The Status Of Occupant Protection In America
Vehicle occupants account for 87 percent of all traffic deaths. When
used properly, safety belts help prevent deaths and reduce injuries.
In 2002, safety belts prevented an estimated 14,164 fatalities, saving
more than $50 billion in medical care, lost productivity, and other
injury-related costs. If ALL passenger vehicle occupants over age 4
were restrained in safety belts, an additional 7,153 lives could have
been saved in 2002.
Motor Vehicle Crashes—The Scope of the Problem
In 2001, deaths and injuries resulting from motor vehicle crashes
were the leading cause of death for persons of every age from 4 through
33-years-old. On average, every 13 minutes, someone in America dies
in a motor-vehicle-related crash, and every 10 seconds, someone is
injured. In 2002, traffic crashes claimed 42,815 lives and resulted
in nearly 3 million injuries. Each year, crashes lead to about 4
million emergency department visits and 500,000 hospitalizations.
Approximately 2 million Americans are disabled by crashes each year.
Potential Benefits of Safety Belt Use
Increasing the national safety belt use rate from 75 percent (the rate
observed in 2002) to 90 percent would:
- Prevent an estimated 4,100 fatalities
- Prevent an estimated 60,000 serious injuries
- Prevent an estimated 50,000 minor injuries annually.
our economy approximately $11.6 billion annually.
The economic cost-savings
cited above are derived from reduced productivity losses, property
damage, medical costs, rehabilitation costs, legal and court costs,
emergency services costs, insurance administration costs, traffic
delay, and reduced costs to employers.
The Effectiveness of Safety Belts
From 1975 through 2002, safety belts are estimated to have
saved 164,753 lives. Research has shown that lap/shoulder belts,
when used properly, reduce the risk of fatal injury to front-seat
passenger car occupants by 45 percent and the risk of moderate
to critical injury by 50 percent. For light-truck occupants,
safety belts reduce the risk of fatal injury by 60 percent
and moderate-to-critical injury by 65 percent.
Safety belts are 80-percent effective in reducing fatalities in
light trucks (including sport utility vehicles [SUVs]) during
rollover crashes. They also help prevent individuals from being totally
ejected during a crash, thus reducing the risk of a fatal injury.
Despite the effectiveness of safety belts in preventing injuries
and fatalities, 59 percent of passenger vehicle occupants killed
in 2002 were unrestrained.
The Effectiveness of Child Safety Seats
Child safety seats, when used correctly, are extremely effective
in preventing injuries and deaths during crashes. From 1975 through
2002, an estimated 6,567 young lives were saved by child restraint
systems. An estimated 376 lives of children under age 5 were saved
in 2002 alone. If 100 percent of children younger than 5 years
of age were properly placed in child safety seats, an estimated
485 lives (that is, an additional 109 lives) could have been saved
Research on the effectiveness of child safety seats has found them
to reduce fatal injury in passenger cars by 71 percent for infants
and 54 percent for toddlers. For infants and toddlers in light
trucks, the corresponding reductions are 58 percent and 59 percent,
respectively. In 2002, 459 children younger than 4 years of age
were killed in passenger vehicle crashes. Of these fatalities,
185 children (or 40 percent) were totally unrestrained.
In spite of these high use rates, the challenge of educating parents
and other caregivers on the correct use of child restraints still
remains. According to data from the National SAFE KIDS Campaign,
the vast majority of child restraints are used incorrectly. The
campaign analyzed errors identified while checking nearly 38,000
child safety seats and safety belts from February 2001 to May 2002.
Overall, 81.6 percent of the child restraints were used incorrectly,
with an average of three errors per restraint. The SAFE KIDS data
found the highest proportion of errors in rear-facing infant seats
and forward-facing toddler seats with harnesses, as follows:
- The safety
belt did not lock the seat tightly for 62 percent of children
in rear-facing seats and 67 percent of children in forward-facing
- Harness straps were loose for 65 percent of
children in rear-facing seats and 67 percent of children in forward-facing
For safety belts, the most common errors were:
shoulder belt was not over the center of shoulder (78.9 percent).
child’s legs did not bend over the vehicle seat without
slouching (75.1 percent).
