Motor Vehicle Safety: Comprehensive State Programs Offer Best Opportunity
for Increasing Use of Safety Belts (Chapter Report, 01/03/96,
GAO/RCED-96-24).

In late 1994, the National Highway Traffic Safety Administration (NHTSA)
did a special nationwide survey on the use of safety belts. This survey
found the rate of safety belt use to be 58 percent. NHTSA's survey
suggests that although the use of safety belts has increased
substantially from the 11 percent reported in 1982, considerable
progress is still needed if the Department of Transportation is to meet
its current goal of 75-percent use of safety belts by 1997. The four
states--California, Hawaii, North Carolina, and Washington--that have
achieved rates of more than 80-percent use of safety belts have
comprehensive programs, including strong laws mandating use of safety
belts, visible and aggressive enforcement of these laws, and vigorous
programs to educate the public. An effective federal strategy to boost
the use of safety belts would be to encourage the states to establish
comprehensive programs that include all the elements that increase
safety belt use--primary enforcement laws with aggressive enforcement,
requirements that all occupants of vehicles that have belts installed
use them, fines that discourage noncompliance, and public education.
Current law does not require the occupants of cars' back seats or any
occupant of a light truck or a van to use safety belts. Neither does the
law specify primary and secondary enforcement. Given the increased
number of light trucks being sold and the low rate of seat belt use in
these vehicles, measures are needed to boost the rate of seat belt use
by the occupants of light trucks.

--------------------------- Indexing Terms -----------------------------

 REPORTNUM:  RCED-96-24
     TITLE:  Motor Vehicle Safety: Comprehensive State Programs Offer 
             Best Opportunity for Increasing Use of Safety Belts
      DATE:  01/03/96
   SUBJECT:  Motor vehicle safety
             Transportation statistics
             Highway safety
             Fines (penalties)
             State-administered programs
             Law enforcement
             National policies
             Public relations
             Traffic violations
             Federal/state relations
IDENTIFIER:  California
             Hawaii
             North Carolina
             Washington
             Maryland
             New Hampshire
             Louisiana
             Idaho
             Colorado
             Mississippi
             New York
             New Jersey
             South Carolina
             Canada
             Newfoundland (Canada)
             NHTSA Fatal Accident Reporting System
             NHTSA General Estimates System
             NHTSA National Occupant Protection Use Survey
             NHTSA Crash Outcome Data Evaluation System
             North Carolina Click It or Ticket Program
             New Jersey 101 Days of Summer Program
             Drive Smart Colorado Program
             
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Cover
================================================================ COVER


Report to the Subcommittee on Transportation and Related Agencies,
Committee on Appropriations, House of Representatives

January 1996

MOTOR VEHICLE SAFETY -
COMPREHENSIVE STATE PROGRAMS OFFER
BEST OPPORTUNITY FOR INCREASING
USE OF SAFETY BELTS

GAO/RCED-96-24

Increasing Use of Safety Belts

(342890)


Abbreviations
=============================================================== ABBREV

  CODES - Crash Outcome Data Evaluation System
  DOT - Department of Transportation
  FARS - Fatal Accident Reporting System
  GAO - General Accounting Office
  GES - General Estimates System
  ISTEA - Intermodal Surface Transportation Efficiency Act
  NHTSA - National Highway Traffic Safety Administration
  NOPUS - National Occupant Protection Use Survey
  NORP - National Occupant Restraint Program
  NTSB - National Transportation Safety Board

Letter
=============================================================== LETTER


B-260214

January 3, 1996

The Honorable Frank R.  Wolf
Chairman
The Honorable Ronald D.  Coleman
Ranking Minority Member
Subcommittee on Transportation and
 Related Agencies
Committee on Appropriations
House of Representatives

As requested, this report describes the nation's progress in
achieving goals for the use of safety belts in motor vehicles,
assesses the strategies used most successfully by some states to
increase the use of safety belts, and identifies federal strategies
that could help increase this use.  The National Highway Traffic
Safety Administration estimates that 10,000 deaths, 200,000 injuries,
and $20 billion in costs to society could be avoided annually if all
of the occupants of motor vehicles wore safety belts.  This report
presents a matter for congressional consideration and a
recommendation to the Secretary of Transportation aimed at further
increasing the use of safety belts. 

We are sending copies of the report to the Secretary of
Transportation and interested congressional committees.  We will also
make copies available to others upon request. 

Please call me at (202) 512-2834 if you or your staff have any
questions.  Major contributors to this report are listed in appendix
II. 

Sincerely yours,

John H.  Anderson, Jr.
Director, Transportation and
 Telecommunications Issues


EXECUTIVE SUMMARY
============================================================ Chapter 0


   PURPOSE
---------------------------------------------------------- Chapter 0:1

Traffic accidents annually result in over 40,000 deaths and over $130
billion in costs to society.  Each year, about 20,000 of the people
who die and another 600,000 people who are injured were not using
safety belts.  The Department of Transportation's (DOT) National
Highway Traffic Safety Administration (NHTSA) believes that
increasing the use of safety belts is the most effective way to lower
the nation's death toll from traffic accidents.  NHTSA estimates that
10,000 deaths, 200,000 injuries, and $20 billion in costs to society
could be avoided annually if all of the occupants of motor vehicles
wore safety belts. 

To assist federal and state deliberations on safety belt programs,
the Chairman and Ranking Minority Member, Subcommittee on
Transportation and Related Agencies, House Committee on
Appropriations, asked GAO to determine (1) the nation's progress in
achieving goals for the use of safety belts, (2) the strategies used
most successfully by some states to increase the use of safety belts,
and (3) federal strategies that could help increase this use. 


   BACKGROUND
---------------------------------------------------------- Chapter 0:2

For the last 30 years, the federal government has had an active
policy of reducing highway deaths and injuries by encouraging the use
of safety belts.  In 1968, DOT required that seat belts be installed
on all new automobiles sold in the United States.  DOT has also
worked with the states to encourage the occupants of motor vehicles
to "buckle up." However, NHTSA has reported that only about 11
percent of people used safety belts until the states adopted laws
mandating belt use in the mid-1980s.  The Intermodal Surface
Transportation Efficiency Act of 1991 (ISTEA) provided grants and
penalties to encourage the states to enact laws or improve the
enforcement of their existing laws mandating the use of safety belts. 
As of December 1, 1995, 48 states and the District of Columbia had
laws mandating the use of safety belts by some occupants of certain
types of motor vehicles.  New Hampshire and Maine had no such law. 

In May 1992, GAO reported\1 that numerous studies revealed that using
safety belts generally reduced the rates of fatalities and serious
injuries by 50 to 75 percent in traffic accidents and that fatalities
were 5 to 20 percent lower in the states with laws on safety belt use
than they were in the states without such laws.  Also, studies of
hospital costs showed that the crash victims who had not used belts
incurred medical costs that were 60 to 80 percent higher than those
of the victims who had used belts.  The general public (through
insurance premiums and tax-supported government programs) paid over
half of these costs.  GAO concluded that state laws mandating safety
belt use should be strengthened. 


--------------------
\1 Highway Safety:  Safety Belt Use Laws Save Lives and Reduce Costs
to Society (GAO/RCED-92-106, May 15, 1992). 


   RESULTS IN BRIEF
---------------------------------------------------------- Chapter 0:3

NHTSA reported rates of safety belt use of 62 percent in 1992 and 67
percent in 1994.  NHTSA recognized that it could not precisely
measure belt use nationwide because its methodology relied on
individual state surveys that did not measure belt use consistently. 
In late 1994, the agency conducted a special nationwide survey to
gather more data on the use of restraints.  This survey found the
rate of safety belt use to be only 58 percent.  NHTSA's survey
suggests that while the use of safety belts has increased
substantially from the 11 percent reported in 1982, considerable
progress is still needed if DOT is to meet its current goal of
75-percent use of safety belts by 1997. 

The four states--California, Hawaii, North Carolina, and
Washington--that have achieved rates of over 80-percent use of safety
belts have comprehensive programs, including strong laws on the
mandatory use of safety belts, visible and aggressive enforcement of
these laws, and vigorous programs to inform and educate the public. 
Most of the successful states have "primary enforcement" laws,
meaning that enforcement officials can stop and ticket a vehicle's
occupants solely for not using their safety belts.  California
reported an increase in safety belt use of 13 percentage points
within 1 year after changing to a primary enforcement law from a
secondary one (which allows a vehicle's occupants to be ticketed for
not using safety belts only if they have been stopped for another
violation).  Ten states have primary enforcement laws, while 39
states (including the District of Columbia) have secondary
enforcement laws. 

Several federal actions could increase the use of safety belts.  An
effective federal strategy would be to encourage the states to have
comprehensive programs that include all the elements that work
together to increase safety belt use--primary enforcement laws with
aggressive enforcement, requirements that all occupants of vehicles
that have belts installed use them, fines that discourage
noncompliance, and public education.  The current federal policy,
contained in the Intermodal Surface Transportation Efficiency Act of
1991, encourages the states to have laws mandating seat belt use by
the occupants of passenger cars' front seat.  The act does not
require the occupants of passenger cars' back seats or any occupant
of a light truck or van to use safety belts and does not specify
primary or secondary enforcement.  Given the increased number of
light trucks being sold and the relatively low rate of belt use in
these vehicles, special attention is needed to increase the rate of
belt use by the occupants of light trucks. 


   PRINCIPAL FINDINGS
---------------------------------------------------------- Chapter 0:4


      SAFETY BELT USE HAS
      IMPROVED, BUT GREAT
      POTENTIAL REMAINS
-------------------------------------------------------- Chapter 0:4.1

The available measures of the rates of safety belt use show large
increases nationwide since 1982, when NHTSA reported a use rate of 11
percent.  NHTSA's estimates, however, indicate that the increase in
belt use nationwide has moderated in recent years.  Although it is
relatively certain that safety belt use has increased overall, the
precise rate of belt use in the United States is unknown.  NHTSA
recognized that its estimate of 67-percent use in 1994 might not
accurately represent the nationwide use rate because this estimate
was based on state surveys that used different methodologies and thus
did not measure belt use consistently.  For example, 22 states
surveyed only passenger cars, while 20 states surveyed cars, light
trucks, and vans.  Also, some states counted only the drivers' use of
safety belts, while others included other passengers' use as well. 
To supplement the state surveys and to obtain additional data on the
use of restraints, NHTSA conducted a nationwide survey on belt use
during October and November 1994.  This survey found a nationwide use
rate of 58 percent--63 percent in passenger cars and 50 percent in
light trucks.  The rate for occupants of light trucks is important
because these vehicles now constitute about 40 percent of the new
vehicles sold. 

NHTSA could increase the reliability of the national average based on
the state surveys if the agency developed tighter guidelines for the
surveys and if the states consistently used those guidelines. 
However, these changes are unlikely to occur, since the states' laws
on safety belt use vary significantly and NHTSA no longer offers
financial incentives to encourage the states to improve their
surveys.  Using state surveys and the 1994 nationwide survey, NHTSA
has estimated that the rate of belt use nationwide is either 67 or 58
percent.  Given NHTSA's estimates, a substantial increase in belt use
must occur if DOT's goal of 75-percent belt use by 1997 is to be met. 


