Taxi driver seat belt wearing in Nanjing, China

Objective

To determine and validate patterns of seat belt use and attitudes of taxi drivers on wearing a seat belt following national and provincial seat belt legislation in 2004-2005. Design: Roadside daylight seat belt observation and interview survey methods were used, as well as observations from inside taxis during routine trips and a taxi driver focus group. The setting was Nanjing, Jiangsu Province, PR China in April of 2006 and 2007.

Main outcome measures

Prevalence of seat belt use and attitudes to wearing a seat belt were determined, as were vehicle and driver characteristics, and comparisons with other motor-vehicle driver's seat belt use and attitudes.

Results

Taxi drivers interviewed were predominantly male and aged 30-39 years. They spent more hours per week in their vehicles and had more driving experience than other drivers. Over half (56.2%) of taxi drivers interviewed reported that they always wore seat belts, while observation of taxi drivers showed lower wearing rates (i.e., roadside observation was 43.8%, and observation from inside taxis was 36.2%). Belt tampering was a practice of 12-15% of taxi drivers. “Fine avoidance, safety, high speed and long trips” were given as important reasons for wearing and “feeling trapped and uncomfortable” for not wearing. Seat belt reminder signs in taxis were common (82.6% of taxis), but did not appear to impact on driver seat belt use.

Conclusion

The four research methods found taxi drivers to have consistently low “correct wearing” rates.

Impact on industry

As in several other countries, taxi drivers are particularly resistant to seat belt use. Innovative strategies, including occupational health and safety approaches, may be required to achieve increased levels of seat belt use.     

Seat belt use among car drivers in Iranian safe communities: An observational study

Objective: The number of road traffic injuries and fatalities in Iran is high. The aim of the present study was to investigate the rate of drivers' seat belt use and a number of related factors in Kashmar, Bardaskan, and Khalilabad (Iranian Safe Communities).Methods: In 2014, driver observations were made at 48 road sites on intercity roads, main streets, side streets, and rural roads in these 3 cities.Results: A total of 10,255 vehicles were observed, with the overall rate of seat belt use being 51.8%. The rates in Kashmar, Bardaskan, and Khalilabad were 51.4, 56.3, and 47.7%, respectively. In Kashmar, the odds of seat belt use were higher among drivers who were female, older, and taxi drivers. Higher use was also found during the afternoon, and lower use was observed on rural roads. In Khalilabad the odds of seat belt use were higher among females, older drivers, taxis, and private car drivers. Seat belt use was also higher on weekends and during the morning but was significantly lower on rural roads. Similarly, in Bardaskan the odds of using a seat belt were higher among females, older drivers, taxis, and private car drivers. Seat belt use was also higher during the afternoon but was significantly lower on rural roads, in comparison to main streets and intercity roads.Conclusions: The rate of seat belt use in these 3 cities was found to be low, despite these cities being designated as International Safe Communities. Therefore, seat belt promotion programs, tougher regulations, stronger enforcement, public awareness campaigns, and more research are needed to promote seat belt use in these Iranian cities.     

Nighttime seat belt use among front seat passengers: Does the driver's belt use matter?

Introduction and Method: We explored the relationship between nighttime seat belt use of right-front passengers and their drivers using observational data from 33,310 vehicles in east Tennessee during March 2015 – May 2017. Results: Overall, nighttime passenger seat belt use varied by 50 percentage points from 92% when drivers were belted to 42% when drivers were not belted, suggesting that part-time seat belt users can be heavily influenced by the seat belt status of their traveling companions. When stratified by vehicle type and sex, passenger seat belt use by driver seat belt status varied as much as 74 percentage points from 96% to 22%. Passenger seat belt use was typically lower when riding with unbelted same-sex drivers than when riding with unbelted drivers of the opposite sex. Conclusions and Practical Applications: This finding suggests that the role of peer influence in decision-making about seat belt use may differ depending on the sex of a vehicle driver and his or her passengers. Further research is warranted to explore this finding as well as other social and cultural influences that have not been fully examined in seat belt research.     

