On March 28th, I moderated a webinar titled “Traffic Safety Through a Public Health Lens.” This joint effort between the NTSB and the American Public Health Association (APHA) ahead of National Public Health Week highlighted traffic safety as a public health issue.
This topic is very important to me as a transportation safety advocate with a degree in public health. When I was studying for my Master of Public Health degree at the University of South Florida, I was the only student in my program (that I knew of) who was interested in traffic safety. I was motivated by the Tampa Bay region’s regrettably high rates of traffic-related fatalities, and the perceptible imbalance of safety interventions along socioeconomic lines. I also knew the statistics nationwide: each year, 43,000 people die on US roadways. I thought, of course this is a public health issue—people are getting hurt and dying on our roads each day!
Since joining the NTSB in November 2023, I have had the pleasure of meeting folks who bring a public health mindset to transportation safety. In fact, the NTSB itself plays a significant role in public health by identifying transportation safety issues and issuing recommendations to make travel safer for the public.
Prior to the webinar, I connected with former NTSB Vice Chair T. Bella Dinh-Zarr, who notably referred to traffic fatalities as an “epidemic on wheels.” Of course, I was thrilled when Dr. Dinh-Zarr and public health colleagues Dr. Kathleen Carlson, Dr. David Ederer, and Dr. Mighty Fine agreed to be panelists on this first-of-its-kind webinar.
Each panelist brought an invaluable perspective to the conversation.
Dr. Carlson, a professor of epidemiology at the Oregon Health and Science University-Portland State University School of Public Health and core investigator at the Portland VA, opened the event with a review of injury epidemiology. She explained that “public health takes a scientific approach to a public health problem” as it seeks to identify the problem’s cause and develop strategies for preventing it from happening again.
Dr. Ederer, an epidemiologist at the CDC’s Physical Activity and Health Branch, followed with a presentation on the Safe Systems Pyramid and how public health principles can be applied to engineering. His presentation underscored the need to apply traffic safety interventions systematically to improve population health.
Dr. Dinh-Zarr, Senior Advisor at FIA Foundation and the Traffic Injury Research Foundation, built upon Dr. Carlson’s and Dr. Ederer’s presentations by providing concrete examples of how the public health lens has been applied to traffic safety efforts. She highlighted the NTSB’s investigation process as an example of taking a public health approach to preventing the recurrence of traffic-related injuries and fatalities.
Finally, Dr. Fine, associate executive director of the APHA’s Division of Public Health Policy & Practice, rounded out the panel by emphasizing the need to apply a health equity perspective to all traffic safety efforts. He urged traffic safety practitioners to ensure that interventions are inclusive, accessible, and culturally relevant.
Overall, it was a wonderful and much-needed discussion that I am certain each attendee walked away from having learned something new. Dr. Ederer said it best in his presentation: “Public health is a way of describing and solving problems.” Given that, I think all of us in the traffic safety space are public health practitioners.
By Stephanie Shaw, Acting Chief, NTSB Safety Advocacy Division
This week, families and friends will gather to celebrate the Thanksgiving holiday. According to estimates from AAA, nearly 55 million people will travel away from home this year, with about 49 million of them taking to the roads.
As we mark the beginning of the holiday travel season, we want to ensure that everyone arrives safely at their destinations. Unfortunately, travel on our roads can be the riskiest mode of travel during the holiday season.
NTSB investigations continue to highlight actions needed by regulators, legislators, and industry to ensure the safest transportation system for the traveling public. Our Most Wanted List (MWL) identifies specific transportation safety improvements needed across all modes. It includes five road safety improvements that address pervasive problems like speeding, alcohol and other drug impairment, and distraction. The MWL also calls for collision-avoidance and connected vehicle technologies and implementation of a Safe System Approach to better protect all road users.
At the NTSB, we believe that safety is a shared responsibility, so for the traveling public, we’ve highlighted some ways you can keep yourself and others safe, regardless of the travel mode you choose.
By Car
Impairment by alcohol and other drugs, unsafe speeds, fatigue, and distraction continue to play major roles in crashes. Here’s what you can do:
Designate a sober driver, or call a taxi, or ridesharing service if your holiday celebrations involve alcohol or other impairing drugs.
Follow safe speeds. In bad weather, safe speeds are often below the designated speed limit. Speeding increases the chance of being involved in a crash and intensifies the severity of crash injuries.
