Testimony of Honorable Kathryn O'Leary Higgins, Board Member
National Transportation Safety Board
before the
Senate Tranportation and Interstate Cooperation Committee
State of New Hampshire

On House Bill 383
Primary Enforcement Seat Belt Legislation
Concord, NH
April 20, 2009


Good morning Chairman Letourneau and members of the Committee. I am pleased to be here in Concord to testify on behalf of the National Transportation Safety Board regarding primary enforcement seat belt laws.

I want to commend you for considering this measure that will so easily save many 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 cannot mandate implementation of these recommendations. However, in our 41 -year history, organizations and government bodies have adopted more than 80 percent of our recommendations.

The Safety Board has recognized for many years that motor vehicle crashes are responsible for more deaths than crashes in all other transportation modes combined. Every year, more than 90 percent of all transportation-related deaths are caused by highway crashes. The single greatest defense against highway fatalities is a vehicle's seat belts. When used properly, seat belts reduce the risk of fatal injury to front seat vehicle occupants by 45 percent.

Unfortunately, seat belt use in the United States remains considerably lower than seat belt use in other industrialized nations. Australia and Canada, for example, have use rates well over 90 percent, while seat belt use in the United States is approximately 83 percent. Here in New Hampshire, it is slightly less than 70 percent. New Hampshire is the only State that does not require motor vehicle occupants to use seat belts.

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 can 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 the potential to save more lives than any other on the list. It also has the potential to save more 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 recommendation on primary enforcement seat belt laws. First, seat belts are effective in reducing motor vehicle injuries and fatalities. Second, the 18 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. Unbelted vehicle occupants frequently injure other occupants, and unbelted drivers are less likely than belted dnvers to be able to control their vehicles. Also, seat belts prevent occupant ejections. Only 1 percent of vehicle occupants using seat belts are ejected, while 30 percent of unrestrained vehicle occupants are ejected. In 2007, 76 percent of passenger vehicle occupants who were totally ejected from a vehicle were killed.

The National Highway Traffic Safety Administration (NHTSA) estimates that from 1975 through 2007, seat belts saved almost 242,000 lives nationwide. According to NHTSA, had all passenger vehicle occupants over age 4 used seat belts in 2007, an additional 5,000 deaths would have been prevented.Unfortunately, some motor vehicle occupants mistakenly believe that they are safer without a seat belt, that their vehicle and/or their air bag provides sufficient occupant protection, or that they will not be in a motor vehicle crash where seat belts would make a difference.

Unrestrained Vehicle Occupants More Frequently Engage in High-Risk Behavior

According to daytime observational surveys, approximately 18 percent of motor vehicle occupants nationwide do not use seat belts. These dnvers, 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 is lowest in the most severe crashes.

Fatal crashes are the most violent motor vehicle crashes and can result from high-risk behaviors such as speeding and impaired dnving. Unfortunately, people who engage in these high-risk behaviors also tend not to use their seat belts. While observational surveys have identified an 83 percent seat belt use rate, use in fatal crashes is significantly lower. From 1998 through 2007, more than 820,000 vehicle occupants were involved in fatal crashes. Of those 820,000 occupants, more than 3 16,000 died. More than 53 percent of the vehicle occupants who died were unrestrained. In New Hampshire, for the same time period, more than 900 vehicle occupants died, and more than 68 percent were unrestrained.

Impaired drivers and teen drivers are also considered high-risk drivers. Seat belt use for these populations is substantially lower than the national observed belt use rate. In 2007, only 27 percent of fatally injured drivers who were violating their State's per se impaired driving statute (had a blood alcohol concentration at or above 0.08 percent) were using seat belts. As for teen drivers, researchers found that while belt use was low in States that authorize primary enforcement (47 percent), it was even lower in States with only secondary enforcement seat belt laws (30 percent).

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, NHTSA calculated that 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 2007, more than 5,000 lives and billions of dollars might have been saved if everyone had used a seat belt.

NHTSA estimates that each critically injured survivor of a motor vehicle crash costs an average of $1.1 million. Medical expenses and lost productivity account for 84 percent of the cost of 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 might have prevented more than 142,000 injuries.

While the affected individual covers some of these costs, 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 an estimated $170 billion for crashes the occurred that year; $21 billion, or 9 percent of total economic costs, were borne by public sources (federal and State government). Motor vehicle injuries and deaths experienced by unbelted vehicle occupants cost the Nation's taxpayers an estimated $26 billion just for medical care, lost productivity, and other injury related costs.

The emotional and financial costs to New Hampshire are just as staggering. In 2007, 76 vehicle occupants (age 18 and older) died; more than 70 percent were not using the available seat belts. NHTSA estimates that if everyone in New Hampshire used a seat belt, New Hampshire would prevent an additional 20 fatalities and more than 750 injuries, saving the State's taxpayers more than $85 million. In 2000, the most recent year for which data is available, the total economic cost of motor vehicle crashes that occurred in New Hampshire was more than $1 billion.

Primary Enforcement Seat belt Laws Do Increase Seat belt Use

Primary enforcement seat belt laws remain the best way to raise and maintain high 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 (September 2008), seat belt use in primary enforcement law States was 88 percent, while the belt use rate in secondary enforcement law States was only 75 percent. States that recently enacted primary enforcement seat belt laws have experienced increased seat belt use rates ranging from almost 5 to almost 18 percentage points. The increased use is based on the perceived risk of being stopped.

Conclusion

American citizens support primary enforcement. NHTSA conducted a survey in 2003 to determine the public's opinion on primary enforcement seat belt laws.(1) Overall, 64 percent of the population surveyed supported primary enforcement. Among people from States with secondary enforcement seat belt laws, more than half (56 percent) approved of primary enforcement. Minority populations are strong proponents of primary enforcement. For example, 74 percent of Hispanics surveyed and 67 percent of African Americans surveyed endorsed primary enforcement, as opposed to 62 percent of whites. Traffic crashes affect people of all ethnic backgrounds.

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 to promote compliance with the law. By allowing police officers to stop vehicles directly for seat belt violations, New Hampshire shows that it takes seat belt use very seriously.

The Safety Board believes that House Bill 383 will save lives and reduce injuries. Enacting this bill is likely the most important life-saving, injury mitigation, and health care cost 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.


Footnote:

1. U.S. Department of Transportation, National Highway Traffic Safety Administration, 2003 Motor Vehicle Occupant Safety Survey Volume 2 Safety Belt Report, DOT HS 809 789 (Washington, DC: NHTSA, 2004).