Use Seatbelts

OVERVIEW

Countless numbers of studies have demonstrated over and over again that seatbelts save lives in automobile accidents. While wearing a seatbelt does not guarantee that one will emerge from an accident without a scratch, it does prevent ejection from a vehicle and any related injuries.

While all states have laws governing the use of seat belts, they vary greatly in the way they are enforced. In many states, law enforcement personnel devote little attention to these laws. Moreover, according to the National Traffic Highway Safety Administration, a division of the U.S. Department of Transportation, teens use seatbelts far less often than any other age group. In 2009, 56 percent of teens and young adults between the ages of 16 and 20 years, involved in crashes, were unbuckled. 1

Concerned about these statistics, the Children’s Hospital of Philadelphia established a Web site to address the problem. It is known as Teen Driver Source. Interestingly, teens who consider their parents to be involved in their driving—establishing rules and monitoring their driving—are twice as likely to wear a seatbelt when they are driving or in the car as a passenger. 2 It is a good idea for drivers to delay turning on the ignition until everyone in the car has buckled their seatbelts. If these rules are not followed, then teens should lose their driving privileges. The failure to comply could be the differences between life, serious injury, or even death.

WHAT THE EXPERTS SAY

People Who Don’t Use Seatbelts Appear to Practice Other Unsafe Driving Behaviors

In a retrospective study published in 2015 in the journal Accident Analysis and Prevention, researchers from Norway wrote that in their country 608 drivers of cars or vans were killed in road crashes from 2005 to 2010. In general, blood samples were taken in about 60 to 70 percent of these traffic crashes and were analyzed for alcohol and commonly used drugs. The researchers were able to obtain results for 369 drivers. All the samples were analyzed for alcohol, and 327 samples were analyzed for 15 drugs. The researchers found statistically significant associations between impairment by alcohol or amphetamines and driving unbelted or speeding. “Statistically smaller proportions of the sober drivers with a fatal outcome were unbelted or speeded.” 3

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In still another study, published in 2014 in the Southern Medical Journal, researchers from Birmingham, Alabama, noted that Alabama ranks fourth in the United States for teen crash fatalities. As a result, they wanted to determine some of the risky driving behaviors practiced by teens 15 years and older in Alabama. Questionnaires were completed by 1,399 teens; slightly over half were males and 64 percent were white. Most of the respondents were 15 or 16 years old; so, they were new drivers. Yet, 58 percent of the teens reported not wearing a seatbelt during the previous 30 days. Forty-one percent reported texting while driving, 67 percent noted that they were a passenger in a car where the driver was texting, and 11 percent reported driving after drinking. Sixty percent noted that they routinely exceeded the speed limit. Clearly, these teens were engaging in a number of different risky driving practices, and they were not “receiving safe driving educational messages from parents, doctors, or driver’s education classes.” 5

Several Factors Appear to Influence a Driver’s Decision to Use Seatbelts 6

Seatbelts Appear to Protect Kidneys in Motor Vehicle Collisions

In a retrospective study published in 2014 in the Journal of Urology, researchers from New York City, Houston, and Chicago wanted to learn more about the ability of seatbelts and airbags to protect the kidneys during motor vehicle collisions. The researchers used data from the National Trauma Data Bank (NTDB). A review of 466,028 motor vehicle collisions found 3,846 renal injuries. When compared to occupants using seatbelts, airbags, or seatbelts and airbags, motor vehicle occupants without these protective devices had higher rates of high grade renal injury, and they were more likely to require a nephrectomy, the surgical removal of all or part of a kidney. Reductions in injury were most often seen when seatbelts were used and airbags inflated. The researchers concluded that “protective devices such as seat belts and airbags are among the most important measures to further reduce motor vehicle occupant injuries and deaths.” 7

