Unbelted Occupants

Executive Summary

Introduction

The AASHTO Strategic Highway Safety Plan identified 22 goals that need to be pursued to achieve a significant reduction in highway crash fatalities. The strategies are divided into three broad categories affecting drivers, vehicles, or the highway. User guides are planned to assist agencies with implementation. Strategy 8, which is located in the driver area, addresses the topic of occupant protection. This is a very broad topic that can include

  • Increasing use of seatbelts and child passenger and booster seats
  • Improving knowledge of airbag function
  • Designing generally safer and more forgiving vehicle interiors

This guide addresses means to increase the use of both seatbelts and child safety and booster seats. For this emphasis area, the phrase “child safety seats” includes all devices intended to protect younger passengers in vehicles, specifically rear-facing infant carriers and booster seats. This area also is focused on the added objective of ensuring proper use of child safety seats according to the age and size of the child.

Seatbelts began to appear in vehicles in the 1950s, and increasingly better systems were required in the decades thereafter. Use of seatbelts did not increase much above 10 percent, however, until mandatory use laws were enacted in the early 1980s. In the years since, every state but one has enacted a seatbelt use law. Laws mandating the use of child safety seats followed a similar pattern. The devices were little known until the late 1970s1 and were not widely used until laws mandating their use came into effect, just ahead of seatbelt use laws. These laws, however, remain inconsistent in terms of what age or weight child must be restrained, what restraint type is appropriate for what size child, and applicability of the law when a nonparent is transporting the child. In addition, and largely unlike seatbelts, proper use of these devices is as important as their use generally. While it is possible to misuse a seatbelt, it is far easier to improperly secure a child into a restraint and easier still to improperly secure the seat to the vehicle.

When mandatory seatbelt-use laws were enacted in most states, a police officer could take enforcement action only if unrestrained passengers were identified following a traffic stop for some other purpose. This type of law is generally referred to as a “secondary enforcement” law. That is, the seatbelt law could be enforced only secondary to another traffic offense. Now, more and more states are making failure to wear seatbelts a primary offense, which can be cited on its own. While secondary enforcement laws have been successful in raising restraint use above 50 percent, primary enforcement has produced the highest use rates seen in the United States (and internationally). The most effective single strategy for improving occupant restraint use rates is enactment of standard (primary) enforcement laws in all states.

While laws have proven very helpful in increasing occupant restraint usage, they alone are not sufficient to increase use. The public must be made aware of the laws and must have a reasonable expectation that the laws will be enforced.

For this project, however, the focus is more on what can be accomplished by single agencies or local coalitions. Therefore, this guide will suggest strategies for increasing

  • Public awareness of occupant restraint laws and the value of using restraints

  • Enforcement levels of those laws

Type of Problem Being Addressed

NHTSA survey data (see Exhibit I-1) show that occupant restraint use has improved across almost all classes of vehicle occupants. The first mandatory use law was passed by New York. By 1992, as more states enacted laws, approximately five of every eight (62 percent) occupants were restrained. As the new century has started, usage is approaching 80 percent, and only one state (New Hampshire) lacks a mandatory use law.

While usage rates have steadily increased, the rate of increase has slowed. This is a function of both the fact that percent changes become smaller as usage approaches 100 percent and the fact that the “easy” converts to restraint have buckled up—in other words, once 60 or 70 percent of the people are in seatbelts, increasing the usage rate by even 10 percent becomes very difficult. The challenge now is to increase restraint usage among those who have not yet accepted the educational or enforcement messages.

EXHIBIT I-1
National Seatbelt Use Rates, 1983-1986
Source: NHTSA City and State Surveys

As shown in Exhibit I-2, driving national usage rates to higher levels should have significant economic benefits as well as saving lives. Other studies have shown that those with the highest crash risk (generally young male drivers from less educated and lower socioeconomic classes) are also those with the lowest restraint usage rates. Therefore, even though the increases in percent usage will be smaller, the potential savings in both lives and economic loss can be proportionately higher.

