title: Trends of behavioral risk factors in motor vehicle crashes in Utah, 1992-1997.
abstract: OBJECTIVE
  Measure changes in the prevalence of behavioral factors including police-reported fatigue and alcohol intoxication, as well as self-reported seatbelt use, and assess their effect on hospitalization or death after a motor vehicle crash.
  
  
  METHODS
  Probabilistic linkage was used to match drivers in motor vehicle crashes with hospital discharge records for the years 1992-1997. Frequencies of specific behavioral factors were evaluated using the Cochran-Armitage test for trend. Odds ratios and corresponding 95% confidence intervals were calculated using generalized estimating equations (GEEs) with crash and driver characteristics as independent variables and hospitalization or death as the dependent variable.
  
  
  RESULTS
  The analysis database consisted of 450,286 crash driver records, which linked to 4219 (0.9%) hospitalizations or deaths. There was an increasing trend for self-reported seatbelt use among crash-involved drivers from 80.5% in 1992 to 89.3% in 1997 (P<0.001). Police-reported alcohol intoxication among crash-involved drivers showed a decreasing trend from 2.4% in 1992 to 1.5% in 1997 (P<0.001). There was no trend for police-reported fatigue-related crashes. Odds ratios of hospitalization or death for seatbelt use, alcohol involvement, and fatigue were significant and did not fluctuate considerably between 1992 and 1997. Seatbelt use offered a protective effect from hospitalization or death, while alcohol intoxication and fatigue contributed to increased likelihood of hospitalization or death.
  
  
  CONCLUSIONS
  These results suggest that while some improvement has been made in decreasing seatbelt non-use and driver alcohol intoxication among crash-involved drivers, no improvement has been made in reducing fatigue-related crashes.
authors.affiliation: TraumaLink, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Smith
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Cook
authors.forename: Lenora M
authors.initials: LM
authors.lastname: Olson
authors.forename: James C
authors.initials: JC
authors.lastname: Reading
authors.forename: J Michael
authors.initials: JM
authors.lastname: Dean
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data* / Q000639:trends*; D000428:Alcohol Drinking / Q000453:epidemiology; D001334:Automobile Driving / Q000706:statistics & numerical data*; D005221:Fatigue / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016017:Odds Ratio; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012424:Rural Population / Q000706:statistics & numerical data; D012622:Seat Belts / Q000706:statistics & numerical data; D014589:Utah / Q000453:epidemiology