Pressley Joyce C, Gatollari Hajere J, Liu Chang
From the Departments of Epidemiology (J.C.P., H.J.G., C.L.) and Health Policy and Management (J.C.P.) and the Center for Injury Epidemiology and Prevention at Columbia, Mailman School of Public Health (J.C.P.), Columbia University, New York, New York.
J Trauma Acute Care Surg. 2016 Oct;81(4 Suppl 1):S36-43. doi: 10.1097/TA.0000000000001178.
There is widespread belief that after childhood rear-seated motor vehicle occupants do not need to wear-seat seatbelts to travel safely. This belief is reflected in the fact that, in many states, teen passengers can ride legally unbelted in the rear seat of a passenger vehicle.
The Fatality Analysis Reporting System for 2010-2011 was used to examine factors associated with teen use of rear-seat seatbelts (n = 3,655) and with injury outcomes of belted and unbelted rear-seated teen passengers traveling in a passenger vehicle on a US roadway. Multilevel models controlled for nonindependence of cases using SAS Glimmix. Odds ratio (OR) is reported with 95% confidence interval (CI).
Slightly more than half (50.8%) of rear-seated teens were restrained, but this declined linearly with age from 65.8% of 13- to 14-year-olds to 43.3% of 18- to 19-year-olds. Overall, 77.0% of rear-seat mortality occurred in unbelted teens. Passengers of belted drivers were more frequently belted (64.1% vs. 19.0%, χ = 586.2, p < 0.0001). Nearly one-fifth (18.5%) of rear-seated teens were ejected, with 95.8% of ejections in unrestrained teens. Presence of a rear-seat seatbelt law was associated with higher restraint use (55.9% vs. 40.0%, χ = 89.0, p < 0.0001). However, in adjusted multilevel, multivariable models, belt status varied by whether the seatbelt law was primary (OR, 1.60; 95% CI, 1.29-1.99) or secondary enforcement (OR, 1.33; 95% CI, 0.98-1.78).
Presence of a primary enforced rear-seat seatbelt law was associated with significantly higher belt use. Ejection was associated with higher mortality and being unrestrained. More than three quarters of rear-seated teens who died were unrestrained.
Epidemiologic study, level III.
人们普遍认为，儿童期过后，坐在汽车后排的乘客无需系安全带就能安全出行。许多州允许青少年乘客合法地不系安全带坐在乘用车后排，这一事实就反映了这种观念。
利用2010 - 2011年的死亡分析报告系统，研究与青少年使用后排安全带相关的因素（n = 3655），以及在美国道路上乘坐乘用车的系安全带和不系安全带的后排青少年乘客的受伤情况。使用SAS Glimmix的多水平模型控制病例的非独立性。报告优势比（OR）及其95%置信区间（CI）。
略超过一半（50.8%）的后排青少年系了安全带，但这一比例随年龄呈线性下降，从13至14岁青少年的65.8%降至18至19岁青少年的43.3%。总体而言，77.0%的后排乘客死亡发生在未系安全带的青少年中。系安全带的驾驶员的乘客更常系安全带（64.1%对19.0%，χ = 586.2，p < 0.0001）。近五分之一（18.5%）的后排青少年被弹出车外，其中95.8%的弹出情况发生在未系安全带的青少年中。存在后排安全带法律与更高的安全带使用率相关（55.9%对40.0%，χ = 89.0，p < 0.0001）。然而，在调整后的多水平、多变量模型中，安全带状态因安全带法律是主要执法（OR，1.60；95% CI，1.29 - 1.99）还是次要执法（OR，1.33；95% CI，0.98 - 1.78）而有所不同。
主要执法的后排安全带法律的存在与显著更高的安全带使用率相关。被弹出车外与更高的死亡率和未系安全带有关。超过四分之三死亡的后排青少年未系安全带。
流行病学研究，III级。
