• Stephanie Blows, Rebecca Q Ivers, Jennie Connor, Shanthi Ameratunga, Mark Ameratunga, and Robyn Norton.
• The George Institute for International Health, University of Sydney, Sydney, Australia. sblows@thegeorgeinstitute.org
• Traffic Inj Prev. 2005 Jun 1; 6 (2): 117-9.

ObjectivesTo examine the relationship between seatbelt non-use at the time of a crash, habitual non-use of seatbelts, and car crash injury; and to calculate the population attributable risk for car crash injury due to seatbelt non-use.MethodsA population-based case control, interview study in Auckland, New Zealand, with 571 injured or killed drivers as cases and 588 population-based controls randomly selected from the driving population.ResultsUnbelted drivers had 10 times the risk of involvement in an injury crash compared to belted drivers after adjustment for multiple confounders. Habitual non-users were likely to be unbelted when involved in a crash. The population attributable risk for seatbelt non-use was 13%.ConclusionsNon-use of seatbelts is very strongly associated with increased injury crash involvement. Even where seatbelt use rates are higher than 90%, there remains a small group of habitual non-users who are at high risk; these drivers may benefit from targeted interventions.

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