In the last five years, over 300 people who died in New Zealand crashes were not wearing their seat belt.

Most of those deaths were in 2016.

The Herald, partnered by the New Zealand Police has launched Belt Up - a four day series about seatbelt safety aiming to raise awareness and improve safety for all Kiwis on our roads.

Police say many of the 93 people who died in crashes last year while not properly restrained, could have survived had they been wearing a seatbelt.

Today we find out why people don't belt up.

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Our message is simple.

Seatbelts save lives - Belt Up New Zealand.

In 2016 just under 100 people were killed on New Zealand roads in crashes where they were unrestrained.

There were also 404 people injured in crashes where they were not wearing seatbelts, or restrained in car seats.

Some of those people escaped with minor injuries - broken bones, cuts, concussions and things that will heal over time - more than a third suffered damage to their bodies that they will struggle with for the rest of their lives.

Head injuries, brain damage, paralysis - for 179 of those injured while not wearing a seatbelt, life will never ever be the same.

Of those injured, 170 were unrestrained drivers and the rest were passengers who, if they had only put their seatbelt on, could have walked away from their crash unscathed.

Along with the personal cost, there is a social and economic cost associated with suffering an injury in a crash.

The Ministry of Transport estimates that the social cost of a fatal crash is $4,729,000.

Each serious crash bears a social cost of $912,000 and every minor crash reported racks up $99,000.

Dr Dominic Fleischer has been at the coal face of a lot of those crashes for the past nine years.

The emergency medicine specialist works on the shop floor of Christchurch Hospital's emergency department and also co-chairs the trauma committee, keeping tabs on the incidents and injuries patients come through the doors with each day.

Christchurch Hospital, where Dr Dominic Fleischer treats people who have been injured in car crashes where they have not been wearing seatbelts. NZME photograph
Christchurch Hospital, where Dr Dominic Fleischer treats people who have been injured in car crashes where they have not been wearing seatbelts. NZME photograph

Many of those injuries are the result of car crashes, and a significant portion of those are people who were unrestrained.

Fleischer said the most concerning injury pattern crash victims presented with when they had not been wearing a seatbelt were spinal including paraplegia and tetraplegia - both severe forms of permanent paralysis.

"With a high speed motor vehicle accident you'll get every single pattern of injury you can imagine - severe head injury, chest and abdominal trauma, pelvic trauma and all your limb injuries," Fleischer said.

"But it's the spinal group that tend to stand out for patients who are unrestrained in motor vehicle crashes; we just seem to notice that with patients who are unrestrained, spinal injuries are a common diagnosis.

"Invariably, they're permanent... we're talking about lifelong problems."

Fleischer said there were hundreds of other injuries that could be sustained during a crash where a seatbelt was not worn, but generally he focuses on the most traumatic end of the scale.

"It's quite common to see patients who are ejected from vehicles which is generally a hallmark of being unrestrained," he said.

"If you are wearing a seatbelt, generally you stay in the vehicle when you have your collision.

"But there are a number of patients we come across who have been ejected - either thrown through the windscreen or a door, and to do that you basically have to have not been wearing a seatbelt; otherwise you'd have been kept in the car.

"Injuries then are not only injuries from a collision but injuries from whatever the impact outside of the vehicle are - they multiply."

Last year 94 people died in crashes where they were unrestrained. File photograph
Last year 94 people died in crashes where they were unrestrained. File photograph

No part of the human body was safe in a crash, and that risk significantly amplified when there was no seatbelt - the most simple way of preventing serious harm.

"MVAs injure every part of the body, the most common injury pattern will be to limbs; arm and leg fractures," Fleischer explained.

"But there can also be head injuries, chest trauma, broken ribs, punctured lungs and then all your abdominal trauma - damage to your organs like your spleen and your liver and pelvic fractures and your spine.

"When spinal injuries do occur they are significant, because obviously they are with the patient for the rest of their life."

The effects of such injuries were not only felt by patients.

"From a hospital point of view they take a huge amount of resource," said Fleischer.

"If a patient is going to be cared for by multiple specialities and be in hospital for not just weeks but sometimes months or years - they might be transferred to a spinal unit and they will spend a long long time there before they get back out, if they ever do, into the community again.

"I'm pretty sure that doesn't enter anyone's thoughts when they belt up - it's difficult for someone who's not familiar with the health system to realise what the injuries are and how permanent they are going to be."

He said when a person suffered such horrendous injuries there was a ripple effect in terms of who was affected.

"The whole community will be impacted - their loved ones, their family, their employers, the wider community but the hospital as well," said Fleischer.

"You're talking about a patient who will take up a bed for weeks to months, so that's a bed that won't be available for that length of time for somebody else.

"We're talking about patients that can cost in the genuine millions of dollars - it's a significant cost to that patient, their family and us."

Fleischer would like nothing better than to never see another patient badly injured through not wearing a seatbelt.

"It's a thoughtless two-second thing to get in and drive without being belted up," he said.

"The message is certainly out there, but the consequences are not something you actively think of when you get in a car.

"It's really simple - belt up.

"That's the ultimate message."

• Safety belts save lives.

• They support you if you're in a crash or when a vehicle stops suddenly.

• The force on safety belts can be as much as 20 times your weight - this is how hard you'd hit the inside of your vehicle without restraint.

• Wearing a safety belt reduces your chance of death or serious injury in a crash by 40 per cent.

• Whether you sit in the front or the back seat, the risk of serious or fatal injury is virtually the same.

• NZ law requires drivers and passengers in cars and other motor vehicles to wear seat belts and child restraints.

• In the last five years, over 300 people who died in NZ crashes were not wearing their seat belt.

• Many of these people would still be alive today if they were safely wearing their seat belt.

(Source NZTA, MOT, NZ Police)