Tidigare forskning indikerar att psykologisk påverkan är effektivt i avsikt att öka bältesanvändningsfrekvensen inom kollektivtrafik (Young, m.fl., 2008). Studiens hypotes är att busschaufförer kan påverka passagerare psykologiskt till att använda säkerhetsbälten vid färd med kollektiv busstrafik med hjälp av uppmaningar. Frågeställningarna involverar huruvida busschaufförer kan påverka med en neutral, påtryckande och/eller humoristisk uppmaning samt hur bältesanvändningen ser ut inom olika åldersgrupper, om det är skillnad mellan kvinnors respektive mäns bältesanvändning och om människors vana påverkar bältesanvändningen. Fyra undersökningsgrupper användes för att testa de olika uppmaningsformerna, varav en av dessa var kontrollgrupp. Deltagarna var resenärer mellan städerna Lidköping och Skövde. Det var 93 passagerare som observerades och 40 av dessa intervjuades. Observationer av bältesanvändningen utfördes innan och efter utdelad uppmaning. Intervjuer rörande passagerares bältesanvändning utfördes efter utdelad uppmaning. Resultaten från observationerna visade inte på någon signifikant skillnad i bältesanvändningen efter utdelad uppmaning. Likaså fanns det ingen signifikant skillnad mellan kvinnors respektive mäns användning av säkerhetsbälte eller mellan passagerares aktuella bältesanvändning och vanan att använda säkerhetsbälte. Resultaten från intervjuerna visade på signifikanta skillnader mellan olika åldersgruppers bältesanvändning. Vid intervjuerna framkom det att uppmaningar troligen skulle öka bältesanvändningen bland passagerare, även om undersökningens resultat från observationerna inte var signifikanta. Det framgick även att bältesanvändningen troligen skulle öka om säkerhetsbältena var bekvämare och mer flexibla. Undersökningen indikerade att bältesanvändningen bland unga passagerare var lägre än bältesanvändningen bland medelålders passagerare och fokus bör därmed troligen läggas på att få de yngre passagerarna att använda säkerhetsbälte mer vid färd med kollektiv busstrafik. / Previous research indicates that it is possible to psychologically affect people to increase their seat belt use on public transport (Young, et al., 2008). The study's hypothesis is that bus drivers can affect passengers' psychologically to use seat belts on public transport by delivering requests. The research questions are whether drivers can affect passengers with a neutral, pressuring, and/or humoristic request, how the seat belt usage appears within different age groups, if there is a difference between the sexes in seat belt usage, and if passengers' habits influence their seat belt usage. Four experimental groups were observed, one of which was the control group. The participants were passengers on a bus traveling from Lidköping to Skövde. 40 participants of the 93 observed were interviewed. Observations of the participants' seat belt use were conducted before and after the delivered request. The results of the observations showed no significant difference in seat belt use after the given request. Neither was there a significant difference in seat belt use between the sexes or a difference between the passengers' seat belt use at the time of the interviews and their habits of using the seat belt on public transport. The results of the interviews showed a significant difference between age groups in seatbelt use. It was suggested that requests from the bus driver would increase the seat belt use, although the observational results were not significant. Furthermore if the seat belts were more comfortable and flexible the seat belt use might increase. Young adults use seat belts less than middle aged adults; therefore, focus should possibly be on increasing the seat belt use of young adults.

CORRELATES OF SEAT BELT USE AMONG TURKISH FRONT SEAT OCCUPANTS SimSekoglu, &Ouml / zlem M.S., Department of Psychology Supervisor: Assoc. Prof. Dr. Timo Lajunen June, 2005, 79 pages This thesis included three separate studies, which were observational, interview and survey studies, on seat belt use among Turkish front seat occupants. The observation study investigated occupant characteristics and environmental factors affecting seat belt use. Seat belts were used significantly more among females and older occupants than among males and younger occupants / and on intercity roads, at weekends and in the afternoons than on city roads, at weekdays and in the evenings. The interview study investigated the common reasons for using and not using a seat belt in different trip types, qualitatively. Safety, situational conditions, habit and avoiding punishment were the commonly reported reasons for using a seat belt, while situational conditions, not believing the effectiveness of seat belt use, discomfort and no habit of using a seat belt were the commonly reported reasons for not using a seat belt, for most of the trip types. In the third study, seat belt use both on urban and rural roads were explained with the basic and extended Theory of Planned Behavior (TPB) models and Health Belief Model (HBM), using Structural Equation Modeling. Basic TPB model showed a good fit to the data, while extended TPB model and HBM showed a low fit to the data. Within TPB constructs, attitudes and the subjective norm had a positive and significant relation to intentions to use a seat belt. Results were discussed for their implications to traffic safety in Turkey, along with limitations of the study and suggestions for further studies.

