Passenger seating position and the risk of passenger death in traffic crashes: a matched cohort study
- 1Harborview Injury Prevention and Research Center, Seattle, WA, USA
- 2Department of Pediatrics, University of Washington, Seattle, WA, USA
- 3Department of Epidemiology, University of Washington, Seattle, WA, USA
- Correspondence to: Dr K M Smith Harborview Injury Prevention and Research Center, 325 Ninth Avenue, Box 359960, Seattle, WA 98104, USA; kaths{at}u.washington.edu
- Accepted 17 January 2006
Abstract
Objective: To estimate the association of passenger seating position with the risk of death for passengers in traffic crashes.
Design, setting, participants: Matched cohort analysis of data from the National Highway Traffic Safety Administration Fatality Analysis Reporting System regarding 56 644 passengers in 23 308 passenger cars, light trucks, vans, and sport utility vehicles that crashed during 1990–2001.
Main outcome measure: The adjusted risk ratio (aRR) for death of a rear seat passenger compared with a front seat passenger within 30 days of a crash.
Results: The aRR for all passengers in the rear seat in a crash was 0.79 (95% CI 0.77 to 0.82). This estimate varied by age, restraint use, and the presence of a front passenger airbag (p<0.001). For restrained passengers in cars with a front passenger airbag, the aRR was 0.62 (95% CI 0.48 to 0.81) for children 0–12 years, 0.96 (95% CI 0.88 to 1.06) for passengers 13–29 years, 1.03 (95% CI 0.93 to 1.15) for passengers 30–59 years, and 1.06 (95% CI 0.90 to 1.26) for passengers 60 years or older. The rear seat was associated with more protection in cars without front airbags and more protection for unrestrained passengers compared with restrained passengers.
Conclusions: Previous studies have reported that the rear seat was safer for persons of all ages; thus seating a young child in the rear has often meant that older children and adults had to assume an increased risk of death by sitting in the front. These results suggest that when front passenger airbags are present and passengers are restrained, putting adults in front and children in back enhances child safety without sacrificing adult safety.
Footnotes
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Funding/Support: this work was supported by grant R49/CE000197 from the Centers for Disease Control and Prevention, Atlanta, GA. The funding organization had no role in the design and conduct of the study, analysis and interpretation of the data, preparation, review, and approval of the manuscript, or the decision to submit the manuscript for publication.
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Competing interests: none.
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Drs Smith and Cummings are responsible for the study conception and design, the drafting and critical revising of the paper for important intellectual content, and the final approval of the version to be published. Drs Smith and Cummings are the guarantors of the paper. The guarantors accept full responsibility for the work and/or conduct of the study, had access to the data, and controlled the decision to publish the paper.
