[Federal Register Volume 71, Number 56 (Thursday, March 23, 2006)]
[Proposed Rules]
[Pages 14675-14676]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 06-2835]


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DEPARTMENT OF TRANSPORTATION

National Highway Traffic Safety Administration

49 CFR Part 571

[Docket No. NHTSA-2006-23996]


Federal Motor Vehicle Safety Standards; Occupant Crash Protection

AGENCY: National Highway Traffic Safety Administration (NHTSA), DOT.

ACTION: Denial of petition for rulemaking.

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SUMMARY: This document denies a petition for rulemaking submitted by 
Mr. James E. Hofferberth, to amend Federal Motor Vehicle Safety 
Standard (FMVSS) No. 208, ``Occupant crash protection,'' to require 
automobile manufacturers to place an advisory placard in all passenger 
automobiles manufactured with both inflatable restraints and seat 
belts, advising that the seat belts should not be used by pregnant 
women. We are denying the petition because the requested placard would 
provide advice that is contrary to the safety of both the mother and 
the unborn baby.

FOR FURTHER INFORMATION CONTACT:
    For Non-Legal Issues: Ms. Carla Cuentas, Office of Crashworthiness 
Standards, National Highway Traffic Safety Administration, 400 Seventh 
Street, SW., Washington, DC 20590, Telephone: (202) 366-4583, 
Facsimile: (202) 366-1740.
    For Legal Issues: Mr. Chris Calamita, Office of Chief Counsel, 
National Highway Traffic Safety Administration, 400 Seventh Street, 
SW., Washington, DC 20590, Telephone: (202) 366-2992, Facsimile: (202) 
366-3820.

SUPPLEMENTARY INFORMATION:

I. Agency Advice: Pregnant Women Should Wear Their Seat Belt

    NHTSA recommends that pregnant women wear their seat belts. The 
American College of Obstetricians and Gynecologists (ACOG) \1\ and the 
Centers for Disease Control and Prevention \2\ also recommend that 
pregnant women wear seat belts. NHTSA publishes a brochure,\3\ 
developed in conjunction with ACOG and the National Healthy Mothers, 
Healthy Babies Coalition, that addresses this issue. The brochure 
explains that doctors recommend that pregnant women wear their seat 
belt and that, in a crash, seat belts are the best protection for both 
the pregnant woman and her unborn child. The brochure explains that 
even if a vehicle has air bags, a pregnant woman still needs to buckle 
up. Air bags are designed to work with seat belts, not replace them. 
Moreover, seat belts provide protection in types of crashes, including 
rollovers, in which air bags provide little or no protection. This is 
why, even though there have been many advancements in air bags, it is 
vital that occupants continue to use their seat belts.
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    \1\ American College of Obstetricians and Gynecologists. Car 
safety for you and your baby. May 1999. Patient Education: AP018.
    \2\ Centers for Disease Control and Prevention. Pregnancy Risk 
Assessment Monitoring System 1999 Report. Issued in 2003.
    \3\ NHTSA publication entitled ``Should pregnant women wear seat 
belts?'' dated September 2002. http://www.nhtsa.dot.gov/people/injury/airbags/buckleplan/Internet_Services_Group/ISG-Restricted/Buckle-Up%20America/pregnancybrochure/BUA_PregnancyNHTSAchange.pdf.
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II. Petition

    On June 1, 2005, Mr. James E. Hofferberth petitioned NHTSA to amend 
FMVSS No. 208, ``Occupant crash protection,'' to require automobile 
manufacturers to place an advisory placard in all passenger automobiles 
manufactured with both inflatable restraints and seat belts, that the 
seat belts should not be used by pregnant women. He has also requested 
that NHTSA establish an official position and associated press release 
on this matter so as to preempt and negate any state or local 
requirements that require seat belt usage by pregnant women.
    Mr. Hofferberth stated his beliefs that seat belts can cause 
serious injury or death to a pregnant woman and/or her unborn fetus in 
both crash impact and non-impact situations. He stated that in the 
presence of inflatable restraint systems, seat belts provide very 
limited additional injury prevention capacity to a pregnant woman. He 
did not submit any data in support of his petition.

III. Analysis of Petition

    In his petition, Mr. Hofferberth expressed his concern that seat 
belts can cause serious injury to a pregnant woman in both crash impact 
and non-impact situations. While pregnant women, like other occupants, 
can sustain belt injuries in certain crash impact situations, the 1999-
2004 National Accident Sampling System (NASS) Crashworthiness Data 
System (CDS) data show the reduction in serious injury associated with 
belt use is approximately 76 percent for pregnant women.\4\ In addition 
to this finding, the

[[Page 14676]]