      SUCCESSFUL STATE PROGRAMS
      CONTAIN SEVERAL KEY
      COMPONENTS
-------------------------------------------------------- Chapter 0:4.2

Wide differences in the states' laws, enforcement, and other
activities concerning safety belts have contributed to belt use rates
in 1994 ranging from a low of 32 percent to a high of 84 percent,
according to reports by the states.  Four states reported rates of
over 80-percent belt use, while six reported rates of less than
50-percent use.  Those states that have been most successful in
increasing belt use generally have primary enforcement laws, visible
and aggressive enforcement, and active public information and
education programs.  Of the 10 states GAO visited, the 3 states with
primary enforcement laws averaged rates of belt use about 20
percentage points higher than the 6 states with secondary enforcement
laws.  California is the only state where recent data show the effect
of switching from a secondary to a primary enforcement law.  That
state reported an increase in safety belt use of 13 percentage points
within 1 year (1993) after changing its law from secondary to primary
enforcement and informing motorists of the change through news
coverage.  California officials said that enforcement activity
increased only slightly, while belt use increased substantially
because of an increased understanding on the part of the public that
ticketing could occur.  The states' estimates of belt use for 1994
show that use in the states with primary enforcement laws averaged 15
percentage points higher than use in the states with secondary
enforcement laws. 

Through concentrated enforcement efforts, many of the states GAO
visited were able to substantially increase the use of safety belts. 
For example, North Carolina, a state with a primary enforcement law,
reported an increase in its belt use rate from 65 to 80 percent in
1993 as a result of an active program of operating safety belt
checkpoints throughout the state.  Also, Idaho, a state with a
secondary enforcement law, reported an increase in its rate of belt
use from 35 to 53 percent over a 2-year period as a result of
increased enforcement.  Public information and education campaigns
are also very important for increasing safety belt use.  For example,
California used a concentrated information and education campaign
between November 1989 and November 1990 and reported an increase in
belt use from 42 to 52 percent. 


      IMPROVING FEDERAL STRATEGIES
      FOR INCREASING BELT USE
-------------------------------------------------------- Chapter 0:4.3

The Intermodal Surface Transportation Efficiency Act of 1991
encourages the states to have laws mandating safety belt use by the
occupants of passenger cars' front seat.  Those states not having
such laws must transfer up to 3 percent of their federal-aid highway
funds to their state highway safety programs.  The act does not
specify whether (1) the state law should involve primary or secondary
enforcement, (2) occupants of other vehicles such as light trucks and
vans or all occupants of any vehicle equipped with safety belts
should be included, or (3) fines should be assessed against violators
of the belt use laws.  Both NHTSA and the National Transportation
Safety Board have strongly supported the use of primary enforcement
by all states. 

Since the enactment of the Intermodal Surface Transportation
Efficiency Act in 1991, seven states that had no law have adopted
secondary enforcement laws.  Four states that had laws have revised
them:  Two of these states changed from primary to secondary
enforcement laws, and two changed from secondary to primary
enforcement laws.  Fines for not using safety belts have remained
low.  Only four states assess fines over $25--one more than GAO
reported in 1992.  Also, in 1992 the laws in 17 states did not
require the occupants of light trucks or vans to use belts, while the
laws in 7 states do not require it now.  Light trucks are an
increasing problem because of their unfavorable rates of rollover,
ejection of occupants, and safety belt use and because increasing
numbers of these vehicles are being sold. 

Several actions could increase the use of safety belts.  The House
Committee on Appropriations recently directed NHTSA, as part of its
1996 program, to develop and distribute a model safety belt law in
order to more aggressively encourage seat belt use nationwide.  In
addition, the states could implement comprehensive belt use programs
by enacting laws that provide for

  primary enforcement, so that enforcing safety belt laws does not
     depend on enforcing other traffic safety laws;

  coverage of all occupants in all vehicles with belts installed,
     including the occupants of passenger cars' rear seats and the
     occupants of light trucks and vans; and

  aggressive enforcement and higher fines to encourage belt use. 

Strong federal involvement has the advantage of facilitating the
nationwide implementation of comprehensive strategies that have
proven successful in the states in increasing belt use and reducing
deaths, injuries, and the costs to society.  A disadvantage is that
the states would have less discretion to structure their own
programs. 


   MATTERS FOR CONGRESSIONAL
   CONSIDERATION
---------------------------------------------------------- Chapter 0:5

Increased seat belt use has the potential to avoid thousands of
deaths and serious injuries and save billions of dollars in medical
costs, lost productivity, and other expenses that result annually
when the occupants of motor vehicles do not use safety belts.  The
federal government's role in encouraging seat belt use is ultimately
a policy decision for the Congress.  Current federal legislation
provides for both grants and penalties to encourage the states to
enact seat belt laws or improve the enforcement of existing laws. 
Comprehensive programs that include primary enforcement laws,
aggressive enforcement, and vigorous public education offer the best
opportunity for increasing belt use.  If the Congress wants to
promote such programs nationwide, it could encourage the states to
adopt primary enforcement laws that cover all the occupants of all
the vehicles in which belts are installed.  Those states that do not
enact such comprehensive laws could continue to be subject to the
provision in the Intermodal Surface Transportation Efficiency Act
requiring a transfer of up to 3 percent of their federal-aid highway
funds to their state highway safety programs. 


   RECOMMENDATION TO THE SECRETARY
   OF TRANSPORTATION
---------------------------------------------------------- Chapter 0:6

In view of the large difference in the rates of seat belt use between
the occupants of passenger cars and those of light trucks, we
recommend that the Department of Transportation provide special
emphasis and targeted programs to increase the use of safety belts by
the occupants of light trucks. 


   AGENCY COMMENTS
---------------------------------------------------------- Chapter 0:7

GAO provided copies of a draft of this report to DOT for its
comments.  GAO met with agency officials, including the Director,
Office of Occupant Protection, NHTSA.  These officials agreed with
GAO's findings, conclusions, matter for congressional consideration,
and recommendation.  The officials provided a number of editorial and
technical comments, which have been incorporated into the report
where appropriate. 


INTRODUCTION
============================================================ Chapter 1

The use of safety belts has long been considered an effective way to
reduce deaths and injuries on the nation's highways.  The Department
of Transportation (DOT) estimates that 10,000 additional lives could
be saved annually if all of the occupants of motor vehicles used
safety belts.  Safety belt technology has existed for more than a
century, but belts were not installed in new cars sold in the United
States until the mid-1960s.  Even after the belts were available,
relatively few people used them.  In 1984, New York became the first
state to enact a law mandating the use of safety belts.  Other states
soon enacted similar laws.  Currently, 48 states and the District of
Columbia have some form of law on using belts.  DOT's National
Highway Traffic Safety Administration (NHTSA) has estimated that
safety belt use increased from 11 percent in 1982 to 67 percent in
1994. 


   HIGH COSTS OF TRAFFIC ACCIDENTS
   AND NONUSE OF SAFETY BELTS
---------------------------------------------------------- Chapter 1:1

More than 40,000 people have died in traffic accidents in the United
States almost every year since 1960.  In 1966, 50,894 fatalities
occurred on the highways; in 1994, about 40,700 people died. 
Although crashes of airplanes and trains receive more attention from
the media, the number of highway fatalities far exceeds those that
occur in all other modes of transportation combined.  NHTSA estimates
that annually

  about 20,000 occupants of motor vehicles die in crashes while not
     using safety belts,

  about 600,000 occupants are injured in crashes while not using
     safety belts,

  more people are killed or seriously injured in road crashes than
     are the victims of crimes, and

  traffic crashes cost society over $130 billion annually. 

NHTSA estimates that from 1982 through 1994, 65,290 lives were saved
by safety belts, and about 1.5 million moderate to critical injuries
were prevented.  Despite these successes, enormous costs are still
generated when people do not use safety belts.  NHTSA reported in
June 1994 that not using belts results in 10,000 deaths and 200,000
moderate to critical injuries annually.\1 NHTSA estimates that these
deaths and injuries cost society $20 billion annually in medical
costs, lost productivity, and other injury-related expenses. 


--------------------
\1 Estimating the Benefits From Increased Safety Belt Use, U.S.  DOT,
NHTSA, Office of Regulatory Analysis Plans and Policy. 


   HISTORY OF SAFETY BELTS
---------------------------------------------------------- Chapter 1:2

Safety belts were developed in the 1880s to keep people from bouncing
off horse-drawn buggies.  However, automobile manufacturers did not
offer safety belts in vehicles until the 1950s.  In 1961, a few
states required that belts be installed in the new cars sold in their
states.  In 1962, manufacturers began to install safety belt
anchorages at the factory, making it easier for car dealers or owners
to add safety belts later.  In 1964, U.S.  manufacturers began making
safety belts standard equipment in the front seat of their cars. 

Various analyses have been conducted to show what happens to belted
and unbelted occupants of vehicles involved in crashes.  Figure 1.1
shows how a steering wheel, instrument panel, and windshield absorb
crash forces affecting an unbelted dummy. 

   Figure 1.1:  Unbelted Dummy in
   Crash

   (See figure in printed
   edition.)

Source:  Insurance Institute for Highway Safety. 

In May 1992, we reported the results of various studies on the
effectiveness of safety belts, laws on the mandatory use of belts,
and the costs of not using belts.\2 These studies showed that using
safety belts generally reduced the rates of both fatalities and
serious injuries by 50 to 75 percent in crashes involving motor
vehicles.  The studies also showed that state laws on safety belt use
reduced both fatalities and serious injuries by 5 to 20 percent, even
though the use of belts was relatively low during the periods in
which these studies were performed.  Most studies that addressed
hospital costs reported that the crash victims who had used belts
averaged 60 to 80 percent lower hospital costs than those who had not
used belts.  The studies also found that the occupants not using
belts who were injured in crashes paid less than one-half of their
hospital costs, since most of the costs were paid through insurance
premiums or Medicare and Medicaid.  The tax-supported programs paid
between 8 and 28 percent of the hospital costs. 


--------------------
\2 Highway Safety:  Safety Belt Use Laws Save Lives and Reduce Costs
to Society (GAO/RCED-92-106, May 15, 1992). 


      FEDERAL AND STATE LAWS
      PROMOTE SAFETY BELTS
-------------------------------------------------------- Chapter 1:2.1

The Congress and federal agencies have encouraged the installation
and use of safety belts since the mid-1960s, and the states began
enacting laws on safety belt use in the mid-1980s.  Under the initial
federal efforts, safety belts were required to meet minimum
standards.  Since few occupants of vehicles voluntarily used manual
safety belts, DOT issued a rule in 1984 mandating that passive
restraints--automatic safety belts and airbags--be phased in
beginning with 1987 model year cars.  Under the rule, the
installation of passive restraints could be avoided if states
representing two-thirds of the U.S.  population enacted satisfactory
laws mandating safety belt use.  This provision focused attention on
mandatory use laws and prompted automobile manufacturers and others
to provide funding and support for such laws.  The first state law
mandating safety belt use was enacted in New York in 1984; by 1986, a
total of 22 states and the District of Columbia had such laws in
effect. 