If you have to wear a seat belt when you drive, are you safer? Intuitively, it may seem that the answer is yes. After all, if you are wearing a seat belt and get in an accident, you are half as likely to die, and 62% of fatal accident victims were not wearing seat belts at the time of accident. The Centers for Disease Control and Prevention, the National Highway and Transportation Safety Administration, the Governors' Highway Safety Administration, and many other organizations highly recommend wearing seat belts. The NHTSA claims that in 2010 alone, approximately 12,500 deaths were prevented by seat belt use alone. Seat belt laws clearly reduce the chance of death to vehicle occupants in a given auto accident. In response to these findings, the federal government has made the release of highway funds to states contingent on the passage of state laws mandating seat belt adoption. Laws mandating seat belt use, along with extensive campaigns to raise public awareness, have caused seat belt use to rise from 69% in 1998 to 88% in 2009. As of this writing, laws mandating the use of seat belts when driving have been passed in every state save New Hampshire. Intuitively, this should make roads safer because seat belts make an accident more survivable. Does wearing a seat belt, however, make that accident more likely to occur in the first place? If a driver wears a seat belt now and I didn't before, does he feel safe enough to take more risk? In this paper, I examine this question using insurance premiums as a proxy for the likelihood of an accident. The rest of the paper is organized as follows. Section 2 offers background information, including a framework with which to interpret a driver’s actions and a review of the relevant literature. Section 3 contains details on the data analyzed. Section 4 covers the results of my preliminary data analysis, model specifications, and robustness checks. Section 5 concludes.

Doctor of Philosophy / Department of Civil Engineering / Sunanda Dissanayake / Seat belt usage is considered to be one of the most effective ways of improving safety of motor vehicle occupants. Thus, increasing seat belt usage among motorists has become one of the top prioritized goals of many highway safety improvement programs. The main objective of this study was to develop a methodology to estimate potential economic benefits associated with increased seat belt usage by Kansas motorists based on conditions prevailing in the State of Kansas. Seat belt effectiveness in reducing injuries was estimated and those values were then used to estimate economic benefits due to injury reductions. Five methodologies were used to estimate seat belt effectiveness which included multiple logistic regression, double pair comparison method, Cox proportional hazards regression, conditional logistic regression, and risk ratio model using estimating equation approach. Crash data from Kansas Accident Reporting System (KARS) database was used. A procedure was developed to estimate economic benefits due to increased seat belt usage based on State conditions. The highest variation in estimated seat belt effectiveness values using different methods were observed for incapacitating injuries while the lowest variation was observed for possible injuries. For fatal injuries, the estimated seat belt effectiveness values ranged from 50-69% for passenger cars and 57-70% for other passenger vehicles. The range of seat belt effectiveness values for incapacitating injuries was 47-65% for passenger cars and 44-69% for other passenger vehicles. It was also found that the multiple logistic regression method provide relatively narrower confidence intervals for almost all the nonfatal injury categories in both vehicle groups. Based on estimations using logistic regression method, seat belts are 56% effective in preventing fatal injuries in passenger cars and 61% effective in other passenger vehicles. The seat belt effectiveness in reducing incapacitating injuries was found to be 53% in passenger cars and 52% in other passenger vehicles. It was found that if seat belt usage rate in Kansas reaches the national average rate of 81% (2006), the resulted annual economic benefits to the State is estimated to be about $ 191 millions in 2006 dollars or in other words, due to lower seat belt usage currently observed in Kansas compared to national usage level, the annual estimated economic loss is about $ 191 millions. Seat belt effectiveness values are currently not available based on KABCO (K-Fatal, A-Incapacitating, B-Non-incapacitating, C-Possible, and O-No injuries) injury scale. Therefore, this study could serve as an initiative towards establishing a procedure to estimate benefits of seat belt usage based on State highway crash data.

