Passenger seating position and the risk of passenger death or injury in traffic crashes

Smith, Kathleen M.; Cummings, Peter

Affiliations

¹Department of Emergency Medicine, Mary Bridge Children’s Hospital, 315 Martin Luther King Jr. Way, Tacoma, WA 98405-0987, USA

²Harborview Injury Prevention and Research Center, Box 359960, 325 Ninth Avenue, Seattle, WA 98104-2499, USA

³Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, WA, USA

Abstract and keywords

Objective: To estimate the association of passenger seat position with the risk of death and serious injury for passengers in traffic crashes.

Methods: Using 1993–2000 data from the National Highway Traffic Safety Administration's Crashworthiness Data System (CDS), the risk ratio for death and serious injury was estimated for rear seat passengers compared with front seat passengers in motor vehicle crashes.

Results: The adjusted risk ratio for death of passengers in the rear seat in a crash was 0.61 (95% confidence interval (CI) 0.46–0.81). Rear seat passenger position was also associated with a decrease in the risk of death and serious injury compared with the front seat passenger position: risk ratio=0.67 (95% CI 0.57–0.78).

Conclusion: We estimated that the rear seat passenger position may reduce the risk of death in a motor vehicle crash by about 39% and reduce the risk of death or serious injury in a crash by 33%, compared with the front seat passenger position. If the associations that we report are causal, sitting in the rear seat, compared with the front seat, may prevent about 4 in 10 passenger deaths, or 3 in 10 passenger deaths and injuries, that might otherwise occur.

Keywords: Passenger seat position; Traffic crashes; Poisson regression; Cohort study; Multiple imputation

Links

DOI: 10.1016/S0001-4575(03)00002-2

PubMed: 14642880

WoS: 000188824200012

History

Received: 2002-08-21

Online: 2003-03-16

Cited Works (7)

Year	Entry
1988	Evans L. Rear seat restraint system effectiveness in preventing fatalities. Accid Anal Prev. April 1988;20(2):129-136.
1998	Braver ER, Whitfield R, Ferguson SA. Seating positions and children’s risk of dying in motor vehicle crashes. Inj Prev. 1998;4(3):181-187.
2000	Berg MD, Cook L, Corneli HM, Vernon DD, Dean JM. Effect of seating position and restraint use on injuries to children in motor vehicle crashes. Pediatrics. April 2000;105(4):831-835.
1986	Evans L. The effectiveness of safety belts in preventing fatalities. Accid Anal Prev. June 1986;18(3):229-241.
1974	Baker SP, O'Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. March 1974;14(3):187-196.
1988	Evans L, Frick MC. Seating position in cars and fatality risk. Am J Public Health. November 1988;78(111):1456-1458.
2001	Traffic Safety Facts 2000: A Compilation of Motor Vehicle Crash Data from the Fatality Analysis Reporting System and the General Estimates System. Washington, DC: U.S. Dept of Transportation, National Center for Statistics and Analysis, National Highway Traffic Safety Administration; December 2001. Report No. DOT HS 809 337.

Cited By (18)

Year	Entry
2008	Forman J, Michaelson J, Kent R, Kuppa S, Bostrom O. Occupant restraint in the rear seat: ATD responses to standard and pre-tensioning, force-limiting belt restraints. In: 52nd Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 6-8, 2008; San Diego, CA.141-153.
2009	Bohman K, Rosén E, Sunnevang C, Boström O. Rear seat occupant thorax protection in near side impacts. In: 53rd Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 5-7, 2009; Baltimore, MD.3-11.
2010	Sahraei E, Digges K, Marzougui D. Reduced protection for belted occupants in rear seats relative to front seats of new model year vehicles. In: 54th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 17-20, 2010; Las Vegas, NV.149-158.
2011	O'Neil J, Bull MJ, Talty J, Slaven JE. Important child occupant saftety trends, Indiana between 2005 and 2010. In: 55th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 3-5, 2011; Paris, France.27-32.
2005	Kuppa S, Saunders J, Fessahaie O. Rear seat occupant protection in frontal crashes. In: Proceedings of the 19th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 6-9, 2005; Washington, DC.
2007	Bohman K, Boström O, Osvalder A-L, Eriksson M. Rear seat frontal impact protection for children seated on booster cushions: an attitude, handling and safety approach. In: Proceedings of the 20th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 18-21, 2007; Lyon, France.
2007	Kent R, Forman J, Parent DP, Kuppa S. Rear seat occupant protection in frontal crashes and its feasibility. In: Proceedings of the 20th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 18-21, 2007; Lyon, France.
2011	Jakobsson L, Bohman K, Andersson M, Stockman I, Boström O, Svensson M, Svanberg H, Wimmerstedt M, Arbogast KB. Rear seat safety in frontal to side impacts: focusing on occupants from 3yrs to small adults. In: Proceedings of the 22nd International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 13-16, 2011; Washington, DC.
2015	Kim S, Lee J, Kim J, Kim G, Suh M. Preliminary study of the responses of Hybrid III 5th female, 50th male, Q6 and Hybrid III 5th pregnant female dummy seated in the 2nd row seats of passenger vehicles in sled tests. In: Proceedings of the 24th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 8-11, 2015; Gothenburg, Sweden.
2010	Martin J-L, Lardy A, Compigne S. Specificities of rear occupant protection: analysis of french accident data. In: Proceedings of the 2010 International IRCOBI Conference on the Biomechanics of Impact. September 15-17, 2010; Hannover, Germany.315-318.
2009	Forman J, Lopez-Valdes F, Lessley D, Kindig M, Kent R, Ridella S, Bostrom O. Rear seat occupant safety: an investigation of a progressive force-limiting, pretensioning 3-point belt system using adult PMHS in frontal sled tests. Stapp Car Crash J. 2009;53:49-74. SAE 2009-22-0002.
2009	Sahraei E, Soudbakhsh D, Digges K. Protection of rear seat occupants in frontal crashes, controlling for occupant and crash characteristics. Stapp Car Crash J. 2009;53:75-91. SAE 2009-22-0003.
2010	Bilston LE, Du W, Brown J. A matched-cohort analysis of belted front and rear seat occupants in newer and older model vehicles shows that gains in front occupant safety have outpaced gains for rear seat occupants. Accid Anal Prev. November 2010;42(6):1974-1977.
2006	Smith KM, Cummings P. Passenger seating position and the risk of passenger death in traffic crashes: a matched cohort study. Inj Prev. 2006;12(2):83-86.
2008	Brown J. The Aetiology and Mechanisms of Serious Injury in Restrained Child Occupants [PhD thesis]. University of New South Wales; 2008.
2012	Beck B. Optimising Protection for Motor Vehicle Rear Seat Occupants [PhD thesis]. University of New South Wales; 2012.
2008	Kapoor T. Methods to Mitigate Injuries to Toddlers in a Vehicle Crash [PhD thesis]. University of Windsor; 2008.
2019	Tatem WM. The Crash Injury Risk to Rear Seated Passenger Vehicle Occupants [PhD thesis]. Virginia Polytechnic Institute and State University; December 13, 2019.