국내 성인에서 체질량지수에 따른 안전벨트 착용률:국민건강영양조사 제6기(2013–2015) 자료 = Body Mass Index and Seatbelt Use in Korea: Analyzing the Sixth Korea National Health and Nutrition Examination Survey (2013–2015)

다국어 초록 (Multilingual Abstract)

Background: The prevalence of obesity in Korea is continuously increasing, and there are several international studies that suggest obese populationsare not likely to wear seatbelts when driving a car. Even though the rate of seatbelt use in Korean adults is 79.8%, which is much lower than 94% forOECD countries, no studies have been conducted related to this particular issue in Korea. This study was conducted to determine the relationshipbetween body mass index (BMI) and seatbelt use in Korea where BMI standards, laws, cultures, and social conventions totally differ from those ofwestern countries.
Methods: This study was conducted on 8,556 drivers, aged 19 or older, using raw data from the 6th Korea National Health and Nutrition ExaminationSurvey (2013–2015). A stratified and cross-sectional analysis was used to figure out seatbelt use rates according to BMI, and a multivariable logisticregression analysis was used to determine the odds ratio (OR) of seatbelt use by BMI groups.
Results: Increase in BMI resulted in a decrease in seatbelt use. The extremely obese group particularly had much lower rates of seatbelt use comparedto other groups. After adjusting other variables, only the extremely obese group had much lower rates of seatbelt use (OR 0.68, 95% confidenceinterval 0.53–0.87).
Conclusion: Seatbelt use rates according to BMI had no significant differences between the non-obese group, the overweight group, and the obesegroup. However, the extremely obese group had a tendency to not wear seatbelts when driving a car.

국문 초록 (Abstract)

연구배경: 국내 비만 유병률은 지속적으로 증가하는 추세이며, 비만한 운전자들은 정상 체질량지수를 가진 운전자들보다 안전벨트착용률이 떨어진다는 연구결과들이 외국에서 꾸준히 제기되어 왔다. 국내의 경우, 성인의 안전벨트 착용률은 79.8%로 크게 낮은 편임에도 불구하고, 이와 관련된 연구는 전무한 상황이다. 서양과는 비만에 대한 체질량지수 기준치, 법과 문화, 사회적 통념이 다르게 적용되는 국내환경에서의 체질량지수와 안전벨트 착용률의 관계를 확인하고자 연구를 진행하였다.
방법: 본 연구는 제6기 국민건강영양조사(2013–2015년) 원시자료를활용하여 19세 이상 성인 운전자 8,556명을 대상으로 하였다. 체질량지수에 따른 안전벨트 착용률을 교차분석 및 층화분석을 통해확인해보고, 독립변수로 체질량지수, 성별, 연령, 교육수준, 소득수준, 지역, 직업변수를 보정하여 체질량지수 정상군에 대한 과체중군, 비만군, 그리고 고도비만군의 안전벨트 착용률의 승산비를 로지스틱 회귀분석을 통해 평가하고자 하였다.
결과: 정상군, 과체중군, 비만군, 고도비만군으로 체질량지수가 증가할수록 안전벨트 착용률은 72.0%, 70.1%, 69.3%, 60.1%로 점점 떨어지는 결과가 나타났으며, 특히 고도비만군의 경우는 60.1%로 정상군, 과체중군, 비만군의 경우보다 큰 차이로 낮은 착용률을 보였다(P<0.001). 다른 변수들을 보정한 후의 과체중군(adjusted OR 1.00,95% CI 0.88–1.14), 비만군(adjusted OR 1.02, 95% CI 0.89–1.17)의 안전벨트 착용률은 정상군에 비해 유의미한 차이가 없었으며, 고도비만군의 경우에만 착용률이 크게 떨어지는 결과를 보였다(adjustedOR 0.68, 95% CI 0.53–0.87).
결론: 국내 체질량지수에 따른 안전벨트 착용률은 과체중군과 비만군에서는 정상군과 큰 차이가 없으나, 고도비만군의 경우 착용률이 크게 떨어지므로, 이에 대한 사회적 관심과 대책이 필요할 것으로 보인다.

참고문헌 (Reference)

1 World Health Organization, "The Asia-Pacific perspective: redefining obesity and its treatment" Health Communications Australia 55-, 2000

2 Behzad B, "Seatbelt usage : is there an association with obesity" 128 : 799-803, 2014

3 Sunshine J, "Seat-belt use in US counties: limited progress toward healthy people 2020 objectives" 36 : 636-639, 2017

4 for Diseases Control and Prevention, "Seat belts: get the facts" Center for Diseases Control and Prevention

5 Price JH, "Seat belt use among overweight and obese adolescents" 36 : 612-615, 2011

6 Glassbrenner D., "Safety belt use in 2005--use rates in the states and territories. Traffic safety facts research note" NHTSA 7-, 2006

7 Beck LF, "Rural and urban differences in passenger-vehicle-occupant deaths and seat belt use among adults-United States, 2014" 66 : 1-13, 2017

8 Shin HY, "Recent trends in the prevalence of underweight, overweight, and obesity in Korean adults: the Korean National Health and Nutrition Examination Survey from 1998 to 2014" 27 : 413-419, 2017

9 World Health Organization, "Obesity: preventing and managing the global epidemic" WHO 2000

10 Jehle D, "Obesity and seatbelt use : a fatal relationship" 32 : 756-760, 2014

11 Zhu S, "Obesity and risk for death due to motor vehicle crashes" 96 : 734-739, 2006

12 Lee LK, "Motor vehicle crash fatalities in states with primary versus secondary seat belt laws : a time-series analysis" 163 : 184-190, 2015

13 Whitlock G, "Is body mass index a risk factor for motor vehicle driver injury? A cohort study with prospective and retrospective outcomes" 32 : 147-149, 2003

14 Kahane CJ, "Fatality reduction by safety belts for front-seat occupants of cars and light trucks: updated and expanded estimates based on 1986-99 FARS data" National Highway Traffic Safety Administration 80-, 2000

15 Gillum RF, "Ethnic variation in validity of classification of overweight and obesity using self-reported weight and height in American women and men : the Third National Health and Nutrition Examination Survey" 4 : 27-, 2005

16 Centers for Disease Control, "Comparison of observed and self-reported seat belt use rates--United States" 37 : 349-351, 1988

17 Lichtenstein MJ, "Body mass as a determinant of seat belt use" 297 : 233-237, 1989

18 Schlundt DG, "BMI and seatbelt use" 15 : 2541-2545, 2007

19 WHO Expert Consultation, "Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies" 363 : 157-163, 2004

20 Korea Road Traffic Authority, "2016 summary of traffic accident analysis" KoROAD 230-, 2016

21 National Highway Traffic Safety Administration, "2015 motor vehicle crashes:overview. Traffic safety facts research note" NHTSA 9-, 2016

22 Korea Road Traffic Authority, "2015 comparative analysis of traffic accidents in OECD countries" KoROAD 70-, 2015

23 Korea Centers for Disease Control and Prevention, "2008-2015 community health survey" Korea Centers for Disease Control and Prevention 641-, 2016