The effect of a gearshift interlock on seat belt use by drivers who do not always use a belt and its acceptance among those who do

IntroductionSeat belts reduce the risk of fatal injury in a crash, yet in 2015, nearly 10,000 people killed in passenger vehicles were unrestrained. Enhanced seat belt reminders increase belt use, but a gearshift interlock that prevents the vehicle from being placed into gear unless the seat belt is used may prove more effective.MethodThirty-two people with a recent seat belt citation and who admitted to not always using a seat belt as a driver were recruited as part-time belt users and asked to evaluate two new vehicles. Sixteen drove two vehicles with an enhanced reminder for one week each, and 16 drove a vehicle with an enhanced reminder for one week and a vehicle with a gearshift interlock the following week. Sixteen full-time belt users who reported always using a seat belt drove a vehicle with a gearshift interlock for one week to evaluate acceptance.ResultsRelative to the enhanced reminder, the gearshift interlock significantly increased the likelihood that a part-time belt user used a belt during travel time in a trip by 21%, and increased the rate of belt use by 16%; this effect approached significance. Although every full-time belt user experienced the gearshift interlock, their acceptance of the technology reported in a post-study survey was fairly positive and not significantly different from part-time belt users. Six part-time belt users circumvented the gearshift interlock by sitting on a seat belt, waiting for the system to deactivate, or unbuckling during travel.ConclusionThe gearshift interlock increased the likelihood that part-time belt users buckled up and the rate of belt use during travel relative to the enhanced reminder but could be more effective if it prevented circumvention.Practical applicationsAn estimated 718–942 lives could be saved annually if the belt use of unbuckled drivers and front passengers increased 16–21%.     

Passenger use of and attitudes toward rear seat belts

Objectives: This study sought to identify attitudes toward belt use in the rear seat and to gain insight into the experiences of rear-seat passengers. Method: A telephone survey conducted between June and August 2016 targeted adult passengers who had recently ridden in the rear and who did not always wear their seat belt when doing so. Respondents were questioned regarding their reasons for not buckling up and possible conditions under which they would be more likely to buckle up during rear-seat travel. Results: Of 1163 recent rear-seat passengers, 72% reported always using their seat belt in the rear. Full-time belt use was lower among passengers who primarily travel in the rear of hired vehicles compared with personal vehicles. The most common explanation for not buckling up was that the back seat is safer than the front. Four out of five agreed they do not buckle up because of type of trip; two-thirds forget or do not see the need; and two-thirds agreed with reasons related to design, comfort, or usability issues. Nearly 40% agreed that they sometimes do not buckle up in the rear because there is no law requiring it. Conclusion: Many reasons for not using belts in the rear are similar to reasons in the front, such as forgetfulness, inconvenience, or discomfort. One difference is that many rear-seat passengers perceive using the belt is unnecessary because the back seat is safer than the front. More than half of part-time belt users and nonusers reported interventions such as rear seat belt reminders, stronger belt-use laws, and more comfortable belts would make them more likely to use their seat belt in the rear seat. Practical applications: This study identifies barriers to rear seat belt use that point to the need for a multi-faceted approach to increase belt use.     

Teens and seat belt use: What makes them click?

ProblemMotor vehicle crashes kill more adolescents in the United States than any other cause, and often the teen is not wearing a seat belt.MethodsUsing data from the 2011 Youth Risk Behavior Surveys from 38 states, we examined teens' self-reported seat belt use while riding as a passenger and identified individual characteristics and environmental factors associated with always wearing a seat belt.ResultsOnly 51% of high school students living in 38 states reported always wearing a seat belt when riding as a passenger; prevalence varied from 32% in South Dakota to 65% in Delaware. Seat belt use was 11 percentage points lower in states with secondary enforcement seat belt laws compared to states with primary enforcement laws. Racial/ethnic minorities, teens living in states with secondary enforcement seat belt laws, and those engaged in substance use were least likely to always wear their seat belts. The likelihood of always being belted declined steadily as the number of substance use behaviors increased.DiscussionSeat belt use among teens in the United States remains unacceptably low. Results suggest that environmental influences can compound individual risk factors, contributing to even lower seat belt use among some subgroups.Practical applicationsThis study provides the most comprehensive state-level estimates to date of seat belt use among U.S. teens. This information can be useful when considering policy options to increase seat belt use and for targeting injury prevention interventions to high-risk teens. States can best increase teen seat belt use by making evidence-informed decisions about state policy options and prevention strategies.     

