The Telegraph
Thursday , June 5 , 2014
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Rear seat-belt nudge after death

New Delhi, June 4: Gopinath Munde’s death has underlined the need for passengers even in the rear of vehicles to wear seat belts and stirred India’s health minister into calling for stronger enforcement of safety measures.

Union health minister Harsh Vardhan suggested today that Munde could have avoided the injuries in his cervical spinal region that took his life had he worn a seat belt when his car was struck by another car at an intersection here.

“I lost my friend to a misconception — most people think the back seat belts serve only a decorative purpose,” Harsh Vardhan said in a statement issued by the health ministry. “Wearing them is as important as wearing front seat belts — they can save lives.”

However, while agreeing that seat belts should be worn by all, some senior trauma specialists at the All India Institute of Medical Sciences (AIIMS) said the nature of the injuries that Munde suffered could not have been prevented by a seat belt.

Munde, sitting on the rear seat of a Maruti SX4, died on Tuesday morning after the left side of his car was struck by a Tata Indica. Trauma specialists said that while the collision was minor, Munde suffered a fatal injury that killed him within minutes.

The post-mortem report said Munde had suffered a “fracture separation of cervical vertebra between C1 and C2”, leading to a severe injury to the spinal cord. The blood vessels carrying blood supply to the brain stem — the seat of cardiac and respiratory activity — were disrupted, triggering cardiac and respiratory arrest.

“Movements of the neck are not restricted by seat belts,” a senior trauma specialist at AIIMS said. “The primary purpose of seat belts is to prevent the body from being thrown forward at high speed which can happen when a car abruptly stops after a head-on collision,” the specialist said.

The Indica struck Munde’s car on its left side. But the impact, according to a doctor who had spoken to Munde’s driver and his personal assistant, did not cause the minister’s car to suddenly decelerate. “Seat belts should be worn by all — those in the front seat and those in the back seat but, in this case, I don’t think a seat belt could have prevented the injury the minister suffered,” the doctor said.

Harsh Vardhan said his ministry would soon launch an initiative to expose people to driving safety protocols.

“Perhaps a system could be developed under which petrol and diesel sales can be denied to those who don’t use seat belts and helmets (on two-wheelers),” Harsh Vardhan said. “A new law along the lines in European countries is necessary to make not wearing seat belts or helmets punishable.”

WHO’s Global Report on Road Safety 2013 has pointed out that Indian regulations do not demand rear seat belts in all new and imported cars. In contrast, front and rear seat belts are required in all new and imported cars in the UK and the US.

In the UK, the seat-belt wearing rates are above 90 per cent for both front seats and rear seats, while in the US they are 84 per cent for front seats and 70 per cent for rear seats. A road safety survey in Bangalore, cited by the WHO report, found that only 27 per cent of drivers wear seat belts.

But police say the actual seat-belt wearing rates are likely to be much higher, particularly so in the cities across India where drivers and passengers are wary about being stopped by traffic police.

A US-based specialist in injury prevention said seat belts are of greatest use in frontal collisions when a vehicle is involved in a frontal crash, and they may have limited use in a side-impact collision.

“In a side-collision, a passenger is more likely to be propelled towards the side of the impact,” said Susan Baker, professor at the Johns Hopkins Bloomberg School of Public Health in the US. “Under such circumstances, seat belts may not prevent severe injury, but side airbags could help minimise injuries,” said Baker who has conducted research on motor vehicle crash fatalities among adults and children.

A study in the US published four years ago in the medical journal Accident Prevention and Analysis had found that seat belts can reduce the risk of serious injuries to the head, chest, and extremities by 50 per cent to 83 per cent.

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