College of Medicine and Life Sciences, University of Toledo, 700 Children's Drive, Columbus, OH 43205-2664, United States.
Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States; Department of Pediatrics, College of Medicine, The Ohio State University, 700 Children's Drive, Columbus, OH 43205, United States.
J Safety Res. 2020 Jun;73:9-16. doi: 10.1016/j.jsr.2020.02.005. Epub 2020 Feb 28.
Motor-vehicle crash is one of the leading causes of unintentional injury death in the United States. Previous studies focused on fatalities among drivers and front-seat passengers, with a limited number of studies examining rear-seat passenger fatalities. The objectives of this study were to assess trends in rear-seat passenger motor-vehicle fatalities in the United States from 2000 to 2016 and to identify demographic factors associated with being unrestrained among fatally injured rear-seat passengers.
Rear-seat passenger fatality data were obtained from the Fatality Analysis Reporting System (FARS) database. The fatality rate ratios for overall rear-seat passengers and for different age and sex groups were determined by comparing fatality rates in 2000 and 2016 using random effects models. Risk ratios of being unrestrained for age and sex groups were obtained using general estimating equations.
Compared to 2000, the overall rear-seat passenger fatality rate in 2016 decreased by 44% (95% confidence interval [CI]: 39-49%). In particular, the fatality rate among rear-seat passengers decreased more in males than females, and passengers aged 14-19 years experienced a larger decline than all other age groups. Fatally injured male rear-seat passengers had a higher risk of being unrestrained (adjusted risk ratio: 1.06, 95% CI: 1.04-1.07) than their female counterparts, and both youngest (≤13 years) and oldest (65-85 years) passengers were less likely to be unrestrained than those aged 20-64 years.
Overall, fatality rates among rear-seat passengers have declined, with differential degrees of improvement by age and sex. Practical Applications: Continued restraint use enforcement campaigns targeted at teenagers and males would further preserve them from fatal injuries and improve traffic safety for the overall population.
机动车事故是美国意外伤害死亡的主要原因之一。先前的研究集中在驾驶员和前排乘客的死亡上，只有少数研究关注后排乘客的死亡。本研究的目的是评估 2000 年至 2016 年美国后排乘客机动车死亡的趋势，并确定与致命性受伤后排乘客未系安全带相关的人口统计学因素。
后排乘客死亡数据来自伤亡分析报告系统（FARS）数据库。通过随机效应模型比较 2000 年和 2016 年的死亡率，确定总体后排乘客和不同年龄及性别组的死亡率比值。使用一般估计方程获得不同年龄和性别组未系安全带的风险比。
与 2000 年相比，2016 年总体后排乘客死亡率下降了 44%（95%置信区间[CI]：39-49%）。特别是，男性后排乘客的死亡率下降幅度大于女性，14-19 岁的乘客死亡率下降幅度大于所有其他年龄组。致命性受伤的男性后排乘客未系安全带的风险更高（校正风险比：1.06，95%CI：1.04-1.07），而最年轻（≤13 岁）和最年长（65-85 岁）的乘客未系安全带的可能性低于 20-64 岁的乘客。
总体而言，后排乘客的死亡率有所下降，不同年龄和性别组的改善程度不同。实用意义：针对青少年和男性的持续安全带使用执法活动将进一步保护他们免受致命伤害，并提高整个人群的交通安全。
