142nd APHA Annual Meeting and Exposition

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Trends in adult motor vehicle occupant mortality: Mortality declines of front-seated occupants have outpaced those of rear-seated occupants

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Nicholas Moloci, B.S.E. , Department of Epidemiology, Columbia University in the City of New York, New York, NY
Joyce C. Pressley, PhD, MPH , Depts of Epidemiology and Health Policy and Management, Center for Injury Epidemiology and Prevention at Columbia, Columbia University, New York, NY
Background. Motor vehicle (MV) occupant mortality has declined over the last decade. Although there are reports that safety efforts have largely targeted front-seated occupants and rear-seated children, there is little information regarding factors that impact trends in adult rear-seated occupant mortality.

Methods. The Fatality Analysis Reporting System (2000-2012) (FARS) was used to examine trends in MV occupant mortality in front vs. rear-seated adult occupants aged 18 years and older (n=639,571). Cochrane-Armitage test for trends (P) was used to analyze occupant, crash, and vehicle characteristics across vehicle types (passenger cars, SUVs and pickup trucks) manufactured between 1970-2012. 

Results. Total mortality declined in front-seated (45.8% vs. 43.4%, P<0.0001), but not in rear-seated occupants (30.1% vs. 30.3%, P=0.975). For front-seated occupants, this trend was observed for passenger cars only (49.9% vs. 47.4%, P<0.0001). Overtime, belt use increased in both front and rear-seated FARS occupants, but rear-seated belt use continued to lag that of front-seated occupants in 2012 (48.1% vs. 70.7%). Mortality trends increased for unbelted occupants (63.0% vs. 70.6%, P <0.0001), but decreased for belted occupants (31.1% vs. 29.6%, P<0.0001), with the decrease attributable to front-seat occupants.  Belted rear-seated occupants did not show statistically significant mortality improvement (18.0% vs. 17.3% P=0.94) while rear-seated unbelted mortality increased (36.0% vs. 42.5%, P <0.0001). Passenger cars decreased as a proportion of the vehicle fleet, but the proportion of front to rear-seated occupants was stable over time.

Conclusions. Mortality declines in adult MV occupants are due primarily to improvements in front-seated occupants traveling in passenger cars.

Learning Areas:

Epidemiology
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy
Public health or related research

Learning Objectives:
Discuss the relative contribution of adult front vs. rear-seated occupant mortality to trends in declining adult MV occupant mortality Explain the relative contribution of seatbelt usage to front and rear-seat mortality trends Discuss fleet changes over time and future implications for MV occupant mortality

Keyword(s): Mortality, Motor Vehicles

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Nicholas Moloci is a current graduate student in the department of epidemiology at the Mailman School of Public Health at Columbia University in the City of New York. Nicholas is a graduate of the University of Michigan – Ann Arbor, with a degree in Civil and Environmental Engineering. Nicholas has had his research published in the journals JAMA Internal Medicine, Cancer and The Oncologist.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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