Since DOT's data showed little increase in safety belt use between
1987 and 1990, the Congress acted in 1991 to again focus attention on
increasing the use of safety belts.  The Intermodal Surface
Transportation Efficiency Act of 1991 (ISTEA) (P.L.  102-240)
included financial incentives--grants and penalties--to encourage the
states to enact basic safety belt laws and increase belt use.  ISTEA
provided for grants for up to 3 years to those states that had laws
mandating safety belt use and that achieved minimal levels of belt
use.  The grants totaled $12 million per year for fiscal years 1992
through 1994.  ISTEA also required those states that did not have
basic safety belt laws to transfer up to 3 percent of their
federal-aid highway funds to their state highway safety programs. 
Maine and New Hampshire are the only states that do not have laws on
safety belt use. 


   OBJECTIVES, SCOPE, AND
   METHODOLOGY
---------------------------------------------------------- Chapter 1:3

This report's objectives were to determine (1) the nation's progress
in achieving goals for the use of safety belts, (2) the strategies
used most successfully by some states to increase safety belt use,
and (3) federal strategies that could help increase this use.  Our
work was requested by the Chairman and Ranking Minority Member,
Subcommittee on Transportation and Related Agencies, House Committee
on Appropriations. 

To conduct our work, we visited NHTSA's headquarters in Washington,
D.C., the agencies responsible for highway traffic safety programs in
10 states (California, Colorado, Idaho, Maryland, Mississippi, New
Hampshire, New Jersey, New York, North Carolina, and South Carolina),
and the seven NHTSA regional offices with responsibility for the 10
states.  We judgmentally selected the 10 states to include a cross
section of state safety belt programs.  In making our selections, we
considered whether a state's survey on safety belt use had been
approved by NHTSA, whether the state had a law on safety belt use
involving primary or secondary enforcement, the fine the state
assessed for noncompliance with the law, the state's reported rate of
safety belt use (so that we selected states with relatively high and
low use), and the period in which the state's last survey on safety
belt use had been conducted.  At NHTSA and the state agencies, we
obtained and reviewed pertinent documents and discussed activities
concerning safety belts with officials.  More specifically, at the
various locations, we

  obtained and reviewed pertinent documents, including NHTSA's
     Regional Action Plans and the states' Highway Safety Plans,
     which described the state's strategies for increasing the use of
     safety belts and provided information on past successes;

  reviewed materials developed for public information and education
     campaigns and for community-based traffic safety programs;

  discussed with state officials what the federal government is
     currently doing to increase safety belt use, what is and is not
     working well, and what changes are desirable;

  reviewed appropriate laws and regulations and other relevant
     documents;

  reviewed the methodologies NHTSA used to calculate the rate of seat
     belt use nationwide;

  analyzed the methodologies used in state surveys to determine
     whether the states were consistent in how the surveys were
     planned and conducted; and

  reviewed NHTSA's guidelines on the state surveys of safety belt use
     to determine the extent to which the guidance provides for
     consistent surveys. 

Also, as requested, we met with the Canadian officials responsible
for implementing safety belt programs to learn what strategies Canada
had used to achieve that country's reported 90-percent rate of safety
belt use. 

We provided DOT with a draft of our report for review and comment. 
We conducted our review between June 1994 and December 1995 in
accordance with generally accepted government auditing standards. 


SAFETY BELT USE HAS INCREASED, BUT
NATIONAL GOALS HAVE NOT BEEN MET
============================================================ Chapter 2

NHTSA has reported that safety belt use increased from 11 percent in
1982 to 67 percent in 1994.  However, DOT's recent goals for safety
belt use nationwide have not been met.  For example, DOT had a goal
of 70-percent belt use by the end of 1992 and reported belt use in
1992 to be 62 percent.  DOT's current goal is to reach a rate of
75-percent belt use nationwide by 1997.  Using two different
methodologies, NHTSA has estimated the rate of safety belt use
nationwide in 1994 to be either 67 or 58 percent. 

NHTSA recognized that its methodology for estimating the 67- percent
nationwide rate of belt use was not precise because it relied on
individual state surveys that did not measure belt use consistently. 
For example, 22 states surveyed only passenger cars, while 20 states
surveyed cars, light trucks, and vans.  Also, some states counted
belt use by drivers only, while others included use by other
passengers as well.  During October and November 1994, NHTSA
conducted a nationwide survey to gather more detailed data on the use
of restraints.  This survey found a nationwide use rate of 58
percent--63 percent in passenger cars and 50 percent in light trucks. 
The rate in light trucks is important because these vehicles now
constitute about 40 percent of the new vehicles sold.  Given NHTSA's
estimates of a 58-percent or 67-percent nationwide rate of belt use
in 1994, significant progress must be made to meet DOT's goal of a
nationwide rate of 75-percent belt use by 1997. 


   NHTSA'S DATA INDICATE INCREASES
   IN SAFETY BELT USE
---------------------------------------------------------- Chapter 2:1

NHTSA has used various methodologies for estimating the rates of
safety belt use, and all show substantial increases since the early
1980s.  NHTSA's data indicate that the increase has been gradual from
one year to the next with two exceptions.  First, the largest
increase occurred during 1985-86 when the first state safety belt
laws went into effect.  The second largest increase occurred during
1991-93 when ISTEA provided financial incentives for the states to
enact safety belt laws and NHTSA initiated new programs with state
enforcement agencies.  The estimates indicate relatively small
increases in belt use before 1985, from 1987 through 1990, and
between 1993 and 1994.  Figure 2.1 shows the changes in safety belt
use nationwide since the early 1980s relative to the number of state
laws on safety belt use. 

   Figure 2.1:  Safety Belt Laws
   and Use Rates

   (See figure in printed
   edition.)

Source:  NHTSA.  Information for 1983-90 came from an annual NHTSA
survey of 19 cities; information for 1991-94 came from the state
surveys. 

Measures of safety belt use over time have been available from a
variety of sources, such as data about the occupants of vehicles
involved in crashes, telephone surveys, and surveys of belt use that
NHTSA performed until 1991 in 19 cities.  For reasons discussed
below, the various sources show very different rates of belt use. 
However, as figure 2.2 shows, all of the data sources show a
substantial increase in belt use since the early 1980s.  In addition,
the indicators show larger increases during periods of increased
federal and state emphasis on safety belt programs. 

   Figure 2.2:  Nationwide Rates
   of Safety Belt Use

   (See figure in printed
   edition.)

Source:  NHTSA. 

These other sources show different but not necessarily more reliable
use rates than those generally quoted by NHTSA and shown in figure
2.1.  From 1982 to 1991, NHTSA used a survey that sampled belt use in
19 cities as an indicator of the nationwide rate of belt use.  These
surveys were useful for tracking changes in use rates in the
particular cities included in the study, but the results from the
sample cities could not be statistically extrapolated to metropolitan
areas not in the sample or to any nonmetropolitan area.  A telephone
survey has been conducted almost every year since 1983, and the
results show higher belt use than NHTSA has reported.  This higher
result is understandable because other studies have shown that
respondents to telephone surveys tend to report higher use than is
actually observed. 

Data about the occupants of vehicles involved in crashes indicate
belt use rates both higher and lower than NHTSA's two reported
estimates, but these different results can be explained logically. 
NHTSA's Fatal Accident Reporting System (FARS) contains data only
from crashes in which someone died.  Belt use by the victims in these
crashes tends to be low because people who use belts tend to be
injured or uninjured rather than killed, so they are more likely to
be reported, not in FARS, but in NHTSA's General Estimates System
(GES) as involved in a crash resulting in injury or property damage
only.  In addition, the belt use reported in the GES data is higher
because the data generally come from statements made by the vehicles'
occupants, who tend to tell police officers that they were complying
with belt use laws.  This tendency is particularly evident in crashes
involving property damage only and no apparent injury. 

While the rates of safety belt use from the federal data on crashes
are of limited value in estimating belt use nationwide, they can be
useful for NHTSA and the states in evaluating the reasonableness of
the use rates shown in the state surveys.  The results of the state
surveys can be expected to be higher than the FARS results and lower
than the GES results for each state for the reasons explained above. 
NHTSA has developed a model that uses FARS data to predict actual
belt use, and these results have been compared with the results from
state surveys.  While the model does not consider all of the relevant
differences among the states, NHTSA officials told us that these
comparisons of estimates of safety belt use from the state survey
data and FARS generally support the reasonableness of the results of
the state surveys. 

Figure 2.2 also demonstrates the importance of changes in the
surveys' methodology and the effects such changes can have on the
results of an analysis.  Figure 2.1 shows NHTSA's analysis of
nationwide rates of belt use between 1983 and 1994.  According to
NHTSA, the sources of the information were the 19-city survey from
1983 through 1990 and the state surveys from 1991 through 1994. 
Figure 2.2 shows that there were 2 years--1990 and 1991--in which the
rates from both the 19-city survey and the state surveys were
computed.  The state surveys, using a different methodology, showed
results 4 percentage points higher in 1990 and 8 percentage points
higher in 1991 than the 19-city survey showed.  As a result, a
substantial portion of the 10-percentage point increase shown in
figure 2.1 between 1990 and 1991 was caused by the change in the
surveys' methodology.  Although NHTSA may have used the best
available data for those years, the change in methodology is an
important factor to consider when analyzing the trend. 


   67-PERCENT BELT USE RATE FOR
   1994 IS NOT RELIABLE
---------------------------------------------------------- Chapter 2:2

NHTSA's estimate of a 67-percent nationwide rate of safety belt use
for 1994 is not reliable because the rate is based on state surveys
that used different methodologies that do not consistently measure
belt use.  For example, 22 states surveyed only passenger cars, while
20 states surveyed cars, light trucks, and vans; the other states
surveyed two of the three vehicle categories.  Five states measured
belt use by drivers only, and the others measured use by drivers and
occupants of the vehicles' right front seat; no state surveyed belt
use by the occupants of the rear seats.  The methodologies used for
the state surveys also varied in selecting observation locations and
in weighting the results.  Some states exempted sparsely populated
areas from their sampling plans, while others considered all
geographic areas eligible for sampling.  Also, some states conducted
annual surveys, while others did not. 