Seat belt use and fit among drivers aged 75 years and older in their own vehicles

Objective: This article aims to describe seat belt wearing patterns and quality of seat belt fit among drivers aged 75 years and older. A secondary aim is to explore associations between body shape, comfort, and seat belt use patterns.

Methods: This is an observation and survey study of a cohort of 380 drivers aged 75 years and over. During home visits, photographs were taken of the drivers in their vehicles for later analysis of belt fit and a short survey was also administered to collect demographic data and information about seat belt use and comfort. Seat belt fit and use of belt and seat accessories were analyzed from the photographs.

Results: Data from 367 participants with photographs were analyzed. Whereas 97% reported using a seat belt and 90% reported their seat belt to be comfortable, 21% reported repositioning their seat belt to improve comfort. Good sash and lap belt fit were achieved in 53 and 59% of participants, respectively, but only 35% achieved overall good fit. Both poor sash and lap belt fit were observed in 23% of participants. Drivers who were in the obese category had over twice the odds (95% confidence interval [CI], 1.2–4.1) of having a poor lap belt fit than those in the normal body mass index [BMI] range, and drivers who were overweight had 1.8 times the odds (95% CI, 1.1–2.9) of having poor lap belt fit. Older females also had twice the odds (95% CI, 1.3–3.5) of poor lap belt fit compared to older males, regardless of BMI. Sash belt fit did not vary significantly by BMI, stature, or gender. However older drivers who reported that they had not made any adjustments to the D-ring height had 1.7 times the odds of having poor sash belt fit than those who made adjustments (1.2–2.9). Females were 7.3 times more likely to report comfort problems than males (95% CI, 3.2, 16.3) but there was no association between reported comfort and BMI or seat belt fit. Drivers who reported comfort problems had 6 times the odds (3.2–13.6) of also reporting active repositioning of the belt.

Conclusions: The results suggest that older drivers face challenges in achieving comfortable and correct seat belt fit. This may have a negative impact on crash protection. Belt fit problems appear to be associated with body shape, particularly high BMI and gender. There is a need for further investigation of comfort accessories; in the interim, older drivers and occupants should be encouraged to use features such as D-ring adjusters to improve sash belt fit.     

Is seat belt usage by front seat passengers related to seat belt usage by their drivers?

INTRODUCTION: Unrestrained drivers and passengers are involved in a significant amount of fatalities and injuries in motor-vehicle crashes in the United States. While the literature documents the effectiveness of seat belt usage in reducing crash outcomes, such as fatalities and the severity of injuries, there is a need to evaluate the impact of seat belt usage by drivers and passengers in their respective vehicles. These findings could help develop effective education and enforcement strategies to enhance occupant safety. METHOD: This paper summarizes a study comparing seat belt usage rates of drivers and passengers based on whether or not the driver uses a seat belt. Observational data from 50 sites in the state of Nevada over 3 years are used for analyses. The data are stratified based on the gender of the driver and passengers in the front seat of the vehicle and are based on area type (rural or urban). RESULTS: A comparison of the rates of seat belt usage across for the aggregated data and for various types of disaggregation and statistical analyses to compare the rates of seat belt use among passengers based on the use of seat belts by drivers confirms that when drivers use seat belts, their respective passengers are much more likely to use seat belts. Further, if drivers do not use seat belts, their passengers are not likely to use seat belts. This observation is comparable for male drivers and female drivers, and also for male passengers and female passengers. Further, there are no differences for combinations of the genders of the drivers and passenger (i.e., both male or female, or one male and one female). IMPACT ON INDUSTRY: These results suggest that education and enforcement strategies would benefit most by working toward increasing seat belt usage rates among drivers.     

