Also, trips made in pick-up trucks, those made within urban areas, those made during weekdays, and those made by means of vehicles with Wyoming license plates were likely to involve seat belt non-use. Furthermore, counties with thriving oil and gas industries had lower seat belt use rates. It was also inferred that young occupants, rear seat occupants, impairment, weekdays, traveling around midnight, traveling on collector roads, and traveling on local roads were associated with seat belt non-use. A strong correlation in seat belt non-use among occupants within the same vehicle warrants the implementation of the hierarchical logistic model to investigate seat belt use among occupants involved in fatal crashes. The findings of this study highlight remarkable trends in seat belt use habits in Wyoming, which will aid legislatures in proposing road safety measures aimed at raising seat belt usage proportions.

Are out-of-state drivers more seatbelt compliant than in-state drivers in the United States?

Introduction: This study explored the seatbelt use among in-state and out-of-state drivers in relation to their personal (age, gender, license status, etc.) and crash characteristics (time, location, roadway factors, etc.) using crash data over a 10-year period (2010–2019) from the Fatality Analysis Reporting System (FARS). Method: Comparison of seatbelt use between the two groups (in-state vs. out-of-state drivers) were conducted using Z-test statistics. Logistic regression models were developed to examine the probability of seatbelt use among each group. Results: New findings in this study showed that out-of-state drivers were 5% more likely than in-state drivers to use seatbelts. Regardless of the driver’s age, gender, license status, vehicle type, and injury severity, seatbelt use was significantly higher among out-of-state drivers. Moreover, irrespective of the location (rural or urban), the season (time, day, or month), road type (arterial, local streets, etc.), and jurisdictional seatbelt law (primary or secondary), out-of-state drivers were more seatbelt compliant than in-state drivers. Finally, out-of-state drivers traveling from states with secondary/no seatbelt laws exhibited higher seatbelt compliance rate in primary seatbelt law states than in states with less strict laws (i.e., secondary/no law). Practical Applications: The findings in this study are critical to addressing a myriad of policy questions related to seatbelt laws and seatbelt use. Future research should focus on the disparity in seatbelt use between the two groups and determine intervention strategies that are effective at promoting seatbelt use across the United States. Additionally, given the significant differences in driver seatbelt use behavior based on the type of seatbelt law, if states with less strict laws upgrade to primary seatbelt laws, there likely will be increases in seatbelt compliance in those states.

Compulsory vaccination: Public benefit or individual’s right limitation

Mass vaccination and its controversial assessments have become key issues under the COVID-19 pandemic. Outbreaks of diseases and popularity of anti-vaccination movements require a study of legal foundations for medical interventions and freedom restrictions which are considered as the result of serious risks to health and sanitary-epidemiological well-being of the population. The question is what should be prioritized - paternalistic powers of the state or individual rights and freedoms to decide what risks to take. In terms of responsibility distribution, people often consider vaccines as more dangerous than infectious diseases, which makes compulsory vaccination a legal phenomenon of particular importance. In the contemporary legislation, there are various national approaches to the individual autonomy and freedoms. In some countries, vaccination is directly linked to the possibility to study (USA), in others it is associated with public health (Australia), financial sanctions (Poland) or freedoms limitations (Pakistan). In terms of public health ethics, vaccination is similar to the use of seat-belts in cars, and compulsory vaccination policy is ethically justified by the same reasons as mandatory seat-belt laws: at first, they were met with great opposition; later the use of seat belts acquired the significance of not only a legal but also a social norm precisely because it was made mandatory. The similar approach is applicable to vaccination: the policy of compulsory vaccination can make it a social norm. However, in the legal perspective, compulsory vaccination is a compulsory medical intervention which raises the question about whether it is possible to limit individual rights and freedoms in the name of public health safety. The article considers contradictory issues in the state policy of compulsory vaccination and its legal support. The author presents a definition of compulsory vaccination, identifies its types, describes the specifics of its national legal regulation and sanctions for the refusal to be vaccinated, and explains its social necessity and expediency as a public good.

