To the Editor: We have read the article by Abbas et al¹ with interest. Seatbelt use compliance has been considered as a contributing factor in the higher death rate from traffic accidents in the Gulf Cooperation Council countries than in other high-income countries.¹ Road traffic collisions are a significant cause of mortality worldwide. In Iran, 27,000 people die annually in traffic accidents.^2,3 Seatbelt use has been mandatory since 2005 in Iran. Traffic mortalities consisted of 13% of all traffic collisions in the year prior to the enforcement of mandatory seatbelt use, while it was reduced to 9.7% in the first year after enforcement.4 Our experiences in Shahid Rajaayee Hospital, a referral trauma center in the south of Iran, are consistent with these results and in those victims used seatbelts in addition to reducing mortality, disabilities from brain damage and spinal injuries have been reduced.

Importantly and interestingly, rear passengers who usually do not use a seatbelt, accounting for a significant percentage of deaths from road traffic collisions and it seems seatbelt use in rear passengers is necessary and should be mandatory. This has been implemented as a component of a new law dealing with driving violations in Iran since May 2011. Also most cars have airbags today, if the seatbelt is not in use at the time of accident, with the inflation of the airbags, the risk of injury to the occupants due to the possibility of being thrown out, will be more.

References

1. Abbas AK, Hefny AF, Abu-Zidan FM. Seatbelt compliance and mortality in the Gulf Cooperation Council countries in comparison with other high-income countries. Ann Saudi Med 2011; 31(4): 347-350. 

2. Akbari M, Naghavi M, Soori H. Epidemiology of Deaths from injuries in the Islamic Republic of Iran. Eastern Medietr Health J 2006; 12: 50-8.

3. WHO: The global burden of disease. 2004 update Geneva: World Health Organization; 2004.

4. Soori H, Nasermoadeli A, Ainy E, Movahedi M, Mehmandar MR, Massoudei Nejhad MR, et al. The effect of mandatory seat belt use legislations on mortalities from road traffic injuries in Iran. Hakim Research Journal 2009; 12 (1): 48-54.