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Original Article
Risk of injury for occupants of motor vehicle collisions from unbelted occupants
  1. P A MacLennan1,
  2. G McGwin, Jr2,
  3. J Metzger3,
  4. S G Moran1,
  5. L W Rue III1
  1. 1Center for Injury Sciences at UAB; and Section of Trauma, Burns, and Surgical Critical Care, Division of General Surgery, Department of Surgery, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
  2. 2Center for Injury Sciences at UAB; and Section of Trauma, Burns, and Surgical Critical Care, Division of General Surgery, Department of Surgery, School of Medicine; Division of Orthopaedic Surgery, Department of Surgery, School of Medicine; and Department of Epidemiology and International Health, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
  3. 3Center for Injury Sciences at UAB, University of Alabama at Birmingham, Birmingham, Alabama, USA
  1. Correspondence to:
 Dr Paul MacLennan
 Department of Surgery, University of Alabama at Birmingham, 115 Kracke Building, 1922 7th Avenue South, Alabama 35294, USA; pmacuab.edu

Abstract

Objective: Unbelted occupants may increase the risk of injury for other occupants in a motor vehicle collision (MVC). This study evaluated the association between occupant restraint use and the risk of injury (including death) to other vehicle occupants.

Design: A population based cohort study.

Setting: United States.

Subjects: MVC occupants (n = 152 191 unweighted, n = 18 426 684 weighted) seated between a belted or unbelted occupant and the line of the principal direction of force in frontal, lateral, and rear MVCs were sampled from the 1991–2002 National Automotive Sampling System General Estimates System. Offset MVCs were not included in the study.

Main outcome measure: Risk ratios and 95% confidence intervals for injury (including death) for occupants seated contiguous to unbelted occupants compared to occupants seated contiguous to belted occupants. Risk ratios were adjusted for at risk occupant’s sex, age, seating position, vehicle type, collision type, travel speed, crash severity, and at risk occupants’ own seat belt use.

Results: Exposure to unbelted occupants was associated with a 40% increased risk of any injury. Belted at risk occupants were at a 90% increased risk of injury but unbelted occupants were not at increased risk. Risks were similar for non-incapacitating and capacitating injuries. There was a 4.8-fold increased risk of death for exposed belted occupants but no increased risk of death for unbelted occupants.

Conclusions: Belted occupants are at an increased risk of injury and death in the event of a MVC from unbelted occupants.

  • CI, confidence interval
  • GES, General Estimates System
  • MVC, motor vehicle collision
  • NASS, National Automotive Sampling System
  • OR, odds ratio
  • PDOF, principal direction of force
  • RR, risk ratio
  • seat belt utilization
  • automobiles
  • motor vehicle collisions

https://doi.org/10.1136/ip.2003.005025

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