NHTSA estimated the 67-percent nationwide rate of safety belt use for
1994 by using 34 state surveys conducted in 1994, 16 surveys
conducted before 1994, and information on belt use from Wyoming's
crash data.  NHTSA calculated the nationwide use rate by taking each
state's most recent rate and weighting the rate by each state's
population as a proportion of the total U.S.  population.  In our
opinion, this methodology does not provide a reliable estimate of the
nationwide rate of safety belt use because it relies on state surveys
that use very different methodologies.  NHTSA has acknowledged that
the state surveys on safety belt use differ in design.  However,
NHTSA pointed out that 28 states--representing over 70 percent of the
U.S.  population--conducted probability-based observational
surveys.\1 Nevertheless, the agency also said that the remaining
states conducted surveys in which their observation sites, while
usually adequate in number, were not randomly selected.  As a result,
no confidence intervals\2 can be calculated from these survey
results. 

In our May 1992 report, we found that statewide data on safety belt
use was questionable.\3 NHTSA analysts had told us that the statewide
rates of safety belt use provided by the states were generally not
based on probability sampling techniques that would provide
statistically valid estimates.  The states had used a variety of
methods that differed in reliability.  The states' data on the rate
of belt use were particularly important at that time because ISTEA
provided for grants to the states on the basis of these rates.  Funds
were allocated to the states during fiscal years 1992-94 in part on
the basis of the rates of safety belt use as measured by the state
surveys. 

To improve the quality of the data in the state surveys, in June 1992
NHTSA finalized guidelines for state observational surveys of belt
use.  These guidelines allowed the states substantial latitude in
designing and carrying out the surveys.  Although the guidelines were
very flexible and NHTSA helped the states conform with the
guidelines, only 28 states received NHTSA's approval of their survey
methodology.  NHTSA officials said that some additional states might
be performing a survey that either conforms to the guidelines or
nearly conforms, but these states did not need NHTSA's approval of
their survey plan.  Since the grants are no longer available, there
is no financial incentive for the states to have their survey plan
conform with NHTSA's guidelines. 

A NHTSA contractor commented on the use of data from the state
surveys for developing a nationwide belt use estimate as follows:\4

     "Available state estimates of safety belt use cannot be used to
     produce a national estimate.  Review of the designs of all
     states that have conducted state-level surveys of occupant
     restraint systems has confirmed that results across states are
     not comparable and cannot be used to produce a national
     estimate."

We agree with the contractor's comments.  However, NHTSA officials
said that the lack of consistency among the state surveys does not
preclude using the surveys to develop a reasonable annual estimate of
belt use nationwide.  They also said that it was important for states
to continue to perform surveys so that each state can identify trends
and specific local problems with belt use. 


--------------------
\1 A probability-based survey is one in which the units (i.e.,
vehicles) sampled are chosen with a known likelihood or probability. 

\2 A confidence interval is a range around the estimate that is
calculated to indicate how closely the result could be reproduced in
a complete count of the universe using the same measurement methods. 

\3 GAO/RCED-92-106. 

\4 National Safety Belt Survey Sample Design:  Final Report
(Washington Consulting Group, Washington, D.C.:  Apr.  15, 1994). 


   NHTSA'S MOST RECENT SURVEY
   REVEALS 58-PERCENT RATE OF BELT
   USE
---------------------------------------------------------- Chapter 2:3

Recognizing that the data from the state surveys were limited in
scope, NHTSA in 1994 conducted a special national analysis--the
National Occupant Protection Use Survey (NOPUS).  Data were collected
by observing traffic at about 4,000 randomly selected sites in 25
states during October, November, and December 1994.  NOPUS was used
to estimate the nationwide rate of belt use and to obtain detailed
data on (1) belt use by vehicle type and the occupant's age and
gender and (2) the misuse of belts. 

The initial results from NOPUS were released by NHTSA in early 1995
and showed an overall nationwide rate of safety belt use of 58
percent for 1994.  These results indicate, among other things, that
the drivers tend to use safety belts more frequently than the
passengers in the right front seat and that belt use is higher in the
western United States than in the rest of the country.  The NOPUS'
breakout by vehicle type showed an overall rate of 63-percent belt
use for the occupants of passenger cars and a 50-percent rate of use
for the occupants of light trucks.\5 This breakout for light trucks
is particularly important because these vehicles make up about 40
percent of the new vehicles sold.  NHTSA recently estimated that
annually 3,600 occupants of light trucks die and 54,000 are injured
because they do not use safety belts.\6

This disparity in belt use rates between the occupants of passenger
cars and light trucks indicates that special emphasis and targeted
programs may be needed to increase belt use in light trucks.  Part of
the disparity could relate to the fact, discussed in chapter 4, that
several states' laws on belt use do not cover the occupants of light
trucks. 

NHTSA officials believe that NOPUS' findings generally support the
estimates of the nationwide rate of belt use calculated from the
state surveys but agree that comparing the rates in the NOPUS and the
state surveys is difficult.  NHTSA plans to conduct another NOPUS
survey if funds become available, but the agency plans to continue
using the state surveys to annually estimate the nationwide rate of
belt use.  The 67-percent weighted average from the state surveys and
the 58-percent rate from NOPUS both fall within the range of
estimates of belt use based on other data.  Both estimates reveal
that substantial progress must be made if DOT's goal of 75-percent
belt use by 1997 is to be achieved. 


--------------------
\5 In our May 1992 report on safety belts, we mentioned this
disparity in safety belt use between the occupants of passenger cars
and light trucks.  The recent NOPUS data on the disparity support the
limited data that were available at the time of our report. 

\6 Estimating the Benefits From Increased Safety Belt Use, NHTSA
Office of Regulatory Analysis, Plans and Policy, June 1994. 


   CONCLUSIONS
---------------------------------------------------------- Chapter 2:4

Safety belt use increased from 11 percent in 1982 to a reported 67
percent in 1994.  Much of the increase resulted from the adoption of
laws mandating safety belt use by 48 states and the District of
Columbia.  Increases in belt use can also be noted during the years
in which federal funds were provided to the states for improving
their safety belt programs.  Belt use in light trucks and vans has
remained relatively low.  These vehicles are not covered by federal
law or by the laws of several states. 

NHTSA has recognized that individual state surveys do not measure
belt use consistently.  NHTSA could improve the guidelines for the
state surveys, but the effect of such improvements could be minimal
since the state laws vary significantly and NHTSA does not offer
financial incentives to encourage the states to improve their
surveys.  Given NHTSA's two reported nationwide rates of belt use--67
or 58 percent--significant progress must be made if the nation is to
achieve DOT's goal of a rate of 75-percent use of safety belts by
1997. 


PRIMARY ENFORCEMENT LAWS AND
AGGRESSIVE ENFORCEMENT ARE KEY TO
INCREASED BELT USE
============================================================ Chapter 3

The states that are most successful in increasing safety belt use
have comprehensive programs that include primary enforcement laws,
visible and aggressive enforcement, and vigorous public information
and education programs.  Primary enforcement laws allow law
enforcement officials to stop and ticket a vehicle's occupants solely
for not using their safety belts.  Ten states currently have safety
belt use laws allowing primary enforcement, while 39 states including
the District of Columbia have laws allowing for only secondary
enforcement.  NHTSA estimated that the rates of belt use in the
states with primary enforcement laws were 15 percentage points higher
in 1994 than the rates in the states with secondary enforcement laws. 


   SUCCESSFUL STATE SAFETY BELT
   PROGRAMS CONTAIN SEVERAL
   COMPONENTS
---------------------------------------------------------- Chapter 3:1

The states' laws on safety belt use differ widely in enforcement,
coverage, and fines, but the most successful programs share several
common key components.  Appendix I shows the 1994 rates of safety
belt use that the states reported to NHTSA, as well as some
information about the belt laws in each state.  As reported by the
states, the rates of belt use in 1994 ranged from a low of 32 percent
to a high of 84 percent; four states reported rates of over
80-percent belt use, while five reported rates of less than
50-percent use. 

To understand the key components of a successful safety belt program
and how they work together to increase belt use, we visited 10 states
and their respective NHTSA regional office.  As shown in table 3.1,
the 10 states we visited included 3 states with primary enforcement
laws, 6 states with secondary enforcement laws, and 1 state with no
law. 



                               Table 3.1
                
                 State Laws and Reported Belt Use Rates
                             for 10 States

                                                                    Us
                                                Primary              e
                                Effectiv  Seat  vehicles        Fi  ra
State                           e date\a  s     covered         ne  te
------------------------------  --------  ----  --------------  --  --
States with primary enforcement laws (3)
----------------------------------------------------------------------
California                        1/1/86  All   Passenger       $2  83
                                                cars, vans,      0   %
                                                and small
                                                trucks

North Carolina                   10/1/85  Fron  Passenger       $2  81
                                          t     vehicles for     5   %
                                                under 11
                                                passengers

New York                         12/1/84  Fron  Motor vehicles  $5  72
                                          t     except for       0   %
                                                special use


States with secondary enforcement laws (6)
----------------------------------------------------------------------
Maryland                          7/1/86  Fron  Passenger/      $2  69
                                          t     multipurpose     5   %
                                                vehicle, bus,
                                                truck, and
                                                tractor

New Jersey                        3/1/85  Fron  Passenger       $2  64
                                          t     automobiles      0   %

South Carolina                    7/1/89  Fron  Passenger       $1  64
                                          t     cars, trucks,    0   %
                                                vans, and
                                                recreational
                                                vehicles

Idaho                             7/1/86  Fron  Motor vehicle   $5  61
                                          t     weighing under       %
                                                8,000 pounds

Colorado                          7/1/87  Fron  Passenger       $1  54
                                          t     cars, vans,      5   %
                                                recreational
                                                vehicles, and
                                                small trucks

Mississippi                      3/20/90  Fron  Motor vehicles  $2  43
                                          t     for under 11     5   %
                                                passengers


State with no safety belt law (1)
----------------------------------------------------------------------
New Hampshire                      N/A\b  N/A   N/A             N/  54
                                                                 A   %
----------------------------------------------------------------------
\a Date first law mandating safety belt use became effective. 

\b N/A = not applicable. 

Source:  NHTSA and state highway safety programs. 

Officials in each NHTSA regional office and state we visited stressed
that primary enforcement laws were the best way to increase safety
belt use but that the other components were needed to maintain that
rate of increase.  They also stated that in the absence of a primary
enforcement law, the most effective way to increase safety belt use
was a secondary enforcement law combined with active community
involvement in law enforcement and public education and information
activities aimed at increasing the use of safety belts.  Figure 3.1
shows that the 3 states with primary enforcement laws we visited
significantly increased belt use after adopting such a law.  Of the
10 states we visited, the average belt use of the 3 states with
primary enforcement was about 20 percentage points higher than the
average belt use of the 6 states with secondary enforcement. 

   Figure 3.1:  Trends in Safety
   Belt Use for Three States With
   Primary Enforcement Laws

   (See figure in printed
   edition.)

Figure 3.2 shows that the six states with secondary enforcement laws
we visited experienced increases in safety belt use after adopting
such a law.  However, the two figures together show that the overall
rates of belt use for the states with secondary enforcement are much
lower than the rates of the states with primary enforcement. 

   Figure 3.2:  Trends in Safety
   Belt Use for Six States With
   Secondary Enforcement Laws

   (See figure in printed
   edition.)


