Motor vehicle crashes and seat belt compliance among law enforcement officers: A systematic literature review

Motor vehicle crashes (MVCs) remain a leading cause of injury and death in the United States, with seatbelt noncompliance identified as a key modifiable risk factor. While previous studies have focused on the general population, emerging evidence suggests that law enforcement officers (LEOs) face unique challenges that may further compromise seatbelt use. Enhancing compliance across both groups is critical to reducing MVC-related injuries and fatalities. This systematic literature review explored factors responsible for seatbelt noncompliance among drivers in the United States. Additionally, with a focus on LEOs, the review also seeks to determine whether any existing interventions or methods applicable to the general population can be specifically adapted for LEOs to enhance their compliance with seatbelt regulations. A systematic search of PubMed, IEEE Xplore, and Web of Science was performed to identify relevant articles published in English from January 2012 to December 2023. Articles were initially evaluated based on their titles and abstracts and then further reviewed and organized to ensure eligibility for inclusion in this study. The extracted data were analyzed to identify common risk factors, intervention outcomes, and recommendations made to improve seatbelt compliance. 227 articles were identified, of which 31 studies were eligible for the review. Four studies focused on LEOs’ seatbelt compliance, and 27 concentrated on the general population. The review identified multiple demographic, behavioral, and environmental risk factors contributing to seatbelt noncompliance, including lower education levels, younger age, male gender, rurality, and cultural risk perceptions. Primary enforcement laws, higher fines, and high-visibility enforcement campaigns were consistently associated with improved compliance in the general population. Among LEOs, unique occupational challenges—such as rapid vehicle egress requirements, interference from duty gear, and organizational culture—were found to hinder seatbelt use. Implementing robust primary enforcement policies and targeted public health interventions can significantly improve seatbelt compliance among the general driving public. Moreover, adapting these strategies to account for the unique operational challenges faced by LEOs is expected to improve their safety on duty. Future efforts should develop integrated approaches that combine legislative change, tailored training, and cultural shifts within law enforcement agencies to reduce MVC-related injuries and fatalities across all populations. • States with primary seatbelt laws have lower rates of motor vehicle crash fatalities than those with secondary laws. • Crash prevention programs can be an effective method in increasing seatbelt compliance. • LEOs' safety perception, driving attitudes, training, and agency policy determined their seatbelt compliance. • Among public, obesity, rurality, education, religiosity, and law enforcement determined seatbelt compliance.