Self-Report and Observational Assessment and Investigation of Seat Belt Use Among Young Drivers and Passengers: The Case of Qatar

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.

Seat belt usage in buses - An observation study of usage and travellers' perspectives

This study aims to evaluate seat belt usage in buses and to understand travellers' incentives of seat belt usage. Methods used are observational studies (10 cities, with 328 bus observations), focus group discussion (7 groups with a total of 32 participants) and a web survey (n = 1737 respondents). The results show that the seat belt use among bus passengers can be improved especially in regional and commercial bus traffic. It is more common to buckle up on long trips than on short trips. However, even though observations show high usage during long trips, travellers report that they remove the seat belt after a while if they want to sleep or for comfort reasons. For the bus drivers it is not possible to control passengers' usage. Dirty seat belts and technical malfunction might deter some passengers from using them and therefore systematic cleaning and control of seats and belts are recommended. On short trips one reason for not using the belt is related to worries about getting stuck and not being ready to get off in time. In general, it is most important to increase the usage on high-speed roads (>60 km/h), in lower speed it might be more important to provide a seat for each passenger. Based on the results a list of recommendations is presented.

Drivers' unsafe behaviors in Iran: An investigation in West Azerbaijan

Background

The present study aims to investigate one of the major causes of traffic accidents: drivers' unsafe behaviors while driving.

Methods

In this cross-sectional study, the behaviors of 946 drivers at traffic lights were observed in the morning, at noon, and in the evening using direct in-field observation. The unsafe behaviors of the drivers included not fastening the seat belt, using a cellphone or handsfree device, smoking, being distracted by a child, talking with passengers, not observing the stop line, eating and drinking, and getting out of the car, letting out a passenger, or arguing with a passenger at the traffic light.

Results

Of the drivers at the traffic light, 60% did not obey the stop line, and 72% did not fasten their seat belt. Also, 13.6% used their cellphones, and 22% talked with passengers. The frequency of the other unsafe behaviors was <3%. For wearing seat belts, drivers aged 41-50 years wore seat belts almost five times more than drivers under 25 years of age (4.94 [2.36-10.320]; p < 0.001), and drivers aged 50 years and older were almost three times likelier to wear seat belts than drivers under 25 years of age (2.8 [1.31-6.08]; p < 0.001). The results showed that the drivers were significantly likelier to wear seat belts on Saturdays (after the weekend) (0.56 [0.40-0.78]; p = 0.001). Regarding using mobile phones while driving, women were twice as likely to use mobile phones as men (2.20 [1.30-3.72]; p < 0.001). Drivers aged 26-40 years used mobile phones significantly less than drivers under 25 years of age (0.24 [0.14-0.43]; p < 0.001) and drivers aged 41-50 years were significantly less likely to use mobile phones than drivers under 25 years of age (0.19 [1.31-6.08]; p < 0.001).

Conclusion

The results showed that the occurrence of wearing a seat belt in Shahin Dej was low. We observed a significant association between wearing a seat belt, age, whether it was Saturday (a day after weekend for Iranians). Additionally, similar associations were observed between using mobile phones and gender, age, and day of the week.

Seatbelt use among bus passengers in Ghana: observed versus self-reported measures

Many road traffic injuries in low- and middle-income countries (LMICs) are to bus passengers. We sought to determine the availability, functionality, and observed vs. self-reported use of seatbelts in large intercity buses in Ghana. We observed seatbelt use for 1,184 passengers in 35 large intercity buses. We interviewed a separate group of 633 bus passengers. All buses observed had seatbelts and most (92.6%) were functional. A little over a fifth (21.6%) of passengers were observed to wear seatbelts. However, 34.5% of passengers in the self-reported survey indicated always wearing seatbelts when riding in buses. Passengers on 5 buses out of the 35 observed where the driver verbally prompted them to wear seatbelts were more likely (57.8%) to wear seatbelts than on the other buses (15.3%, p = 0.001). Comparing the self-reported survey with observations, passengers tended to overinflate seatbelt use by a factor of 1.6. This study provides useful information for efforts to increase and monitor seatbelt use among large intercity bus passengers in LMICs.Supplemental data for this article is available online at.

Assessment of seat-belt related injuries using the FORTIS forensic system

This study presents (1) a case of an injury to an unbelted passenger and (2) the possibilities of proving the occurrence of injuries to traffic accident participants. We demonstrate the case of an injury to a passenger who failed to fasten her seat belt, and question whether her injuries would have been equally serious if she had fastened her seat belt. Theoretical bases and methods for the interdisciplinary procedure of medical examiners using the PC Fortis program and technical analysts of traffic accidents using the PC Crash program are presented. Furthermore, individual practical steps are documented, the result showing that the injuries to the passenger would have occurred, but, to a minimum extent, i.e., 6.9% of the original injuries, which would have not exceeded the legal limit for damage to health.