Belief about seat belt use and seat belt wearing behavior among front and rear seat passengers in the United States

Introduction: Unrestrained drivers and passengers represent almost half of all passenger vehicle occupant deaths in the United States. The current study assessed the relationship between the belief about importance of seat belt use and the behavior of always wearing a seat belt. Method: Data from 2012 ConsumerStyles were analyzed separately for front and rear passenger seating positions. Multivariable regression models were constructed to identify the association between seat belt belief and behavior (i.e., always wears seat belt) among adults. Models controlled for type of state seat belt law (primary, secondary, or none). Results: Seat belt use was higher in front passenger seats (86.1%) than in rear passenger seats (61.6%). Similarly, belief that seat belt use was very important was higher in reference to the front passenger seat (84.2%) versus the rear passenger seat (70.5%). For the front passenger seat, belief was significantly associated with seat belt use in states with both primary enforcement laws (adjPR 1.64) and secondary enforcement laws (adjPR 2.77). For the rear passenger seat, belief was also significantly associated with seat belt use, and two 2-way interactions were observed (belief by sex, belief by region). Conclusions: Despite overall high rates of seat belt use in the United States, certain groups are less likely to buckle up than others. The study findings suggest that efforts to increase seat belt use among high-risk populations, such as those who live in states with secondary or no seat belt laws and those who ride in rear seats (which include people who utilize taxis or ride-hailing vehicles) could benefit from interventions designed to strengthen beliefs related to the benefits of seat belt use. Practical applications: Future research that uses a theoretical framework to better understand the relationship between beliefs and behavior may inform interventions to improve seat belt use.     

Children's and Adults’ Comfort Experience of Extra Seat Belts When Riding in the Rear Seat of a Passenger Car

Objective: The objective of this study was to explore passengers’ comfort experience of extra seat belts during on-road driving in the rear seat of a passenger car and to investigate how the use of extra belts affects children's and adults’ attitudes to the product.

Methods: Two different seat belt systems were tested, criss-cross (CC) and backpack (BP), consisting of the standard 3-point belt together with an additional 2-point belt. In total, 32 participants (15 children aged 6–10, 6 youths aged 11–15, and 11 adults aged 20–79, who differed considerably in size, shape, and proportions) traveled for one hour with each system, including city traffic and highway driving. Four video cameras monitored the test subject during the drive. Subjective data regarding emotions and perceived discomfort were collected in questionnaires every 20 min. A semistructured interview was held afterwards.

Results: All participant groups accepted the new products and especially the increased feeling of safety (P <.01); 56% preferred CC and 44% preferred BP but the difference was not significant. In total, 81% wanted to have extra seat belts in their family car. CC was appreciated for its symmetry, comfort, and the perceived feeling of safety. Some participants found CC unpleasant because the belts tended to slip close to the neck, described as a strangling feeling. BP was simpler to use and did not cause annoyance to the neck in the way CC did. Instead, it felt asymmetric and to some extent less safe than CC. Body size and shape affected seat belt fit to a great extent, which in turn affected the experience of comfort, both initially and over time. Perceived safety benefit and experienced comfort were the most determinant factors for the attitude toward the extra seat belts. The extra seat belts were perceived as being better than the participants had expected before the test, and they became more used to them over time.

Conclusion: This exploratory study provided valuable knowledge from a user perspective for further development of new seat belt systems in cars. In addition to an increased feeling of safety, seat belt fit and comfort are supplementary influencing factors when it comes to gaining acceptance of new seat belt systems.     

Effect of enhanced seat belt reminders on driver fatality risk

Objective

Enhanced seat belt reminders in automobiles have been shown to increase belt use rates by approximately 3 percentage points. The objective of this study was to estimate the effect of enhanced seat belt reminders on driver fatality risk.

Method

Data included all passenger vehicle driver deaths and vehicle registration counts in the United States for calendar years 2000-2007. Driver fatality rates per vehicle registration per year were compared for otherwise identical vehicle models with and without enhanced seat belt reminders.

