NEW YORK (Reuters Health) - Two new studies reaffirm that seat belts are lifesavers, but one questions how much protection driver-side air bags afford.

In the air bag study, researchers found that driver-side air bags were associated with an 8% reduction in death risk, regardless of whether the driver was wearing a seat belt. In contrast, drivers wearing a seat belt were 65% less likely to die in a crash than unbelted drivers were. Wearing a seat belt and having an air bag cut the death risk by 68%, according to findings published in the May 11th issue of the British Medical Journal.

"While driver air bags offer some protection against death, seat belts offer much more protection," said the study's lead author, Dr. Peter Cummings of the University of Washington in Seattle.

If drivers want to cut their odds of dying in a crash, they should strap on their seat belts, he told Reuters Health.

Cummings and his colleagues base their conclusions on records of US passenger-vehicle crashes between 1990 and 2000. They looked specifically at more than 51,000 accidents involving someone in the front passenger seat, in which the driver, passenger or both died.

In general, driver air bags appeared to provide more protection to women than men--which is surprising, the researchers say, as there have been reports of short women being killed by the force of deployed air bags. As a possible explanation, they speculate that men, being generally heavier than women, may more easily "overcome" the cushioning of the air bag and strike the steering column.

Cummings noted that the study findings do not offer insight into the effectiveness of passenger or side-impact air bags.

In the second study, conducted in Canada, researchers found that seat belts appeared to offer at least as much protection to school-age children as they do adults. This has been a question because seat belts are designed for an adult's anatomy.

Dr. Stephen I. Halman and colleagues at the Hospital for Sick Children in Toronto found that among 470 children aged 4 to 14, those wearing seat belts were far less likely than unbelted children to sustain a serious injury or die in a crash. This was particularly true of kids riding in the front passenger seat.

And, the researchers report, "despite standard seat belts being designed for adults, school-age children were at least as well protected as adults."

Unfortunately, Halman's team points out, 40% of the children studied were not wearing a seat belt at the time of the crash.

"Therefore," they write, "the most critical issue identified in this study is the need to urge parents and guardians to 'buckle up' their children."

The US National Highway Traffic Safety Administration states that infants and toddlers should always ride in car seats, and young children shorter than 4 feet, 9 inches should use booster seats designed for use with a vehicle's shoulder and lap belts. All children younger than 12 should ride in the back seat, according to the agency.

And Halman's team points out that their findings do not mean that standard adult belts alone provide school-age children with the best protection.

A third report in the same journal issue--dedicated to road safety--suggests that not enough attention has gone to protecting pedestrians struck by cars. However, the same principles of car design that have saved passengers' lives can be focused on protecting pedestrians, biomechanics researchers at the University of Virginia in Charlottesville suggest.

For example, they write, front hoods that "pop up" slightly in a crash could prevent a struck pedestrian from slamming into the windshield. And better-designed bumpers might reduce serious lower-limb injuries.

According to the report authors, the European Enhanced Vehicle-Safety Committee has developed tests and rating systems for pedestrians' injury risk from vehicle front-end structures. European automotive makers have proposed a voluntary move to make all new cars introduced after 2010 comply with the committee's standards.

SOURCE: British Medical Journal 2002;324:1119-1122, 1123-1125, 1145-1148.

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