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

The prevalence of seat belt use among drivers and passengers: a systematic review and meta-analysis

BACKGROUND

Seat belts might save people's lives in car accidents by preventing severe collision damage and keeping passengers safe from critical injuries. This meta-analysis was performed to assess the prevalence of seat belt use among drivers and passengers.

METHODS

The databases of PubMed, Web of Science (WOS), and Google Scholar were searched from the beginning of 2000 to late December 2020 to identify studies that investigated the prevalence of seat belt use among drivers and passengers. The pooled prevalence was calculated using a random-effects model. The STATA-v14 software was used to perform data analysis.

RESULTS

Sixty-eight studies that met the inclusion criteria and were suitable for this meta-analysis were identified. The pooled prevalence of seat belt use was 43.94% (95% CI: 42.23-45.73) among drivers, 38.47% (95% CI: 34.89-42.42) among front-seat passengers, and 15.32% (95% CI: 12.33-19.03) among rear-seat passengers. The lowest seat belt use among drivers and passengers was observed in Asia, the Middle East, and Africa, while the highest use was reported in Europe and America. Moreover, the prevalence of seat belt use was higher among women drivers [51.47% (95% CI: 48.62-54.48)] than men drivers [38.27% (95% CI: 34.98-41.87)] (P < 0.001). Furthermore, the highest prevalence of seat belt use was seen among drivers (68.9%) and front-seat passengers (50.5%) of sports utility vehicles (SUVs); in contrast, the lowest prevalence was observed among drivers and passengers of public vehicles such as buses, minibuses, and taxis.

CONCLUSIONS

In general, the prevalence of seat belt use was not high among drivers and was even lower among passengers. Moreover, drivers and passengers in Asia, the Middle East, and Africa had the lowest prevalence of seat belt usage. Additionally, drivers and passengers of public transportation (buses, minibuses, and taxis) had a lower rate of seat belt use, especially among men. Therefore, effective interventional programs to improve seat belt use should be designed and implemented, particularly among these at-risk populations in Asia, the Middle East, and Africa.

Investigating the role of health belief model on seat belt use for front seat passengers on urban and rural roads

What makes a vehicle user buckle up? Considering the strong effect of seat belt use in reducing injuries and fatalities in a vehicle crash, we investigated the role of the health belief model on seat belt use among front-seat passengers on urban and rural roads. A questionnaire based on the theory components was randomly distributed in public areas of Sari, Iran. Structural equation model was used to test the study hypotheses. The results revealed that anticipated severity and perceived susceptibility directly affected seat belt use on urban roads, whereas perceived barriers had a reverse effect on seat belt use on urban roads. Perceived barriers with an indirect and perceived susceptibility with a direct effect, played an essential role in explaining seat belts use on rural roads. Outcomes of this study extend the knowledge of seat belts use behavior among front seat passengers by introducing new factors of potential influence, which could lead to practical solutions aimed to enhance seat belts utilization among these vehicle users and decrease the rate of injuries and fatalities in road crashes.

Are out-of-state drivers more seatbelt compliant than in-state drivers in the United States?

INTRODUCTION

This study explored the seatbelt use among in-state and out-of-state drivers in relation to their personal (age, gender, license status, etc.) and crash characteristics (time, location, roadway factors, etc.) using crash data over a 10-year period (2010-2019) from the Fatality Analysis Reporting System (FARS).

METHOD

Comparison of seatbelt use between the two groups (in-state vs. out-of-state drivers) were conducted using Z-test statistics. Logistic regression models were developed to examine the probability of seatbelt use among each group.

RESULTS

New findings in this study showed that out-of-state drivers were 5% more likely than in-state drivers to use seatbelts. Regardless of the driver's age, gender, license status, vehicle type, and injury severity, seatbelt use was significantly higher among out-of-state drivers. Moreover, irrespective of the location (rural or urban), the season (time, day, or month), road type (arterial, local streets, etc.), and jurisdictional seatbelt law (primary or secondary), out-of-state drivers were more seatbelt compliant than in-state drivers. Finally, out-of-state drivers traveling from states with secondary/no seatbelt laws exhibited higher seatbelt compliance rate in primary seatbelt law states than in states with less strict laws (i.e., secondary/no law).

PRACTICAL APPLICATIONS

The findings in this study are critical to addressing a myriad of policy questions related to seatbelt laws and seatbelt use. Future research should focus on the disparity in seatbelt use between the two groups and determine intervention strategies that are effective at promoting seatbelt use across the United States. Additionally, given the significant differences in driver seatbelt use behavior based on the type of seatbelt law, if states with less strict laws upgrade to primary seatbelt laws, there likely will be increases in seatbelt compliance in those states.

A study of students' use of restraint systems in school transportation services in primary and secondary schools in northern Iran: an observational study

Background

Traffic accidents are one of the leading causes of death and severe injury among child occupants of vehicles in most countries. This has led to the consideration of how to use restraint systems for students in school buses. The purpose of the present study was to determine the percentage of students’ use of restraint systems in school transportation services in 2020.

