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American Journal of Epidemiology Advance Access originally published online on December 12, 2007
American Journal of Epidemiology 2008 167(5):546-552; doi:10.1093/aje/kwm336
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American Journal of Epidemiology © The Author 2007. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Using Head-on Collisions to Compare Risk of Driver Death by Frontal Air Bag Generation: A Matched-Pair Cohort Study

Elisa R. Braver1,2, Joseph A. Kufera1, Melvin T. Alexander1, Marge Scerbo1, Karen Volpini1 and Joseph P. Lloyd1

1 National Study Center for Trauma and Emergency Medical Systems, Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD
2 War-Related Illness and Injury Study Center, Washington DC VA Medical Center, Washington, DC

Correspondence to Dr. Elisa R. Braver, National Study Center for Trauma and EMS, 701 West Pratt Street, Room 526, Baltimore, MD 21201 (e-mail: elisabraver{at}gmail.com).

Received for publication June 26, 2007. Accepted for publication October 23, 2007.

US air bag regulations were changed in 1997 to allow tests of unbelted male dummies in vehicles mounted and accelerated on sleds, resulting in longer crash pulses than rigid-barrier crashes. This change facilitated depowering of frontal air bags and was intended to reduce air bag–induced deaths. Controversy ensued as to whether sled-certified air bags could increase adult fatality risk. A matched-pair cohort study of two-vehicle, head-on, fatal collisions between drivers involving first-generation versus sled-certified air bags during 1998–2005 was conducted by using Fatality Analysis Reporting System data. Sled certification was ascertained from public information and a survey of automakers. Conditional Poisson regression for matched-pair cohorts was used to estimate risk ratios adjusted for age, seat belt status, vehicle type, passenger car size, and model year for driver deaths in vehicles with sled-certified air bags versus first-generation air bags. For all passenger-vehicle pairs, the adjusted risk ratio was 0.87 (95% confidence interval: 0.77, 0.98). In head-on collisions involving only passenger cars, the adjusted risk ratio was 1.04 (95% confidence interval: 0.85, 1.29). Increased fatality risk for drivers with sled-certified air bags was not observed. A borderline significant interaction between vehicle type and air bag generation suggested that sled-certified air bags may have reduced the risk of dying in head-on collisions among drivers of pickup trucks.

accidents, traffic; air bags; automobiles; government regulation; seat belts


Abbreviations: FARS, Fatality Analysis Reporting System; NHTSA, National Highway Traffic Safety Administration; SUV, sport utility vehicle


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RE: "USING HEAD-ON COLLISIONS TO COMPARE RISK OF DRIVER DEATH BY FRONTAL AIR BAG GENERATION: A MATCHED-PAIR COHORT STUDY"
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