Make sure you’re well rested! A fatigued driver is just as dangerous as one impaired by alcohol or other drugs.
Avoid distractions. Don’t take or make calls or text while driving, even using a hands-free device. Set your navigation system before you start driving. If you’re traveling with others, ask them to navigate.
Ensure you and all your passengers are buckled up! In a crash, seat belts (and proper child restraints) are your best protection against death and serious injuries.
By Bus
The NTSB has made recommendations to improve motorcoach operations and vehicle crashworthiness, but travelers should know what to do in an emergency.
Pay attention to safety briefings and know where the nearest emergency exit is. If it’s a window or roof hatch, make sure you know how to use it.
Ask your driver to give you a safety briefing if you’re unsure of where the exits are or how to use them.
Use your seat belt when they’re available!
By Plane or Boat
These tips can help you and your loved ones in an emergency on planes or vessels.
Pay close attention to the safety briefing! Airline and marine accidents have become very rare, but you and your family can be safer by being prepared.
Know where to find the nearest emergency exit and flotation device whether you’re on an airplane or a boat.
Confirm that you and your traveling companions—even children under age 2—have your own seats and are buckled up when flying.
Don’t forget your child’s car seat. The label will usually tell you if your child car seat is certified for airplane use; the owner’s manual always has this information.
Call the airline and ask what the rules are for using a child’s car seat on your flight, if you don’t already know.
Follow crewmember instructions and remain calm in an emergency.
By Train
The NTSB has made recommendations to improve passenger rail operations and vehicle crashworthiness, but travelers should also follow these safety tips.
Stow carry-ons in the locations provided (overhead and racks). Don’t block aisles.
Review your trains safety information which may be provided as a safety card in your seat pocket or displayed in your railcar.
Follow crewmember instructions and remain calm in an emergency.
No matter how you travel, make a commitment to put safety first.
Motor vehicle crashes are a leading cause of death for teens. According to the Centers for Disease Control and Prevention, in 2019, approximately 2,400 teens in the United States aged 13–19 died and about 258,000 were injured in motor vehicle crashes. This means that approximately 7 teens died, and hundreds more were injured, every day due to preventable motor vehicle crashes.
These numbers are staggering and unacceptable.
From our investigations, we know that collision-avoidance technologies—increasingly seen in newer vehicles—can help reduce that number. And a recent Insurance Institute for Highway Safety (IIHS) study has also found that crash-avoidance features and teen-specific vehicle technologies have the potential to prevent or mitigate up to 75% of all fatal crashes involving teen drivers. Collision-avoidance technologies include features such as automatic emergency braking (AEB), collision warning, and lane departure prevention. These features can serve to warn a driver of an impending crash and stop or slow the vehicle to prevent or mitigate a collision.
To increase awareness about the life-saving capabilities of collision-avoidance technologies among parents, teens, and educators, on March 23, I convened a panel of teen driving safety experts and researchers to explore how collision-avoidance technologies can improve the safety of our teen drivers. Panelists included representatives from the IIHS, Alliance for Automotive Innovation, OFFICIAL Driving Schools, AAA National, and INRIX, as well as investigators from the NTSB.
During this webinar, we discussed the role of vehicle technology in reducing teen traffic crashes and fatalities. We dove deeper into the IIHS’s recent research on collision-avoidance technology and teen driver safety, explored perspectives from educators and the automotive industry, and addressed how vehicle technology, if made standard in all vehicles, can contribute to equitable and accessible safe transportation for all.
I encourage all of you to watch the full recording of our webinar—but especially if you’re a parent, educator, motor vehicle administrator, or highway department of transportation employee.
One point we all agreed on during the webinar, is that these technologies have the potential to dramatically improve safety for teen drivers. However, they need to be broadly accepted and equitable, and the barriers to adoption—such as education, awareness, availability, and affordability—need to be addressed.
Here were some of the key takeaways, as summed up by our panelists:
We need to emphasize education and safe driving behavior. We also need to educate drivers on how these systems function and the role of the driver. It’s important to integrate these technologies into driver skills training to broaden awareness.
We must understand how teens are interacting with collision-avoidance systems. There’s an opportunity for engagement with academics and researchers to dig into the data and look at it from a local level.
More work should be done for equity and access.
Modern training vehicles at driving schools, preparing instructors to educate teens on these technologies, and better communication between driving schools and parents about the benefits of these technologies could instill the benefits of collision-avoidance technologies and encourage voluntary adoption.
