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Influence of Seat Belts in Reducing Traumatic Injuries and Fatalities in Motor Vehicle Accidents | Part 1

Motor vehicle accidents remain the most common cause of death or trauma in persons age 1-34. Seat belts have been very effective in reducing traumatic injuries and reducing fatalities. Air bags also have been shown to reduce trauma and fatalities resulting from motor vehicle accidents.

Only over the last ten years have air bags gained widespread use in the United States. Air bags were first designed in 1952 but were not federally mandated as standard safety equipment until 1987. All passenger cars manufactured after September 1, 1997, are required to have air bags and manual three-point seat belts.

When discussing the influence of restraint systems on driver and passenger injury, it is helpful first to look at impact data. Information from the National Accident Sampling System (NASS) database indicated that the presence of unrestrained front passengers appears to enhance driver injury level in left-side crashes, but the presence of a passenger in right-side crashes appears to moderate driver injury severity. The AIS Scale is used to describe level of injury.

Analysis of passenger car side impacts by Huelke and Compton at the University of Michigan found in left-side impacts that unrestrained drivers with passengers have a higher frequency of AIS 3-6 injuries than when alone in left-side impacts. A study by Bourbeau et al. found that cervical spine fractures were more prevalent among unbelted front seat occupants. The same study found that neck sprains were more frequent among belted occupants.

Both the frequency of major injury and deaths have decreased with lap-shoulder belts. It has been postulated, however, that the cervical spine is not restrained in front-end collisions when a lap-shoulder belt is used, which has led to an increase in minor neck pain. These injuries depend on the way in which the neck is flexed, which in turn depends on the specifics of crash severity, occupant size, sitting position, and the position of the shoulder belt in relation to the neck and chest. Huelke et al. concluded that because the neck/head complex of three-point restrained occupants is unrestrained, the cervical spine may be a focus for high force concentration, resulting in injury due to inertial forces.

Excerpt from Pathophysiology of Spinal Trauma in Motor Vehicle Accidents

By:
Robert D. Gruber, DO
Kenneth P. Botwin, MD
Constantine G. Bouchlas, MD
Francisco M. Torres, MD

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