- Lap belt
was not over upper thighs (70.6 percent).
on these findings is available at www.safekids.org.
State and Regional Trends in Safety Belt Use
According to NHTSA’s National Occupant Protection Use Survey (NOPUS),
safety belt use continued an upward trend in 2002, reaching 75 percent—its
highest level since national surveys began in 1994.
Up 2 percentage points from 2001, this increase in
belt use translates into an additional 6 million
users and the saving of approximately 500 lives.
States with primary safety belt laws averaged an
80-percent belt use rate, while States with secondary
laws averaged a 69-percent use rate. Primary safety
belt laws allow a police officer to stop a vehicle
in which passengers are not in compliance with the
State safety belt law.
Three States and Puerto Rico
had safety belt use rates that
were 90 percent or higher in
2002: California (91 percent),
Hawaii (90 percent), Washington (93 percent),
and Puerto Rico (91 percent). The District
of Columbia and 12 States had rates that
were 80 percent or higher: District of
Columbia (85 percent), Iowa (82 percent),
New Jersey (81 percent), New Mexico (88
percent), New York (83 percent), North
Carolina (84 percent), Oregon (88 percent),
Maryland (86 percent), Michigan (83 percent)
Texas (81 percent), Utah (80 percent),
and Vermont (85 percent). The majority
of States that have usage rates above 80
percent also have enacted primary enforcement
safety belt use laws.
Of special note, Washington was the only State that passed a primary
law in 2002 and the State’s safety belt use rate rose
10 percentage points, from 83 percent in 2001 to 93 percent
The Northeast, historically the lowest
region for safety belt use, showed the
largest gain in safety belt use, up 8
percentage points from 2001 to 69 percent
in 2002. However, drivers and passengers
in the West still buckle up at the highest
rate nationwide at 79 percent—up
2 percentage points from 2001. The South maintained
the 76-percent usage rate it achieved in 2001, up 7 percentage points
from 2000, while the Midwest showed an increase from 72 percent in
2001 to 74 percent in 2002.
National Trends and Initiatives in Child Passenger Safety
Restraint use by young children reached record
levels in 2002. NHTSA’s
observational studies (NOPUS) showed that 99 percent
of infants and 94 percent of toddlers were restrained. Occupant fatalities for
children under age 5 declined by 9 percent in 2002. For the first time, the
number of fatalities among this age group dropped
below 500, to 459. This continued decrease in the number of child occupant deaths
is in large part due to the significant increase in child restraint use since
Up America campaign began. In 1996, just
before the campaign began, restraint use among infants (1- to 12 months of age)
was 85 percent and only about 60 percent of toddlers (1- to 4-years-old) were
restrained while riding in vehicles.
In spite of the strides that
have been made, the need for
ongoing outreach and education
remains. NHTSA’s 2002 NOPUS surveys also showed that
too many young children—15 percent of infants,
10 percent of 1-3-year-olds, and 29 percent of 4-
to 7-year-olds continue to be placed in the front
seat, which is the most dangerous seating position.
Restraint Use Among Older
The odds of injury for children
riding in booster seats were
59 percent lower than the risks
children face when using safety
belts alone, according to a study
published in the June 4, 2003, edition
of the Journal of the American Medical
Association. The study, conducted by Partners
for Child Passenger Safety (PCPS), a research
project at The Children’s
Hospital of Philadelphia, and supported by State
Farm Mutual Automobile Insurance Company, examined insurance claim
data from December 1998 through May 2002 concerning 3,616 crashes in
15 States involving 4,243 children. The study also found that none
of the 4- to 7-year-olds who were in belt-positioning booster seats
had any injuries to the abdomen, neck, spine, and back. Such injuries
did occur, however, in children who used safety belts alone.
