Rivara F P, Koepsell T D, Grossman D C, Mock C
Harborview Injury Prevention and Research Center, Box 359960, 325 Ninth Ave, Seattle, WA 98104.
JAMA. 2000 Jun 7;283(21):2826-8. doi: 10.1001/jama.283.21.2826.
Approximately 10 million cars with automatic shoulder belt systems are currently in use in the United States. However, reports on the effectiveness of such restraints have yielded conflicting results.
To determine the effectiveness of automatic shoulder belt systems in reducing the risk of injury and death among front-seat passenger vehicle occupants.
DESIGN, SETTING, AND SUBJECTS: Analysis of data collected from the 1993-1996 National Highway Traffic Safety Administration Crashworthiness Data System on front-seat occupants involved in 25,811 tow-away crashes of passenger cars, light trucks, vans, and sport utility vehicles.
Death and serious injury to specific body areas by use of manual lap and shoulder belts, automatic shoulder belts with manual lap belts, or automatic shoulder belts without lap belts, compared with no restraint use.
Use of automatic shoulder belts without lap belts was associated with a decrease in the risk of death vs no restraint use but was not statistically significant for all crashes (odds ratio [OR], 0.66; 95% confidence interval [CI], 0.42-1.06) or for frontal crashes (OR, 0.71; 95% CI, 0.38-1.35) after adjustment for occupant age, sex, vehicle year, air-bag deployment, estimated change in vehicle speed during the crash, and principal direction of force. This association was significantly weaker than the 86% lower risk observed for use of automatic shoulder belts with lap belts (OR, 0.14; 95% CI, 0.07-0.26 vs no restraint; P<.05). Use of automatic shoulder belts without lap belts was associated with an increased risk of serious chest (OR, 2.66; 95% CI, 1.11-6.35) and abdominal (OR, 2.06; 95% CI, 1.004-4.22) injuries for all crashes.
These data indicate that improperly used automatic restraint systems may be less effective than properly used systems and are associated with an increased risk of serious chest and abdominal injuries. Given the continued widespread use of these automatic systems, educational programs may be warranted. JAMA. 2000;283:2826-2828
目前美国约有1000万辆配备自动肩带系统的汽车在使用。然而，关于这种约束装置有效性的报告结果相互矛盾。
确定自动肩带系统在降低前排乘用车乘客受伤和死亡风险方面的有效性。
设计、地点和研究对象：对1993 - 1996年国家公路交通安全管理局碰撞安全性数据系统收集的数据进行分析，这些数据涉及25811起乘用车、轻型卡车、厢式货车和运动型多用途汽车的拖移碰撞事故中的前排乘客。
与未使用约束装置相比，使用手动腰部和肩部安全带、带手动腰部安全带的自动肩带或不带腰部安全带的自动肩带时特定身体部位的死亡和重伤情况。
与未使用约束装置相比，使用不带腰部安全带的自动肩带与死亡风险降低相关，但在所有碰撞事故（优势比[OR]，0.66；95%置信区间[CI]，0.42 - 1.06）或正面碰撞事故（OR，0.71；95% CI，0.38 - 1.35）中，经调整乘客年龄、性别、车辆年份、安全气囊展开情况、碰撞期间车速估计变化以及主要受力方向后，差异无统计学意义。这种关联明显弱于使用带腰部安全带的自动肩带所观察到的低86%的风险（OR，0.14；95% CI，0.07 - 0.26对比未使用约束装置；P <.05）。对于所有碰撞事故，使用不带腰部安全带的自动肩带与严重胸部（OR，2.66；95% CI，1.11 - 6.35）和腹部（OR，2.06；95% CI，1.004 - 4.22）受伤风险增加相关。
这些数据表明，使用不当的自动约束系统可能不如使用得当的系统有效，并且与严重胸部和腹部受伤风险增加相关。鉴于这些自动系统仍在广泛使用，可能需要开展教育项目。《美国医学会杂志》。《美国医学会杂志》。2000年；283：2826 - 2828
