Seatbelt non-use and car crash injury: An interview study

Objectives: To examine the relationship between seatbelt non-use at the time of a crash, habitual non-use of seatbelts, and car crash injury; and to calculate the population attributable risk for car crash injury due to seatbelt non-use. Methods: A population-based case control, interview study in Auckland, New Zealand, with 571 injured or killed drivers as cases and 588 population-based controls randomly selected from the driving population. Results: Unbelted drivers had 10 times the risk of involvement in an injury crash compared to belted drivers after adjustment for multiple confounders. Habitual non-users were likely to be unbelted when involved in a crash. The population attributable risk for seatbelt non-use was 13%. Conclusions: Non-use of seatbelts is very strongly associated with increased injury crash involvement. Even where seatbelt use rates are higher than 90%, there remains a small group of habitual non-users who are at high risk; these drivers may benefit from targeted interventions.