State departments or agencies that provide training curriculum to driving schools should encourage technology use and incorporate it in the training curriculum.
States need to look at their existing graduated driver license law (GDL) and strengthen them to ensure they have a comprehensive GDL program that provides a three-stage graduated process for newly licensed young drivers to gain experience while minimizing risk.
We are heading in the wrong direction with fatalities; we must do more at the federal level, with the new car assessment ratings and research to help us guide the technology forward. These collision-avoidance technologies should be standard in all vehicles.
As a result of our crash investigations, the NTSB has made numerous recommendations to implement and encourage the use of collision-avoidance technologies. The topic is highlighted on our 2021–2022 Most Wanted List of Transportation Safety Improvements (MWL), and teen driving safety has been a topic on previous MWLs. We encourage you to check out our webpages on these topics to learn more about our specific recommendations.
May is Global Youth Traffic Safety Month. If you haven’t already done so this month, take the time to learn more about these technologies—for the sake of your teen and the sake of road safety. The IIHS, National Highway Traffic Safety Administration, and the National Safety Council all offer information on these technologies. What better way to protect our next generation of drivers than to learn more now about these life-saving technologies? As we all work toward achieving zero traffic deaths and serious injuries on our roads, we must remember that it all begins with preparing our teens with the best possible technologies and strategies for preventing roadway crashes.
By Kathryn Catania, Acting Director, NTSB Office of Safety Recommendations and Communications
Since the unveiling a year ago of the 2021-2022 cycle of the NTSB’s Most Wanted List of Transportation Safety Improvements, we have seen increased awareness and discussion of safety items, high levels of engagement from the public, and incremental progress toward implementation of many recommendations.
Soon after the unveiling of the MWL last year, NTSB Board members and staff sprang into action to educate, engage, and amplify the critical safety messages of our 10 safety improvements. Here’s a quick look by mode, starting with Highway, which makes up 5 of our 10 safety improvements.
Highway
In recent years, we have increasingly expressed our highway safety goals in the language of the Safe System Approach—the very approach that we use in our own safety investigations. (We first discussed the approach in our 2017 report on reducing speeding.)
The Safe System Approach views every aspect of the crash as an opportunity to interrupt the series of events leading to it, and an opportunity to mitigate the harm that the crash does. People make mistakes, but safe roads, safe vehicles, safe road users, safe speeds, and post-crash care can combine to prevent the crash entirely, or failing that, to prevent the deaths or serious injuries of road users.
Between May 2021 and February 2022, we produced seven virtual roundtables to explain the approach and call for its adoption. National and international experts discussed the approach and shared their successes and challenges. More than 1,000 advocates, regulators, academics, and others attended our webinars.
In 2021, the Department of Transportation and Congress incorporated the approach into the DOT’s National Roadway Safety Strategy and the Infrastructure Investment and Jobs Act, respectively.
Will the new model result in lifesaving protections? Only final, and positive, closure of our recommendations will answer that. But the signs are very good, with the alignment of Congress, the DOT, and the road safety community.
Vehicle to everything (V2X) technology can save lives but has been delayed, and might be reduced or stopped, due to FCC rulings limiting the spectrum for safety operations. We released a four-part video series in which Member Graham interviewed some of the leading experts in V2X technologies—including academics, researchers, automakers, and policymakers—to discuss what can be done to find a way forward to deployment.
In progress toward Eliminating Distracted Driving, Vice Chairman Landsberg and staff joined government officials, industry, academia, insurers, and transportation safety advocates to announce the launch of a new National Distracted Driving Coalition. This is the first such broad national coalition on distracted driving.
We kept working with states considering lowering their BAC limit from .08 to .05 or lower, to help Prevent Alcohol- and Other Drug-Impairment. The National Highway Traffic Safety Administration (NHTSA) has now evaluated the results from Utah, which has made the change to .05. Not surprisingly, the lower threshold prevented drinking and driving and saved lives. NHTSA’s study showed that the state’s fatal crash rate dropped by 19.8% in 2019, the first year under the lower legal limit, and the fatality rate decreased by 18.3%.
With an increasing number of deadly fishing vessel accidents in recent years, Office of Marine Safety Director Morgan Turrell and Chair Homendy hosted a virtual roundtable on improving fishing vessel safety that was viewed by over 1,000 people. Panelists discussed what can be done to address commercial fishing safety, implement NTSB safety recommendations, and improve the safety of fishing operations in the United States.
