1 Hawaii Strategic Highway Safety Plan: SEAT BELT USE/OCCUPANT PROTECTION Dan Galanis Injury Prevention and Control Program Hawaii Department of Health 1250 Punchbowl St., Room 214 Honolulu, HI Ph:

2 Overview of presentation Fatal traffic crashes (292 crashes, killing 335 residents) –State/national comparisons (CDC data) –Overall data (FARS) Trends, county comparisons Associated factors among drivers: age, gender, speeding, alcohol/drug use, time, day of week, etc. Non-fatal traffic crashes –Seating position, county comparisons, trends, age MVAR/DOT crash data –Descriptions of injuries Hospital and emergency department (ED) records Trauma Registry data (Queen’s Hospital) Data from observational studies

3 Percent of fatally injured occupants who were not wearing seat belts, by state, HI Percent unrestrained for Hawaii: 53% (40 th ) Percent for rest of U.S.: 57% % not restrained

4 Rates of non-use of seat belts among fatally injured occupants, in Hawaii, by seat position,

5 Unrestrained occupants killed in traffic crashes in Hawaii, by county,

6 Characteristics of drivers involved in fatal crashes in Hawaii, *indicates statistically significant difference between restrained and unrestrained drivers Unrestrained drivers (139)Restrained drivers (267) Age average32.8 years*39.7 years ages 15 to 29 years51%*39% Gender (% male)80%*71% Speeding56%*28% Any contributing factor (driver error)75%*54% Licensing problem (none, suspended, etc.) 18%*8% Alcohol use63%*23% Drug positive37%*13% Impaired driver79%*32% Fatality rate73%*42% Weekend crash (Saturday-Sunday)35% Nighttime crash (8 pm - 4 am)71%*42%

7 The “injury pyramid” for injuries to car occupants in Hawaii Deaths* 1 (67/yr.) Hospitalizations* 12 : 1 death (~810/yr.) Emergency department visits* 91 : 1 death (~6,100/yr.) Traffic crashes (police attended) 77 : 1 death (~5,170/yr., including 2,510 “possible” injuries) *Includes only residents of Hawaii

8 Rates of non-use of seat belts among occupants involved in non-fatal traffic crashes in Hawaii, by seat position,

9 Unrestrained occupants involved in non-fatal traffic crashes in Hawaii, by county, *denotes statistically significant trend over 5-year period

10 Unrestrained occupants involved in non-fatal traffic crashes in Hawaii, by age,

11 Unrestrained occupants involved in non-fatal traffic crashes in Hawaii, by age and gender,

12 Injury status of occupants involved in major traffic crashes in Hawaii, by restraint status,

13 Seatbelt use: 66% (2 in 3) –Higher for drivers (72%) vs. passengers (54%) Restrained occupants were less likely to: –Have a TBI (41% vs. 62% for unrestrained) –Have a spinal cord injury (1.3% vs. 2.4% for unrestrained) –Have a fatal injury (1.3% vs. 4.1% for unrestrained) Alcohol use among those (49%) tested –More common among unrestrained occupants (49%), compared to restrained occupants (37%) –More common among unrestrained drivers (52%), compared to restrained drivers (35%) Car occupants admitted into the Queen’s Trauma Registry,

14 Data from observational studies of occupant safety

15 Observed seat belt use rates among front seat occupants in Hawaii, by county, a indicates observations collected from January-March of that year, b indicates observations collected during June of that year

16 Observed seat belt use rates among front seat occupants in Hawaii, 2005 Restraint use is higher for: –Drivers than in passengers (95.8% vs. 94.0%) –Occupants of cars than in trucks (96.5% vs. 92.3%) –Occupants in high traffic volume than in low traffic volume (95.5% vs. 91.5%) –Occupants in high speed zones (55 mph) than in low speed (<25 mph) zones (96.4% vs. 92.7%) –Occupants traveling in morning than in afternoon/evening (96.3% vs. 94.7%)

17 How much? *53% of deaths to occupants (32 residents each year) * Only about 4% of those in non-fatal crashes, but non-use is directly related to injury severity *Decreasing trends across the state (increasing use) Who? *Younger occupants in general *toddlers (2-3 yrs.) and teens. Males somewhat Where? *Generally comparable across counties Maui somewhat higher Why? *Associations with alcohol and drug use, speeding, and other high risk behaviors among drivers Data summary for non-use of seat belts among occupants

18 Observed car seat use rates among child occupants in Hawaii, by county,

19 Fatal crashes Fatal crash/FARS data –Traffic only, i.e. crashes on public roads Excludes crashes in parking lots, driveways, military bases, gated sub-divisions, etc. –Includes only “passenger vehicles”—cars, pickups, SUV’s, vans, etc. Excludes motorcycles, mopeds, buses, limo’s, large trucks (semi’s, 3+ axles, 6+ tires) –Unintentional in nature Excludes deaths of undetermined intent (3 crashes, 1% of total) –Excludes 19 crashes (6%) that did not involve a Hawaii resident fatality –Excludes 6 crashes (2%) that only involved fatalities among truck bed passengers –Final sample: 335 resident occupants killed in 292 crashes