The use of seat belts in cars with smart seat belt reminders--results of an observational study

Recently, smart seat belt reminders (SBR) have been introduced in cars. By increasingly reminding drivers and passengers if they are not using the seat belt, the intention is to increase the belt use to almost 100%. OBJECTIVE: The objective was to study if there were differences in driver's seat belt use between cars with and without SBR. METHODS: Drivers of cars with and without SBR were observed concerning seat belt use. The case (cars with SBR) and the control group (cars without SBR) were similar in all major aspects except SBR. In all, more than 3,000 drivers were observed in five cities in Sweden. RESULTS: In cars without SBR, 82.3 percent of the drivers used the seat belt, while in cars with SBR, the seat belt use was 98.9 percent. The difference was significant. In cars with mild reminders, the use was 93.0 percent. CONCLUSION: It is concluded, that if the results can be generalised to the whole car population this would have a dramatic impact on the number of fatally and seriously injured car occupants.     

Variations in booster seat use by child characteristics

IntroductionChild weight and height are the basis of manufacturer and best practice guidelines for child restraint system use. However, these guides do not address behavioral differences among children of similar age, weight, and height, which may result in child-induced restraint use errors. The objective of this study was to characterize child behaviors across age in relation to appropriate restraint system use during simulated drives. Methods: Fifty mother–child (4–8 years) dyads completed an installation into a driving simulator, followed by a simulated drive that was video-recorded and coded for child-induced errors. Time inappropriately restrained was measured as the total amount of the simulated drive spent in an improper or unsafe position for the restraint to be effective divided by the total drive time. Kruskal-Wallis tests were used to determine differences across age in the frequency of error events and overall time inappropriately restrained. Results: Children in harnessed seats had no observed errors during trips. Within children sitting in booster seats there were differences in time inappropriately restrained across age (p = 0.01), with 4 year-olds spending on average 67% (Median = 76%) of the drive inappropriately restrained, compared to the rest of the age categories spending less than 28% (Medians ranged from 3% to 23%). Conclusion: Some children may be physically compatible with booster seats, but not behaviorally mature enough to safely use them. More research is needed that examines how child behavior influences child passenger safety. Practical Applications: Not all children physically big enough are behaviorally ready to use belt positioning booster seats. Primary sources of information should provide caregivers with individualized guidance about when it is appropriate to transition children out of harnessed seats. Additionally, best practice guidelines should be updated to reflect what behaviors are needed from children to safely use specific types of child restraint systems.     

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.     

The role of enforcement programs in increasing seat belt use

Seat belt laws by themselves led to increased belt use in the United States and Canada, but initial effects were limited. Canadian provincial officials launched highly publicized enforcement campaigns in the early 1980s that resulted in substantially increased belt use. Canadian-style enforcement programs subsequently were adopted in the United States, and the use of such programs has grown in recent years. Lessons from these efforts include the importance of police leadership, focused publicity about enforcement, and sustained rather than single-shot efforts. What is needed in the United States to achieve a national belt use rate of 90% or greater is widespread, methodical, and sustained application of enforcement programs augmented by creative publicity. Enhanced penalties-in particular drivers license points-likely will be needed to reach hard-core nonusers.     

An observational study of child safety seat use in an international safe community: Tehran,Iran

Objective: Despite strong evidence of the effectiveness of child safety seats in reducing injuries, the use of these devices in some communities is still rare. The purpose of this study was to determine the prevalence of child safety seat use and the factors influencing its use in the safe community of Tehran.

Methods: This roadside observational study was conducted in 2015 and 2,178 personal cars with a child under 12 years aboard were observed on Tehran's streets in regard to use of child safety seats. Other variables such as the gender of the driver, driver's age group, type of street, region of municipality, time of day, and day of the week were also collected.

Results: Prevalence of child safety seat use was 4.3% and was significantly higher among women drivers, on freeways, and in municipal regions 1, 4, and 7.

Conclusions: The prevalence of child safety seat use in Tehran as a most populous member of the international safe community was very low and most children commuted in insecure situations in the vehicle. Therefore, it is proposed that plans should be made to increase the use of child safety seats in international safe communities.     