Use of Seatbelts Appears to Be Associated with Socioeconomic Status

In a study published in 2014 in the Iranian Journal of Public Health, researchers from Iran wanted to learn more about the association between socioeconomic status and the use of seatbelts in cars and helmets when motorcycling. The data used in this study were originally collected for a noncommunicable disease surveillance system in 2009 in Kurdistan. It included a total of 997 people, with a mean age of 39.77 years. Information was obtained from interviews and questionnaires. The researchers found a direct association between socioeconomic status and the nonuse of seatbelts and helmets. People with higher levels of socioeconomic status were more likely to wear seatbelts and helmets. As a result, efforts to address the needs of the most disadvantaged members of society may well increase the use of seatbelts and helmets. This may be accomplished by “reducing poverty, improving education, paying more attention to the poorer groups in society in health politics, increasing the access of disadvantaged groups, and designing special programs for reducing inequality.” 8

BARRIERS AND PROBLEMS

People Who Are Obese Are Less Likely to Use Seatbelts 9

A study on the association between overweight teens and seatbelt use was published in 2011 in the Journal of Community Health. The investigation, which was conducted by researchers in Toledo, Ohio, and Jacksonville, Florida, initially included 1,966 students in grades 6 to 12 from 40 different schools. A total of 1,887 students completed the questionnaire. Almost 60 percent had a normal weight. About equal numbers of the remaining students were overweight or obese. When compared to the normal weight students, the researchers determined that the teens who were obese were less likely to wear seatbelts. The researchers wondered if the seatbelts were too small and uncomfortable for the teens to use. “Car manufacturers may need to take into consideration ergonomic factors of seat belt wearing for obese individuals.” 10

Seatbelts May Cause Harm, Especially If Used Incorrectly

In a study published in 2014 in the Journal of Emergencies, Trauma, and Shock, researchers from Israel conducted a retrospective analysis of injuries caused by seatbelts during automobile accidents. When these are more severe, they may require a laparotomy or a surgical incision into the abdominal cavity. The cohort consisted of 41 patients, who had a median age of 26 years. They were seen at a level 1 trauma unit in Israel between 2005 and 2010. Patients had solid organ and bowel injuries associated with malpositioned seatbelts. When compared to the drivers, passengers in a back seat of the car were significantly more likely to require a laparotomy. The researchers suggested that “seatbelts worn by passengers in the back seat of cars do tend to be malpositioned more commonly than the front seat (especially as children usually sit in the back seat).” 11

NOTES

1. National Highway Traffic Safety Administration, www.nhtsa.gov.

2. Teen Driver Source, www.teendriversource.org.

3. Stig Tore Bogstrand, Magnus Larsson, Anders Holtan et al., “Associations Between Driving Under the Influence of Alcohol or Drugs, Speeding and Seatbelt Use Among Fatally Injured Car Drivers in Norway,” Accident Analysis and Prevention 78 (2015): 14-19.

4. J. Pulido, G. Barrio, P. Lardelli et al., 2010. “Association Between Cannabis and Cocaine Use, Traffic Injuries and Use of Protective Devices,” European Journal of Public Health 21, no. 6 (2010): 753-55.

5. Elizabeth Irons, Michele Nichols, William D. King et al., “Teen Driving Behaviors in a Rural Southern State,” Southern Medical Journal 107, no. 12 (2014): 735-38.

6. Brendan J. Russo, Jonathan J. Kay, Peter T. Savolainen, and Timothy J. Gates, “Assessing Characteristics Related to the Use of Seatbelts and Cell Phones by Drivers: Application of a Bivariate Probit Model,” Journal of Safety Research 49 (2014): 137-42.

7. Marc A. Bjurlin, Richard J. Fantus, Michele M. Mellett et al., “The Impact of Seat Belts and Airbags on High Grade Renal Injuries and Nephrectomy Rates in Motor Vehicle Collisions,” Journal of Urology 192, no. 4 (2014): 1131-36.