Methods

In the present cross-sectional observational study, seatbelt use was assessed in 400 students in school transport vehicles using a checklist. The observation team sat at their vehicle, at the nearest location on one of the three sides of the school’s entrance: they had by manually registering the variable in the checklist. They focused on exactly the first vehicle parked next to the school entrance. There were two other observers to validate the observations. Data were analyzed by SPSS software (version 21).

Results

The rate of using restraint systems was 11.3%, use of restraint systems in the Sport Utility Vehicles (SUVs) was significantly higher (P < 0.03), in areas with medium income (P < 0.009) and low income (p < 0.012) as well as when the students were sitting in the rear seats, using the seatbelt were significantly lower (P < 0.001). Seatbelt use in students was less in services driven by drivers over the age of 40 (P < 0.01) and more in vehicles driven by female drivers (P < 0.003) and newer vehicles (p < 0.001).

Conclusion

School authorities must enforce traffic safety rules for school transportation services. These rules should be taught to drivers, families, and students. A restraint system must be mandatory for all students. School officials must equip their buses with seatbelts and employ school bus assistants to encourage wearing seatbelts and prevent students from standing.

Rear-seat seatbelt use in urban Southeast Asia: results from Bandung and Bangkok

Road traffic injuries (RTIs) remain a leading cause of morbidity and mortality in Southeast Asia. We aim to estimate the prevalence and predictors of rear seatbelt use, a key behavioural risk factor for RTI, in Bandung and Bangkok, two cities in Southeast Asia. Roadside observational studies were conducted to provide a representative picture of the prevalence in each city. From eight rounds of observations (July 2015 to April 2019), 39,479 and 7,207 rear-seat passengers were observed in Bandung and Bangkok. Across all rounds, 4.2% of rear-seat passengers used seatbelts in Bandung, compared to 8.4% in Bangkok. In both cities, males and adults, as compared to females and adolescents (aged 12-17 years), had higher odds of rear seatbelt use, as did passengers with a restrained driver. Findings highlight the need for rear seatbelt laws in Bandung and improved enforcement of existing rear seatbelt laws in Bangkok.

Does driver seatbelt use increase usage among front seat passengers? An exploratory analysis

INTRODUCTION AND METHOD

Observational data collected during the Wisconsin 2017, 2018, and 2019 National Occupant Protection Use Survey (NOPUS) were analyzed for this study to explore the influence of drivers' seatbelt use on front seat passengers' usage in the same vehicle. The analyses include comparing seatbelt usage rates for drivers and front passenger(s) based on their gender and based on geographical area as well as analyses of the aggregated data.

RESULTS

The descriptive analyses strongly suggest that seatbelt usage rates of passengers differ considerably depending on whether the driver uses the seatbelt. When female drivers wear seatbelts, seatbelt usage rates for female front seat passengers for the three years 2017, 2018, and 2019 are 97.8%, 96.3%, and 97.1% respectively, with corresponding usage rates for male passengers being 95.5%, 93.0%, and 96.0% respectively. When male drivers wear seatbelts, the seatbelt usage rates for male front seat passengers for the three years 2017, 2018, and 2019, are 93.4%, 95.5%, and 94.3%, respectively, with the corresponding usage rates for female passengers being 97.7%, 96.0%, and 97.7%, respectively. The evidence suggests that drivers' use of seatbelts significantly improves the seatbelt usage of front seat passengers. Seatbelt usage rates of male passengers as well as female passengers are higher while traveling with female drivers who use seatbelts than while traveling with male drivers who use seatbelts. Conclusions and Practical Applications: Future seatbelt use campaigns should target males.

Latent Class Model with Heterogeneous Decision Rule for Identification of Factors to the Choice of Drivers’ Seat Belt Use

The choice of not buckling a seat belt has resulted in a high number of deaths worldwide. Although extensive studies have been done to identify factors of seat belt use, most of those studies have ignored the presence of heterogeneity across vehicle occupants. Not accounting for heterogeneity might result in a bias in model outputs. One of the main approaches to capture random heterogeneity is the employment of the latent class (LC) model by means of a discrete distribution. In a standard LC model, the heterogeneity across observations is considered while assuming the homogeneous utility maximization for decision rules. However, that notion ignores the heterogeneity in the decision rule across individual drivers. In other words, while some drivers make a choice of buckling up with some characteristics, others might ignore those factors while making a choice. Those differences could be accommodated for by allowing class allocation to vary based on various socio-economic characteristics and by constraining some of those rules at zeroes across some of the classes. Thus, in this study, in addition to accounting for heterogeneity across individual drivers, we accounted for heterogeneity in the decision rule by varying the parameters for class allocation. Our results showed that the assignment of various observations to classes is a function of factors such as vehicle type, roadway classification, and vehicle license registration. Additionally, the results showed that a minor consideration of the heterogeneous decision rule resulted in a minor gain in model fits, as well as changes in significance and magnitude of the parameter estimates. All of this was despite the challenges of fully identifying exact attributes for class allocation due to the inclusion of high number of attributes. The findings of this study have important implications for the use of an LC model to account for not only the taste heterogeneity but also heterogeneity across the decision rule to enhance model fit and to expand our understanding about the unbiased point estimates of parameters.