While safety-belt use markedly reduces morbidity and mortality, many young adults in the U.S. do not buckle-up 100% of the time. Following a series of community-level interventions on a university campus, this dissertation project focused on promoting individual-level safety-belt use. More specifically, a targeted web-based assessment and brief motivational intervention for individuals with lower rates of safety-belt use was developed and tested. A Pilot Study conducted prior to the Main Study developed self-reported assessment measures for safety-belt use and motivation. Recruitment, baseline assessment, intervention, and follow-up assessment were conducted via the Internet. Student drivers who buckled-up less than 70% of the time and who met other eligibility requirements were enrolled in a within subjects, randomized, attention-controlled design. At baseline, each participant completed an assessment of: (1) demographics; (2) driving behaviors; and (3) social cognitive and motivational variables including knowledge, perceived importance, confidence (self-efficacy), and readiness to buckle-up. Participants were then randomly assigned to one of two groups: (1) an attention-control group receiving emailed general nutrition information or (2) a motivational interviewing-consistent feedback group receiving emailed personalized feedback. Dependent variables were re-assessed approximately ten days after feedback/general nutrition information were emailed via follow-up assessment. Outcomes analyses using non-parametric statistics were conducted twice. First, an analysis of “completers” was conducted using data from those who completed follow-up. Second, a more conservative intent-to-treat analysis was conducted after carrying the last observation forward for those who did not complete follow-up, assuming no change among those who did not complete follow-up. Overall, results suggest this web-based assessment and brief motivational intervention was feasible and acceptable to participants. Overall, results from both analyses found statistically significant increases in median driver and passenger belt use between baseline and follow-up among participants in both groups. Further, effect sizes suggest the magnitude of change was greater among those in the intervention group versus those in the attention-control group. Participants were then categorized according to whether or not they increased driver belt use by at least one instance between baseline and follow-up. Those who received the intervention were not significantly more likely than those who received general nutrition information (i.e., assessment only) to increase driver safety-belt use by at least one instance. No statistical differences were found in either the completer or intent-to-treat analyses. Yet, when participants were categorized according to whether or not they increased passenger belt use by at least one instance between baseline and follow-up, those who received the intervention were 1.75 times more likely than those who received general nutrition information (i.e., assessment only) to increase passenger safety-belt use by at least one instance. This difference was not found in the intent-to-treat analysis. In general, study participation was associated with increased ratings of motivation (i.e., importance, confidence, and readiness) at follow-up. Results were interpreted with caution given psychometric weaknesses including high intercorrelations found between constructs of motivation in the Pilot Study. However, median change in one construct, readiness, was investigated in post-hoc analyses. Using the intent-to-treat sample, it was found that participants who were categorized as having increased driver safety-belt use by at least one instance also reported statistically significant median changes in readiness to buckle-up as a driver. Those categorized as having increased passenger safety-belt use by at least one instance also reported statistically significant median changes in readiness to buckle-up as a passenger. Further, although there was a trend for participants in the intervention group to be more likely than those in the attention-control group to commit to buckling-up and asking others to do the same at follow-up, there were no significant differences in commitment between groups. However, regardless of group assignment, change in median readiness was associated with: (1) commitment to buckle-up as a driver; (2) commitment to buckle-up as a passenger; (3) commitment to ask others to buckle-up while acting as a driver; and (4) commitment to ask others to buckle-up while acting as a passenger. Overall, these studies found the Internet to be an acceptable and promising venue for assessment and brief motivational intervention to promote safety-belt use among university students. Further, safety-belt use and motivational constructs such as importance, confidence, and readiness may be measured via self-report methodology. Results suggest participation in the study was associated with improvement in safety-belt use and some levels of motivation. While there were trends for those in the intervention group to report greater increases, there were no statistically significant differences between the groups in the ITT analyses. In the completer analyses, it was found that those in the intervention group were significantly more likely to report increased passenger safety-belt use. Future research may elucidate more specific psychometric properties of new measures used. In particular, readiness may be a proxy motivational variable that appears to relate to change in safety-belt use among drivers and passengers as well as commitment to buckle-up and ask others to do the same. The simple process of assessment may be sufficient to produce changes in readiness related to behavior change. / Ph. D.