Pipeline and Hazardous Materials
Our MWL calls for pipeline and hazardous materials (hazmat) stakeholders to “Improve Pipeline Leak Detection and Mitigation” by equipping all pipeline systems with leak-detection systems and automatic shutoff or remote-control valves. These valves allow for quick detection and mitigation.
Additionally, we produced a video featuring Member Michael Graham and Hazardous Materials Investigator Rachael Gunaratnam, which explores cases in which odorants failed as a natural gas leak-detection strategy, and promotes both required natural gas leak detectors, and voluntary adoption of such detectors until they are required.
Rail
To highlight the dangers to rail roadway workers and to help Improve Rail Worker Safety, Member Tom Chapman wrote a blog on rail worker safety, discussing how the railroad regulators—the Federal Railroad Administration (FRA), the Federal Transit Administration (FTA), and the Pipeline and Hazardous Material Safety Administration (PHMSA)— are in the best position to make change.
We also completed our investigation of the April 24, 2018, accident in which an Amtrak rail watchman was killed in Bowie, Maryland. As a result of this investigation, we called on the FRA and Amtrak to put an immediate end to the use of train approach warning (TAW) systems as the sole method of on-track safety in areas covered by positive train control.
To mark the anniversary of the January 2017 train collision in Edgemont, South Dakota, we also issued a media statement again urging railroads to act to better protect rail roadway workers.
Looking ahead
We are pleased by the engagement of so many of our safety advocacy partners, industry groups, and associations in the past year, to promote our recommendations and highlight transportation safety concerns. Also, we acknowledge that many industry groups and operators are making voluntary efforts to improve safety, including on some of our recommendations. However, without mandates, many others may not act.
We remain disappointed by the lack of movement by regulators to implement the safety recommendations associated with our MWL. While there has been some progress during this first year, much more needs to be done to implement the 167 remaining safety recommendations associated with the current list. The longer these authorities wait to implement our recommendations, the greater the risk to the traveling public. Safety delayed is safety denied.
The NTSB will not stand by quietly and watch as regulators, industry, and other recommendation recipients ignore and dismiss our safety recommendations—and neither should the public. As NTSB Chair Homendy expressed in recent remarks to the largest highway safety gathering in the U.S, “The horrific toll of people who’ve died on our roads and their families… millions of people who were injured… are counting on us to “fight like hell” for the next family. To give a voice to those who no longer have one.”
All our lives are on the line, and no death in transportation is acceptable. It is our mission to advocate for the changes outlined in our safety recommendations which, if implemented, will save lives.
Safety is a shared responsibility. We all play a role in getting us to zero transportation deaths. The NTSB cannot do this alone. We need each of you, individually and collectively, to help us advocate for these critical safety improvements.
Motor vehicle crashes are a leading cause of death and injuries in the United States. Early estimates for 2020 show that more than 38,000 people lost their lives in traffic crashes on our nation’s roads. These preventable tragedies are often due to driver mistakes and poor decisions—speeding or driving while impaired, distracted, or fatigued. Collision-avoidance technologies have the potential to mitigate the impact of these mistakes by alerting a driver to impending danger or actively reducing the vehicle’s speed if the driver does not act.
“Require Collision-Avoidance and Connected-Vehicle Technologies on all Vehicles” is on the NTSB’s 2021–2022 Most Wanted List of Safety Improvements to increase public awareness about collision-avoidance systems as a lifesaving technology. The National Highway Traffic Safety Administration (NHTSA) should develop comprehensive performance standards and mandates for collision-avoidance systems and connected-vehicle technology, and we urge NHTSA to incorporate collision-avoidance system ratings into its New Car Assessment Program (NCAP).
Collision-Avoidance Systems
The primary goal of any collision-avoidance technology is to prevent and mitigate the severity of crashes by detecting a conflict, alerting the driver and, when necessary, automatically braking. A standard collision-avoidance system is comprised of two separate technologies that work together to prevent and mitigate crashes: forward collision warning and automatic emergency braking. Forward collision warning assists a driver by presenting an auditory, visual, or haptic warning to the driver before a collision. Typically, once a warning occurs and a driver does not respond, automatic emergency braking autonomously applies the brakes to prevent or mitigate a crash.