The use of seat belt by motor vehicle occupants in South Africa

OBJECTIVE: The purpose of this article was to examine the use of seat belt by motor vehicle users in the various provinces in South Africa. METHODS: Data were abstracted from published reports of the national Department of Transport. Percentage distribution and correlation of road safety variables and seat belt wearing rates for motor vehicle users were calculated for the different provinces. RESULTS: High seat belt wearing rates by the drivers (between 75.1% and 88.1%, national rate was 81%). The seat belt wearing rates for the front and back seat passengers were much lower than for the drivers. The seat belt wearing rates for front seat passengers (44.5% to 60.5%, national - 50.1%) and back seat passengers (1% to 16%, national - 7.6%) were much lower than for the drivers. The national seat belt wearing rate for all vehicles between 1982 and 1995 was between 46.9% and 69.2%, but this has generally declined. CONCLUSION: There is a need for the implementation of strategies to increase the use of seat belts to reduce injuries and fatalities.     

Characteristics of drivers not using seat belts in a high belt use state

A study was undertaken in North Carolina to determine the characteristics of the minority of drivers who were not using seat belts following an extensive publicity/enforcement campaign, which had increased statewide use to 80%. Vehicles and drivers whose seat belt use was observed at sites across North Carolina were matched against Division of Motor Vehicles registration and driver history files for vehicle owners. The study file consisted of those observed drivers who matched the owners with respect to sex, race, and approximate age. The results of this investigation indicate that nonuse of seat belts was associated with males; younger age (<35); older vehicles (pre-1985); vehicles other than cars, especially pickups; and poor driving records. Telephone survey information indicated that nonusers were less likely to have health care coverage, more likely to acknowledge having consumed large amounts of alcohol in the past year, and more likely to have an arrest record. When asked about enforcement of the belt use law, many nonusers said that they would not respond to higher fines but they would respond to driver license points. To change the belt use behavior of this hard-core nonuser population, it well may be necessary as was done in Canada to combine publicity/enforcement campaigns with driver license points as a penalty for nonuse.     

Ninety five percent: an evaluation of law, policy, and programs to promote seat belt use in Washington state

Seat belt use in Washington state was 83% in 2001. In 2002, a series of law, policy, and program initiatives coalesced to produce a dramatic increase in seat belt use. Washington enacted a primary enforcement seat belt, the Chief of the Washington State Patrol made safety belt enforcement one of the core missions of that agency, and Washington participated in the national Memorial Day Click It or Ticket program during May 2002 and continued the program into 2003. Evaluation of these initiatives was accomplished through observation surveys of seat belt use, analysis of seat belt violation data, and analysis of data on traffic deaths of motor vehicle occupants. The major findings were that there was a two- to three-fold increase in enforcement of the seat belt law, belt use rates increased to 93% in 2002 and again to 95% in 2003, and motor-vehicle occupant fatalities decreased by 13%. IMPACT ON PRACTICE AND POLICY: The primary seat belt law and Click It or Ticket program activities were critical factors in increasing belt use in Washington state. Media and enforcement programs targeting seat belt use can be very effective in raising the belt use rate, but a long-term commitment to continuation of these program activities is essential. Other states implementing new primary seat belt laws should consider delivering a Click It or Ticket campaign prior to the effective date of the primary law and continuing these activities during subsequent months and years.     

Child safety and booster seat use in five tribal communities, 2010–2014

ProblemMotor-vehicle crashes are a leading cause of death for American Indian/Alaska Natives (AI/AN) including AI/AN children. Child safety seats prevent injury and death among children in a motor-vehicle crash, yet use is low among AI/AN children.MethodsTo increase the use of child safety seats (CSS; car seats and booster seats), five tribal communities implemented evidence-based strategies from the Guide to Community Preventive Services during 2010–2014. Increased CSS use was evaluated through direct observational surveys and CSS event data. CSS events are used to check the installation, use, and safety of CSS and new CSS can be provided.ResultsCSS use increased in all five programs (ranging from 6% to 40%). Four out of five programs exceeded their goals for increased use. Among the five communities, a total of 91 CSS events occurred resulting in 1417 CSS checked or provided.Conclusions and practical applicationsEvidence-based child passenger safety interventions are both feasible in and transferable to tribal communities.     