This thesis presents the results of a research effort investigating the effect of belt usage reporting errors of National Automotive Sampling System-Crash Data System (NASS-CDS) investigators on injury risk estimates. Current estimates of injury risk are developed under the assumption that NASS-CDS investigators are always accurate at determining seat belt usage. The primary purpose of this research is to determine the accuracy of NASS-CDS investigators using event data recorders (EDRs) as the baseline for accuracy, and then recalculating injury risk estimates based on our findings. The analysis of a 107 EDR dataset, from vehicle tests conducted by the National Highway Traffic Safety Administration (NHTSA) and the Insurance Institute for Highway Safety (IIHS), was conducted to determine the accuracy of Chrysler, Ford, GM and Toyota EDRs. This accuracy was examined by both EDR module type and vehicle make. EDR accuracy was determined for crash delta-V, seat belt buckle status, pre-impact speed, airbag deployment status and front seat position. From this analysis we were able to conclude that EDRs were accurate, within 4.5%, when comparing maximum delta-V of EDRs that recorded the entire crash pulse length. We also determined that EDRs were 100% accurate when reporting driver seat belt status for EDRs that completely recorded the event and recorded a status for the driver's seat belt. All GM, Ford and Chrysler EDRs in our database reported a pre-impact velocity less than 6 mph different than the NHTSA and IIHS reported pre-impact velocities. We also found that all but 2 (101 out of 103) of the GM, Ford, and Toyota EDRs correctly reported airbag deployment status. Lastly we were able to conclude that seat position status was useful in determining when a smaller sized occupant was the driver or right front occupant. EDRs reported seat position of 5% Hybrid III females as "forward" in every case that seat position was recorded for this smaller occupant size. Based on the analysis of seat belt status accuracy, a comparison of NASS-CDS investigator driver seat belt status and EDR driver seat belt status was conducted to determine the accuracy of the NASS-CDS investigators. This same comparison was conducted on reports of driver seat belt status provided by police. We found that NASS-CDS investigators had an overall error of 9.5% when determining driver seat belt status. When the EDR stated that the driver was unbuckled, investigators incorrectly coded buckled in of 29.5% of the cases. When the EDR stated that the driver was buckled, NASS-CDS error was only 1.2%. Police officers were less accurate than NASS-CDS investigators, with an overall error of 21.7%. When the EDR stated that the driver was buckled, police had an error of 2.4%. When the EDR stated that the driver's belt was unbuckled, police had an error of around 69%. In 2008, NASS-CDS investigators reported that drivers had an overall belt usage rate during accidents of 82%. After correcting for the errors we discovered, we estimate that the driver belt buckle status during a crash is around 72.6%. Injury risk estimates and odd ratio point estimates were then calculated for NASS-CDS investigator and EDR buckled versus unbuckled cases. The cases included only frontal collisions in which there was no rollover event or fire. Injury was defined as AIS 2+. The risk ratios and point estimates were then compared between investigators and EDRs. We found that injury risk for unbelted drivers may be over estimated by NASS-CDS investigators. The unbuckled to buckled risk ratio for EDRs was 8%-12% lower than the risk ratio calculated for NASS-CDS investigators. / Master of Science

Seat belts save lives; however, unintentional injuries are still the leading cause of death for those between 1 and 44 years in the United States. Seat belts also cause injuries during motor vehicle crashes (MVCs) and obesity changes how seat belts fit. The purpose of this retrospective causal inference quantitative study was to reduce the knowledge gap in scholarly research on seat belt fit in relation to blunt cerebrovascular injuries (BCVI) during MVCs and seat belt compliance. The theoretical framework used was based on H.W. Heinrich's domino theory. The research questions focused on the following dependent variables: BCVI, compliance, and seat belt fit; and independent variables: the size of the individual and seat belt fit. Secondary and primary data were used and analyzed using Spearman's Rank-Order Correlation. The results yielded no relationship between seat belt fit and BCVI in the secondary data (n = 97). In the primary data (n = 138), there was significance found between seatbelt fit and a) seat belt use, and b) BMI. The study contributed to positive social change by enhancing the awareness of the knowledge deficit regarding seat belt fit, and BCVIs sustained during MVCs, and that comfort was influenced by seat belt fit and had a role in compliance. Seat belts were not used by 5.3% and 9.5% or used incorrectly by 3.2% and 2.9% of the people in the primary data and secondary data sets. This knowledge may contribute to a) future seat belt testing to ensure it is done in such a manner that seat belts fit everyone; b) new seat belt laws to ensure that they are consistent across all states, and c) medical care focusing on seat belt fit as a mechanism of injury (blunt) to ensure screenings are done with the appropriate diagnostic tools.

