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TUESDAY, Jan. 20 (HealthDayNews) -- It's not enough if you wear your seat belt; everyone else in the vehicle better buckle up as well.

In the event of an accident, "unrestrained" occupants can essentially become human projectiles, harming or even killing those who are strapped in, new research says.

"Overall, having somebody in the vehicle without a belt increases your risk of death by about 20 percent," says Dr. Peter Cummings, lead author of the study appearing in the Jan. 21 issue of the Journal of the American Medical Association.

Although the findings are not completely new, they add more credibility to an important dimension of car safety.

"There's tons of anecdotal evidence, case reports and previous studies that have certainly made a strong case for this, but this is probably the strongest evidence to date," says Scott Osberg, director of research for the AAA Foundation for Traffic Safety.

"We have known that being unbuckled is not only dangerous to the person who is not buckled, but can also be dangerous to other people, but this is the first time that I've heard of a study that has actually quantified it," adds Jackie Gillan, vice president of Advocates for Highway and Auto Safety.

The study authors analyzed data regarding U.S. traffic crashes from 1988 through 2000 from the National Highway Traffic Safety Administration's Fatality Analysis Reporting System. They looked only at pairs of occupants who were in the same car when it crashed.

Cummings and his co-author, Dr. Frederick P. Bivara, both core faculty members at the Harborview Injury Prevention and Treatment Center, part of the University of Washington in Seattle, looked at more than 70,000 vehicle crashes.

"If you're buckled up and in the front seat and somebody's directly behind you in the rear seat, it matters to you whether they are buckled up or not," Cummings says. "If they are not restrained, it increases your risk of death by about 20 percent."

"If somebody is in the back seat and wearing a seat belt, it's essentially as if there was nobody in the back seat," he adds. "If they're not belted, then in some crashes they can fly forward and kill you."

In the reverse situation (you are buckled up in the back seat and someone in the front seat is not buckled up), your risk of death is increased by about 22 percent.

If a person with no seat belt is sitting beside you, either in the front or back seat, your risk of death is increased by about 15 percent.

Previous research had shown that wearing a seat belt decreases your own risk of dying by about 60 percent.

What this study shows is that it does make a difference what other people do.

"Most of the people in the safety community have really tried to press the message buckle up for your own safety," Gillan says. "Now we have a study that says buckle up for your own safety as well as the safety of other people in the car. This is another compelling reason why everybody should be buckled up."

Not all states require adults in the back seat to buckle up. "This is ridiculous," Gillan says. "Buckling up should be for every person in every seat in a car, and not just for those who happen to be in the front. This study is showing that not only is it dangerous for those who are not belted in the back seat, but they're going to present an unbelievable threat and danger to those in the front seat. We're constantly battling with states to close the gaps, and this is another piece of research that is going to help us with the battle."

The study did not address the danger of unbuckled pets or cargo.

More information

For more on seat belts, visit the Advocates for Highway and Auto Safety or Buckle Up America.

(SOURCES: Scott Osberg, Ph.D., director, research, AAA Foundation for Traffic Safety, Washington, D.C.; Peter Cummings, M.D., core faculty member, Harborview Injury Prevention and Treatment Center, University of Washington, Seattle; Jackie Gillan, vice president, Advocates for Highway and Auto Safety, Washington, D.C.; Jan. 21, 2004, Journal of the American Medical Association)

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