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8A.004 MV crash characteristics and medical charges: front-and rear-seated restrained and unrestrained adults
  1. Joyce C Pressley1,
  2. Michael Bauer2,
  3. Emilia Pawlowski2,
  4. Sabana Bhatta2,
  5. Leah Hines2
  1. 1Columbia University, New York, USA
  2. 2Bureau of Occupational Health and Injury Prevention, New York State Department of Health, Albany, USA


Background There are reports that historically higher mortality observed for front- compared to rear-seated adult motor vehicle (MV) occupants has narrowed. Vast improvements have been made in strengthening laws and restraint use in front-, but not rear-seated MV occupants suggesting there may be value in expanding the science on rear-seat safety.

Methods A linked 2016–2017 hospital and MV crash data set, the Crash Outcomes Data Evaluation System (CODES), was used to compare characteristics of front-seated (n=130,761) and rear-seated (n=6,641) adults aged 18 years and older involved in a MV crash in New York State (NYS). A primary enforced seatbelt law was in effect for front-seated, but not rear-seated occupants. Chi Square and linear regression use SAS 9.4.

Results Compared to front-seated occupants, those rear-seated were more likely to be unrestrained (21.2% vs. 4.3%, P<0.0001) and to have more moderate-to-severe injury/death (11.9% vs. 11.3%, p<0.0001). Compared to restrained rear-seated occupants, unrestrained rear-seated occupants had higher moderate-to-severe injury/death (21.5% vs. 7.5%, P<0.0001) and 4-fold higher hospitalization. Ninety percent (9 of 10) of rear-seated deaths were unrestrained. More than 95% of ejections were unrestrained and had 7-fold higher medical charges. Hospital stays were longer, hospital charges higher and societal financial costs higher as the unrestrained were more frequently uninsured/self-insured/government-insured.

Conclusions These findings document increased medical charges and support the need to educate consumers and policymakers on the risks associated with adults riding unrestrained in the rear-seat.

Learning outcomes Describe crash outcomes and medical charges in front- and rear-seated restrained and unrestrained adult passengers

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