Organizational policy and other factors associated with emergency medical technician seat belt use

INTRODUCTION: The purpose of this study was to determine factors associated with seat belt usage among Emergency Medical Technicians (EMTs). METHODS: As part of biennial re-registration paperwork, nationally registered EMTs completed a survey on the safety and health risks facing Emergency Medical Services (EMS) providers. Respondents were asked to describe their seat belt use while in the front seats of an ambulance. They were categorized as "high" in seat belt use if it had been more than a year since they had not worn their seat belt or "low" in seat belt use if they had not worn their seat belt at least once within the past 12 months. A logistic regression model was fit to estimate the association between seat belt use, organizational seat belt policy, type of EMS organization worked for, EMT certification level, and the size of community where EMS work is performed. RESULTS: Of the 41,823 EMTs that re-registered in 2003, surveys were received from 29,575 (70.7%). A significant interaction between organizational seat belt policy and type of EMS organization was found to exist. Participants reporting no organizational seat belt policy had lower odds of seat belt usage when compared to individuals that do have a seat belt policy. Odds Ratios ranged from 0.20 (95% CI 0.10-0.40) for military organizations to 0.59 (95% CI 0.38-0.93) for private EMS organizations. Paramedics and those working in rural areas also had lower odds of seat belt use. CONCLUSION: Several factors were found to be associated with seat belt usage among EMTs while in the front compartment of an ambulance. However, it appears that only one, organizational policy, is a modifiable characteristic.     

Seat Belt Use in States and Territories with Primary and Secondary Laws -- United States, 2006

Problem

Motor-vehicle crashes are a leading cause of death in the United States. In the event of a crash, seat belts are highly effective in preventing serious injury and death.

Methods

Data from the 2006 Behavioral Risk Factor Surveillance System were used to calculate prevalence of seat belt use by state and territory and by type of state seat belt law (primary vs. secondary enforcement).

Results

In 2006, seat belt use among adults ranged from 58.3% to 91.9% in the states and territories. Seat belt use was 86.0% in states and territories with primary enforcement laws and 75.9% in states with secondary enforcement laws.

Discussion

Seat belt use continues to increase in the United States. Primary enforcement laws remain a more effective strategy than secondary enforcement laws in getting motor-vehicle occupants to wear their seat belts.     

构造运动与中国沿岸平原的地质灾害

中国海岸穿过构造沉降带和隆起带，沉降带及隆起带断陷盆地的持续下降吸引了源远流长的大河在此人海，而隆起带内入海的河流多为近源小河，从而引起河流泥沙沿岸分配的不均和海岸沉积物的差异。沉降带内每公里海岸线接受的沉积物是隆起带的数十倍，且以砂质沉积物为主．隆起带河流泥沙来量少．而且砂质沉积物占了压倒的优势．河流泥沙沿岸分配的不均决定了中国沙质和淤泥质海岸的基本类型和分布格局、沉降带和隆起带松散沉积层的厚度和结构，山此产生了中国沿岸与第四纪沉积层有关的灾害和环境问题的有规律的分布。地面沉降主要分布于沉降带内，而地下海水入侵多出现在依赖地下水的隆起带内，底辟构造、浅层天然气往往在大河三角洲构成灾害和潜在的地质灾害．沉降带和隆起带断陷盆地内的海岸低地通常是海平面上升的主要脆弱地区．此外，丰富的河流泥沙使中国海岸对全球海平面上升的响应也不相同，如海岸湿地的再生和海岸侵蚀原因的复杂性等．     

Effectiveness of primary enforcement safety belt laws and enhanced enforcement of safety belt laws: a summary of the Guide to Community Preventive Services systematic reviews

BACKGROUND: The use of safety belts is the single most effective means of reducing fatal and nonfatal injuries in motor-vehicle crashes. This paper summarizes the systematic reviews of two interventions to increase safety belt use: primary enforcement safety belt laws and enhanced enforcement of safety belt laws. The reviews were previously published in the American Journal of Preventive Medicine. METHODS: We conducted the systematic reviews using the methodology developed for the Guide to Community Preventive Services. RESULTS: These reviews provide strong evidence that primary laws are more effective than secondary laws in increasing safety belt use and decreasing fatalities and that enhanced enforcement is effective in increasing safety belt use. Increases in belt use are generally highest in states with low baseline rates of belt use. DISCUSSION: Primary safety belt laws and enhanced enforcement programs tend to result in greater increases in usage rates for target groups with lower baseline rates. Concerns regarding public opposition to these interventions may impede their implementation in some jurisdictions. However, surveys indicate that a substantial majority of the public supports implementation of both primary laws and enhanced enforcement programs. CONCLUSION: Based on the strong evidence for effectiveness of primary safety belt laws and enhanced enforcement programs, the Task Force on Community Preventive Services recommended that all states enact primary safety belt laws and that communities implement enhanced enforcement programs.     