The thesis presents an investigation of pregnant women s safety and comfort needs during car travel. A survey is used to investigate all aspects and problems of car travel. This survey is a comprehensive examination of the entire driving activity with much detail of reported difficulties from pregnant women that forms a novel resource for the automotive engineers. The survey results are used to generate guidelines for the automotive industry. A series of sled tests are presented that investigate seat belt use in pregnancy including the use of lap belt positioners. The peak abdominal pressure results clearly agree with current guidelines that the lap belt should be positioned across the hips and not across the abdomen. This research includes a novel anthropometric dataset for 107 pregnant women including measurements especially selected for the field of automotive design and to describe the changes of pregnancy. This includes investigation of pregnant driver s proximity to the steering wheel. A novel measurement of knee splay is used to define the pregnant women s preference to sit with their knees widely spaced instead of knees together, in both normal sitting and in a car. Comparison is made between the pregnant women's measurements and the available data in the literature for non-pregnant women and males, and this shows that pregnant women can be excluded from designs if the accommodation does not consider their needs. The pregnant women's anthropometric data is presented as a novel website in order to make the data available to the automotive industry. This website is generated for use by automotive engineers and is designed to suit their usability needs and the general trends within the industry, in order to make the site more user-friendly and more likely to be used as a reference for pregnant occupant's needs.

Ambulanser kör ofta i hög hastighet och gör så vid dygnets alla tidpunkter och vid alla årstider. Vid en eventuell kollision innebär en undermålig säkerhetsbältesanvändning en betydande risk för skador, både för patienten, vårdaren och eventuella medåkare. Det ställs höga krav på hur ambulanser ska vara utrustade vad gäller bland annat inredning och medicinskteknisk utrustning. Detta för att garantera säkerheten för både patienter och personal. Att vistas i ambulansens vårdhytt har visat sig innebära en ökad risk för olyckor och dödsfall jämfört med andra arbetsplatser inom vården. Flertalet studier har gjorts avseende personalens bältesanvändning i vårdhytten men inte i samma utsträckning vad gäller bältesanvändning på ambulansbåren. Studiens syfte var att belysa användningen av ambulansbårens säkerhetsbälten vid transport av vuxna patienter i ambulans. Syftet nåddes genom insamling av data avseende bältesanvändning och personalens inställning till centrala begrepp, vilket skedde med enkät som metod. Resultatet visade att patienter inte åker obältade och att midjebältet var det vanligast använda bältet. Underbensbältet var det minst använda bältet. En knapp tredjedel av vårdarna i studien använde samtliga befintliga bälten på båren och bara en tredjedel av dessa applicerade dessutom bältena på ett korrekt och ändamålsenligt sätt. Två olika bårar användes i studien. På bår B användes axelbälten i högre utsträckning än på bår A. Den vanligaste orsaken till att axelbälten inte användes var att vårdaren rutinmässigt inte brukade använda dessa. Detta gällde för urvalet i allmänhet och för bår A i synnerhet. Utbildningsmetod och användningsgrad av det egna säkerhetsbältet i vårdhytten påverkade inte vårdarens benägenhet att använda patientens säkerhetsbälten vid transport på bår. Av studiens resultat kunde slutsatsen dras att säkerhetsbältesanvändningen i ambulansen har stor förbättringspotential. Resultatet påvisade tydliga brister i användningen av bårens säkerhetsbälten vid patienttransport. Att säkerhetsbältesanvändningen för patienterna i ambulansen förs upp till diskussion, anser forskarna, är mycket viktigt för att främja såväl patientsäkerheten som trafiksäkerheten och ambulanspersonalens arbetsmiljö. / Ambulances frequently drive at high speed, at all hours and all through the year. In case of a collision there is a significant risk of injury to patients and staff alike if seat belts are not used properly. To guarantee the safety of patients and staff while travelling in the ambulance high standards are set for the fitting and medical technical equipment