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

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

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.

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).

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.