title: Injury severity in relation to seatbelt use in Cape Town, South Africa: a pilot study.
abstract: BACKGROUND
  Injuries and deaths from road traffic collisions present an enormous challenge to the South African (SA) healthcare system. The use of restraining devices is an important preventive measure.
  
  
  OBJECTIVE
  To determine the relationship between seatbelt use and injury severity in vehicle occupants involved in road traffic collisions in Cape Town, SA.
  
  
  METHODS
  A prospective cohort design was used. Occupants of vehicles involved in road traffic collisions attended to by EMS METRO Rescue were included during the 3-month data collection period. Triage categories of prehospital patients were compared between restrained and unrestrained groups. Patients transferred to hospital were followed up and injury severity scores were calculated. Disposition from the emergency centre and follow-up after 1 week were also documented and compared.
  
  
  RESULTS
  A total of 107 patients were included in the prehospital phase. The prevalence of seatbelt use was 25.2%. Unrestrained vehicle occupants were five times more likely to have a high triage score (odds ratio (OR) 5.4; 95% confidence interval (CI) 1.5 - 19.5). Fifty patients were transferred to study hospitals. Although seatbelt non-users were more likely to be admitted to hospital (p=0.002), they did not sustain more serious injuries (OR 0.44; 95% CI 0.02 - 8.8).
  
  
  CONCLUSIONS
  The prevalence of seatbelt use in vehicle occupants involved in road traffic collisions was very low. The association between seatbelt non-use and injury severity calls for stricter enforcement of current seatbelt laws, together with the development and implementation of road safety interventions specifically focused on high-risk groups.
authors.affiliation: Division of Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa. nvhoving@sun.ac.za.
authors.forename: Daniël J
authors.initials: DJ
authors.lastname: Van Hoving
authors.forename: Clint
authors.initials: C
authors.lastname: Hendrikse
authors.forename: Rachel Jacoba
authors.initials: RJ
authors.lastname: Gerber
authors.forename: Marion
authors.initials: M
authors.lastname: Sinclair
authors.forename: Lee Allen
authors.initials: LA
authors.lastname: Wallis
mesh_terms: D000063:Accidents, Traffic / Q000145:classification / Q000706:statistics & numerical data; D000328:Adult; D016001:Confidence Intervals; D005260:Female; D023261:Glasgow Outcome Scale; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010865:Pilot Projects; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D012622:Seat Belts / Q000706:statistics & numerical data*; D013019:South Africa / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000628:therapy