|
Affiliation
|
Columbia University Departments of Epidemiology 1, Health Policy and Management 2 and the Center for Injury Epidemiology and Prevention at Columbia 3 in the Mailman School of Public Health, Columbia University, New York, NY 10032. |
|
Abstract
|
BACKGROUND: There is widespread belief that after childhood, rear-seated motor vehicle occupants do not need to wear seatbelts to travel safely. This belief is reflected in the fact that, in many states, teen passengers can ride legally unbelted in the rear seat of a passenger vehicle.
METHODS: The Fatal Analysis Reporting System (FARS) for 2010-2011 was used to examine factors associated with teen use of rear seatbelts (n=3,655) and with injury outcomes of belted and unbelted rear-seated teen passengers traveling in a passenger vehicle on a U.S. roadway. Multi-level models controlled for non-independence of cases using SAS Glimmix. Odds ratio is reported with 95% CI.
RESULTS: Slightly more than half (50.8%) of rear-seated teens were restrained, but this declined linearly with age from 65.8% of 13-14 year olds to 43.3% of 18-19 year olds. Overall, 77.0% of rear-seat mortality occurred in unbelted teens. Passengers of belted drivers were more frequently belted (64.1% vs. 19.0%, χ =586.2, p<0.0001). Nearly one-fifth (18.5%) of rear-seated teens were ejected with 95.8% of ejections in unrestrained teens. Presence of a rear-seat seatbelt law was associated with higher restraint use (55.9% vs. 40.0%, χ =89.0, p<0.0001). However, in adjusted multilevel, multivariable models, belt status varied by whether the seatbelt law was primary (1.60, 1.29-1.99) or secondary enforcement (1.33, 0.98-1.78).
CONCLUSION: Presence of a primary enforced rear-seat belt law was associated with significantly higher belt use. Ejection was associated with higher mortality and being unrestrained. Over three quarters of rear-seated teens who died were unrestrained. LEVEL OF EVIDENCE: Level III.
Language: en |