According to the Insurance Institute for Highway Safety (IIHS), an estimated 56 precent of rear‑end crashes that result in injuries could be prevented if passenger vehicles were equipped with a combination of forward collision warning and automatic emergency braking. These technologies can also improve the safety of commercial trucks. The IIHS found that equipping large trucks with both of these systems could eliminate more than 40 percent of crashes in which a large truck rear-ends another vehicle.
Despite the proven safety benefit of collision-avoidance systems, these lifesaving technologies are not required as standard options on passenger vehicles or commercial trucks. NHTSA’s regulatory inaction has delayed the broad deployment of these systems for too long. NHTSA must require forward collision warning and automatic emergency braking on all passenger vehicles and commercial trucks.
Performance Standards
Although more collision-avoidance technologies have been deployed into new vehicles recently, forward collision warning and automatic emergency braking performance and reliability vary significantly among vehicle manufacturers and models. Performance standards specify the minimum level of performance for these technologies, and NHTSA has been slow to adopt comprehensive performance standards and criteria to assess these systems. Testing protocols to assess the performance of forward collision-avoidance systems should be expanded to include common obstacles, such as traffic safety hardware, cross-traffic vehicle profiles, and other applicable vehicle shapes or objects found in the highway operating environment. Further, testing protocols should also assess their performance at various speeds that represent the wide range of speed conditions seen in crashes, including high speeds. NHTSA should set robust minimum performance standards for both systems to provide consumers with confidence and certainty of the safety benefits of these technologies.
New Car Assessment Program
The NCAP is a government resource, developed by NHTSA, that evaluates and rates the crashworthiness of all passenger vehicles. Consumers rely on NHTSA’s vehicle safety ratings to make informed purchasing decisions for their safety and that of their loved ones. The NCAP has been an effective tool for informing the public about a vehicle’s crashworthiness; however, the current NCAP does not rate collision-avoidance technologies such as forward collision warning and automatic emergency braking. This allows a vehicle without collision-avoidance technology to achieve the same safety rating as a vehicle equipped with a highly effective collision‑avoidance system.
The NTSB recommends that NHTSA expand the NCAP to rate collision-avoidance technology performance. Such a rating can inform the public about a vehicle’s capacity to prevent and mitigate crashes, as well as differentiate collision-avoidance systems based on their performance. Incorporating collision-avoidance system ratings into the NCAP also provides an incentive for vehicle manufacturers to equip new vehicles with forward collision-avoidance systems, which can speed up deployment of such systems into all vehicles.
Connected-Vehicle Technologies
One of the most promising lifesaving collision-avoidance technologies being researched and developed for nearly three decades is connected-vehicle technology. This technology does not rely on radar or cameras but on direct communication between vehicles, called vehicle-to-vehicle (V2V) communications. This technology also allows vehicles to communicate with infrastructure and vulnerable road users such as pedestrians—collectively known as vehicle-to-everything communications (V2X).
The NTSB’s investigations have found that V2X communications-based technology could address many crash scenarios, including many intersection crashes. Additionally, connected-vehicle technology increases the safety and visibility of vulnerable road users by alerting drivers to the presence of pedestrians, bicyclists, and motorcyclists that may be outside a driver’s or vehicle‑based sensor’s field of observation.
However, connected-vehicle technology depends on an available communications spectrum. Currently, the entire program is at risk due to a recent decision by the Federal Communications Commission (FCC) to allow shared use of a wireless communications band previously dedicated solely for transportation safety. We are concerned that sharing this spectrum could compromise successful connected-vehicle technology deployment. The NTSB urges the FCC and others to overcome this communications challenge so connected-vehicle technology can be deployed widely and securely.
Bottom Line
Every day we lose more than 100 lives in preventable traffic crashes on our nation’s roads. Humans make mistakes that lead to crashes, but technology can mitigate those mistakes, avoiding death and serious injuries. Collision-avoidance technologies assist drivers by alerting a driver to an impending crash and automatically stopping the vehicle if the driver does not act. This proven, lifesaving technology is available today.
Tragically, regulatory inaction has slowed both deployment and broad availability of these technologies. The NTSB calls on the NHTSA to:
require forward collision warning and automatic emergency braking on all passenger vehicles and commercial trucks,
adopt comprehensive performance standards and criteria to assess these systems, and
expand the NCAP to rate the performance of collision-avoidance technologies.
NTSB Safety Compass Blog 