   PRIMARY ENFORCEMENT LAWS ARE
   KEY TO INCREASING SAFETY BELT
   USE
---------------------------------------------------------- Chapter 3:2

States with primary enforcement laws have been the most successful in
increasing safety belt use.  This success is the result of law
enforcement officers stopping and assessing fines to a vehicle's
occupants solely for not using their safety belts.  Officials of
state safety belt programs work with law enforcement agencies to
encourage enforcement and also to help educate and inform the public
about the law and the consequences of noncompliance.  According to
state officials, one of the most successful ways to reach the public
is by involving community groups in programs aimed at increasing
safety belt use. 

The ability of primary enforcement laws to increase safety belt use
is best illustrated by California's upgrade of its law mandating
safety belt use from a secondary enforcement law to a primary
enforcement law.  In November 1992, California reported a rate of
safety belt use of 70 percent.  At that time, California's secondary
enforcement law had been in place for about 7 years.  On January 1,
1993, California implemented a primary enforcement law, resulting in
an increase in safety belt use of 13 percentage points for a
statewide rate of 83 percent in late 1993, according to the results
of a state survey.  California officials actively publicized this
change in the law.  A survey of some California drivers conducted
during March through September 1993 found that 90 percent of those
surveyed knew that they could be stopped for violating a belt law
alone and 75 percent felt that the law was being strictly enforced. 
California increased only slightly the number of citations issued
during this period.  Therefore, NHTSA officials believe that the
change to a primary enforcement law is the primary reason for the
significant increase in belt use. 

Primary enforcement laws increase safety belt use, but sustained and
increased safety belt use can be better achieved when these laws are
supported with enforcement and public education and information
activities.  North Carolina provides an example of how these
activities, when associated with a primary enforcement law, can
dramatically increase safety belt use.  Before implementing its
primary enforcement law in October 1985, North Carolina had a rate of
safety belt use of 24 percent.  During a 15-month period when only
warnings were issued to violators, the reported rates of safety belt
use ranged from 41 to 49 percent.  On January 1, 1987, citations
began to be issued for not using a belt, and the reported rate of
belt use quickly increased to 78 percent.  However, after a few
years, state surveys showed that the rate of belt use had dropped
back to 60 percent. 

In September 1993, North Carolina embarked on a multiyear
campaign--"Click It or Ticket"--to further increase safety belt use
and reduce related injuries and fatalities.  This intensive
enforcement and publicity campaign is credited with increasing North
Carolina's reported rate of safety belt use by 15 percentage points
in 3 months--65 to 80 percent--and with achieving North Carolina's
current rate of 81 percent.  The campaign featured increased and
highly visible enforcement through the use of safety belt
checkpoints.  These activities were publicized locally, and the
message provided to the public was that activities to enforce the
safety belt law were the major focus of local law enforcement
agencies during the first 4 weeks of the program.  This highly
visible program was also directly endorsed by North Carolina's
governor, who cited the high costs society pays for individuals who
do not use their safety belts.  State officials report that in its
first 6 months, the "Click It or Ticket" campaign saved 45 lives,
prevented 320 disabling injuries, and saved more than $51 million in
health care and other costs. 

New York has also used enforcement and public education and
information activities to sustain and increase the rate of safety
belt use that the state achieved after it passed the nation's first
law mandating safety belt use on December 1, 1984.  Before the
passage of this law, New York's rate of safety belt use was estimated
to be 16 percent.  Within 6 months, the state's reported rate of belt
use increased to 57 percent.  New York now reports a belt use rate of
72 percent.  This gain was primarily due to the emphasis placed on
enforcing the law through police training and an increase in the
number of citations issued.  New York has also used public
information campaigns and special workshops on restraints for
children.  NHTSA officials told us that the state's ability to
continue to positively affect the rate of safety belt use results
from their emphasis on establishing and incorporating community-based
networks into programs to improve traffic safety. 


   SECONDARY ENFORCEMENT LAWS CAN
   INCREASE SAFETY BELT USE
---------------------------------------------------------- Chapter 3:3

States with secondary enforcement laws are also successful in
increasing safety belt use, but their success is limited by the
difficulty in effectively enforcing the law.  Today, 38 states and
the District of Columbia have secondary enforcement laws, which allow
a vehicle's occupants to be ticketed for not using safety belts after
they have been stopped for another violation.  The success of
secondary enforcement laws depends on how well the states work with
law enforcement agencies to encourage enforcement and reach out to
community members to educate and inform them about the laws and the
importance of using safety belts.  The states' efforts to strengthen
laws on restraints for children also contribute to increasing adults'
use of safety belts. 

For the six states with secondary enforcement laws that we visited,
the laws contributed greatly to increasing the rates of safety belt
use.  Also important were aggressive enforcement and public education
and information activities.  For example, Idaho was able to increase
its reported rate of belt use by 24 percentage points--from 35
percent in June 1990 to 59 percent in September 1993--through an
increased emphasis on education and enforcement at the local level. 
Idaho used some of its highway safety funds to provide grants to the
local law enforcement agencies that administered these programs. 
These agencies provided the community with information and education
on safety belts and child restraints, and trained law enforcement
officers on the use of restraints and the need for increased
enforcement.  To receive these grants, the enforcement agencies were
required to have a policy of writing one safety belt citation for
every five citations for hazardous violations.  This approach greatly
increased the number of citations issued for safety belt violations
and resulted in a statewide rate of belt use of 61 percent in 1994. 

New Jersey was also able to increase its rate of safety belt use
substantially through increased enforcement activities.  From 1990 to
1991, New Jersey doubled the number of safety belt citations issued,
resulting in a reported increase of 18 percentage points--from 50
percent to 68 percent--in its rate of safety belt use.  New Jersey
also was very active in public information and education, including a
"101 Days of Summer" publicity campaign that emphasized why it was
important to use safety belts and activities connected with "Buckle
Up America Week." New Jersey's safety officials are attempting to
upgrade the state's safety belt law to a primary enforcement law
because they believe this change could immediately increase the
state's rate of safety belt use by up to 12 percentage points.  New
Jersey reported a current rate of safety belt use of 64 percent. 

Other states with secondary enforcement laws we visited have not
experienced the level of increase in use rates that Idaho and New
Jersey have.  Colorado, for example, reported an increase in its use
rate to 51 percent from 18 percent when it implemented its law on
July 1, 1987, but has not been able to make substantial progress
since that time.  As of January 1995, Colorado reported a use rate of
54 percent.  However, the state believes its rate will likely
increase as its many activities are implemented.  For example, the
state is training law enforcement officers to enforce the safety belt
law and is conducting a "Drive Smart Colorado" campaign that assists
community leaders in developing strategies and programs to ensure the
safety of the traveling public.  Also, Colorado recently amended its
law on restraints for children to increase the age of the children
covered by the law from 4 to 16. 

New Hampshire, which has no law on mandatory belt use, shows how
having a law on restraints for children and aggressive public
information and education about that law can contribute to increased
adult use of safety belts.  In 1984, New Hampshire found that only 16
percent of drivers were using safety belts.  Since then, the largest
reported annual increase in New Hampshire's rate of safety belt use
by adults--from 37 percent in 1988 to 50 percent in 1989--coincided
with an increase in the age of the children covered by the law on
restraints for children from up to age 4 to up to age 12.\1 This
change in the law provided New Hampshire with the opportunity to
educate and inform the public about the child restraint law and the
consequences of not using safety belts and then being involved in a
traffic accident.  In September 1994, New Hampshire reported a rate
of safety belt use by adults of 54 percent.  State officials said
that this latest increase can be attributed to another change in the
child restraint law (effective Jan.  1, 1994), which requires
children up to age 4 to be restrained in a proper restraint system--a
car seat. 


--------------------
\1 The Insurance Institute for Highway Safety has been critical of
New Hampshire's methodology for measuring safety belt use.  The
Institute believes that the state's reported use rate is higher than
the actual rate of belt use because of an alleged bias in the state's
sampling criteria for the site survey. 


   CONCLUSIONS
---------------------------------------------------------- Chapter 3:4

The states that are most successful in increasing their rates of
safety belt use have comprehensive programs that include mandatory
primary enforcement laws that are visibly and aggressively enforced. 
These states also actively educate and inform the public about the
laws, their benefits, and the consequences of noncompliance.  Those
states that do not have mandatory safety belt laws involving primary
enforcement can also achieve increased safety belt use through
increased enforcement of their secondary enforcement laws and through
effective efforts to educate and inform the public.  However, given
the benefits in increased use rates that primary enforcement laws
provide, the effectiveness of the state programs that are currently
based on secondary enforcement laws could be dramatically increased
through the implementation of primary enforcement laws, assuming the
other program elements are continued. 


FEDERAL STRATEGIES FOR INCREASING
SAFETY BELT USE
============================================================ Chapter 4

Stronger state laws on safety belt use could increase the rates of
belt use, annually preventing thousands of deaths and serious
injuries and saving up to $20 billion.  Various studies have shown
that the public pays for most of the costs resulting from not using
safety belts through higher taxes and insurance premiums.  While
various federal actions could be taken to increase safety belt use,
an effective strategy would encourage the states to have
comprehensive programs, including primary enforcement laws with
aggressive enforcement, coverage of all occupants in vehicles with
belts installed, fines that discourage noncompliance, and public
education.  The current federal policy, contained in ISTEA,
encourages the states to have a law mandating safety belt use that
covers occupants of passenger cars' front seats.  ISTEA does not
specify a primary or secondary enforcement law and does not require
occupants of passenger cars' rear seats or any occupants of light
trucks and vans to use safety belts. 


   NONUSE OF SAFETY BELTS
   GENERATES LARGE COSTS TO
   SOCIETY
---------------------------------------------------------- Chapter 4:1

In June 1994, NHTSA reported\1 that the nonuse of safety belts by
occupants of passenger cars results in about 6,200 deaths and 150,000
moderate to critical injuries each year.  Additionally, 3,600
occupants of light trucks and multipurpose vehicles die and 54,000
are injured unnecessarily because they do not use safety belts. 
NHTSA estimated that these deaths and injuries cost society $20
billion annually in medical costs, lost productivity, and other
injury-related expenses.  Most of these costs are borne by society in
the form of tax-supported programs and insurance premiums. 

In response to a mandate in ISTEA,\2 NHTSA analyzed data from seven
states to determine the benefits of medical care for crash victims
and who pays for that care.  This Crash Outcome Data Evaluation
System (CODES) project linked statewide data from police reports on
motor vehicle crashes with computerized data from emergency medical
services, hospital emergency departments, hospital discharges, and
other activities so that the costs of the medical treatment of people
injured in traffic crashes could be tracked.  CODES obtained data on
about 880,000 vehicle drivers for various periods between 1990 and
1992 in the seven states.  The final report is expected to be
provided to the Congress in February 1996. 