8. Ghobad Moradi, Hossein Malekafzali Ardakani, Reza Majdzadeh et al., “Socioeconomic Inequalities in Nonuse of Seatbelts in Cars and Helmets on Motorcycles Among People Living in Kurdistan Province, Iran,” Iranian Journal of Public Health 43, no. 9 (2014): 1239-47.

9. Dietrich Jehle, Chirag Doshi, Jenna Karagianis et al., “Obesity and Seatbelt Use: A Fatal Relationship,” American Journal of Emergency Medicine 32 (2014): 756-60.

10. James H. Price, Joseph A. Dake, Joyce E. Balls-Berry, and Margaret Wielinski, “Seat Belt Use Among Overweight and Obese Adolescents,” Journal of Community Health 36 (2011): 612-15.

11. Seema Biswas, Mohamed Adileh, Gidon Almogy, and Mikosh Bala, “Abdominal Injury Patterns in Patients with Seatbelt Signs Requiring Laparotomy,” Journal of Emergencies, Trauma, and Shock 7, no. 4 (2014): 295-300.

REFERENCES AND RESOURCES

Magazines, Journals, and Newspapers

Barr Jr., Gavin C., Kathleen E. Kane, Robert D. Barraco et al. “Gender Differences in Perceptions and Self-Reported Driving Behaviors Among Teenagers.” Journal of Emergency Medicine 48, no. 3 (2015): 366-70.

Biswas, Seema, Mohamed Adileh, Gidon Almogy, and Miklosh Bala. “Abdominal Injury Patterns in Patients with Seatbelt Signs Requiring Laparotomy.” Journal of Emergencies, Trauma, and Shock 7, no. 4 (2014): 295-300.

Bjurlin, Marc A., Richard J. Fantus, Michele M. Mellett et al. “The Impact of Seat Belts and Airbags on High Grade Renal Injuries and Nephrectomy Rates in Motor Vehicle Collisions.” Journal of Urology 192, no. 4 (2014): 1131-36.

Bogstrand, Stig Tore, Magnus Larsson, Anders Holtan et al. “Associations Between Driving Under the Influence of Alcohol or Drugs, Speeding and Seatbelt Use Among Fatally Injured Car Drivers in Norway.” Accident Analysis and Prevention 78 (2015): 14-19.

Irons, Elizabeth, Michele Nichols, William D. King et al. “Teen Driving Behaviors in a Rural Southern State.” Southern Medical Journal 107, no. 12 (2014): 735-38.

Jehle, Dietrich, Chirag Doshi, Jenna Karagianis et al. “Obesity and Seatbelt Use: A Fatal Relationship.” American Journal of Emergency Medicine 32 (2014): 756-60.

Moradi, Ghobad, Hossein Malekafzali Ardakani, Reza Majdzadeh et al. “Socioeconomic Inequalities in Nonuse of Seatbelts in Cars and Helmets in Motorcycles Among People Living in Kurdistan Province, Iran.” Iranian Journal of Public Health 43, no. 9 (2014): 1239-47.

Price, James H., Joseph A. Dake, Joyce E. Balls-Berry, and Margaret Wielinski. “Seat Belt Use Among Overweight and Obese Adolescents.” Journal of Community Health 36 (2011): 612-15.

Pulido, J., G. Barrio, P. Lardelli et al. “Association Between Cannabis and Cocaine Use, Traffic Injuries and Use of Protective Devices.” European Journal of Public Health 21, no. 6 (2010): 753-55.

Russo, Brendan J., Jonathan J. Kay, Peter T. Savolainen, and Timothy J. Gates. “Assessing Characteristics Related to the Use of Seatbelts and Cell Phones by Drivers: Application of a Bivariate Probit Model.” Journal of Safety Research 49 (2014): 137-42.

Web Sites

National Highway Traffic Safety Administration. www.nhtsa.gov .

Teen Driver Source. www.teendriversource.org .

  This information is not a tool for self-diagnosis or a substitute for professional care.