data also show that the reduction in fatalities associated with belt 
use is approximately 90 percent for pregnant women. Therefore NHTSA 
considers this concern unwarranted by the facts. We are also not aware 
of any serious injuries to pregnant women caused by seat belts in non-
impact situations.
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    \4\ ``Supplemental Analyses of Crash Investigation Data'', 
Docket No. NHTSA-2006-23996. We note that the agency's regulatory 
impact analysis conducted in 1984 entitled, ``Final Regulatory 
Impact Analysis Amendment to FMVSS No. 208. Passenger Car Front Seat 
Occupant Protection'', estimated that manual 3-point safety belts, 
when used by drivers or right-front passengers of cars, reduce 
fatality risk by 40 to 50 percent relative to the unrestrained 
occupant. The percent reductions calculated above are higher than 
agency's overall safety belt effectiveness estimates because they do 
not account for confounding factors. Confounding factors include 
age, gender, speed limit, and occupant misinterpretation of belt 
use. Self-selection is another confounding factor, which suggests 
that a driver who is wearing a seat belt or who is pregnant will 
have a tendency to practice safer driving habits than an unbelted or 
non-pregnant driver.
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    Mr. Hofferberth also stated that in the presence of inflatable 
restraint systems, seat belts provide very limited additional injury 
prevention capacity to a pregnant woman. NHTSA does not concur with 
this statement. Seat belts alone are very effective in preventing 
fatalities in rollover crashes (74 percent fatality reduction in 
passenger cars and 80 percent for light trucks).\5\ Approximately 
10,000 people per year are killed in rollover crashes. Inflatable 
restraints that are designed for frontal impacts provide little injury 
prevention in side or rollover crash impacts. Thus, we do not agree 
that inflatable restraints alone would provide optimal protection to 
pregnant occupants under all crash circumstances, particularly rollover 
events.
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    \5\ Based on NHTSA study of 1986-99 FARS data, ``Initiatives to 
Address the Mitigation of Vehicle Rollover,'' June 2003.
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    Mr. Hofferberth also stated that seat belts are a known hazard to a 
fetus and that they are likely to cause serious injury or death in 
crash impact situations. The 1999-2004 NASS CDS data actually suggest 
that seat belt usage is advantageous for a fetus, because the estimated 
reduction in fatalities associated with belt use is approximately 89 
percent for fetuses. We also examined the 30 sampled cases involving 
fetal death in the 1999-2004 data. (We note that this number includes 
some for whom the crash report explicitly reported fetal death plus 
nine other fetuses for whom we inferred death based on the pregnancy 
term and the death of the mother.) National estimates based on these 
cases suggest that an average of 180 fetal deaths in crashes per year 
involved unbelted women, 73 involved belted women, and seven involved 
women for whom belt use could not be determined. Thus, an estimated 71 
percent of the identified fetal deaths were associated with pregnant 
women who were not using their seat belts at the time of the crash.
    Other evidence also supports the use of a properly positioned seat 
belt during pregnancy. Several research studies support our analyses 
that seat belts reduce the risk of fetal injury and have shown that 
pregnant women in crashes in which the mother wore her seat belt were 
not significantly more at risk for adverse fetal outcomes. The 
University of Utah undertook a study in 2003 on the effects of crashes 
on fetal outcomes and reported that pregnant women who did not wear 
seat belts during a crash were twice as likely to experience maternal 
bleeding and 2.8 times more likely to experience a fetal death than 
belted pregnant women in crashes.\6\ Pearlman et al. reported that in 
42 investigations involving pregnant occupants, an improperly 
restrained or unrestrained mother suffered an adverse fetal outcome 62 
percent of the time, whereas a properly restrained mother only suffered 
an adverse fetal outcome 27 percent of the time.\7\ This suggested that 
unrestrained pregnant women were at a higher risk of suffering an 
adverse fetal outcome than restrained mothers for the same crash 
severity. An additional paper by Pearlman, M., and Viano, D. found that 
when seat belts were placed in the position recommended by NHTSA on the 
pregnant crash test dummy, the outcome resulted in the lowest recorded 
readings of the force transmission to the uterus and fetal head 
acceleration.\8\ It further found that the abdominal force and fetal 
head acceleration were highest for the unrestrained pregnant occupant.
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    \6\ Hyde, Lisa K. et al., entitled ``Effect of Motor Vehicle 
Crashes on Adverse Fetal Outcomes,'' dated 2003. This research was 
partially supported by the Health Resources and Services 
Administration, Maternal and Child Health Bureau, NHTSA, and the 
Centers for Disease Control and Prevention.
    \7\ Pearlman, M. et al., entitled ``A comprehensive program to 
improve safety for pregnant women and fetuses in motor vehicle 
crashes: A Preliminary Report,'' dated October 1999. This work was 
supported by General Motors Corporation, pursuant to an agreement 
with the U.S. Department of Transportation.
    \8\ Pearlman, M., and Viano, D., ``Automobile crash simulation 
with the first pregnant crash test dummy,'' dated October 1996. This 
work was funded in part through the U.S. Department of 
Transportation, NHTSA grant DTNH22-95H-07157.
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IV. Conclusion

    Based on our analysis of the aforementioned information, NHTSA 
finds no basis to amend FMVSS No. 208 to require automobile 
manufacturers to place an advisory placard in all passenger automobiles 
manufactured with both inflatable restraints and seat belts advising 
pregnant women not to use their seat belt. The available information 
shows that seat belts are beneficial to both the mother and her unborn 
baby. Therefore, the requested placard would provide advice that is 
contrary to the safety of both the mother and the unborn baby.
    Subsequent to his initial petition, an additional letter from Mr. 
Hofferberth was received on September 8, 2005, requesting that NHTSA 
recall our publication that advocates belt usage by all pregnant women, 
because he believes it displays improper belt placement. Specifically, 
he believes the illustration could be interpreted as depicting improper 
positioning of the lap belt. His request to modify the illustration is 
denied. The illustration shows the lap belt positioned below the 
pregnant woman's belly and specifically states that the pregnant woman 
must ``adjust the lap belt across your hips/pelvis, and below your 
belly.'' NHTSA may consider whether the illustration or other aspects 
of the brochure can be improved in future revisions, but the agency is 
not making any changes at this time.
    Based on the foregoing, the agency is denying Mr. Hofferberth's 
petition to amend FMVSS No. 208, ``Occupant crash protection,'' in 
accordance with 49 CFR part 552. This completes the agency's review of 
the petition.

    Authority: 49 U.S.C. 322, 30111, 30115, 30117 and 30166; 
delegation of authority at 49 CFR 1.50.

    Issued on: March 20, 2006.
Stephen R. Kratzke,
Associate Administrator for Rulemaking.
[FR Doc. 06-2835 Filed 3-22-06; 8:45 am]
BILLING CODE 4910-59-P