title: Association between exposure/non-exposure to the mandatory seat belt law with regards to compliance in vehicle accident victims--a hospital review.
abstract: OBJECTIVE
  Injuries sustained in motor vehicle accidents (MVAs) are a major challenge to the Jamaican healthcare system. In November 1999, Jamaica enacted legislation to make seat belt usage in motor vehicles compulsory. The effect of this policy change on seat belt usage is unclear. This study therefore sought to determine the prevalence of seat belt usage and to determine the association between exposure/non-exposure to the mandatory seat belt law and seat belt use in subjects who presented to the Accident and Emergency Department (A&E) of the University Hospital of the West Indies (UHWI) as a result of motor vehicle accidents.
  
  
  METHODS
  Subjects were recruited from June to November 2003, post-seat belt law (POBL) period, and May to October 1999, pre-seat belt law (PRBL) period. Data collected included demographic variables, seat belt use and position of the occupants in the vehicle.
  
  
  RESULTS
  Of the 277 patients who were eligible for inclusion, data were complete in 258 subjects, 87 in the PRBL period and 171 in the POBL period. The prevalence of seat belt use was 47% (PRBL) and 63% (POBL) respectively. There was no significant gender difference at each period. The odds of wearing seat belt in the rear of a motor vehicle were significantly lower than that of a driver (Table 3, OR 0.19, 95% CI 0.07, 0.48). Adjusting for age, gender and position in vehicle exposure, there was about 100% increase in the odds of seat belt use during the post seat belt law era (OR = 2.09, 95% CI 1.21, 3.61).
  
  
  CONCLUSIONS
  It is concluded from this hospital-based study that the mandatory seat belt law legislature was associated with increased seat belt use in motor vehicle accident victims. However, current data from the Road Traffic Agency indicate that there is still an alarming number of fatalities. This clearly suggests that additional public health measures are needed to address the epidemic of motor vehicle trauma in Jamaica.
authors: Emergency Medicine Division, Department of Surgery, Radiology, Anaesthesia and Intensive Care, The University of the West Indies, Kingston 7, Jamaica, West Indies. verz3us@yahoo.com
authors: E W
authors: EW
authors: Williams
authors: M
authors: M
authors: Reid
authors: J L M
authors: JL
authors: Lindo
authors: J
authors: J
authors: Williams-Johnson
authors: S
authors: S
authors: French
authors: P
authors: P
authors: Singh
authors: A H
authors: AH
authors: McDonald
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001336:Automobiles / Q000331:legislation & jurisprudence* / Q000592:standards; D002648:Child; D005260:Female; D006291:Health Policy; D006293:Health Promotion; D006306:Health Surveys; D006801:Humans; D007563:Jamaica; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D011634:Public Health / Q000331:legislation & jurisprudence*; D012307:Risk Factors; D017751:Safety Management; D012622:Seat Belts / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D040241:Social Marketing; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000517:prevention & control*