Technology use and psychosocial factors in the self-reporting of musculoskeletal disorder symptoms in call center workers

PROBLEM: Evidence exists to suggest that working with computer terminals and keyboards is associated with the development and exacerbation of a range of musculoskeletal disorders (MSDs). Research has suggested that psychosocial factors may be of more importance than computer use factors in the development of MSDs in the computing workplace. METHOD: A questionnaire-based study was undertaken to test this hypothesis in a sample of 67 call center workers. A Spearman's rho was performed on the data, as well as chi(2) tests on the individual variables. RESULTS: It was found that overall, computer use factors were significantly associated with self-reporting of MSD symptoms, whereas psychosocial factors had no such association. However, certain individual psychosocial factors emerged as having a significant association with MSD symptoms. DISCUSSION: The findings suggest that specific areas of call center work have associations with poor worker health and possible long-term MSD problems. These areas appear to be workload and particular management-worker relations, rather than computer use. SUMMARY: This suggests that the relationship among computer use, psychosocial factors, and MSD is a complex area that would benefit from more research. IMPACT ON INDUSTRY: This study raises issues about the importance of psychosocial and organizational factors and employee welfare in the call center working environment.     

Evaluation of give kids a boost: A school-based program to increase booster seat use among urban children in economically disadvantaged areas

Objective: This study evaluated the effectiveness of a series of 1-year multifaceted school-based programs aimed at increasing booster seat use among urban children 4–7 years of age in economically disadvantaged areas.

Methods: During 4 consecutive school years, 2011–2015, the Give Kids a Boost (GKB) program was implemented in a total of 8 schools with similar demographics in Dallas County. Observational surveys were conducted at project schools before project implementation (P₀), 1–4 weeks after the completion of project implementation (P₁), and 4–5 months later (P₂). Changes in booster seat use for the 3 time periods were compared for the 8 project and 14 comparison schools that received no intervention using a nonrandomized trial process.

The intervention included (1) train-the-trainer sessions with teachers and parents; (2) presentations about booster seat safety; (3) tailored communication to parents; (4) distribution of fact sheets/resources; (5) walk-around education; and (6) booster seat inspections.

The association between the GKB intervention and proper booster seat use was determined initially using univariate analysis. The association was also estimated using a generalized linear mixed model predicting a binomial outcome (booster seat use) for those aged 4 to 7 years, adjusted for child-level variables (age, sex, race/ethnicity) and car-level variables (vehicle type). The model incorporated the effects of clustering by site and by collection date to account for the possibility of repeated sampling.

Results: In the 8 project schools, booster seat use for children 4–7 years of age increased an average of 20.9 percentage points between P₀ and P₁ (P₀ = 4.8%, P₁ = 25.7%; odds ratio [OR] = 6.9; 95% confidence interval [CI], 5.5, 8.7; P < .001) and remained at that level in the P₂ time period (P₂ = 25.7%; P < .001, for P₀ vs. P₂) in the univariate analysis. The 14 comparison schools had minimal change in booster seat use. The multivariable model showed that children at the project schools were significantly more likely to be properly restrained in a booster seat after the intervention (OR = 2.7; 95% CI, 2.2, 3.3) compared to the P₀ time period and compared to the comparison schools.

Conclusion: Despite study limitations, the GKB program was positively associated with an increase in proper booster seat use for children 4–7 years of age in school settings among diverse populations in economically disadvantaged areas. These increases persisted into the following school year in a majority of the project schools. The GKB model may be a replicable strategy to increase booster seat use among school-age children in similar urban settings.     

A four-year validation study of an assessment center in a financial corporation

Ratings on 18 assessment dimensions formulated independently by assessors (psychologists and high-level managers), consensus ratings on the same dimensions, and overall assessment ratings were collected for 329 assessees. Two hundred and seventy-four of the assessees were promoted based on their scores obtained in the assessment process. For 240 of these we succeeded in obtaining ratings on two criterion measures over a period of four years. These criterion data were provided by their superiors who were unaware of the scores obtained in the assessment process. Multiple regression analyses were run on the data from all the assessment ratings and criterion measures. The results demonstrated a long-term validity for the assessment center. However, we were not able to discern a consistent pattern of statistically significant differences between the predictive validities of high-level managers and psychologists as assessors. Possibly, the type of criterion measure moderates the predictive validity of managers' and psychologists' ratings. Further, theoretical and practical implications of the findings are discussed.     

Independent factors associated with bicycle helmet use in a Korean population: A cross-sectional study

Objective: Although identification of factors that influence helmet use during bicycle riding is necessary for the selection of groups that require safe cycling education, limited baseline data are available. The aim of the present study was to analyze the rate of helmet use and the demographic factors that were independently associated with helmet use among Korean bicycle riders.