Investigation of seat belt use among the drivers of different education levels

Seat belt use habit has been investigated according to the education level of drivers. Copies of a questionnaire were distributed to 1000 participants of four different education levels. Factors such as seat belt usage habit, restricting factors and crash data have been investigated. Data have been analyzed with SPSS 15.0 software. Increased level of education leads to increased seat belt usage, lower numbers of crashes and crash severities. The factors restricting seat belt use are lack of habit, discomfort and short distance driving. The use of precaution signal and increases in comfort can increase seat belt usage. The primary and high school education on traffic safety and seat belt usage has been serving the purpose.     

长江流域水环境的主要问题,原因及对策探讨

从几个触目惊心的实例出发，分析出长江流域水环境存在的主要问题是水污染、泥沙淤积、对洪涝的环境容量不高和未能充分发挥水环境的多功能特别是生态功能的作用。其原因主要是工业、农业、城市和流动源排污，土壤侵蚀和人类活动不遵守持续发展原则，管理不善。作者在本文末尾提出了对策。     

Connecticut statewide sTEP wave evaluation

INTRODUCTION: Selective Traffic Enforcement Programs (sTEPs) are a proven method to change motorists' behavior. Since 1997, the Connecticut DOT's Division of Highway Safety has organized a statewide seat belt enforcement program, with sTEP waves every three or four months. To date, 28 waves have been implemented. METHOD: Pre-wave and post-wave seat belt observation surveys are conducted by both state and municipal police across the state. Survey results, as well as a summary of all enforcement activity during the wave, are submitted for evaluation. RESULTS: Connecticut seat belt use has continued to rise from one wave to the next in a predictable "saw blade" pattern. CONCLUSIONS: The data clearly demonstrate that agencies that have participated in a greater number of waves have experienced the greatest increase in belt use. Belt use has not yet plateaued and additional sTEP enforcement seems indicated. However, evidence from other states suggests that a plateau may occur somewhere in the mid 80% range. IMPACT ON INDUSTRY: Should this occur, Connecticut will work toward strengthening the round the clock model, emphasizing the importance of aggressive primary enforcement.     

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.     

The effects of persistent audible seat belt reminders and a speed-limiting interlock on the seat belt use of drivers who do not always use a seat belt

Introduction: Vehicle technologies that increase seat belt use can save thousands of lives each year. Kidd, Singer, Huey, and Kerfoot (2018) found that a gearshift interlock was more effective for increasing seat belt use than an intermittent audible reminder, but interlocks may not be more effective than persistent audible reminders lasting at least 90 seconds. Method: Forty-nine part-time belt users with a recent seat belt citation who self-reported not always using a seat belt drove two vehicles for 1 week each. Thirty-three drove a Chevrolet with an intermittent audible reminder followed by either a BMW with a persistent 90-second audible reminder (n = 17) or a Subaru with an incessant audible reminder (n = 16). The other 16 participants experienced the BMW persistent reminder followed by an interlock that limited speed to 15 mph during unbelted driving. These data were combined with data from 32 part-time belt users in Kidd et al. (2018) who experienced the intermittent reminder for 2 weeks or the intermittent reminder for 1 week and a gearshift interlock the next. Results: Relative to the intermittent reminder, seat belt use was significantly increased an estimated 30% by the BMW persistent reminder, 34% by the Subaru incessant reminder, and 33% by the speed-limiting interlock. Belt use was increased an estimated 16% by the gearshift interlock, but this change was not significant. More participants circumvented the speed-limiting interlock to drive unbelted than the audible reminders. Responses to a poststudy survey indicated that interlocks were less acceptable than reminders. Conclusions: Audible reminders lasting at least 90 seconds and a speed-limiting interlock were more effective for increasing seat belt use than an intermittent audible reminder, but reminders were found more acceptable. Practical applications: Strengthening existing U.S. safety standards to require audible reminders lasting at least 90 seconds for front-row occupants could save up to 1,489 lives annually.     

Restraint use and seating position among children less than 13 years of age: Is it still a problem?

Introduction

The purpose of this study was to calculate national estimates and examine the extent to which children prematurely use adult seat belts and ride in the front seat of a vehicle during a 30 day period.

Methods

Data were obtained from a nationally representative cross-sectional random-digit-dial telephone survey that included child-specific questions on motor vehicle restraint use and seating position.

Results

Among children less than 13 years, parents reported an estimated 618,337 who rode unrestrained and more than one million who rode in the front seat of a vehicle at least some of the time in the past 30 days. During the same time period, close to 11 million children 8 years and younger reportedly used only adult seat belts.

Discussion

Our results highlight the need for continued outreach to parents regarding optimal restraint use and rear seating position for children every trip, every time.