2. Seatbelt Compliance in Singapore: How Useful are Trauma Registry Data for Injury Prevention?
Dr Wong Ting Hway
Department of General Surgery
Singapore General Hospital
TH Wong1, Zaw NN2, HC Chin3, S Koh4, SF Lim5, PL Ng4, H Hassan4, N Sani4, S T Chin6, S Yeo6, P Teo6, WW Lim7, K Go8, M T Chiu9, MJ Norhayati10 ,P L Chong10, CK Cheong5, V Ong11, P Iau12, HH Li2, MEH Ong13
1. Department of Surgery, Singapore General Hospital, Singapore
2. Health Service Research - Division of Research, Singapore General Hospital, Singapore
3. Department of Civil and Environmental Engineering, National University of Singapore, Singapore
4. Trauma Service, Changi General Hospital, Singapore
5. Department of Surgery, Changi General Hospital, Singapore
6. Trauma Service, National University Hospital, Singapore
7. Trauma Service, Khoo Teck Puat Hospital, Singapore
8. Trauma Service, Tan Tock Seng Hospital, Singapore
9. Department of General Surgery, Tan Tock Seng Hospital, Singapore
10. Trauma Service, Singapore General Hospital, Singapore
11. Department of Emergency Medicine, National University Hospital, Singapore
12. Department of General Surgery, National University Hospital, Singapore
13. Department of Emergency Medicine, Singapore General Hospital, Singapore

3. Disclosures -National Trauma Registry

4. Background National Trauma Registry in Singapore started in 2011
Goal was to collect injury-related data for policy and clinical use
Epidemiological data – demographics, mechanism of injury
Clinical data – injury severity score, revised trauma score
Outcomes – mortality, length of stay, functional scores
Optional “add-ons” include injury prevention fields
Each public hospital in Singapore has trauma data coordinators

5. Methods
Seat belt data collected at 5 of the 6 adult public hospitals in Singapore, different inclusion criteria
4866 known seat belt status (2011 to 2014)
Demographics (age, gender, race, residency status, work related ,drinking status and time )
Seat position-front seat, back seat or driver
Type of vehicle- Large Vehicle /Van/Truck ,Taxi or private)

6. Non-compliance of Seat Belt Use - Seat Positions
Non-compliance rate of seat belt in Singapore is 23.2 %.
Higher in rear seat passengers (66.5%)
But lower in rear front seat passengers (12.7%).
Drivers are most seat belt users as their non-compliance rate is only 8.6 %.

7. Among type of vehicles
Large vehicle /truck/van have highest non-compliance rate (43%)
Taxi have slightly higher non-compliance rate (26%) and
Lowest (14.7%) in private car

8. Age
Seat belt non wearer were generally have 6 year lower median age (33 year) compare to user (39 year).
Non-compliance is highest in lower age group (33%)
Became lower as age increased
Reached lowest in over 45 year group (46 to 55) with 16.7%
Increased again to over 55 and 65 groups with 19% and 22% respectively.

9. Sex ,work related and Citizens
Females tend to be more non-compliant seat belt user 29% compared to male (20%).
Work related vehicle occupant wear seatbelt more then non-work related vehicle trips-non-compliant rate is 16.3% compared to 23.3% respectively
Non-citizen have about twice the non-seatbelt use rate of 44.7% then citizen (20.5%).

10. Work Related and Citizen vs Non-Citizen

11. Race and Rush Hours Indian and other races have higher non-compliance
Seat belt use is only 35.8% in Indian compared to other races 50.1%

12. People tend to not use during rush hours in the morning (7-9 AM)
39.7% don’t use seatbelt in rush hours compared to other hours of the day (21.2%).
Weekend effect

13. Multivariable binary logistic regression analysis
Large Vehicle /Ven /Truck is significant
Compared to Taxi Large Vehicle /Ven /Truck occupants were seat belt times less
All seat positions are significant
Back seat occupant were seatbelt least
Drivers are time wear seatbelt than back seat occupants
Front seat occupants wear seatbelt time more than back seat occupants
Seat Position
Driver
2577
244
91.4%
8.6%
Adjusted OR/chi-square
14.017
.000
Front Seat Occupant
719
105
87.3%
12.7%
10.729
REFERENCE
Rear Seat Occupant
379
753
33.5%
66.5%

14. Conclusion and Q&A
Seat belt campaign should prioritize their target to Large Vehicle/Van/Truck and Rear Seat Occupants
Should be aware of specific time point and on particular day of weeks to get maximum result for prevention/ education
Recommend to do population based study to understand more about noncompliance