When Safety Should Take the Back Seat

By Vice Chairman T. Bella Dinh-Zarr, PhD, MPH

As a public health professional, I have spent my career working in the United States and internationally to prevent injuries and deaths. At the NTSB, one of my primary roles is to advocate for the changes needed to prevent transportation accidents.

Significant advancements have been made to improve the safety of occupants in the front seats of passenger vehicles, including the development of advanced restraint and airbag systems, safer seat designs, and structural improvements to minimize injury due to intrusion. Today, 32 states have adopted legislation that requires front-seat passengers to use a seat belt, and we can celebrate that we have achieved a national daytime average seat-belt-use rate of 90 percent for front-seat passengers.

But what about rear seats? We have not seen similar technology advances in rear seats, and research shows that rear seat belt use is considerably lower, at 83 percent. How can research, engineering, and advocacy make an impact in increasing rear seat belt use?

In 2015, after decades of decline, the United States experienced the largest increase in motor vehicle crashes and resulting deaths. Another historic increase is expected for 2016.  In examining such a complex issue, we at the NTSB found ourselves asking the following: why aren’t people buckling up when they sit in the rear seat, and how can research, engineering, and advocacy increase rear seat belt use?

To answer these questions, we reached out to occupant protection experts drawn from the auto industry, the research community, safety advocates, and the government to participate in a workshop to help us find ways to strengthen occupant protection in the rear seat of passenger vehicles.

During the workshop, we discussed the current knowledge about rear seat occupants in motor vehicle crashes, and how these occupants utilize existing vehicle safety systems, such as seat belts.  We examined how the rear seat environment is different from the front, both in design and user demographics. The workshop also addressed advanced vehicle and emerging seat belt technologies, innovative seat designs, as well as areas of needed research and education.

Our workshop was designed to allow the sharing of experience and knowledge, as well as to encourage participants to collaborate on inventive strategies. As a result, in the detailed summary we are publishing today, participants identified short- and long-term goals that will require a greater amount of collaboration, engineering, design, and advocacy to achieve.

Together with researchers, automobile manufacturers, legislators, regulators, and safety advocates, we are identifying practical, real-world applications and opportunities to make rear seats safer for everyone.

For more information about the workshop, presentations and the summary document visit https://www.ntsb.gov/news/events/Pages/2016_rss_WS.aspx.

Primary Enforcement of Seat Belts – A Law we Can’t Live Without

By Member Robert L. Sumwalt

Member Sumwalt (2nd from left) joined AAA Northeast Public & Legislative Affairs Director Mary Maguire (3rd from left), BJ Williams (center) and Sarah Langenthal (3rd from right) – who both survived crashes with traumatic brain injuries – to testify in support of Massachusetts’ Representative Garrett Bradley’s H.B. 1187. Also pictured are NTSB’s Michael Hughes (far left), Stephanie Shaw (2nd from right) and Amy Terrone (far right).

On Wednesday, I had the opportunity to testify before the Massachusetts Legislature in support of House Bill 1187 (H.B. 1187). If enacted, H.B. 1187 would allow for primary enforcement of the state’s existing seat belt law.

Currently, only 34 states have primary enforcement of seat belt laws. Massachusetts has only secondary enforcement, which means that police officers cannot issue a citation for a seat belt violation unless the vehicle has been stopped for another reason. Primary enforcement safety belt laws give law enforcement officers the authority to stop a vehicle solely for a safety belt violation if he/she observes anyone in the vehicle not buckled up.

My testimony came on the heels of Tuesday’s NTSB board meeting, where the NTSB deliberated a highway crash in which four members of a college women’s softball team were ejected from their bus and died. None were wearing seatbelts. As I said in my testimony, these four young ladies would likely be alive today had they been wearing their seat belts.

For more than two decades, the NTSB has recommended primary enforcement of seat belt laws, and for just as long, Massachusetts has tried to enact a primary seat belt law. And after seeing too many deaths and injuries that would have been prevented and reduced had seat belts been used, the NTSB once again called on states to enact primary seat belt laws that apply to all vehicles that are equipped with a seat belt—whether it is a passenger car, a school bus, or a motorcoach.

When properly worn, seat belts are a person’s single greatest safety defense against injury and death in the event of a crash. However, they are only effective when used, and primary enforcement has been shown to significantly increase seat belt use in those states that have adopted it.

Take my home state of South Carolina, for example. In late 2005, South Carolina adopted primary enforcement of its seat belt law. At that time, seat belt usage in South Carolina was hovering around 74 percent. A decade later, seat belt usage in the state is 90 percent! Figures show that states that have enacted primary enforcement seat belt laws have experienced increased seat belt use rates between 5 and 18 percentage points.

Today, seat belt usage in Massachusetts is 76 percent—well below the national average of 87 percent. In fact, Massachusetts ranks 46^th in the nation for seat belt use.

As to be expected, an increase in seat belt usage is associated with a decrease in the number of injuries and fatalities. In her testimony before the Massachusetts Legislature, Dr. Lois Lee, an emergency medicine specialist, referred to a Boston Children’s Hospital study that found states with primary enforcement seat belt laws have a 17 percent lower rate of motor vehicle crash deaths than states that do not. Mary Maguire of AAA Northeast testified that a primary seat belt enforcement law in Massachusetts would save 18 lives each year and would prevent more than 650 traumatic injuries per year, including many life-altering spinal and brain injuries.

