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Publication Date: 12/07/2009
The Problem:
The leading cause of death for people age 34 and below in the United States is motor vehicle crashes. CDC: Motor Vehicle Safety Factsheet. Crashes occur due to impaired driving, inexperience, faulty vision and general recklessness. In congested areas, pedestrian safety is major public health concern. Approximately 700 children are killed each year by motor vehicles while walking. CDC: Reducing Childhood Pedestrian Injuries: Summary of a Multidisciplinary Conference.
The Law:
Traffic laws are designed to minimize motor vehicle crashes and to improve driver, passenger and pedestrian safety. Enforcing traffic laws can be difficult. Red light cameras take a picture of any car that fails to appropriately abide by a red light thereby endangering other drivers and pedestrians. The pictures are used to issue traffic citations, which often include sizable mandatory fines ($446 in Los Angeles: Photo Red Light Program). Twenty-four states and the District of Columbia have red light programs operating somewhere within their jurisdiction authorized either through state or local law. Governors’ Highway Association: Red Light Cameras. For an example of a state law authorizing the use of red light cameras, see RI Stat 42-28.9
The Evidence:
In a systematic review, Aeron-Thomas and Hess reviewed ten studies measuring the impact of red light cameras on motor vehicle crashes. Aeron-Thomas A, Hess, S. Red-Light Cameras for the Prevention of Road Traffic Crashes. The Cochrane Library. 2009, v.2. The reviewers found that the studies generally identified an association between the red light cameras and reductions in fatal crashes. However, weaker and often statistically insignificant relationships were observed between the cameras and overall crashes. On this basis, the reviewers concluded that there was sufficient evidence to establish the effectiveness of red light cameras as an intervention aimed at reducing fatal crashes, but that additional research is needed to validate the impact of these cameras on overall crashes and reckless driving generally.
The Bottom Line:
In the judgment of a Cochrane Collaborative expert panel, sufficient evidence exists to support red light cameras as an effective public health intervention to reduce motor vehicle crash fatalities, but there is insufficient evidence to validate the effectiveness of the cameras in reducing overall crashes.
Additional Information:
The Governors’ Highway Association provides online access to a table indicating in which states red light cameras are authorized or prohibited under state law.
Additional Resources: Governors’ Highway Association
Publication Date: 12/07/2009
The Problem:
The operation of motor vehicles while intoxicated is a major public health problem. Each year in the United States roughly 13,400 people die and an additional 255,500 are injured in motor vehicle crashes involving an alcohol-impaired driver. In 2006, these crashes accounted for almost a third of all U.S. traffic-related deaths. CDC: Impaired Driving Factsheet.
The Law:
In an effort to reduce drunk-driving recidivism, municipalities and states have experimented with ignition interlock programs. Ignition interlock devices disable a car’s ignition until the driver provides a breath sample that confirms that the driver’s blood alcohol content (BAC) is under the requisite limit. Participation in ignition interlock programs is sometimes required as a condition of sentences for violating drunk- driving laws. Initially, participation in the US was generally on a voluntary basis (e.g., violators could participate to regain their driving privileges earlier than otherwise provided) or was left to the court’s discretion and implemented only for repeat offenders. For examples of ignition interlock laws, see 75 Pa.C.S. §§ 88.1-88.8 (Pennsylvania), 90 MGL 24(c)(2) (Massachusetts), and A.R.S. §28-1381(I)(6) (Arizona).
The Evidence:
In a systematic review, Willis et al. reviewed 14 studies in the U.S. and Canada evaluating the effects of ignition interlock programs on drunk-driving recidivism. Willis et al. Alcohol ignition interlock programmes for reducing drink driving recidivism. Cochrane Database of Systematic Reviews. 2004; Issue 3. The underlying studies measured three types of outcomes: (1) recidivism rates while the driver participated in the ignition interlock program, (2) recidivism rates after the ignition interlock device was removed from the vehicle, and (3) recidivism rates during the entire study period. The reviewers found that interlock program participants were less likely to repeat offend than the control group. The impact was even more pronounced for repeat offenders. However, in each instance, recidivism returned to pre-intervention rates after the devices were removed. Though effective as a short term intervention, continued research on the effects of ignition interlock programs on drunk-driving recidivism over longer time periods is needed.
The Bottom Line:
In the judgment of a Cochrane Collaboration expert panel, ignition interlock programs reduce drunk-driving recidivism, but only while the devices are attached.
Additional Information:
Mothers Against Drunk Driving (MADD) maintains an online table listing the states with ignition interlock laws.
Additional Resources: Mothers Against Drunk Driving
Publication Date: 12/07/2009
The Problem:
In 2008, 968 children under the age of 15 died from injuries suffered during motor vehicle crashes and approximately 168,000 other children were injured. CDC: Child Passenger Safety Factsheet. The use of child safety seats has been found to substantially reduce the risk of mortality to infants in motor-vehicle accidents (70 percent) and in children ages 1 to 4 years (47 precent to 54 percent). Yet, each year children are injured and killed due to the nonuse or improper use of child safety seats. Zaza S, et al. Recommendations to reduce injuries to motor vehicle occupants increasing child safety seat use, increasing safety belt use, and reducing alcohol-impaired driving. Am J Prev Med. 2001;21(4S):16–22. It is estimated that universal proper child safety seat use could save roughly 160 lives and prevent 20,000 injuries each year. Zaza S, et al. Reviews of evidence regarding interventions to increase use of child safety seats. Am J Prev Med. 2001;21(4S):31-47
The Law:
Today, every state has a law requiring children to be restrained in federally-approved child safety seats while riding in motor-vehicles. These laws differ from state to state based on number of factors (e.g., age, height and weight of the children requiring safety seats). All current child safety seat laws allow for primary enforcement, meaning a police officer can stop a driver solely for a violation of such laws. Child restraint/belt use laws: The Insurance Institute for Highway Safety, Highway Loss Data Institute. For examples of child safety seat laws, see La. R.S. 32:295 (Louisiana), Tenn. Code Ann. § 55-9-602 (Tennessee), Ala. Code § 32-5-222 (Alabama) and N.J.S. 39:3-76.2a (New Jersey).
The Evidence:
In a systematic review, Zaza et al. reviewed nine studies that evaluated the effectiveness of child safety seat laws in reducing rates of childhood motor-vehicle injuries. Zaza S, et al. Reviews of evidence regarding interventions to increase use of child safety seats. Am J Prev Med. 2001;21(4S):31-47. The underlying studies focused on laws that were passed in every state in the United States between the years 1978 and 1986. The reviewers found a 35 percent median reduction in fatal childhood injuries and 17.3 percent reduction in overall motor-vehicle child injuries following the introduction and enforcement of child safety seat laws. The effects of additional requirements in particular states (for example, requiring a particular seating position or providing for harsher penalties) could not be determined from the available studies. The reviewers also identified a 13 percent increase in the use of child safety seat use subsequent to the adoption of child safety seat laws.
The Bottom Line:
There is strong evidence to support the effectiveness of child safety seat laws in substantially reducing injuries to children during motor vehicle crashes, according to a Community Guide expert panel.
Additional Resources: Insurance Institute for Highway Safety
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Public Health Law Research is a national program of the Robert Wood Johnson Foundation. It is housed at the Temple University Beasley School of Law.