Noncompliance with seat-belt use in patients involved in motor vehicle collisions

Seat-belt compliance in trauma patients involved in motor vehicle collisions (MVCs) appears low when compared with compliance of the general public. In this study we wished to define the relative frequency of seat-belt use in injured Canadian drivers and passengers and to determine if there are risk factors particular to seat-belt noncompliance in this cohort.

We identified trauma patients who were involved in MVCs over a 24-month period and contacted them 2-4 years after the injury by telephone to administer a standardized survey. Potential determinants of seat-belt noncompliance were compared with the occurrence of an MVC by multiple logistic regression.

Seat-belt noncompliance in 386 MVC patients was associated with drinking and driving, youth, speeding, male sex, being a passenger, smoking, secondary roads, rural residence, low level of education, overnight driving, having no dependents, licence demerit points, previous collisions, unemployment and short journeys. There was an increase in seat-belt awareness and a decrease in self-rated driving ability after the MVC.

Factors that indicate poor driving habits (alcohol, speeding, previous MVCs and driving offences) also predict seat-belt noncompliance. Injury prevention programs should selectively target these high-risk drivers to improve seat-belt compliance and limit associated injury and consumption of health care resources.