Results

Driver fatality rates were 6% lower for vehicles with enhanced seat belt reminders compared with vehicles without enhanced belt reminders. After adjusting for vehicle age differences, the estimated effect of enhanced belt reminders on driver fatality risk ranged from a 9% reduction for General Motors vehicles to a 2% increase for Honda vehicles. Combining all manufacturers, enhanced belt reminders reduced fatality risk by approximately 2%. Although not statistically significant, the 2% reduction in fatality risk agrees with what should be expected from a 3 percentage point increase in seat belt use rates.

Conclusions

Enhanced seat belt reminders have raised driver belt use rates and reduced fatality rates, but more aggressive systems may be needed for some drivers. It can be inferred that nonfatal injury rates also have been reduced.

Impact on Industry

Manufacturers should be encouraged to put enhanced seat belt reminders on all vehicles as soon as possible.     

Underutilization of occupant restraint systems in motor vehicle injury crashes: A quantitative analysis from Qatar

Introduction: Restraint systems (seat belts and airbags) are important tools that improve vehicle occupant safety during motor vehicle crashes (MVCs). We aimed to identify the pattern and impact of the utilization of passenger restraint systems on the outcomes of MVC victims in Qatar.

Methods: A retrospective study was conducted for all admitted patients who sustained MVC-related injuries between March 2011 and March 2014 inclusive.

Results: Out of 2,730 road traffic injury cases, 1,830 (67%) sustained MVC-related injuries, of whom 88% were young males, 70% were expatriates, and 53% were drivers. The use of seat belts and airbags was documented in 26 and 2.5% of cases, respectively. Unrestrained passengers had greater injury severity scores, longer hospital stays, and higher rates of pneumonia and mortality compared to restrained passengers (P = .001 for all). There were 311 (17%) ejected cases. Seat belt use was significantly lower and the mortality rate was 3-fold higher in the ejected group compared to the nonejected group (P = .001). The overall mortality was 8.3%. On multivariate regression analysis, predictors of not using a seat belt were being a front seat passenger, driver, or Qatari national and young age. Unrestrained males had a 3-fold increase in mortality in comparison to unrestrained females. The risk of severe injury (relative risk [RR] = 1.82, 95% confidence interval [CI], 1.49–2.26, P = .001) and death (RR = 4.13, 95% CI, 2.31–7.38, P = .001) was significantly greater among unrestrained passengers.

Conclusion: The nonuse of seat belts is associated with worse outcomes during MVCs in Qatar. Our study highlights the lower rate of seat belt compliance in young car occupants that results in more severe injuries, longer hospital stays, and higher mortality rates. Therefore, we recommend more effective seat belt awareness and education campaigns, the enforcement of current seat belt laws, their extension to all vehicle occupants, and the adoption of proven interventions that will assure sustained behavioral changes toward improvements in seat belt use in Qatar.     

Multiple dimensions of work-related risk factors and their relationship to work ability among industrial workers in Iran

Objectives. The present study was designed to investigate the simultaneous effects of physical, psychosocial and other work-related risk factors on the work ability index (WAI) score among industrial workers. Methods. This study used a cross-sectional design with a questionnaire survey. A total of 280 workers were included in the study. Data were collected using three questionnaires including the Persian version of the WAI, the Persian version of the job content questionnaire and an author-developed measure (to assess work-related factors, health-related factors and socio-demographic characteristics). Results. The majority of the participants were young, but they had poor WAI scores (mean 37.3?±?6.4) and 44.3% of them had poor or moderate work ability. Occupational accidents and injuries were found to be the strongest predictors of WAI scores. Additionally, there was a strong association between WAI scores and supervisor support, skill discretion, occupational training, sleep quality, work nature and educational level. Conclusions. Intervention programs should focus on improving supervisor support, sleep quality, job skills and knowledge and on decreasing physical and mental work demands. Additionally, implementing a comprehensive occupational health and ergonomics program for controlling and reducing hazardous working environments and occupational injury rates should be considered.     