These are much more than theoretical statistics – there is very much a human side to each and every case. Dr. Michael Hirsh testified that the most painful part of his job as a 30-year pediatric trauma surgeon is when he goes to the hospital’s “quiet room” to meet anxiously waiting family members. “If I have an unbelted passenger or driver that was brought in, chances are I’m going to be giving very bad news,” Hirsh said. The tranquility of the quiet room is transformed by screaming and “wails and sadness that comes out of the parent, saying, ‘I can’t believe he wasn’t wearing his seat belt.’” 

Some claim that not using a seat belt is a personal choice and affects only the individual. While diverse viewpoints are appreciated and respected, that argument simply overlooks the significant societal costs associated with motor vehicle crashes. AAA Northeast’s Maguire testified that if Massachusetts adopted a primary enforcement law, Massachusetts would save nearly $1 BILLION in four years. That’s based on that fact that crash-related injuries and fatalities pose significant productivity and medical costs.

Seat belts save lives. Primary enforcement of seat belt laws is a proven, effective means of increasing seat belt use. Primary enforcement is a law Massachusetts and other states can’t live without.

Robert Sumwalt is a Member of the NTSB Board.

A Beautiful Mind; A Tragic Loss

By Robert L. Sumwalt

I spend a fair amount of time on airline flights these days. I usually spend most of that time working and catching up on reading. Late last month, however, I did something I rarely do – I watched an inflight movie. The movie, 2001’s “A Beautiful Mind,” starred Russell Crowe as Dr. John Nash, widely regarded as one of the greatest mathematicians of the 20^th Century.

The movie depicted many of Nash’s struggles with mental illness and how he overcame those struggles to be awarded the Nobel Prize for Economics in 1994. The last scene showed Nash and his wife, Alicia, departing the ceremony with happy words scrolling across the screen: “John and Alicia Nash live in Princeton, New Jersey. John keeps regular office hours in the Mathematics Department. He still walks to campus every day.”

Despite the movie’s happy ending, the real-life story did not end so happily. On May 24, 2015, just a few days before I watched the movie, John and Alicia Nash were killed in an automobile crash. The NTSB is not involved with the investigation of this crash, but according to news reports, they were sitting in the back seat of a taxi when another car ran into their vehicle. Neither John nor Alicia were wearing a seat belt; tragically, they were ejected from the vehicle and died at the scene. The taxi driver was treated for non-life threatening injuries.

The question that came to my mind was, “Why would someone so brilliant make such a devastating decision — not to wear a seatbelt?” Perhaps there’s a false sense of security when it comes to riding in the back seat, especially in taxis. CBS News recently featured a story, however, which should dispel any false beliefs about not needing to wear seat belts in the back seat.

The Insurance Institute for Highway Safety (IIHS) teamed with Children’s Hospital of Philadelphia to examine the characteristics of back seat safety. Among the report’s findings was that “the risk of serious injury was nearly 8 times higher among unrestrained rear-row occupants as compared with those using restraints.”

With numbers like that, each of us — mathematical genius and layperson alike – can understand why it is important to wear seat belts, even in the back seat. Make sure every occupant is buckled up when getting on the road.

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Robert L. Sumwalt has been a Member of the NTSB since 2006. He is a frequent contributor to the blog.

The Lives Seat Belts Might Have Saved

By Stephanie Shaw

According to research, nationwide, about 86 percent of us use our seat belts. A use rate that hasn’t really changed much over the last decade. And to most, that probably seems pretty good . . . until you realize that it means 14 percent still choose not to buckle up!

Let’s look at this a little closer.

The national belt use rate only reflects those people sitting in the front seat observed using a belt between 7am and 6pm. And it doesn’t show how the use rate differs from state to state. In states with a primary seat belt law, average belt use for front seat occupants is 90 percent; in states with a secondary law, it’s only 78 percent. It also doesn’t reflect the fact that seat belt use by back seat passengers is startlingly low.

In 2012, nearly 21,667 people died in motor vehicle crashes; more than 50 percent of them were not buckled up—lives the seat belt might have saved!

When used, lap/shoulder seat belts reduce the risk of fatal injury to front-seat passenger car occupants by 45 percent. It’s estimated that seat belts saved an estimated 12,174 lives in 2012.

Another startling fact not reflected in that 86 percent, the number of children not buckled up. Car crashes are a leading cause of death to children in the U.S. Every day, an average of 3 children age 14 and younger are killed and nearly 500 more are injured in motor vehicle crashes.

In 2012, there were 4,888 passenger vehicle occupants 14 and younger involved in fatal crashes. Among the children killed in those crashes, 40 percent were unrestrained.

When used, research shows that child safety seats reduce the risk of fatal injury by 71 percent for infants (younger than 1 year old) and by 54 percent for toddlers (1 to 4 years old) in passenger cars. Among children under age 5, an estimated 284 lives were saved in 2012 by the use of child safety seats and seat belts; 265 as a result of the use of child safety seats and 18 with the use of adult seat belts.

Occupant restraints such as child safety seats and seat belts save lives! If all passenger vehicle occupants age 5 and older had worn seat belts in 2012, more than 3,000 additional lives could have been saved. And, if all children under age 5 had used a child safety seat, an additional 59 lives could have been saved!

So, on every trip, make sure you and everyone in your car buckle up every time. Don’t let your life or the life of someone you love be the one the seat belt might have saved!