Seat belt use among car drivers in Iranian safe communities: An observational study

Objective: The number of road traffic injuries and fatalities in Iran is high. The aim of the present study was to investigate the rate of drivers' seat belt use and a number of related factors in Kashmar, Bardaskan, and Khalilabad (Iranian Safe Communities).Methods: In 2014, driver observations were made at 48 road sites on intercity roads, main streets, side streets, and rural roads in these 3 cities.Results: A total of 10,255 vehicles were observed, with the overall rate of seat belt use being 51.8%. The rates in Kashmar, Bardaskan, and Khalilabad were 51.4, 56.3, and 47.7%, respectively. In Kashmar, the odds of seat belt use were higher among drivers who were female, older, and taxi drivers. Higher use was also found during the afternoon, and lower use was observed on rural roads. In Khalilabad the odds of seat belt use were higher among females, older drivers, taxis, and private car drivers. Seat belt use was also higher on weekends and during the morning but was significantly lower on rural roads. Similarly, in Bardaskan the odds of using a seat belt were higher among females, older drivers, taxis, and private car drivers. Seat belt use was also higher during the afternoon but was significantly lower on rural roads, in comparison to main streets and intercity roads.Conclusions: The rate of seat belt use in these 3 cities was found to be low, despite these cities being designated as International Safe Communities. Therefore, seat belt promotion programs, tougher regulations, stronger enforcement, public awareness campaigns, and more research are needed to promote seat belt use in these Iranian cities.