Occupational injuries of immigrant and Finnish bus drivers

Problem

With baby boomers reaching retirement age, Western countries may need more immigrant workers to ensure productivity. Many studies have suggested a higher occupational injury frequency among immigrant workers, which could considerably reduce their contribution to society. The aim of this study was to examine whether immigrant workers have a higher injury frequency compared to Finnish workers when performing the exact same tasks under the same working conditions.

Method

A total of 176 Finnish and 130 immigrant bus drivers were asked about their occupational injuries during the past 12 months via a questionnaire. In addition, the data contained 134 injuries reported by the transport firm to an insurance company.

Results

There was no significant difference in reporting occupational injuries by self-reporting or by company-records. Because there were more accident-repeaters among Finnish drivers, their injury frequency (114) was higher than that of immigrant drivers (78).

Application/Impact

This study showed that immigrant workers did not have a higher injury frequency than other workers when they worked in the exact same conditions. Immigrant workers can work as safely as native-Finnish workers, when their working conditions and job contracts are at the same level as those of the original population. Immigrant workers can compensate for the shortage of workforce caused by an aging population.     

Occupational hazards to health of port workers

Objectives. The aim of this article is to reduce the risk of occupational hazards and improve safety conditions by enhancing hazard knowledge and identification as well as improving safety behavior for freight port enterprises. Methods. In the article, occupational hazards to health and their prevention measures of freight port enterprises have been summarized through a lot of occupational health evaluation work, experience and understanding. Results. Workers of freight port enterprises confront an equally wide variety of chemical, physical and psychological hazards in production technology, production environment and the course of labor. Such health hazards have been identified, the risks evaluated, the dangers to health notified and effective prevention measures which should be put in place to ensure the health of the port workers summarized. Discussion. There is still a long way to go for the freight port enterprises to prevent and control the occupational hazards. Except for occupational hazards and their prevention measures, other factors that influence the health of port workers should also be paid attention to, such as age, work history, gender, contraindication and even the occurrence and development rules of occupational hazards in current production conditions.     

Seat belt use in the ambulance patient compartment by emergency medical services professionals is low regardless of patient presence,seating position,or patient acuity

Background: Inconsistent use of seat belts in an ambulance may increase the risk of injury for emergency medical services (EMS) professionals and their patients. Our objectives were to: (1) describe the prevalence of seat belt usage based on patient acuity and seat location, and (2) assess the association between EMS-related characteristics and consistent use of a seat belt. Methods: We administered a cross-sectional electronic questionnaire to a random sample of 20,000 nationally-certified EMS professionals, measuring seat belt use in each seating location of an ambulance during transport of stable, critical, or no patients. We included practicing, non-military, emergency medical technicians or higher who reported working in ambulances. We used multivariable logistic regression models to estimate the odds of consistent (≥50% of the time) use of seat belts for the rear-facing jump seat and right-sided crew bench during transport of stable and critical patients. Results: A total of 1431 respondents were included in the analysis. Patient compartment seat belt use varied with the highest use in forward-facing seats when no patient was being transported (59.8%) and lowest use in the left-side “CPR” seat with a critical patient (9.4%). Only 40.2% of respondents reported an agency policy regarding seat belt use while riding in the patient compartment. In all multivariable logistic regression models, advanced life support level certification and fewer years of experience were associated with decreased odds of consistent seat belt use. An agency seat belt policy was strongly associated with increased odds of seat belt use in the patient compartment. Conclusions: Seat belt use was low and varied by seating location and patient acuity in the patient compartment of an ambulance. Practical Applications: EMS organizations should consider primary prevention approaches of provider education, improved ambulance designs, enactment and enforcement of policies to improve seat belt compliance and provider safety.     