The PCPS study also found that only 16 percent
of 4-year-olds, 13 percent of 5-year-olds, and
4 percent of 6- and 7-year-olds were using booster
seats. NHTSA recommends that children who have
outgrown child safety seats be properly restrained
in booster seats from about age 4 and 40 pounds
to at least age 8, unless they are 4 feet 9 inches
National Strategy to Increase Booster Seat Use
In 2002, NHTSA published National Strategy to Promote
Booster Seat Use, modeled after the four elements of the
BUA campaign. That document called for the expansion of current
occupant restraint initiatives to: 1) promote the use of booster
seats for 4- to 8-year-old children and 2) increase the use of occupant
restraints for all children. A major focus of the strategy is the
need to inform the public that the safest occupant restraint for 4- to
8-year-old children is an age/size-appropriate, belt-positioning
To obtain national input for developing the strategy,
on June 6, 2001, NHTSA announced a public meeting and
request for comments in the Federal Register. Many of
the tools and tactics that shaped the development of
the document came from docket comments, along with recommendations
obtained during the public meeting.
New Rule for the Annual Rating of Child Safety Seats
During 2002, NHTSA announced issuance of a final rule to
begin a program for the annual rating of child safety seats
based on their ease of use by consumers. (In early 2003,
NHTSA began posting ease-of-use ratings for child safety
seats on the agency’s Web site.) NHTSA also will
publish a brochure listing
all of its ease-of-use ratings. Under the new rating system, child
safety seats, including booster seats, will each be given an overall “A,” “B,” or “C” ease-of-use
rating. Such letter grades
will also be used to rate seats in each of five categories:
the seat is pre-assembled or requires assembly after purchase.
- Clarity of labeling attached to the seat.
of written instructions on the seat’s proper use.
- Ease of
installation of the seat in a vehicle.
- Ease of securing a child
correctly in the seat.
Full Implementation of LATCH
Lower Anchors and Tethers for Children (LATCH) is a restraint system
to work independently of the vehicle safety belt system and to
make it easier to install a child safety seat correctly. Once it
has been fully phased in, NHTSA estimates that the LATCH system
will eliminate as much as half of the misuse associated with the
incorrect installation of child safety seats.
Since September 1, 2000, all vehicle manufacturers
have been required to install a top tether
anchor to secure forward-facing child safety seats. Most child
safety seats come equipped with a top strap
or tether that attaches to the tether anchor.
As of September 1, 2002, nearly all newly manufactured
passenger vehicles were also required to have lower anchors
installed in at least two rear seating positions. In addition,
also as of September 1, 2002, all new child safety seats
were required to come equipped with a pair of lower attachments
that fasten to the vehicle anchors.
On August 28, 2002, NHTSA Administrator Dr. Jeffrey W.
Runge joined with officials from DaimlerChrysler, Graco
Children’s Products, and
R Us/Babies R Us to call the public’s
attention to the new LATCH requirements, to explain
their benefits and demonstrate their use. The event
received extensive media coverage and boosted public
awareness about this important new technology.
in Child Deaths from Air Bags
the rate of child
air bag deaths
declined a remarkable
96 percent, despite
a five-fold increase in the
number of passenger air-bag-equipped
vehicles on the road, according
to the Air Bag & Safety
Belt Safety campaign (a Buckle Up America partner
organization). Based on the number of rear-seated fatalities and a
conservative 30 percent estimated effectiveness of moving children
to the rear seat, research has found that more than 1,700 child deaths
have been prevented since 1996 (an average of about 340 per year).
Air bags contributed to 1
child fatality for every
8.9 million-passenger air
bags in 2000, compared with
1 child fatality for every 870,000
passenger air bags in 1996. In
1996, 26 children were killed by air bags; in 2000, 9 were killed. Nearly
all the children killed were either
completely unrestrained or improperly buckled in the front seat.
This reduction in deaths is another positive outcome
of many of the activities undertaken as part of the Buckle
Up America campaign. These activities include the passage
of stronger State safety belt and child restraint laws,
stepped-up law enforcement, and intense public education
about air bag safety.
On September 1, 2003, 20 percent of all new motor vehicles
sold in the United States must be equipped
with advanced air bag technologies and by September 1, 2006, the
requirement will apply to all new light trucks and cars.