of the vehicle. Travelling in the back of an ambulance has shown an increased risk of injury and death compared to other workplaces in the nursing community. Several studies have been conducted regarding the use of seat belts use for the ambulance staff, but not when it comes to the use of seat belts on the ambulance stretcher. The aim of this study was to high-light the use of seat belts on the ambulance stretcher in transporting adult patients in the ambulance. This was accomplished by the collection of data regarding the use of seat belts and the staff’s view on some central concepts. This was achieved by using a questionnaire as method. The result showed that patients did not go completely without seat belts and that the waist belt was the most commonly used seat belt. The belt for the lower part of the leg was the least used. Barely a third of the staff in the study used all of the available seat belts on the stretcher, and only a third of those that did, used it in accordance with the instructions from the manufacturer. Two different types of stretchers were used in the study. On stretcher B the shoulder straps were used more frequently than on stretcher A. The most common reason for not using the shoulder straps was that the personnel routinely chose not to use them. This applied for the sample as a whole, and more significantly for the users of stretcher A. The method of learning and to what degree the staff used their own seat belts did not correlate to the tendency of using belts on patients. From the result of the study the conclusion can be drawn that the use of seat belts in the ambulance has great potential for improvement. The result pointed to evident deficiencies in the use of seat belts on the stretcher in patient transport. The researchers believe that bringing attention to the use of seat belts for patients in ambulance transportation is very important in promoting patient safety, traffic safety and working environment for the staff.

Event data recorders (EDRs) are an invaluable data source that have begun to, and will increasingly, provide novel insight into motor vehicle crash characteristics. The "black boxes" in automobiles, EDRs directly measure precrash and crash kinematics. This data has the potential to eclipse the many traditional surrogate measures used in vehicle safety that often rely upon assumptions and simplifications of real world crashes. Although EDRs have been equipped in passenger vehicles for over two decades, the recent establishment of regulation has greatly affected the quantity, resolution, duration, and accuracy of the recorded data elements. Thus, there was not only a demand to reestablish confidence in the data, but a need to demonstrate the potential of the data. The objectives of the research presented in this dissertation were to (1) validate EDR data accuracy in full-frontal, side-impact moving deformable barrier, and small overlap crash tests; (2) evaluate EDR survivability beyond regulatory crash tests, (3) determine the seat belt accuracy of current databases, and (4) assess the merits of other vehicle-based crash severity metrics relative to delta-v. This dissertation firstly assessed the capabilities of EDRs. Chapter 2 demonstrated the accuracy of 176 crash tests, corresponding to 29 module types, 5 model years, 9 manufacturers, and 4 testing configurations from 2 regulatory agencies. Beyond accuracy, Chapter 3 established that EDRs are anecdotally capable of surviving extreme events of vehicle fire, vehicle immersion, and high delta; although the frequency of these events are very rare on U.S. highways. The studies in Chapters 4 and 5 evaluated specific applications intended to showcase the potential of EDR data. Even single value data elements from EDRs were shown to be advantageous. In particular, the seat belt use status may become a useful tool to supplement crash investigators, especially in low severity crashes that provide little forensic evidence. Moreover, time-series data from EDRs broadens the number of available vehicle-based crash severity metrics that can be utilized. In particular, EDR data was used to calculate vehicle pulse index (VPI), which was shown to have modestly increased predictive abilities of serious injury compared to the widely used delta-v among belted occupants. Ultimately, this work has strong implications for EDR users, regulatory agencies, and future technologies. / Ph. D.