Why Mumbai’s imposition of a front/back seat belt rule can save lives

Now that Mumbai has made wearing front and back seat belts mandatory while travelling in cars, it is being seen as a much-needed measure that should be applied all over India. This is pertinent because of India’s road crash severity. According to data SaveLife Foundation, our country is at the top of the risk pyramid with 38.6 deaths per 100 crashes. Maharashtra, in fact, is the third state in the country to have regered the highest number of road crash deaths after Uttar Pradesh and Tamil Nadu.
“Medical literature is full of several studies across the world, citing the importance of passenger seat belts and saving lives. In a Spanish study, researchers found that up to 24 per cent of fatalities in a car accident were because people were not wearing a seatbelt. An article published the National Highway Traffic Safety Adminration clearly says that in 2017, up to 14,955 lives were saved and up to 51 per cent people, who lost lives in a road crash in 2020, were unrestrained. Though coming from a developed country, our Indian roads have certainly improved over the last 20 years as have cars in terms of performance, speed and luxury. So, the fact that a seatbelt saves lives is highly relevant to us as well,” says Mumbai’s renowned critical care special, Dr Rahul Pandit.

In India, according to the recent data from the National Crime Records Bureau, road crashes claimed 1.55 lakh lives in India in 2021. The United Nations General Assembly has set an ambitious target of halving the global number of deaths and injuries from road traffic crashes 2030. As per the US Center for Disease Control and Prevention, wearing seat belts reduces one’s risk of suffering injuries or death about half. The US reports some of the highest car crashes in the world. Its Department of Transportation has conducted studies that indicate of the 23,824 passenger vehicle occupants killed in 2020, 51 per cent were not wearing seat belts — a four per cent increase from 2019. Seat belts saved an estimated 14,955 lives in the US and could have saved an additional 2,549 people if they had been wearing seat belts in 2017 alone.
“Not just life, but seat belt use front and rear passengers will restrain them from being ejected from their seat or in a high impact collision, even being thrown out of the car, thus saving them from severe facial, head, spine and thoracic injuries. A study Kahane in 2015 clearly indicated that one can reduce fatality and critical injury to the tune of 50 per cent wearing a seat belt,” adds Dr Pandit.
“In my clinical practice, I have seen several trauma patients who have been unfortunate victims of road accidents, and have suffered severe injury in a crash due to being unrestrained. Facial, spinal and head injuries are grievous and can be fatal. Though a whiplash injury to the spine may be difficult to prevent, certainly the severity of it can be reduced in patients who wear a seat belt,” he says.
Arguing for both frontal and rear seat belts, automobile expert Tutu Dhawan says, “It’s basic science and mathematics that we all tend to ignore. It is important to know what happens to your body during a crash. Suppose you are driving on a highway at plus 120 kmph, your body too is travelling at the same speed. So when your car hits an obstacle or brakes suddenly, your car stops with a wobble but not your body. Your body will lurch forward like a torpedo with nothing to hold you in place. You would be thrown forward with such speed that you would hit the front row and even the dashboard hard. Imagine the brute force of body momentum and mass and even two co-passengers can collide with each other and injure each other fatally. The rear seat passenger can hit the front seat passenger and driver and injure them seriously.”

Dr Mayur Kardile, consultant spine surgeon at Pune’s Jehangir Hospital, says, “Motor vehicles these days have greater safety features with airbags, lane departure prevention systems and so on. But what people forget is that the first line of defence is a seat belt.” Dr Shrikrishna Joshi, Vice-President, Lokmanya Group of Hospitals, Pune, has dealt with many car crash victims who suffer from polytrauma. “This means that apart from a severe head injury, there is a heavy impact on the ribs and spine with femur fractures,” he adds.
So how does a seat belt protect you? Dr Neeraj Adkar, Head of the Department of Orthopaedics at Ru Hall Clinic, Pune, says, “Depending on the speed at the time of impact, seat belts help the body absorb the force and disperse it to the shoulder and hips, the parts of the body that can handle the impact strongest. The seat belt also contains spinal injuries, which can lead to death or loss of organs.”
So how should you buckle up? “Make sure that the lap and shoulder belts are tightly secured across the stomach and rib cage without slipping off, as these parts are better able to brace up and absorb the shock. The most common make we make is to place the top belt near our necks and the bottom across our hips, leaving the crucial torso unprotected. The right fit is important,” advises Dhawan.