Injury risk for matched front and rear seat car passengers by injury severity and crash type: An exploratory study

  • Published: Accident Analysis and Prevention Vol 82, 2015
  • Authors: R.J. Mitchell , M.R. Bambach, Barbara Toson
  • Date Added: 07 Dec 2015
  • Last Update: 07 Dec 2015
  • Format: html


To examine the injury severity risk for rear seat compared to front seat car passengers.


A retrospective matched-cohort analysis of vehicle crashes involving injured rear vs front seat car passengers identified in linked police-reported, hospitalisation and emergency department (ED) presentation records during 2001–2011 in New South Wales (NSW), Australia

Key Findings

  • Of the 10,007 car passengers in 3,681 vehicles identified in this study who were killed or injured in car crashes, 5,419 were front seat passengers and 4,588 rear seat passengers.

  • There was a higher odds of sustaining a higher injury severity as a rear-compared to a front seat car passenger, with a higher odds of rear seat passengers sustaining serious injuries compared to minimal injuries.

  • Where the vehicle occupant was older, travelling in a vehicle manufactured between 1990 and 1996 or after 1997, where the airbag deployed, and where the vehicle was driven on a road with a speed limit of 70 km/h or more there was a higher odds of the rear passenger sustaining a higher injury severity then a front seated occupant.

  • Rear seat car passengers are sustaining injuries of a higher severity compared to front seat passengers travelling in the same vehicle, as well as when travelling in newer vehicles and where the front seat occupant is shielded by an airbag deployed in the crash.

  • The increased risk of serious injury for rear seat passengers is likely to be due to the introduction of safety features aimed at front seat protection, such as frontal airbags.

  • Rear seat occupant protective mechanisms should be examined.

  • Pre-hospital trauma management policies could influence whether an individual is transported to a hospital emergency department.

  • Further examination of injury severity between rear and front seat passengers is warranted to examine less severe non-fatal injuries by car seating position and vehicle intrusion.