Seat belt use among rear passengers: validity of self-reported versus observational measures

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Abstract

Background

The effects of seat belt laws and public education campaigns on seat belt use are assessed on the basis of observational or self-reported data on seat belt use.

Previous studies focusing on front seat occupants have shown that self-reports indicate a greater seat belt usage than observational findings.

Whether this over-reporting in self reports applies to rear seat belt usage, and to what extent, have yet to be investigated.

We aimed to evaluate the over-reporting factor for rear seat passengers and whether this varies by gender and under different compulsory seat belt use conditions.

Methods

The study was conducted in the Veneto Region, an area in the North-East of Italy with a population of 4.7 million.

The prevalence of seat belt use among rear seat passengers was determined by means of a cross-sectional self-report survey and an observational study.

Both investigations were performed in two time periods: in 2003, when rear seat belt use was not enforced by primary legislation, and in 2005, after rear seat belt use had become compulsory (June 2003).

Overall, 8138 observations and 7902 interviews were recorded.

Gender differences in the prevalence of rear seat belt use were examined using the chi-square test. The over-reporting factor, defined as the ratio of the self-reported to the observed prevalence of rear seat belt use, was calculated by gender before and after the rear seat belt legislation came into effect.

Results

Among rear seat passengers, self-reported rates were always higher than the observational findings, with an overall over-reporting factor of 1.4.

We registered no statistically significant changes over time in the over-reporting factor, nor any major differences between genders.

Conclusion

Self-reported seat belt usage by rear passengers represents an efficient alternative to observational studies for tracking changes in actual behavior, although the reported figures need to be adjusted using an appropriate over-reporting factor in order to gain an idea of genuine seat belt use.

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Most cited references 22

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Association of rear seat safety belt use with death in a traffic crash: a matched cohort study.

Peter Cummings, Motao Zhu, Haitao Chu … (2007)

To estimate the association of rear seat safety belt use with death in a traffic crash. Matched cohort study. The US during 2000 through 2004. Drivers (10,427) and rear seat passengers (15,922) in passenger vehicles that crashed and had at least one driver or rear passenger death. Data from the Fatality Analysis Reporting System. The adjusted relative risk (aRR) of death for a belted rear seat passenger compared with an otherwise similar unbelted rear passenger. Safety belt use was associated with a reduced risk of death for rear car occupants: outboard rear seat aRR 0.42 (95% CI 0.38 to 0.46), and center rear seat aRR 0.30 (95% CI 0.20 to 0.44). For rear occupants of light trucks, vans, and utility vehicles, the estimates were: outboard aRR 0.25 (95% CI 0.21 to 0.29), center aRR 0.34 (95% CI 0.24 to 0.48). If the authors' estimates are causal, traffic crash mortality can be reduced for rear occupants by approximately 55-75% if they use safety belts.

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Self-reports of safe driving behaviors in relationship to sex, age, education and income in the US adult driving population.

E Schechtman, Jaimee R. Compton, D Shinar (2000)

This study analyzed the data of a health and safety survey conducted on a representative sample of the adult driving population. The analysis focused on the relationships between self-reported safe driving behaviors (including belt use, observing speed limits, and abstaining from drinking and driving), and demographic characteristics (including sex, age, education and income). The results showed that the three behaviors are quite independent of each other, and, contrary to some stereotypes, there is no single high-risk group that is most likely to violate all three safe driving behaviors. The only consistent effect was that of sex: women reported higher observance rates of all three behaviors. Reported use of safety belts increases with age and education for both men and women. However while for women the reported use increases with income, for males the reported use does not change with income. Complete avoidance of drinking and driving was reported by most drivers in all groups, and the high rates hardly varied across the different age, education, and income groups. The number of people who reported that they observe the speed limit all the time increased with age, but decreased with increasing education and income. The results have implications for identifying violation-specific high-risk groups, and stressing different factors for each.

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Pattern of seat belt wearing in Nanjing, China.

X. Hu, D Li, Y. Qin … (2007)

To describe the patterns of seat belt wearing in Nanjing, China for drivers, front seat passengers, and rear occupants of motor vehicles. Roadside observational study. Four sites in central and northern Nanjing during daylight hours over 1 week in April 2005. Drivers and passengers of 17 147 cars, taxis, goods vans, and pickups, which traveled in the inside traffic lane. Percentage seat belt wearing for each of seating position, age/sex, time of day, vehicle type, day of week. The rate of seat belt wearing was significantly higher in drivers (67.3%, 95% CI 66.6 to 68.0) than front seat passengers (18.9%, 95% CI, 18.0 to 19.8). It was negligible for second front seat passengers (2.6%, 95% CI 0.3 to 4.9) and rear seat passengers (0.5%, 95% CI 0.3 to 0.7). Belt tampering, such that protection would be reduced in the event of a crash, was observed for 18.5% of taxi drivers. Drivers were most likely to wear seat belts in cars and vans and at a city roundabout; front seat passengers were most likely to wear seat belts in non-taxi vehicles, during the evening rush hour, if the driver was wearing a belt, and on the local north road. Drivers were least likely to wear a belt in the early morning, in pickups and taxis, on Tuesday (or the following week), and on the local north road; front seat passengers were least likely to wear a belt in taxis and if the driver was not wearing a belt. Rates of seat belt wearing by passengers were low despite national legislation and provincial regulations coming into effect several months before the survey. Combined education and enforcement are necessary accompaniments to legislation.

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Author and article information

Journal

Journal ID (nlm-ta): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central

ISSN (Electronic): 1471-2458

Publication date Collection: 2008

Publication date (Electronic): 9 July 2008

Volume: 8

Page: 233

Affiliations

[1 ]Regional Center for Epidemiology, Veneto Region, Via Ospedale 18, 31033 Castelfranco Veneto, Italy

[2 ]Regional Department for Prevention, Public Health Section, Rio Novo 3493, 30123 Venezia, Italy

Article

Publisher ID: 1471-2458-8-233

DOI: 10.1186/1471-2458-8-233

PMC ID: 2483976

PubMed ID: 18613955

SO-VID: 3f674a4c-ac8b-417f-981b-8624768a50b3

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Seat belt use among rear passengers: validity of self-reported versus observational measures

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Abstract

Background

Methods

Results

Conclusion

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Most cited references 22

Association of rear seat safety belt use with death in a traffic crash: a matched cohort study.

Self-reports of safe driving behaviors in relationship to sex, age, education and income in the US adult driving population.

Pattern of seat belt wearing in Nanjing, China.

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