Testimony of Richard F. Healing
Member, National Transportation Safety Board
before the
Committee on Transportation
Missouri Senate
on
Senate Bill 1260 - Primary Safety Belt Enforcement
Jefferson City, Missouri
March 2, 2004


Good morning Chairman Dolan and members of the Transportation Committee. It is my pleasure to be here in Jefferson City to talk about strengthening your seat belt law.

I want to commend you for considering a measure that will so easily save motor vehicle occupants from crash-related deaths and injuries.

The National Transportation Safety Board is an independent Federal agency charged by Congress to investigate transportation accidents, determine their probable cause, and make recommendations to prevent their recurrence. The recommendations that arise from our investigations and safety studies are our most important product. The Safety Board has neither regulatory authority nor grant funds. However, in our 37-year history, organizations and government bodies have adopted more than 80 percent of our recommendations.

The Safety Board has recognized for many years that traffic crashes are this nation's most serious transportation safety problem. Every year, more than 90 percent of all transportation-related deaths are caused by highway crashes. The single greatest defense against highway fatalities is the seat belt. When used properly, seat belts reduce the risk of fatal injury to front seat passenger vehicle occupants by 45 percent and to back seat occupants by 44 percent.

Unfortunately, seat belt use in the United States remains significantly lower than seat belt use in other industrialized nations. Australia and Canada, for example, have use rates over 90 percent, while seat belt use in the United States is approximately 75 percent. Although 49 States require motor vehicle occupants to use seat belts, 29 States, including Missouri, allow only secondary enforcement of their seat belt laws. Secondary enforcement means that police officers cannot issue a citation for a seat belt violation unless the vehicle has been stopped for another reason.

The Safety Board recommended in June 1995 that States enact legislation that provides for primary enforcement of seat belt laws. In 1997, the Safety Board again called for the States to enact primary enforcement and to provide the political will that will enable law enforcement agencies to vigorously enforce this important lifesaving law. The Safety Board maintains a Most Wanted list of safety recommendations because of their potential to save lives. Primary Enforcement is one of the issues on that list, the one with a greater potential to save lives than any other on the list. It also has more potential to save lives than probably any other piece of legislation you will consider this year.

Today I want to discuss four elements that support the Safety Board's position on seat belt laws. First, seat belts are effective in reducing motor vehicle injuries and fatalities. Second, the remaining 21 percent of motor vehicle occupants who do not use seat belts engage more frequently in high-risk behavior. Third, the economic cost from the failure to use seat belts is substantial. Finally, primary enforcement seat belt laws do increase seat belt use.

Seat Belts Are Effective

Seat belts are the number one defense against motor vehicle injuries and fatalities. Seat belts restrain vehicle occupants from the extreme forces experienced during motor vehicle crashes. Also, seat belts prevent occupant ejections. Only 1 percent of vehicle occupants using seat belts are ejected. Unrestrained vehicle occupants are ejected 30 percent of the time. Seventy-three percent of persons who are totally ejected from a vehicle are killed. From 1975 through 2002, seat belts saved almost 165,000 lives nationwide. According to the National Highway Traffic Safety Administration (NHTSA), a nationwide seat belt use rate of 90 percent by front seat occupants would prevent an additional 5,000 deaths and 130,000 serious injuries each year.

One issue that particularly concerns the Safety Board is that not all seat belt laws apply to all motor vehicle occupants. In 31 States, including Missouri, the seat belt law permits back seat occupants to ride unrestrained. However, unbelted vehicle occupants frequently injure other occupants, and unbelted drivers are less likely than belted drivers to be able to control their vehicles. An article recently published in the Journal of the American Medical Association stated that a person's risk of death in a crash is associated with the restraint use of other occupants; in the study, the risk was lowest when all occupants were restrained.

Unrestrained Vehicle Occupants More Frequently Engage in High-Risk Behavior

Approximately 20 percent of motor vehicle occupants nationwide do not use seat belts. These drivers, who choose not to buckle up, tend to exhibit multiple high-risk behaviors and are more frequently involved in crashes. According to the National Automotive Sampling System (crash data composed of representative, randomly selected cases from police reports), belt use among motorists in crashes decreases with increasing crash severity.

Fatal crashes are the most violent motor vehicle crashes and can result from high-risk behaviors such as speeding and impaired driving. Unfortunately, people involved in fatal crashes also tend not to use their seat belts. While observational surveys have identified a 79 percent seat belt use rate, use in fatal crashes is significantly lower. From 1994 through 2002, 799,205 vehicle occupants were involved in fatal crashes. Of those 799,205 occupants, 303,291 died. Approximately 59 percent of the vehicle occupants who died were unrestrained. In Missouri, 8,847 vehicle occupants died, and 64 percent were unrestrained.