The preliminary data from CODES indicates there is a direct
relationship between safety belt use and the medical costs resulting
from traffic crashes.  The average charges for all drivers (including
those not hospitalized) in the CODES study who were involved in
crashes was $562 for those not using safety belts and $110 for those
using belts.  Thus, those drivers using safety belts averaged 80
percent lower charges.  For crash victims who were actually admitted
to hospitals, the average charges were $13,937 for those not using
safety belts and $9,004 for those using belts, which indicates a
35-percent reduction in hospital charges when safety belts were used. 

The data from CODES are consistent with the data from other studies. 
Our May 1992 report on the effectiveness of safety belts presented
the results from eight studies containing data on the effectiveness
of safety belts in reducing hospital charges.  All the studies showed
that hospital costs were lower for the vehicle occupants using safety
belts than for the occupants not using belts.  The victims who used
belts had average hospital costs that were from 27 to 87 percent
lower than those of the victims who did not use belts; most of the
studies showed costs between 60 and 80 percent lower.  Stated another
way, most of the studies showed the hospital costs for the crash
victims who did not use belts to be 2-1/2 to 5 times the cost for the
victims who used belts.  The studies also provided data showing that
safety belts reduce other costs related to injuries in traffic
crashes, such as ambulance costs or insurance claims costs for
personal injury.  While the studies discussed in that report
indicated a higher rate of temporary and permanent disability for the
victims who did not use belts, the data on such long-term effects
were generally not available.  Unfortunately, none of the studies
captured information on the level of income replacement resulting
from providing disability or welfare benefits to victims who did or
did not use belts. 

CODES and other studies have shown that society pays a large part of
the costs of medical treatment for those injured in traffic crashes. 
Preliminary data from CODES show that the public paid 16 percent of
these costs through such programs as Medicare and Medicaid.  About 69
percent was paid by private insurance, which spread the cost to all
who pay insurance premiums.  At the time the victims were discharged
from the hospital, only 15 percent of the charges were classified as
paid by others, generally "self payers." NHTSA pointed out in its
draft report that these self payers often are unable to pay their
bills, and the cost of providing this care is ultimately passed on
through higher charges for those who do pay. 

CODES data show that the general public may pay a larger portion of
the costs than some of the earlier data showed.  NHTSA published a
report in January 1992 that used data from five states to estimate
the costs of hospital care for people injured in motor vehicle
crashes in 1990 and the sources of payment of those costs.\3 Those
data show that 29 percent was paid by government sources, 52 percent
by insurance, and 19 percent by others.  Five studies of hospital
costs that we reviewed for our May 1992 report\4 also collected data
on medical payments for crash victims.  Among the victims who did not
use belts, from 8 to 28 percent were covered by Medicare or Medicaid,
from 41 to 55 percent were covered by insurance, and the remaining 22
to 49 percent were considered self payers.  Some costs not covered by
public programs or insurance ultimately will not be paid by the
injured person or the person's family, so a portion of the costs to
self payers will be paid by other sources of funding for the
hospitals. 


--------------------
\1 Estimating the Benefits From Increased Safety Belt Use, DOT,
NHTSA, Office of Regulatory Analysis Plans and Policy (June 1994). 

\2 NHTSA has prepared a draft report entitled Report to Congress on
the Benefits of Safety Belts and Motorcycle Helmets Based on Data
from CODES--The Crash Outcome Data Evaluation System.  The draft
includes an analysis of data from seven states. 

\3 Joan S.  Harris, Source of Payment for the Medical Cost of Motor
Vehicle Injuries in the United States, 1990, DOT HS 807 800, U.S. 
DOT, National Highway Traffic Safety Administration (Jan.  1992). 

\4 GAO/RCED-92-106. 


   FEDERAL EFFORTS HAVE INCREASED
   BELT USE, BUT STATE LAWS ARE
   NOT COMPREHENSIVE
---------------------------------------------------------- Chapter 4:2

The federal government has recognized the benefits of safety belts
and has been requiring their installation and encouraging their use
since the mid-1960s.  Federal efforts have been effective in
encouraging the states to enact basic laws on mandatory safety belt
use.  NHTSA has not been successful, however, in encouraging the
majority of states to enact a primary enforcement law that covers
occupants in all types of motor vehicles that have belts installed. 

NHTSA has encouraged the states to enact a law mandating safety belt
use and has distributed material for the states and others to use in
urging the public to use safety belts.  NHTSA has also initiated
national campaigns for public information and awareness and has
assisted in state and local campaigns to increase safety belt use. 
In addition, the states receive federal funding to help them
implement highway safety programs.  About $170 million was requested
for fiscal year 1996 for assistance to the states under the federal
highway safety program.  DOT encourages the states to use the funds
in support of program areas that are national priorities.  The
Secretary of Transportation has established a goal of a nationwide
rate of 75-percent belt use by 1997, in place of an earlier goal of
70-percent use by 1992.  NHTSA has worked with the states and local
agencies to achieve these goals. 

NHTSA's primary focus in increasing safety belt use has been through
encouraging states to enact stronger laws and through related efforts
in enforcement and public education.  Officials in the states we
visited told us that NHTSA's assistance has helped them develop
safety belt programs at the state and local levels.  They also said
that the federal funds have been an important element in state and
local activities for education and enforcement.  To varying degrees,
the states have used NHTSA's public information materials and have
joined in the federal promotional campaigns. 

NHTSA has encouraged the states to strengthen their safety belt laws. 
However, most state laws provide for secondary enforcement and
minimal fines for violations, cover only occupants of the vehicles'
front seat, and often exempt the occupants of light trucks.  Our May
1992 report concluded that stronger and more comprehensive laws were
needed and that society could save billions of dollars annually
through increased safety belt use.  As discussed in chapter 3 of this
report, the most effective state laws have strong enforcement
provisions and cover all occupants of passenger cars, light trucks,
and vans.  Since our 1992 report, nine states have enacted new laws
on belt use, but these laws are similar to the earlier
laws--generally providing for secondary enforcement and relatively
low fines.  Overall, little progress has been made recently in
getting the states to adopt stronger and more comprehensive safety
belt laws. 

As table 4.1 shows, most state laws cover the occupants of the front
seat only, and some exempt the occupants of light trucks and/or vans. 
Ten states provide for primary enforcement, and 39 states (including
the District of Columbia) provide for secondary enforcement.  Only 11
state laws cover the occupants of rear seats, and 7 state laws exempt
the occupants of light trucks and vans.  Only 4 states assess fines
for violations of belt use laws that exceed $25, and 13 states assess
fines of $10 or less, including 2 states that do not assess any fine. 



                               Table 4.1
                
                   Examples of Differences in States'
                            Safety Belt Laws

                                                             Number of
Requirements                                                    states
------------------------------------------------------  --------------
Coverage
----------------------------------------------------------------------
Only occupants of front seat                                        38
All occupants                                                       11
Light trucks and/or vans exempted                                    7

Enforcement
----------------------------------------------------------------------
Primary                                                             10
Secondary                                                           39

Fines
----------------------------------------------------------------------
Over $25                                                            4\
$11 to $25                                                          32
$10 or less                                                        13\
----------------------------------------------------------------------
Source:  NHTSA's data (see app.I). 

Although 49 states (including the District of Columbia) now have laws
on safety belt use, compared with 42 in 1991, the laws could be
stronger and more comprehensive.  Ten states have primary enforcement
laws--the same number as in 1991.  While California and Louisiana
have enacted a primary enforcement law since 1991, Mississippi and
Wisconsin have changed from primary to secondary enforcement.\5 The
states' fines for violating belt use laws have changed little since
1991, and most are so low that they have little influence on
motivating nonusers of belts to buckle up. 

NHTSA has recognized the value of stronger state laws and has worked
with the states on these issues but has not developed for use by the
states a model law on mandatory safety belt use that requires primary
enforcement, coverage of all occupants in vehicles that have belts
installed, and fines sufficient to encourage belt use.  Instead,
NHTSA has encouraged the states to establish their own safety belt
goals, pass stronger laws, and design and improve safety belt
programs, and has supported education and media campaigns to increase
awareness about safety belts.  As part of NHTSA's fiscal year 1996
appropriations process, the report of the House Committee on
Appropriations states that

     "the Committee believes that more aggressive action needs to be
     taken to achieve a 75 percent seat belt usage rate by 1997. 
     Specifically, the Committee directs NHTSA to develop and
     distribute it to all states a model seat belt use law as part of
     its 1996 program."

The National Transportation Safety Board (NTSB) in July 1995 urged
state governments to adopt stricter methods of enforcing safety belt
laws and to consider tougher penalties for drivers and passengers who
do not use them.  Citing the effectiveness of stronger laws, NTSB has
recommended that the states: 

     "Enact legislation that provides for primary enforcement of
     mandatory safety belt use laws.  Consider provisions such as
     adequate fine levels and the imposition of driver license
     penalty points."

NTSB sent its recommendations to all the states with a secondary
enforcement law and those without safety belt laws, asking the states
to report any actions taken on its recommendations. 


--------------------
\5 Louisiana's primary enforcement law became effective in September
1995, and fines for noncompliance begin in November 1995.  Although
Mississippi has changed from primary to secondary enforcement, the
state now provides for a fine for violations of its belt law, which
it did not do before. 


   FEDERAL LEGISLATION COULD
   ENCOURAGE STRONGER STATE SAFETY
   BELT LAWS
---------------------------------------------------------- Chapter 4:3

Our May 1992 report discussed the relevant provisions of ISTEA and
stated that "the act's provisions may do little to encourage states
to strengthen their existing laws." The grants established by ISTEA
to encourage belt use were available for a 3-year
period--1992-94--and did not require strong state laws as a condition
of receiving the grants.  The penalty provision transfers the fiscal
year 1995 funds of the states that have no safety belt law as of
October 1, 1993.  This provision transfers up to 3 percent of a
state's federal-aid highway funds to the state's highway safety
programs.  Under current law, in 1996 only Maine and New Hampshire
will be subject to the safety belt penalty, which is estimated at
about $1.6 million for each state. 

ISTEA requires the states to have laws on mandatory safety belt use
to avoid the penalty, but it does not require primary enforcement or
state fines for nonuse of belts.  Also, the act applies only to the
occupants of passenger vehicles' front seats and defines passenger
vehicles to exclude vehicles constructed on a truck chassis.  As a
result, state laws do not have to include the occupants of passenger
cars' rear seats or any occupants of pickup trucks or many vans, even
though over 10,000 occupants of such vehicles die each year in
crashes. 

While the number of deaths resulting from crashes of light trucks and
vans might be sufficient reason for focusing greater attention on
increasing belt use in these vehicles, other data also point to this
need.  Recent data on crashes show that occupants killed in light
trucks were ejected at twice the rate of occupants of passenger cars. 
NHTSA officials told us that safety belts are very successful in
preventing such ejections.  NHTSA estimated that annually 3,600
occupants of light trucks die and 54,000 are injured because they do
not use safety belts.  Also, a 1994 national survey of belt use
showed an overall rate of 63-percent use for occupants of passenger
cars and 50 percent for occupants of light trucks.\6

The disparities between the use rates in cars and light trucks
indicate that special emphasis and targeted programs are needed to
increase belt use by the occupants of light trucks.  NHTSA currently
does not have such emphasis or programs. 


