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Unlabelled: Growing evidence from data base and laboratory studies demonstrates effective occupant protection with the airbag supplemental restraint and seatbelt restraint system. Concern that drivers of vehicles equipped with airbags may assume adequate protection without concomitant seatbelt use prompted the study of unbelted occupant behavior in frontal crashes., Objective: To evaluate the crash protection afforded unbelted drivers in airbag-equipped vehicles., Design: Six laboratory sled tests were conducted with a production driver's side airbag and knee bolster restraint system but without a seatbelt restraint system., Materials and Methods: Four human cadavers and the Hybrid III dummy were used as occupants in 32 km/h and 48 km/h tests with a simulated mid-size vehicle., Measurements and Main Results: Head contact with the windshield/header region of the simulated vehicle and abdominal impingement on the lower rim of the steering wheel were noted in all tests. Autopsy examinations and radiographic images identified extensive spinal and thoracic trauma in addition to lower extremity and facial injuries. Injury Severity Scores were considered severe to critical for all occupants., Conclusions: The evidence suggests the need to emphasize the use of seatbelts in conjunction with airbags and to develop a redesigned airbag and knee bolster system to control occupant kinematics and loading more effectively.

Injuries to front seat occupants in tow-away crashes in the Charlottesville, Va, area were compared for 1 year before and 1 year after Virginia's seat belt use law took effect. Vehicle and occupant data were combined to examine crash and injury patterns. Reported seat belt use in crashes increased after the law, and there were substantial decreases in injuries. Front seat occupants were less likely to receive medical treatment following a crash in the postlaw period. The reduction in the number of injuries was greater for passengers in the right front seat than for drivers and for frontal crashes than for other types of crashes. The injury reduction effects occurred primarily through reductions in the number of head and face injuries, particularly those that occur from contact with windshields and instrument panels.