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Unbelted motorists risk neck injury from air bags

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Air bags have never been an excuse for failing to “buckle up,” but a new study finds that, in a crash, seat belt shirkers are actually more likely to suffer neck injuries in a car equipped with air bags than in one without air bags.

Without seat belts holding drivers and front-seat passengers in the correct position, the air bag becomes a weapon that deploys at 140 to 220 miles an hour, said Dr. William F. Donaldson III, chief of spinal surgery at the University of Pittsburgh School of Medicine.

A Pitt analysis of 86,000 people injured in frontal collisions in Pennsylvania from 1990 to 2002 found that unbelted occupants in cars with air bags were 1.7 times more likely to suffer a broken neck and 2.4 times more likely to have spinal cord injury than those who both used seat belts and had air bags.

People who neither used seat belts nor had air bags also did poorly —- 1.3 times greater risk of neck fracture; 1.8 times greater risk of spinal cord injury —- compared with belted drivers who had air bags. But they didn’t fare as poorly as unbelted drivers and passengers in cars with air bags.

With air bags now in three out of every five cars on the road, this increased risk to unbelted occupants is a growing concern, Donaldson said, and will only get worse as the percentage of air bag-equipped cars increases. In Pennsylvania, he added, one out of four drivers fail to buckle up regularly.

“It’s a new pattern of injury,” said Donaldson, who presented the study last month at the annual meeting of the International Society for the Study of the Lumbar Spine in Porto, Portugal.

John Ulczycki, spokesman for the National Safety Council, said he hadn’t seen the Pitt study, but noted that many previous studies have shown that unrestrained drivers and passengers suffer more neck and spinal cord injuries than belted occupants, regardless of whether the car has air bags or not.

“It really has to do with the force of the body being thrown” in a frontal collision, not with the air bag, Ulczycki said.

Donaldson said he was prompted to do the study by what he was seeing in the UPMC Presbyterian trauma center: what seemed to be a growing number of collision victims showing up at the hospital with neck injuries, despite the fact that an air bag had deployed and they had not been thrown out of the vehicle.

He guessed that the patients not only were out of position when the air bags deployed, but that the lack of restraints caused the forward motion of their heads to accelerate in frontal collisions, relative to the vehicle, even as the air bags were deploying rapidly in the opposite direction.

Donaldson emphasized that the study focused only on neck fractures and spinal injuries. It did not account for other spinal fractures or other injuries that might occur in front-end collisions.

Motor vehicle crashes account for about 42 percent of all spinal cord injuries, Ulczycki noted, and, according to one study, about three out of every five spinal cord injuries involve the neck, resulting in Quadriplegia.

Driver-side air bags have been federally required since 1987 and passenger-side air bags have been required since 1997.

People who fail to wear seat belts are at high risk for injury in collisions, regardless of whether air bags are available, Donaldson said. But those who think air bags alone give them at least some measure of protection may literally be putting their necks on the line.

“In a newer car,” he said, “you’d better wear a seat belt.”

By Byron Spice, Pittsburgh Post-Gazette

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