--------------------
\6 In our May 1992 report, we mentioned this disparity in safety belt
use between the occupants of passenger cars and light trucks.  The
recent data on this disparity support the limited data that were
available at the time of that report. 


   FEDERAL ROLE IN ENCOURAGING
   SAFETY BELT USE
---------------------------------------------------------- Chapter 4:4

NHTSA officials told us that they have limited authority to encourage
the states to enact stronger safety belt laws--primary enforcement,
higher fines for nonuse, and coverage for all occupants of vehicles. 
Additionally, NHTSA officials told us that the current political
environment that favors local and state initiatives over federal
efforts has further reduced the agency's ability to influence state
and local activities. 

The state officials we interviewed reflected the attitude that the
states welcome federal funds but not federal requirements or advice. 
They told us that the states still want federal funds for their
programs but do not want any federal influence on how the funds are
spent.  They generally agreed that federal financial and technical
assistance have helped them increase belt use, thereby reducing
deaths, injuries, and the related costs to society.  Several said
that the positive changes might not have occurred without NHTSA's
influence and the conditions under which the states could accept
federal funds under ISTEA. 

While NHTSA's focus has been on encouraging the states to enact and
enforce laws on safety belt use, other federal agencies have
required, through federal regulations and an executive order, that
certain occupants of vehicles use safety belts.  The Federal Aviation
Administration requires each occupant over 2 years old in an airplane
to use safety belts during takeoff and landing.\7

Likewise, the Federal Highway Administration requires commercial
drivers of interstate trucks and buses to use safety belts.\8

Furthermore, Executive Order 12566, issued in September 1986,
requires federal employees to use safety belts when driving on
official duty.  Federal efforts have been effective in encouraging
federal employees to use safety belts in motor vehicles.  For
example, 48 federal organizations reported a rate of at least
90-percent belt use during 1993 based on observational surveys. 

Although federal and state officials often disagree on the roles that
federal and state agencies should play in traffic safety, several
recent polls indicate general public acceptance of laws on mandatory
safety belt use.  A recent nationwide public opinion poll of 1,000
people by McKeon and Associates found strong support for safety belt
laws.  A large majority opposed any weakening or repeal of the laws. 
These results support findings in individual states.  For example,
California reported widespread public knowledge about and compliance
with the state's recent primary enforcement law.  Also, a poll
conducted in 1994 for South Carolina found that 88 percent of the
state's residents supported the state's law on mandatory safety belt
use. 


--------------------
\7 14 C.F.R.  121.311. 

\8 49 C.F.R.  392.16. 


   CANADIAN SAFETY BELT LAWS ARE
   STRONG AND VERY SUCCESSFUL
---------------------------------------------------------- Chapter 4:5

Safety belt use laws and programs in Canada have been very effective
in achieving a high rate of belt use.  As of mid-1994, Canada
reported that its nationwide rate of belt use was about 90 percent in
passenger cars and 88 percent in all vehicles, including vans and
light trucks.  Five of the 12 Canadian jurisdictions reported rates
of belt use over 90 percent.  Only one jurisdiction reported a use
rate lower than 75 percent.  In comparison, NHTSA estimates that the
rate of safety belt use in the United States in 1994 averaged either
58 percent or 67 percent, depending on the methodology used. 

Laws mandating safety belt use were enacted in all 12 Canadian
jurisdictions between 1976 and 1992; most were enacted during the
1980s.  All the jurisdictions' laws require primary enforcement
(compared with 20 percent of the states in the United States), and
all the laws cover occupants of light trucks and vans.  Fines for
noncompliance are generally higher in Canada than those in the
states, and five Canadian jurisdictions provide for demerit points
against driver's licenses for violating belt use laws.  In contrast,
no U.S.  state requires demerit points for such violations.  Four
states, however, provide demerit points for violating laws on
restraints for children. 

Canada's success with safety belts appears to result in large part
from designating increased belt use as a top national priority. 
Safety belt use in Canada had leveled off at about 75 percent between
1987 and 1989.  In 1989, Canadian officials endorsed the
recommendation "to have each jurisdiction set itself the goal of
reaching a seat belt use rate of 95% for all occupants by 1995." The
Canadian Council of Motor Transport Administrators developed a
strategy, known as the National Occupant Restraint Program (NORP), to
assist the jurisdictions in reaching the goal of 95-percent.  NORP
involved a 6-year strategy in two phases.  Phase I was a short-term
strategy during late 1989 and all of 1990 that included centralizing
the development of training and briefing materials and the delivery
of those materials through coordinating committees in each
jurisdiction.  Phase II, covering 1991-95, involved coordinating, in
each jurisdiction, intensive campaigns for enforcement and awareness
as well as efforts to reduce the number of exemptions from the laws
on safety belt use.\9

The province of Newfoundland's experience illustrates how the
Canadian strategy has worked.  The province enacted its law on
mandatory safety belt use in 1982.  In 1989, the rate of belt use was
observed to be 64 percent.  In 1990, Newfoundland adopted demerit
points for violations of the law, and belt use increased to 84
percent.  The demerit system assesses 2 points for most driving
infractions, including nonuse of belts, and the accumulation of 12
points in a 2-year period results in suspension of the license.  As
public awareness campaigns and enforcement programs continued in
1991, belt use increased to 91 percent.  One of the strategies
recommended by NORP was the issuance of at least 4,000 citations for
safety belt violations per year per million population; the rate for
1991 in Newfoundland was 12,525.  In 1992, Newfoundland removed many
of the exemptions in its belt use law, and the rate of use reached
almost 95 percent.  The rate remained above 95 percent during 1993
and 1994.  This high level of belt use was maintained despite a
decrease in the number of citations issued per million population
from 12,525 in 1991 to 507 in 1993.  A Canadian official said the
public has been motivated more by the demerit points provided by the
law than by the $45 fine. 


--------------------
\9 Belt use laws in some Canadian jurisdictions include exemptions
for people with certain medical conditions, police transporting
someone in custody, persons held in custody by the police, ambulance
attendants while treating patients, delivery route drivers making
frequent stops and traveling under 40 km/hr, and taxicab drivers. 


   CONCLUSIONS
---------------------------------------------------------- Chapter 4:6

The Congress faces difficult decisions in balancing the federal and
state roles concerning safety belts while reducing deaths, injuries,
and the costs to society.  Increases in the rate of belt use can
still be made in many states through better enforcement of existing
laws, but the larger increases are likely to be achieved through
stronger and more comprehensive state laws on belt use.  Stronger
state laws could help reduce the thousands of deaths and serious
injuries and save up to $20 billion in costs annually because safety
belts are not used.  The general public, through higher taxes and
insurance premiums, pays most of the medical costs for those who fail
to use safety belts.  The large number of deaths and injuries and the
costs to society for nonuse of safety belts will likely continue
unless the states adopt stronger and more comprehensive safety belt
laws. 

Federal strategies can be improved in a variety of ways.  The House
Committee on Appropriations recently directed NHTSA to develop and
distribute to the states in 1996 a model safety belt law in order to
more aggressively encourage nationwide use of safety belts.  States
could be encouraged to implement comprehensive safety belt programs
that provide for

  primary rather than secondary enforcement;

  coverage of all of the occupants in all of the vehicles in which
     belts are installed, including the occupants of passenger cars'
     rear seats and the occupants of light trucks and vans; and

  aggressive enforcement and higher fines/penalties to encourage belt
     use. 

Strong federal involvement has the advantage of facilitating the
nationwide implementation of comprehensive strategies that have
proven to be successful in the states in increasing belt use and
reducing deaths, injuries, and the costs to society.  A disadvantage
is that the states would have less authority to structure their own
programs. 

NHTSA has reported that the rate of belt use by the occupants of
light trucks is only 50 percent.  Considering that light trucks now
constitute about 40 percent of the new vehicles sold and are
increasingly being used to transport passengers, deaths, injuries,
and costs could be avoided by giving special attention to increasing
belt use by the occupants of these vehicles. 


   MATTER FOR CONGRESSIONAL
   CONSIDERATION
---------------------------------------------------------- Chapter 4:7

Increased seat belt use has the potential to avoid thousands of
deaths and serious injuries and save billions of dollars in medical
costs, lost productivity, and other expenses resulting annually from
the nonuse of safety belts.  The federal government's role in
encouraging safety belt use is ultimately a policy decision for the
U.S.  Congress.  Current federal legislation provides for both grants
and penalties to encourage the states to enact safety belt laws or
improve enforcement of existing laws.  Comprehensive programs that
include primary enforcement laws, aggressive enforcement, and
vigorous public education offer the best opportunity for increasing
belt use.  If the Congress wants to promote this type of program
nationwide, it could encourage the states to adopt a primary
enforcement law that covers all occupants in all vehicles in which
belts are installed.  Those states that do not enact such a
comprehensive law could continue to be subject to the provision in
the Intermodal Surface Transportation Efficiency Act requiring a
transfer of up to 3 percent of their federal-aid highway funds to
their state highway safety programs. 


   RECOMMENDATION TO THE SECRETARY
   OF TRANSPORTATION
---------------------------------------------------------- Chapter 4:8

In view of the large differences in the rates of safety belt use
between the occupants of passenger cars and the occupants of light
trucks, we recommend that the Department of Transportation provide
special emphasis and targeted programs to increase belt use by the
occupants of light trucks. 


   AGENCY COMMENTS AND OUR
   EVALUATION
---------------------------------------------------------- Chapter 4:9

We provided copies of a draft of our report to DOT for its comments. 
We met with agency officials, including the Director, Office of
Occupant Protection, NHTSA, and these officials agreed with the
report's findings, conclusions, matter for congressional
consideration, and recommendation.  The officials agreed that an
effective way to increase the nationwide rate of safety belt use is
for the states to have a primary enforcement law that contains fines
to discourage noncompliance and is aggressively enforced.  They
agreed that such a law should also cover all of the occupants of all
motor vehicles in which belts are installed.  The officials provided
a number of editorial and technical comments, which we have
incorporated in the report where appropriate. 