Self-reported factors that influence rear seat belt use among adults

Introduction: While seat belt use among front seat occupants has significantly increased overtime a substantial usage gap still exists between front and back seat occupants. This study aims to identify factors that predict rear seat belt use among adult back seat passengers. Methods: We examined data from the 2016 Motor Vehicle Occupant Safety Survey, conducted by the National Highway Traffic Safety Administration, to determine the influence of front seat belt use, support of and belief of rear seat belt use laws, peer perception of seat belt use, nighttime belt use, and demographic factors on self-reported rear seat belt use. Rao-Scott chi-squared tests were used to determine significant associations between self-reported rear belt use and each predictor. Multivariate logistic regression was used to calculate adjusted odds ratios and determine the influence of significant predictors on rear seat belt use. Sampling weights were applied to produce nationally representative estimates; all statistical significance tests accounted for the complex survey design. Results: Among adults who reported riding in the back seat, 63% reported always using a rear seat belt. Front seat belt use, support and belief of state seat belt laws, nighttime seat belt use, age, and education were significantly associated with rear seat belt use. Multivariate regression results showed that adults who supported rear seat belt laws, reported front seat belt use and believed their state has a rear seat belt law were significantly more likely to report full-time use in the back seat. Conclusions: Seat belt laws and front seat belt use had the strongest association with reporting full-time use in the back seat. Practical Applications: Increasing familiarity with existing laws directed towards rear seat belt use as well as increasing awareness about the benefits of seat belts in all seating positions may help improve rear seat belt use.     

Self-Reported Seat Belt Use in Four Countries: A Telephone Survey

A telephone survey was conducted in four countries in November 1998 to compare drivers in the United States with those in Australia, Canada, and the United Kingdom regarding their attitudes toward seat belts and belt use laws. More than 90 percent of the 2251 respondents said they thought seat belts are effective, but self-reported belt use was significantly lower in the United States than in the other countries. Respondents in Australia and the United Kingdom had similar views about what they thought were important reasons for using seat belts and had the highest self-reported use. Reasons given for using belts by Canadian and US respondents were quite similar to one another, yet US respondents had significantly lower self-reported use rates, a difference thought to be due to vigorous enforcement of the law in Canada. US drivers were less likely than Australian and UK drivers to say they used belts out of habit, to avoid a ticket, or because it is required by law and more likely to say they used belts for situational reasons. US drivers were least likely to be in favor of belt use laws. Canadian drivers reported the most experience being checked by police for belt use and were most likely to think that nonusers would be caught. US drivers in primary enforcement jurisdictions were more likely than those in secondary jurisdictions to think that drivers not using belts would be caught and more likely to say they always used belts. Results of this survey indicate that seat belt use in the United States could be increased by adoption of primary enforcement laws and highly visible enforcement programs of the type used in Canada, and that seat belt use could be increased in all countries by increasing the penalties for nonuse.     

Factors related to seat belt use among fatally injured teenage drivers

PROBLEM: In the United States, teenage drivers have a higher crash risk and lower observed seat belt use than other age groups. METHOD: Seat belt use was examined for teenage (16-19 years) drivers who were fatally injured in traffic crashes occurring in the United States during the years 1995-2000. Vehicle, driver, and crash factors potentially related to belt use were examined. State differences in belt use rates among fatally injured teenage drivers were related to states' observed belt use rates for all ages and other state-level variables. RESULTS: During 1995-2000, mean belt use was 36% among fatally injured teenage drivers and 23% among fatally injured teenage passengers. One of the strongest predictors of higher belt use for both drivers and passengers was whether the crash occurred in a state with a primary seat belt law. Belt use rates for 1995-2000 for fatally injured teenage drivers ranged from 20% or less in six states to more than 60% in two states. States with the highest use rates were those with strong primary belt use laws and those with high rates of observed belt use for all ages. Lower belt use among fatally injured teenage drivers was associated with increasing age; male drivers; drivers of SUVs, vans, or pickup trucks rather than cars; older vehicles; crashes occurring late at night; crashes occurring on rural roadways; single vehicle crashes; and drivers with BACs of 0.10 or higher. Teenage driver belt use declined as the number of teenage passengers increased, but increased in the presence of at least one passenger 30 years or older. IMPACT ON TRAFFIC SAFETY: It is suggested that to increase teenage belt use, states should enact strong primary belt use laws and mount highly publicized efforts to enforce these laws. Graduated driver licensing systems should incorporate strong provisions that require seat belt use by teenage drivers and passengers.