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ObjectiveAdvanced occupant protection systems in motor-vehicles (e.g., seat belts and airbags), while widely adopted for front-seat passengers, are either absent or offer disproportionally lower safety to rearseat passengers in similar crashes. Optimization of advanced restraint systems for the rear-seat environment will require a detailed understanding of epidemiology and associated risk factors for injuries sustained by rear-seat passengers. Thus, the objective of the study is to use national level motor-vehicle travel and crash data to quantify rear-seat travel exposure, and determine the descriptive characteristics and the injury outcomes for rear-seat passengers involved in frontal collisions. MethodsWhile U.S. travel data from the 2009 National Household Travel Survey was used to determine rear-seat travel estimates, crash data from 2001 to 2010 National Automotive Sampling System Crash Worthiness Data System was used to enroll rear-seat passengers injured in a frontal crash. The descriptive epidemiology of rear-seat crash victims was separately done for the three age-groups: children (8 to 15 (8-15 years old), adults (16 to 59 (16-59 years old), and senior adults (60+). ResultsThe study indicated that senior adults in rear-seats were associated with a significantly higher rate of sustaining fatal (6%) and severe injuries (16% for MAIS 3+ injuries) in comparison to the younger cohorts. The distribution of severe injuries further indicated that the thorax was the most frequently injured region across all age groups irrespective of the belt-use status. ConclusionsFindings of the study conclude that while rear-seat travel in the U.S. is still very low and improving belt usage is a primary concern among rear-seat passengers; however, the epidemiology supports the need for adapting rear-seat restraint performance for effective protection for all groups of rear-seat passengers.Keywords: Rear seat passenger; seatSeat belt; motorMotor vehicle crash; airbagAirbag; frontalFrontal crash; optimizedOptimized restrain systems trips in a motor-vehicle involve a rear-seat passenger , and rear seat occupants are present in approximately 13-17% of all tow-away collisions (Parenteau and Viano, 2003). As a result of low-exposure, rear-seat passengers are responsible for less than 10% of overall fatalities and injured victims (USDOT,(USDOT, 1997. Consequently, this cohort of vehicle passengers has traditionally received less attention than front seat occupants in terms of targeted injury countermeasures and understanding of the relative risk factors applicable to the rear-seat environment ).Various studies indicate that for children, a car's rear seat is safer than the front seat (Smith and Cummings, 2004;Kuppa et al., 2005). Moreover, recent research indicate that the fatality and injury-reducing efficacy of the rear seat highly depends on the passenger's age since the rear seat has been reported to be less safe than the front seat for older persons. Kuppa et al. (2005) reported a greater fatality risk for rear s...

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