Alcohol-related crashes cause approximately 40 percent of motor vehicle fatalities, and impaired drivers are notorious for not using seat belts. Alcohol-related crashes are also responsible for 22 percent of the total economic cost of motor vehicle crashes. Primary enforcement seat belt laws can help police officers identify impaired drivers and can certainly reduce the death and injury rate associated with impaired driving, since everyone's best defense against drunk driving is a seat belt.

Teenagers are generally considered high-risk drivers because of their inexperience and immaturity. Teen drivers and their teen passengers have the lowest seat belt use rates. In an analysis by the Air Bag and Seat Belt Safety Campaign, it was reported that among fatally injured 16-to 19-year-old drivers in States with secondary enforcement seat belt laws, belt use is an abysmal 30 percent. Teenagers are our future, and we need to ensure that they get in the habit of using seat belts.

Economic Costs from the Failure to Use Seat Belts are Significant

Although opponents to primary enforcement seat belt laws claim that nonuse is a personal choice and affects only the individual, the fact is that motor vehicle injuries and fatalities have a significant societal cost. For example, the lifetime cost to society for each fatality is over $977,000, over 80 percent of which is attributed to lost workplace and household productivity. In 2002, more than 7,100 lives could have been saved if everyone had used a seat belt. Society would have saved almost $7 billion.

Each critically injured survivor of a motor vehicle crash costs an average of $1.1 million. Medical costs and lost productivity account for 84 percent for the most serious level of non-fatal injury. In a 1996 study, NHTSA found that the average inpatient cost for unbelted crash victims was 55 percent higher than for belted crash victims. In 2000 alone, seat belts could have prevented over 142,000 injuries.

While the affected individual covers some of these costs, overall, those not directly involved in crashes pay for nearly three-quarters of all crash costs, primarily through insurance premiums, taxes, and travel delay. In 2000, those not directly involved in crashes paid over $170 billion. Just for medical care, lost productivity, and other injury related costs, society annually pays an estimated $26 billion for motor vehicle injuries and deaths experienced by unbelted vehicle occupants, and a substantial part of this cost is publicly funded.

The emotional and financial costs to Missouri are just as staggering. In 2002, 707 people died while riding unrestrained in motor vehicles on Missouri's roads. Seat belts are 44 to 73 percent effective in preventing fatalities depending on the vehicle type and seating position for the occupant. Therefore, it is reasonable to estimate conservatively that approximately 311 of the unrestrained occupants would have survived crashes in 2002, saving Missouri about $300 million if they had buckled up.

Primary Enforcement Seat Belt Laws Do Increase Seat Belt Use

Primary enforcement seat belt laws can make a difference in seat belt use rates. With primary enforcement, police officers are authorized to execute a traffic stop and cite unbelted vehicle occupants without needing another reason for making the stop. According to the National Occupant Protection Usage Survey (June 2003), seat belt use in primary enforcement law States was 83 percent, while the belt use rate in secondary enforcement law States was only 75 percent. States that recently enacted primary enforcement seat belt laws experienced increased seat belt use rates ranging from almost 5 percent to almost 18 percent. The increased use is based on the perceived risk of being stopped.

Conclusion

Average American citizens, not just highway safety advocates, support primary enforcement. NHTSA conducted a survey in 2000 to determine the public's opinion on primary enforcement seat belt laws. Overall, 61 percent of the population surveyed supported primary enforcement. Among people from States with secondary enforcement seat belt laws, more than half approved of primary enforcement. Minority populations are greater proponents of primary enforcement than whites. For example, 72 percent of Hispanics surveyed and 68 percent of African Americans surveyed endorsed primary enforcement.

Key provisions of a comprehensive primary enforcement seat belt law should include coverage of all vehicle occupants in all seating positions, coverage of all vehicles, and sufficient penalties. By allowing police officers to stop vehicles directly for seat belt violations, Missouri shows that it takes seat belt use very seriously. There are additional benefits to allowing primary enforcement. For example, when police officers stop vehicles for traffic law violations, such as failure to use a seat belt, they often discover additional traffic or criminal violations that otherwise might have gone undetected. Additionally, changing from secondary enforcement to primary enforcement does not impose additional requirements on vehicle occupants.

The measure sponsored by Senator Dolan, SB 1260, will save lives and reduce injuries. Enacting this bill is the single most important life-saving and deficit reduction measure you can take this session. It costs nothing, but will save much. Thank you again for inviting the Safety Board to testify about this important problem. I would be happy to answer any questions you may have.