强制性安全带法律的主要执行与机动车碰撞死亡。

Primary Enforcement of Mandatory Seat Belt Laws and Motor Vehicle Crash Deaths.

机构信息

Department of Epidemiology, Biostatistics and Occupational Health, The Institute for Health and Social Policy, and the Department of Economics, McGill University, Montreal, Canada.

出版信息

Am J Prev Med. 2017 Aug;53(2):176-183. doi: 10.1016/j.amepre.2017.02.003. Epub 2017 Mar 20.

DOI:10.1016/j.amepre.2017.02.003

PMID:28336356

Abstract

INTRODUCTION

Policies that allow directly citing motorists for seat belt non-use (primary enforcement) have been shown to reduce motor vehicle crash deaths relative to secondary enforcement, but the evidence base is dated and does not account for recent improvements in vehicle designs and road safety. The purpose of this study was to test whether recent upgrades to primary enforcement still reduce motor vehicle crash deaths.

METHODS

In 2016, researchers used motor vehicle crash death data from the Fatal Analysis Reporting System for 2000-2014 and calculated rates using both person- and exposure-based denominators. Researchers used a difference-in-differences design to estimate the effect of primary enforcement on death rates, and estimated negative binomial regression models, controlling for age, substance use involvement, ﬁxed state characteristics, secular trends, state median household income, and other state-level trafﬁc safety policies.

RESULTS

Models adjusted only for crash characteristics and state-level covariates models showed a protective effect of primary enforcement (rate ratio, 0.88, 95% CI=0.77, 0.98; rate difference, -1.47 deaths per 100,000 population, 95% CI= -2.75, -0.19). After adjustment for ﬁxed state characteristics and secular trends, there was no evidence of an effect of upgrading from secondary to primary enforcement in the whole population (rate ratio, 0.98, 95% CI=0.92, 1.04; rate difference, -0.22, 95% CI= -0.90, 0.46) or for any age group.

CONCLUSIONS

Upgrading to primary enforcement no longer appears protective for motor vehicle crash death rates.

摘要

简介

允许直接对不系安全带的驾车者进行处罚（主要执法）的政策已被证明可以降低机动车碰撞死亡人数，与次要执法相比，但证据基础是陈旧的，并且没有考虑到最近车辆设计和道路安全的改进。本研究的目的是检验最近升级后的主要执法是否仍然能降低机动车碰撞死亡人数。

方法

2016 年，研究人员使用 2000-2014 年 Fatal Analysis Reporting System 的机动车碰撞死亡数据，使用基于人员和暴露的分母计算比率。研究人员使用差异差异设计来估计主要执法对死亡率的影响，并使用负二项式回归模型进行估计，控制年龄、物质使用情况、固定州特征、季节性趋势、州家庭中位数收入和其他州级交通安全政策。

结果

仅调整碰撞特征和州级协变量的模型显示，主要执法具有保护作用（比率比，0.88，95%置信区间=0.77，0.98；率差，每 10 万人减少 1.47 人死亡，95%置信区间= -2.75，-0.19）。在调整固定州特征和季节性趋势后，在整个人群中，从次要执法升级为主要执法并没有证据表明有效果（比率比，0.98，95%置信区间=0.92，1.04；率差，-0.22，95%置信区间= -0.90，0.46），也没有任何年龄组有效果。