Restraint use for children, especially infants and toddlers, is very high, exceeding 90 percent in recent national surveys. NHTSA states that these devices have been shown to be 71 percent effective in reducing the risk of death to infants and 54 percent effective in reducing deaths to children between the ages of 1 and 4. However, a 1996 study on child passenger safety conducted by the National Transportation Safety Board (NTSB) examined whether child restraint systems were properly used, and found that in 62 percent of the cases, the restraint was improperly secured in the vehicle and/or the child was improperly secured in the child restraint. This high level of child safety seat misuse was consistent with the findings of both a 1983 NTSB report and a 1985 NTSB symposium on child restraint misuse. The issue to be addressed concerning child restraints, then, is not their use generally; rather, it is ensuring proper use.

In addition, while all states do have child restraint laws, there is considerable variation among those laws. Some states have adopted what is considered a model law, covering children of all ages in all seating positions, regardless of who owns or is operating the vehicle. Other states have less satisfactory laws that do not cover all ages or seating positions or that exempt nonparent drivers from the law.

EXHIBIT I-2
Potential Savings with Increased Restraint Usage
Source: U.S. Department of Transportation, 1997

Objectives and Strategies for Resolving the Problem

Three objectives were identified for the occupant restraint area:

  1. Initiate programs to maximize use of occupant restraints by all vehicle occupants

  2. Insure that child and infant restraints are properly used

  3. Provide access to appropriate information, materials, and guidelines for those implementing programs to increase occupant restraint use

The intent of these objectives is to enable primarily local and regional entities, but also entire states, to implement programs to increase use of restraints and to ensure that those systems are properly used. Restraint use for adults varies across the states from just over 55 percent (Massachusetts) to more than 90 percent (California, Hawaii, and Washington). Many studies have been done on the effectiveness of occupant restraints, and they continue to show that vehicle occupants are about 50 percent more likely to be hospitalized from crashrelated injuries if they were not wearing a seatbelt at the time of the crash (Boyle and Sharp, 1997a, 1997c).

Targeted programs to increase restraint usage have been proven effective. Localities in some states have implemented programs that have increased local restraint use by 20 to 30 percentage points over statewide averages at the start of their program. Entire states have also implemented programs that have increased use substantially. Exhibit I-3 shows the restraint usage increases attained by states after implementation of the “Click It or Ticket” program throughout each of those states.

The combination of enforcement and public information campaigns appears to be the key to achieving meaningful, lasting increases in restraint usage. Recent studies by the Insurance Institute for Highway Safety (IIHS) (Insurance Institute for Highway Safety, 2001) show that public education efforts alone, without an enforcement component, are generally not successful.

EXHIBIT I-3
Click It or Ticket Seatbelt Use Rate Increases

The objectives are listed in Exhibit I-4, along with a series of strategies recommended for achieving them.

EXHIBIT I-4
Emphasis Area Objectives and Strategies

Objectives

Strategies

8.1 A Maximize use of occupant restraints by all vehicle occupants

8.1 A1 Conduct highly publicized enforcement campaigns to maximize restraint use.

8.1 A2 Provide enhanced public education to population groups with lower than average restraint use rates.

8.1 A3 Encourage the enactment of local laws that will permit standard enforcement of restraint laws.

8.1 B Insure that restraints, especially child and infant restraints, are properly used

8.1 B1 Provide community locations for instruction in proper child restraint use, including both public safety agencies and health care providers, that are almost always available.

8.1 B2 Conduct high-profile “child restraint inspection” events at multiple community locations.

8.1 B3 Train law enforcement personnel to check for proper child restraint use in all motorist encounters.

8.1.C Provide access to appropriate information, materials, and guidelines for those implementing programs to increase occupant restraint use

8.1.C1 Create state-level clearing houses for materials that offer guidance in implementing programs to increase restraint use.

1Infant carriers were common by this time and were often used for transporting very young children in autos, but they were not designed to be locked into the vehicle's occupant restraint system and offered virtually no crash protection to their occupants.