142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

314967
Factors associated with mortality in rear-seated adult passengers involved in fatal motor vehicle crashes on US roadways

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 11:00 AM - 11:15 AM

Eli Raneses, MPH , Department of Epidemiology, Columbia University Mailman School of Public Health, Philadelphia, PA
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. Recent efforts to pass rear seatbelt laws for adults have been hampered by large gaps in the literature. This study examines driver, vehicle, crash and passenger characteristics associated with mortality in rear-seated adult passengers.

Methods. The Fatality Analysis Reporting System (FARS) 2010-2011 was used to examine motor vehicle occupant mortality in rear-seated adult passengers 18 years and older.  Side crash vehicle safety ratings were assessed in a subset analysis of vehicles struck on the same side as the rear-seated passenger. Multi-level models used SAS Glimmix.

Results. Of the 7,230 rear-seated adult passengers, 2,092 (28.9%) died. Multivariable predictors of increased mortality were advancing passenger age, younger driver age, excessive speed, ejection, being unbelted, rear impact and same side crash. Belt use was associated with a 68% reduction in total mortality. Belt wearing was low (48.1%) and differed by seating position, with less than one-third of middle-seated passengers belted. Mortality was higher for same-side impacts (OR=2.89, 2.30, 3.63). In a subset analysis of same-side crashes adjusted for belt status, right-seated passengers experienced a 50% increase and left-seated a 27% increase in mortality compared to middle-seated passengers. Vehicle side crash safety ratings, available for 27.7% of same side crashes, were not predictive of mortality.

Conclusions. Several areas were identified for further improvement in rear-seated passenger mortality. Except for same side crashes, seatbelt wearing was associated with significantly lowered mortality. Despite this, seatbelt wearing was low and represents one of several areas where further improvements in mortality might be realized.

Learning Areas:

Epidemiology
Public health or related public policy
Public health or related research

Learning Objectives:
Identify independent factors associated with rear-seated adult MV occupant mortality Describe the role that passenger, vehicle, crash and driver factors contribute to rear-seat MV mortality in adult occupants

Keyword(s): Mortality

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: NA

Qualified on the content I am responsible for because: Eli Raneses completed his bachelors in Public Health Studies at Johns Hopkins University, and MPH in epidemiology at Columbia University. This work, under the guidance and mentorship of Dr. Joyce Pressley, represents a two semester endeavor culminating in his MPH thesis. He performed all analyses under Dr. Pressley.
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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