Prediction of Seat Belt Use Behavior among Adolescents Based on the Theory of Planned Behavior

BACKGROUND

Road Traffic Injuries (RTIs) are the important causes of unintentional injuries and deaths. In this respect, seat belt wearing is an influential factor in reducing the mortality and severity of road traffic injuries. The rate of seat belt use among is lower adolescents, compared to adults. The present study aimed to investigate the influential factors on seat belt-weraing behavior among adolescent students as car occupants based on the Theory of Planned Behavior (TPB).

STUDY DESIGN

  A cross-sectional design.

METHODS

This study was conducted among 952 adolescent students studying in grades 7, 8, and 9 in the schools of Tabriz, Iran, in the 2019-20 academic year. A researcher-made questionnaire was designed based on TPB for data collection, the validity and reliability of which have been confirmed.

RESULTS

The results indicated that the rate of seat belt use in the front seat inside the city was lower than that outside the city. Regarding TPB constructs, perceived behavioral control (β=0.137; 95% CI: 0.006-0.013; P<0.001), subjective norm (β=0.313; 95% CI: 0.021-0.032; P<0.001), and attitude (β=0.322; 95% CI: 0.034-0.053; P<0.001) had a significant and positive relationship with the intention of seat belt-wearing behavior. Moreover, the behavioral intention (β=0.571; 95% CI: 0.62-0.64; P<0.001) had a significantly positive relationship with seat belt-wearing behavior.

CONCLUSION

The Theory of Planned Behavior is appropriate to determine predictor factors of seat belt-weraing behavior among adolescent students as car occupants. In addition, the results of the present study may provide a theoretical basis for policy-making to improve adolescent students' seat belt use.

Predictors of Seatbelt Use Among Saudi Adults: Results From the National Biobank Project

Introduction: Road traffic crashes (RTCs) are a leading cause of death and disabilities and impose a significant burden on the healthcare system and economy of Saudi Arabia. Around 20% of all hospital beds are occupied by victims of RTCs, which represent approximately 80% of trauma deaths occurring in these facilities. Using a seatbelt is an effective method to reduce traffic deaths and minimize the extent of associated injuries. However, little is currently known about the prevalence and predictors of seatbelt use in Saudi Arabia. More studies are needed to determine the trends of seatbelt use and study the relationship between individual factors and compliance with seatbelt use laws. The aim of the present study is to examine the prevalence and predictors of seatbelt use using the National Saudi Biobank dataset.

Materials and Methods: This cross-sectional study was conducted using an in-person survey from the Saudi National Biobank (SNB). The participants were adults affiliated with the Ministry of National Guard Health Affairs in Riyadh who were examined between 2017 and 2019. Chi-squared and Wald tests were used to assess the association between the respondents' characteristics and their seatbelt use. In addition, logistic regression models were constructed to assess the univariate and multivariate associations between seatbelt use and potential predictors. All statistical tests were two-sided, and the findings were considered significant at P < 0.05.

Results: A total of 5,790 adults participated in the survey. The majority of the participants (52.44%) were between 18 and 25 years old, half were males, and 58.80% were single. About 42.83% of the participants reported consistent seatbelt use as drivers or passengers. In the multivariable analysis, females were 86% less likely to wear seatbelts than males (OR = 0.136, 95%CI = 0.107–0.173). Individuals who rated their mental health as “weak” were 26% less likely to wear seatbelts than those who reported “excellent” mental health status.

Conclusion: Seatbelt use remains low in the country and substantially lower than in developed countries. Young adults, females, and individuals reporting suboptimal mental health were less likely to fasten their seatbelts. These findings are valuable for public health programs to target specific groups and raise awareness about the need to increase seatbelt compliance and reduce traffic injuries.

Psychological predictors of seat belt usage among university student passengers and an examination of the differences between the front and rear seats

Objective: This study aimed to analyze the cognitive psychological process and to understand the decision-making process involved in university student passengers' seat belt usage behavior and the difference between front and rear seat belt use. Based on the Theory of Planned Behavior (TPB), two extended variables, namely, perceived accident severity and safety consciousness, were introduced. From the perspective of social psychology, we explored the psychological factors influencing university student passengers' seat belt usage behavior and the relationship between these factors.Methods: The reliability and validity of 544 valid questionnaires were tested, and the differences were analyzed in the scores of the TPB variables between university student transportation majors and other majors. Finally, structural equation models were established to compare the factors affecting seat belt usage in the front and rear seats.Results: The results show that the TPB could effectively explain and predict university student passengers' seat belt usage behavior. Significant differences were observed in the TPB variables, the extended variables and the behavioral intention scores between the university students majoring in transportation and those with other majors. In addition, significant differences were observed between front and rear seat belt usage. All psychological factors had significant positive effects on the seat belt usage behavior of the university student passengers, and all factors directly or indirectly affected seat belt usage behavior.Conclusions: The present research adds further empirical evidence regarding the ability of the TPB to predict seat belt usage behavior. In addition, the current research results may provide a theoretical basis for policy-making aiming to improve university students' seat belt usage.