Methods: In this cross-sectional study, we used public data from the Sixth Korean National Health and Nutrition Examination Survey conducted in 2013 and 2014. Helmet users were defined as subjects who always, usually, or frequently wore helmets when cycling. Independent factors associated with helmet use were determined using odds ratios (ORss) adjusted for 5 demographic factors via multivariate logistic regression analysis.

Results: In the total population, 4,103 individuals were bicycle riders; among these, 782 individuals (19.1%) wore helmets. A total of 21.1% of male riders used helmets, compared to 15.5% of female riders (P <.001). The adjusted logistic regression model revealed that female sex (OR = 0.665; 95% confidence interval [CI], 0.554–0.797), teenage status (OR = 0.475, 95% CI, 0.333–0.678), and low household income (OR = 0.657, 95% CI 0.513–0.841) were significantly associated with nonuse of helmets.

Conclusions: Female sex, teenage status, and low household income were independent factors associated with the nonuse of helmets. We identified factors associated with helmet use during bicycle riding through analysis of baseline data on helmet usage.     

Factors that influence the use of safe patient transfer technique in home care service

The aim of this pilot study was to explore whether home care service personnel used knowledge and skills in transfer technique in their daily work; knowledge and skills gained by participating in training programmes, and to identify factors that may hinder and support their use. Focus group interviews were held with 2 home care service groups in 2 Swedish towns. Individual interviews were conducted with the personnel's managers, unit leaders and safety representatives. Qualitative content analysis was used. The findings revealed that the personnel tried to use their knowledge and skills. However, there were both hindering and supporting factors for the use of safe work technique. The findings indicate that training programmes in transfer technique should not be implemented as isolated actions without considering the physical environment, the wishes of persons receiving care and their relatives, the work organisation, the safety culture and the role of managers.     

How future trends in societal aging, air bag availability, seat belt use, and fleet composition will affect serious injury risk and occurrence in the United States

The objective of this study was to quantify the importance of societal aging relative to other factors that are known to affect injury risk. An aging population's effect on Maximum Abbreviated Injury Scale (MAIS) 3+ injury trends for passenger car drivers in frontal crashes was projected and compared to the effects of projected changes in fleet composition, changes in seat belt usage, and changes in air bag availability. It was determined that increased frailty due to an aging population will result in 19,816 to 43,568 additional injuries to passenger car drivers in frontal crashes from 1996 to 2012. Aging was shown to have an effect similar to the increased presence of light trucks in the fleet (a cumulative increase of approximately 47,428 injuries). Aging and changing fleet composition were shown to have a smaller effect than the projected increases in seat belt use or air bag availability, though the effect of increased belt use is not much greater than the effect of aging. After 2012, however, air bag availability and seat belt use will plateau, while societal aging will continue.     

Substance exposure and helmet use in all-terrain vehicle accidents: Nine years of experience at a level 1 trauma center

IntroductionThe surging popularity of all-terrain vehicles (ATV) in the United States has caused an “epidemic of injuries and mortality.” The U.S. Consumer Product Safety Commission reported 99,600 injuries and 426 fatalities from ATV accidents in 2013. The aim of this study was to examine the relationship between helmet use and positive toxicology screenings on outcomes in ATV accident victims.MethodsThis is a retrospective study of patients admitted to a Level 1 Trauma Center in southwestern West Virginia following an ATV accident between 2005 and 2013. Data were obtained from the institution's Trauma Registry.ResultsA total of 1,857 patients were admitted during the study period with 39 (1.9%) reported deaths. Positive serum alcohol and/or urine drug screens were obtained in 66.4% of the patients tested (n = 1,293). Those with positive screenings were 9.5% less likely to utilize a helmet (13.2% vs. 22.7%, p < 0.001); and the lack of helmet use was associated with an increase in traumatic brain injury (57.1% vs. 41.7%, p < 0.001). Positivity for substances or the lack of helmet use was significantly associated with higher morbidity. Lack of helmet use resulted in a 3.94-fold increase in the risk of discharge in a vegetative state or death.ConclusionsDrugs and alcohol use may predispose riders to be less likely to wear helmets and significantly increase the risk of a poor clinical outcome following an ATV accident. Rigorous efforts should be made to enhance safety measures through educational endeavors and amendment of current regulations to promote safe and responsible use of ATVs.Practical applicationsModification of regulatory requirements should be considered in order to mandate the wearing of helmets during ATV operation. In addition, expansion of safety programs should be considered in an effort to improve availability, affordability and awareness of safe ATV practices.