The American College of Surgeons (ACS) Committee on Trauma (COT) Subcommittee on Injury Prevention and Control prepared the following statement. The purpose of the statement is to educate surgeons about the important differences between primary and secondary laws and to encourage surgeons to support primary restraint legislation in their respective states. The ACS Board of Regents approved the statement at its October 2015 meeting in Chicago, IL.
More than 5.6 million U.S. motor vehicle crashes occurred in 2012, resulting in 1.63 million injuries and 30,000 deaths. More than 52 percent of fatal injuries occurred in unrestrained occupants, and 79 percent of unrestrained occupants who were completely ejected from the vehicle died. Safety belts have been shown to significantly reduce morbidity, mortality, and the risk for occupant ejection in motor vehicle crashes. Jurisdictions that have primary seat belt laws continue to have high seat belt use. In the U.S., 33 states and the District of Columbia have primary seat belt laws and use is 85 percent. Safety belt use is approximately 62 percent in tribal reservations, and those with primary seat belt laws have the highest use. All Canadian provinces have primary seat belt laws, with 95 percent use.
Regarding the use of safety belts in motor vehicles, the ACS recognizes the following:
- Safety belts are the most effective safety device in preventing serious injury and death in motor vehicle crashes.
- Appropriate safety belt use reduces the possibility of ejection and the risk of death in vehicular crashes.
- Safety belt use varies significantly by age, gender, ethnicity, and time of day. Youth, males, Native Americans, and rural area occupants are among the lowest safety belt users and the highest mortality rate populations.
- Safety belt use reduces the risk of fatal injury for front seat passengers by 45 percent and the risk of moderate to severe injury by 50 percent.
- Primary safety belt laws allow a citation to be issued whenever a law enforcement officer observes unrestrained vehicle occupants. Secondary safety belt laws require law enforcement to stop a violator for another traffic infraction before a safety belt citation may be issued.
- Primary safety belt laws have been shown to decrease mortality by 8 percent and increase safety belt use by 14 percent compared with secondary law states.
- Strong legislation and effective enforcement are crucially important to the success of safety belt laws.
Therefore, the ACS supports legislation enacting primary safety belt laws for all occupants and their effective enforcement.
Bibliography
Banerji A, Canadian Paediatric Society, First Nations, Inuit and Metis Health Committee. Preventing unintentional injuries in indigenous children and youth in Canada. Paediatr Child Health. 2012;17(7):393.
Chaudhary NK , Tison J, Casanova TM. Evaluation of Maine’s safety belt law change from secondary to primary enforcement. Final Report, National Highway Traffic Safety Administration, Washington, DC. DOT HS 811 259.
Centers for Disease Control and Prevention. Injury prevention and control: Motor vehicle safety. Tribal road safety: Get the facts. Available at: www.cdc.gov/Motorvehiclesafety/native/factsheet.html. Accessed November 6, 2015.
Community Preventative Services Task Force. Use of safety belts: Primary (vs. secondary) enforcement laws. Available at: www.thecommunityguide.org/mvoi/safetybelts/enforcementlaws.html. Accessed November 6, 2015.
Governors Highway Safety Administration. Seat belt laws. November 2015. Available at: www.ghsa.org/html/stateinfo/laws/seatbelt_laws.html. Accessed November 6, 2015.
Sen A, Mizzen B. Estimating the impact of seat belt use on traffic fatalities: Empirical evidence from Canada. Can Public Pol. 2007;33(3):315-336.
Transport Canada. Seatbelt use continues to rise: Transport Canada surveys. Press release. January 26, 2011. Available at: news.gc.ca/web/article-en.do?nid=616509. Accessed November 6, 2015.
U.S. Department of Transportation. National Highway Traffic Safety Administration. 2006 seat belt use estimate for Native American tribal reservations. May 2008. Available at: www.nhtsa.gov/DOT/NHTSA/Traffic%20Injury%20Control/Articles/Associated%20Files/810967.pdf. Accessed November 6, 2015.
U.S. Department of Transportation. National Highway Traffic Safety Administration. Safety belt use estimate for Native American tribal reservations. October 2005. Available at: www.nhtsa.gov/staticfiles/nti/pdf/809921.pdf. Accessed November 6, 2015.
U.S. Department of Transportation. National Highway Traffic Safety Administration Traffic safety facts 2012. Available at: www-nrd.nhtsa.dot.gov/Pubs/812032.pdf. Accessed November 6, 2015.
U.S. Department of Transportation. National Highway Traffic Safety Administration. Traffic safety facts 2012 data. DOT HS 811 691. Available at: www-nrd.nhtsa.dot.gov/Pubs/811892.pdf. Accessed November 6, 2015.
U.S. Department of Transportation. National Highway Traffic Safety Administration. Traffic safety facts research note. January 2014. Seat belt use in 2013—overall results. DOT HS 811 875. Available at: www-nrd.nhtsa.dot.gov/Pubs/811875.pdf. Accessed November 6, 2015.
