child restraint
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
Publication Date: 12/07/2009
The Problem:
Safety belts saved approximately 164,753 lives between 1975 and 2002 according to the National Highway Traffic Safety Administration (NHTSA). However, despite rising rates of safety belt use in the United States over the past 20 years, many American still do not consistently wear safety belts. David J. Houston and Lilliard E. Richardson, Jr., “Getting Americans to buckle up: The efficacy of state seat belt laws,” Accident Analysis and Prevention, 37 (2005) 1114–1120, at 1114
The Law:
Primary enforcement seatbelt laws authorize police officers to stop drivers solely because individuals in a vehicle are not complying with safety belt laws. Secondary enforcement, in contrast, only authorizes enforcement of safety belt laws in conjunction with another offense (i.e., drivers cannot be stopped if the only offense is not wearing a belt). For example of primary enforcement safety belt laws, see GA Code Ann § 40-8-6 (Georgia) and Fla Stat § 316.614 (Florida).
The Evidence:
In a systematic review, Dinh-Zarr et al. reviewed 13 studies that examined the effectiveness of primary enforcement safety belt laws as a means of reducing injuries related to motor vehicle crashes. Dinh-Zarr TB, et al. Reviews of evidence regarding interventions to increase the use of safety belts. Am J Prev Med. 2001;21(4S): 48-65. Nine of the reviewed studies compared the effectiveness of primary enforcement laws to that of secondary enforcement laws in the US; the other four measured the impact of changing from a secondary enforcement law to a primary enforcement law. Three studies focused their assessment on the impact of enacting primary enforcement legislation on specific populations (drunk drivers, African-American and Hispanics). The review found that primary enforcement laws are more effective in reducing fatal injuries and in increasing the frequency of safety belt use than secondary enforcement laws. Primary laws were found to reduce fatal injuries by a median 8 percent and to increase observed safety belt use a median 14 percent. Two studies found that primary enforcement laws increased safety-belt use by African-Americans and Hispanics compared to whites. There was no evidence in these studies that the difference was based on differential enforcement.
The Bottom Line:
Safety belt laws work, but there is strong evidence to support that primary enforcement safety belt laws are more effective than secondary enforcement laws in increasing seat belt use and reducing crash injuries.
Publication Date: 12/07/2009
The Problem:
Safety belts saved approximately 164,753 lives between 1975 and 2002 according to the National Highway Traffic Safety Administration (NHTSA). However, despite rising rates of safety belt use in the United States over the past 20 years, many Americans still do not consistently wear safety belts. David J. Houston and Lilliard E. Richardson, Jr. Getting Americans to buckle up: The efficacy of state seat belt laws. Accident Analysis and Prevention, 37 (2005) 1114–1120, at 1114.
The Law:
Enhanced enforcement of safety belt laws may include increased numbers of officers on patrol, increased numbers of tickets issued for safety belt violations during normal patrols, and setting up safety belt checkpoints. Dinh-Zarr TB, et al. Reviews of evidence regarding interventions to increase the use of safety belts. Am J Prev Med. 2001;21(4S): 48-65. These programs are usually publicized through media campaigns. Enhanced enforcement programs usually take the form of short, intense efforts (called waves or blitzes) lasting for days or weeks.
The Evidence:
The Community Guide reviewed 15 studies that measuring the effectiveness of enhanced enforcement programs, focusing on programs that targeted safety belt use and excluding studies of programs that simultaneously targeted other driving practices. Dinh-Zarr TB, et al. Reviews of evidence regarding interventions to increase the use of safety belts. Am J Prev Med. 2001;21(4S): 48-65. The reviewed studies analyzed a variety of city, county, state, provincial and national programs in the United States and Canada. Enhanced enforcement programs were found to be effective in reducing both fatal and nonfatal injuries as well as in increasing the frequency of safety belt use. The two studies measuring the effects of enhanced enforcement programs on injury rates found a reduction of 7 percent and 15 percent. Across the studies, the median increase in safety belt use was 16 percent.
The Bottom Line:
Seat belt laws work, and there is strong evidence that enhanced seat belt enforcement interventions can substantially increase seat belt use and its associated benefits.
Additional Information:
The Community Guide provides an online table listing the enhanced enforcement programs underlying the reviewed studies.
Additional Resources: The Community Guide
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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.