STATE LAWS ON SAFETY BELT USE
=========================================================== Appendix I

                                                                           Usage
            Effective     Enforcemen                  Key belt use          rate
State       date          t           Fine  Seats     provisions           (%)\a
----------  ------------  ----------  ----  --------  ------------------  ------
Alabama     July 18,      Secondary    $25  Front     Motor vehicles          55
            1992                                      after model year
                                                      1964 designed to
                                                      carry no more than
                                                      10 persons

Alaska      Sept. 12,     Secondary    $15  All       Motor vehicles          69
            1990                                      equipped with
                                                      safety belts

Arizona     Jan. 1, 1991  Secondary    $10  Front     Motor vehicles          60
                                                      after model year
                                                      1971 designed to
                                                      carry 10 or fewer
                                                      passengers

Arkansas    July 15,      Secondary    $30  Front     Motor vehicles          51
            1991                                      except for buses
                                                      and other public
                                                      conveyances

California  Jan. 1, 1986  Primary      $20  All       Passenger motor         83
                                                      vehicles designed
                                                      to carry no more
                                                      than 10 persons
                                                      and trucks of less
                                                      than 6,000 lbs
                                                      unladen weight

Colorado    July 1, 1987  Secondary    $15  Front     \Passenger cars,        54
                                                      small trucks,
                                                      vans, taxis,
                                                      ambulances, and
                                                      recreational
                                                      vehicles

Connecticu  Jan. 1, 1986  Primary      $37  Front     Passenger motor         72
t                                                     vehicles
                                                      (passenger car,
                                                      station wagon,
                                                      camper, trucks
                                                      with load capacity
                                                      of 1,500 lbs or
                                                      less, vanpool)\

Delaware    Jan. 1, 1992  Secondary    $20  Front     Motor vehicles          63
                                                      except for farm
                                                      tractors, medical
                                                      vehicles, and
                                                      letter carriers

District    Dec. 12,      Secondary    $15  Front     Motor vehicles          62
of          1985                                      with seating
Columbia                                              capacity of eight
                                                      passengers or
                                                      fewer

Florida     July 1, 1986  Secondary    $20  Front     Motor vehicles,         61
                                                      trucks of unladen
                                                      weight more than
                                                      5,000 lbs except
                                                      buses and farm
                                                      tractors

Georgia     Sept. 1,      Secondary    $15  Front     Passenger cars          57
            1988                                      after model year
                                                      1964 designed to
                                                      carry 10
                                                      passengers or less

Hawaii      Dec. 16,      Primary      $20  Front     Motor vehicles          84
            1985                                      except medical,
                                                      emergency, rental,
                                                      and commercial
                                                      vehicles and buses

Idaho       July 1, 1986  Secondary     $5  Front     Motor vehicles          61
                                                      with weight under
                                                      8,000 lbs except
                                                      for medical and
                                                      emergency vehicles

Illinois    July 1, 1985  Secondary    $25  Front     Motor vehicles          68
                                                      manufactured after
                                                      12/31/64 except
                                                      special-use
                                                      vehicles

Indiana     July 1, 1987  Secondary    $25  Front     Passenger motor         56
                                                      vehicles
                                                      manufactured after
                                                      12/31/64
                                                      (including buses
                                                      but excluding
                                                      trucks, tractors,
                                                      and recreational
                                                      vehicles)

Iowa        July 1, 1986  Primary      $10  Front     Motor vehicles          73
                                                      after model year
                                                      1965 except
                                                      special-use
                                                      vehicles

Kansas      July 1, 1986  Secondary    $10  Front     Passenger cars and      70
                                                      vans manufactured
                                                      with safety belts
                                                      and designed to
                                                      carry 10
                                                      passengers or
                                                      fewer

Kentucky    July 13,      Secondary    $25  All       Motor vehicles          58
            1994                                      manufactured after
                                                      12/31/65 and
                                                      designed to carry
                                                      no more than 10
                                                      passengers

Louisiana   July 1, 1986  Primary      $25  Front     Passenger cars,         50
                                                      vans, and trucks
                                                      having gross
                                                      weight 6,000 lbs
                                                      or less (including
                                                      pickups)
                                                      manufactured after
                                                      1/1/81

Maryland    July 1, 1986  Secondary    $25  Front     Passenger cars,         69
                                                      multipurpose
                                                      vehicles, trucks
                                                      with capacity of
                                                      3/4 ton or less
                                                      and gross weight
                                                      of 7,000 lbs or
                                                      less

Massachuse  Feb. 1, 1994  Secondary    $25  All       Motor vehicles          47
tts                                                   manufactured after
                                                      7/1/66 except
                                                      buses

Michigan    July 1, 1985  Secondary    $25  Front     Motor vehicles          66
                                                      manufactured after
                                                      1/1/65 except
                                                      buses

Minnesota   Aug. 1, 1986  Secondary    $25  Front     Passenger cars,         57
                                                      pickup trucks,
                                                      vans, and
                                                      recreational
                                                      vehicles
                                                      manufactured after
                                                      12/31/64

Mississipp  Mar. 20,      Secondary    $25  Front     Motor vehicles          43
i           1990                                      designed to carry
                                                      10 passengers or
                                                      fewer except for
                                                      all-terrain
                                                      vehicles,
                                                      trailers, and
                                                      special-use
                                                      vehicles

Missouri    Sept. 28,     Secondary    $10  Front     Motor vehicles          68
            1985                                      manufactured after
                                                      12/31/67 designed
                                                      to carry 10
                                                      passengers or
                                                      fewer except
                                                      trucks

Montana     Oct. 1, 1987  Secondary    $20  All       Motor vehicles          69
                                                      except special-
                                                      use vehicles

Nebraska    Jan. 1, 1993  Secondary    $25  Front     Motor vehicles          63
                                                      with safety belts
                                                      installed by
                                                      manufacturer

Nevada      July 1, 1987  Secondary    $25  All       Motor vehicles of       71
                                                      unladen weight of
                                                      less than 6,000
                                                      lbs with installed
                                                      belts

New Jersey  Mar. 1, 1985  Secondary    $20  Front     Passenger               64
                                                      automobiles
                                                      manufactured after
                                                      6/30/66

New Mexico  Jan. 1, 1986  Primary      $25  Front     Motor vehicles          79
                                                      designed to carry
                                                      10 passengers or
                                                      fewer except
                                                      trailers, school
                                                      buses, and trucks

New York    Dec. 1, 1984  Primary      $50  Front     Motor vehicles          72
                                                      except medical
                                                      vehicles, taxis,
                                                      buses, and other
                                                      special-use
                                                      vehicles

North       Oct. 1, 1985  Primary      $25  Front     Motor vehicles          81
Carolina                                              designed for
                                                      carrying 10
                                                      passengers or
                                                      fewer except
                                                      trailers and
                                                      special-use
                                                      vehicles

North       July 14,      Secondary    $20  Front     Motor vehicles          32
Dakota      1994                                      manufactured with
                                                      safety belts and
                                                      designed to carry
                                                      no more than 11
                                                      passengers except
                                                      special-use
                                                      vehicles

Ohio        May 6, 1986   Secondary    $25  Front     Passenger cars,         62
                                                      commercial cars,
                                                      commercial
                                                      tractors, and
                                                      trucks with
                                                      factory-equipped
                                                      safety belts

Oklahoma    Feb. 1, 1987  Secondary    $10  Front     Passenger cars          45
                                                      (excluding trucks,
                                                      tractors, pickups,
                                                      vans, recreational
                                                      vehicles, farm-
                                                      use vehicles,
                                                      passengers with
                                                      medical excuses,
                                                      and postal
                                                      carriers)

Oregon      Dec. 7, 1990  Primary      $95  All       Motor vehicles          77
                                                      with safety belts
                                                      installed except
                                                      for pickup trucks
                                                      of 8,000 lbs or
                                                      less and special-
                                                      use vehicles

Pennsylvan  Nov. 23,      Secondary    $10  Front     Passenger cars,         72
ia          1987                                      trucks, and motor
                                                      homes manufactured
                                                      after 6/30/66
                                                      except special-
                                                      use vehicles

Rhode       June 18,      Secondary     No  All       Motor vehicles          58
Island      1991                                      manufactured after
                                                      6/30/66 except
                                                      special-use
                                                      vehicles

South       July 1, 1989  Secondary    $10  Front     Passenger cars,         64
Carolina                                              trucks, vans,
                                                      recreational
                                                      vehicles
                                                      manufactured after
                                                      6/30/66 except
                                                      special-use
                                                      vehicles

South       Jan. 1, 1995  Secondary    $20  Front     Passenger cars,         40
Dakota                                                trucks, vans,
                                                      recreational
                                                      vehicles
                                                      manufactured after
                                                      12/31/72 except
                                                      special-use
                                                      vehicles

Tennessee   Apr. 21,      Secondary    $25  Front     Motor vehicles          60
            1986                                      after model year
                                                      1968 with gross
                                                      weight 8,500 lbs
                                                      or less except
                                                      special-use
                                                      vehicles

Texas       Sept. 1,      Primary      $25  Front     Passenger cars          71
            1985                                      designed to carry
                                                      10 passengers or
                                                      less (including
                                                      trucks with rated
                                                      capacity of not
                                                      more than 1,500
                                                      lbs) except
                                                      passengers with
                                                      medical excuses
                                                      and postal
                                                      carriers

Utah        Apr. 28,      Secondary    $10  Front     Motor vehicles          53
            1986                                      manufactured after
                                                      6/30/66 except
                                                      special-use
                                                      vehicles

Vermont     Jan. 1, 1994  Secondary    $10  All       Motor vehicles          68
                                                      except special-
                                                      use vehicles

Virginia    Jan. 1, 1988  Secondary    $25  Front     Motor vehicles          72
                                                      except special-
                                                      use vehicles

Washington  June 11,      Secondary    $25  All       Motor vehicles          81
            1986                                      including
                                                      passenger cars,
                                                      multipurpose
                                                      passenger vehicles
                                                      except trailers,
                                                      buses, trucks, and
                                                      special-use
                                                      vehicles

West        Sept. 1,      Secondary    $25  Front     Motor vehicles          58
Virginia    1993                                      manufactured after
                                                      12/31/66 designed
                                                      to transport 10
                                                      passengers or
                                                      fewer except
                                                      trailers and
                                                      special-use
                                                      vehicles

Wisconsin   Dec. 1, 1987  Secondary    $10  All       Motor vehicles          64
                                                      manufactured after
                                                      12/31/71 except
                                                      special-use
                                                      vehicles

Wyoming     June 8, 1989  Secondary     No  Front     Motor vehicles          \b
                                                      (including pickup
                                                      trucks) designed
                                                      to carry 11
                                                      persons or fewer
                                                      and primarily used
                                                      to transport
                                                      persons except
                                                      special-use
                                                      vehicles
--------------------------------------------------------------------------------
Note:  Total safety belt use laws:  48 states and the District of
Columbia.  New Hampshire and Maine have no use laws. 

\a Reported in December 1994. 

\b No usage rate provided. 

Source:  NHTSA Traffic Safety Programs, Nov.  1995. 


MAJOR CONTRIBUTORS TO THIS REPORT
========================================================== Appendix II

TRANSPORTATION AND
TELECOMMUNICATIONS ISSUES

Ronnie E.  Wood, Assistant Director
R.  Kenneth Schmidt, Evaluator-in-Charge (retired)
MeShae Brooks-Rollings
Karlton P.  Davis
Susan K.  Hoffman
David K.  Hooper
Lynne Goldfarb
Paul D.  Lacey
Sara Ann Moessbauer
Phyllis F.  Scheinberg
Mike Volpe


*** End of document. ***