title: Using head-on collisions to compare risk of driver death by frontal air bag generation: a matched-pair cohort study.
abstract: US air bag regulations were changed in 1997 to allow tests of unbelted male dummies in vehicles mounted and accelerated on sleds, resulting in longer crash pulses than rigid-barrier crashes. This change facilitated depowering of frontal air bags and was intended to reduce air bag-induced deaths. Controversy ensued as to whether sled-certified air bags could increase adult fatality risk. A matched-pair cohort study of two-vehicle, head-on, fatal collisions between drivers involving first-generation versus sled-certified air bags during 1998-2005 was conducted by using Fatality Analysis Reporting System data. Sled certification was ascertained from public information and a survey of automakers. Conditional Poisson regression for matched-pair cohorts was used to estimate risk ratios adjusted for age, seat belt status, vehicle type, passenger car size, and model year for driver deaths in vehicles with sled-certified air bags versus first-generation air bags. For all passenger-vehicle pairs, the adjusted risk ratio was 0.87 (95% confidence interval: 0.77, 0.98). In head-on collisions involving only passenger cars, the adjusted risk ratio was 1.04 (95% confidence interval: 0.85, 1.29). Increased fatality risk for drivers with sled-certified air bags was not observed. A borderline significant interaction between vehicle type and air bag generation suggested that sled-certified air bags may have reduced the risk of dying in head-on collisions among drivers of pickup trucks.
authors: National Study Center for Trauma and Emergency Medical Systems, Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA. elisabraver@gmail.com
authors: Elisa R
authors: ER
authors: Braver
authors: Joseph A
authors: JA
authors: Kufera
authors: Melvin T
authors: MT
authors: Alexander
authors: Marge
authors: M
authors: Scerbo
authors: Karen
authors: K
authors: Volpini
authors: Joseph P
authors: JP
authors: Lloyd
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality*; D000328:Adult; D017278:Air Bags / Q000009:adverse effects* / Q000592:standards; D001334:Automobile Driving / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D001336:Automobiles / Q000331:legislation & jurisprudence*; D004869:Equipment Safety; D033161:Government Regulation; D006801:Humans; D008348:Manikins; D016017:Odds Ratio; D016012:Poisson Distribution; D011446:Prospective Studies; D040442:Public Health Informatics; D018570:Risk Assessment / Q000379:methods* / Q000706:statistics & numerical data; D012307:Risk Factors; D012622:Seat Belts / Q000009:adverse effects / Q000592:standards; D014481:United States / Q000453:epidemiology