Long-term safety evaluation of the primary seat-belt law

Many states in the United States have passed the primary enforcement seat-belt law. Though there is strong evidence from previous studies that enhanced seat-belt enforcement interventions can substantially increase seat-belt use, thereby reducing fatalities. It is still necessary to evaluate the long-term effects of implementing the primary seat-belt law. In this study, changes in fatalities over time after the primary seat-belt law enactment are investigated using before-and-after study with the comparison group methods for fatality modification factors (FMFs). This study confirms that the number of adult fatalities without seat-belt has significantly decreased by 17.29%. Another key finding is that the fatality rates in states with a higher maximum fine amount are significantly lower than those with a lower one, however, the decrease in fatality trend is not as effective above about $100 fine. Implementing the primary seat-belt law is significantly effective in reducing fatalities without seat-belt in the long-term. Meanwhile, the relationship between fatalities reduction and the maximum fine amount is not positively linear related. It is imperative that states with the secondary seat-belt laws must reform their seat-belt laws to the primary seat-belt law. An appropriate fine amount can be determined to maximize the effectiveness of the primary seat-belt law.

Compulsory vaccination: Public benefit or individual’s right limitation

Mass vaccination and its controversial assessments have become key issues under the covid-19 pandemic. Outbreaks of diseases and popularity of anti-vaccination movements require a study of legal foundations for medical interventions and freedom restrictions which are considered as the result of serious risks to health and sanitary-epidemiological well-being of the population. The question is what should be prioritized - paternalistic powers of the state or individual rights and freedoms to decide what risks to take. In terms of responsibility distribution, people often consider vaccines as more dangerous than infectious diseases [17], which makes compulsory vaccination a legal phenomenon of particular importance. In the contemporary legislation, there are various national approaches to the individual autonomy and freedoms. In some countries, vaccination is directly linked to the possibility to study (USA), in others it is associated with public health (Australia), financial sanctions (Poland) or freedoms limitations (Pakistan). In terms of public health ethics, vaccination is similar to the use of seat-belts in cars, and compulsory vaccination policy is ethically justified by the same reasons as mandatory seat-belt laws [8]: at first, they were met with great opposition; later the use of seat belts acquired the significance of not only a legal but also a social norm precisely because it was made mandatory [1]. The similar approach is applicable to vaccination: the policy of compulsory vaccination can make it a social norm. However, in the legal perspective, compulsory vaccination is a compulsory medical intervention which raises the question about whether it is possible to limit individual rights and freedoms in the name of public health safety. The article considers contradictory issues in the state policy of compulsory vaccination and its legal support. The author presents a definition of compulsory vaccination, identifies its types, describes the specifics of its national legal regulation and sanctions for the refusal to be vaccinated, and explains its social necessity and expediency as a public good.

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.

Rear-seat seatbelt use in urban Southeast Asia: results from Bandung and Bangkok

Road traffic injuries (RTIs) remain a leading cause of morbidity and mortality in Southeast Asia. We aim to estimate the prevalence and predictors of rear seatbelt use, a key behavioural risk factor for RTI, in Bandung and Bangkok, two cities in Southeast Asia. Roadside observational studies were conducted to provide a representative picture of the prevalence in each city. From eight rounds of observations (July 2015 to April 2019), 39,479 and 7,207 rear-seat passengers were observed in Bandung and Bangkok. Across all rounds, 4.2% of rear-seat passengers used seatbelts in Bandung, compared to 8.4% in Bangkok. In both cities, males and adults, as compared to females and adolescents (aged 12-17 years), had higher odds of rear seatbelt use, as did passengers with a restrained driver. Findings highlight the need for rear seatbelt laws in Bandung and improved enforcement of existing rear seatbelt laws in Bangkok.

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.