title: Association of seat belt use with death: a comparison of estimates based on data from police and estimates based on data from trained crash investigators.
abstract: OBJECTIVE
  Estimates of any protective effect of seat belts could be exaggerated if some crash survivors falsely claimed to police that they were belted in order to avoid a fine. The aim of this study was to determine whether estimates of seat belt effectiveness differed when based on belt use as recorded by the police and belt use determined by trained crash investigators.
  
  
  METHODS
  Matched cohort study.
  
  
  METHODS
  United States.
  
  
  METHODS
  Adult driver-passenger pairs in the same vehicle with at least one death (n=1689) sampled from crashes during 1988-2000; data from the National Accident Sampling System Crashworthiness Data System.
  
  
  METHODS
  Risk ratio for death among belted occupants compared with those not belted.
  
  
  RESULTS
  Trained investigators determined post-crash seat belt use by vehicle inspections for 92% of the occupants, confidential interviews with survivors for 5%, and medical or autopsy reports for 3%. Using this information, the adjusted risk ratio for belted persons was 0.36 (95% confidence interval 0.29 to 0.46). The risk ratio was also 0.36 using police reported belt use for the same crashes.
  
  
  CONCLUSIONS
  Estimates of seat belt effects based upon police data were not substantially different from estimates which used data obtained by trained crash investigators who were not police officers. These results were from vehicles in which at least one front seat occupant died; these findings may not apply to estimates which use data from crashes without a death.
authors.affiliation: Harborview Injury Prevention and Research Center and the Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington 98104, USA. peterc@u.washington.edu
authors.forename: P
authors.initials: P
authors.lastname: Cummings
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D015982:Bias; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016495:Police / Q000706:statistics & numerical data; D012307:Risk Factors; D012622:Seat Belts / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology