The effects of mandatory seat belt wearing on the mortality and pattern of injury of car occupants involved in motor vehicle crashes in Victoria.

Compulsory seat belt wearing, first introduced in the world in Victoria in 1970, has effectively reduced the number of deaths and injuries for car occupants involved in motor vehicle crashes, whilst those for the unprotected pedestrian and pedal and motor cyclist have continued to increase. This legislation does not apply to children under the age of eight years, only 5.5% of whom travel restrained in motor cars, and their death and injury patterns remain unchanged. Seat belts offer the most remarkable protection for car occupants involved in frontal-impact collisions. However, a high percentage of car occupants who are the recipients of a side impact in a collision receive serious multiple injuries, particularly chest and pelvic injuries, and seat belts offer little protection except that head injuries are less common when a seat belt is being worn. Compulsory lateral strengthening of motor vehicles must be introduced in Australia. Ten per cent of car occupants admitted to hospital after frontal-impact collisions show injuries directly attributable to the wearing of seat belts. These include fracture of the clavicle, bruising and fracture of the sternum, cardiac tamponade, abdominal contusions and bowel lacerations. Seat belts, to be fully effective, must be fitted correctly. There is definite room for improvement in seat belt design.