Roadway incidents involving motorized vehicles accounted for 24% of fatal occupational injuries in the United States during 2013 and were the leading cause of fatal injuries among workers. In 2013, workers’ compensation costs for serious, nonfatal injuries among work-related roadway incidents involving motorized land vehicles were estimated at $2.96 billion. Seat belt use is a proven method to reduce injuries to motor vehicle occupants. Use of lap/shoulder seat belts reduces the risk for fatal injuries to front seat occupants of cars by 45% and the risk to light truck occupants by 60%. To characterize seat belt use among adult workers by occupational group, CDC analysed data from the 2013 Behavioural Risk Factor Surveillance System (BRFSS) and found that not always using a seat belt was significantly associated with occupational group after controlling for factors known to influence seat belt use. Occupational groups with the highest prevalences of not always using a seat belt included construction and extraction; farming, fishing, and forestry; and installation, maintenance, and repair. To increase seat belt use among persons currently employed, states can enact and enforce primary seat belt laws, employers can set and enforce safety policies requiring seat belt use by all vehicle occupants, and seat belt safety advocates can target interventions to workers in occupational groups with lower reported seat belt use. BRFSS is an annual, state-based, random-digit—dialled landline and cell phone survey of noninstitutionalized adults aged 18 years or over residing in the United States. In 2013, all states asked survey participants about seat belt use. Industry and occupation were first available on the BRFSS survey in 2013, and 21 states asked currently employed respondents about their industry and occupation. This report describes self-reported seat belt use by occupational group among workers in those 21 states who were employed for wages or self-employed at the time of the interview. All responses to the question about frequency of seat belt use except “always” (i.e., “nearly always,” “sometimes,” “seldom,” and “never”) were combined and categorized as “not always.” Participants’ responses were coded to 2002 U.S. Census Bureau occupation numeric codes. Census occupation codes were then grouped for analysis into 2000 Standard Occupational Classification (SOC) System major groups. Records with missing occupation codes or that were not able to be coded because of insufficient information were excluded, as were records where the seat belt responses were blank, “don’t know/not sure,” “never drive or ride in a car,” or “refused.” Because BRFSS data are not representative of active duty service members, the 263 respondents who worked in the armed forces also were excluded. Results were stratified by type of seat belt law in the state of residence because type of law is known to be associated with seat belt use. Fourteen of the 21 states had primary seat belt laws in 2013; in these states, a driver can be stopped and ticketed solely for not using a seat belt. Six states had secondary seat belt laws; in these states, a driver can be ticketed for not using a seat belt only if stopped for another offense. New Hampshire had no seat belt law covering adults§§ and was grouped with the secondary law states. Data were weighted and analysed to account for the complex BRFSS multistage sampling design. The prevalence of not always using a seat belt was estimated by occupational group and sociodemographic characteristics. Adjusted prevalences, stratified by type of seat belt law, were estimated with logistic regression controlling for the potential confounders of age, sex, race/ethnicity, education, marital status, body mass index, and county urbanization. All statistically significant interaction terms between occupational group and confounders, including the interaction between occupational group and type of seat belt law, were included in the model. County of residence was classified as metropolitan (codes 1—3), urban (4—7), or rural (8—9), based on the U.S. Department of Agriculture’s 2013 Rural-Urban Continuum Codes. Among the 21 states, the overall survey response rates ranged from 31.1% to 59.2%. Data from 84,593 respondents were included in the analysis, including 54,187 (64%) who lived in states with primary seat belt laws and 30,406 (36%) who lived in states with secondary seat belt laws. The prevalence of not always using a seat belt varied by age, sex, race/ethnicity, education, marital status, body mass index, and county urbanization, and for each characteristic, was higher in states with secondary seat belt laws. For all occupational groups combined, the crude prevalence of not always using a seat belt was 10.4% in states with primary seat belt laws and 23.6% in states with secondary seat belt laws. For every occupational group, the prevalence was higher in states with secondary seat belt laws. Crude prevalences ranged from 5.4% (business and financial operations) to 18.0% (construction and extraction) in the states with primary seat belt laws and from 8.1% (life, physical, and social science) to 55.5% (farming, fishing, and forestry) in states with secondary seat belt laws. Among workers in the transportation and material moving group, which includes several occupations that involve frequent driving, 12.4% and 33.7% in states with primary and secondary seat belt laws, respectively, did not always use a seat belt. Among all occupational groups, the adjusted prevalence of not always using a seat belt was higher in states with secondary seat belt laws. The highest adjusted prevalences in states with primary seat belt laws were observed in the construction and extraction (14.1%); legal (14.0%); installation, maintenance, and repair (12.8%); protective service (12.7%); and farming, fishing, and forestry (12.7%) occupational groups. In states with secondary seat belt laws, the highest adjusted prevalences were in the farming, fishing, and forestry (38.1%); construction and extraction (32.1%); installation, maintenance, and repair (27.0%); building and grounds cleaning and maintenance (25.9%); and protective service (25.4%) occupational groups. Percentage-point differences between adjusted prevalences of states with primary and secondary seat belt laws ranged from a low of 2.0 (life, physical, and, social science) to a high of 25.5 (farming, fishing, and forestry). (Author/publisher)
Samenvatting