More than 5. 6 million U.S. motor vehicle crashes occurred in 2012, resulting in 1. 63 million injuries and 30,000 deaths. More than 52 percent of fatal
injuries occurred in unrestrained occupants, and 79
percent of unrestrained occupants who were completely ejected from the vehicle died. Safety belts
have been shown to significantly reduce morbidity,
mortality, and the risk for occupant ejection in motor
vehicle crashes. Jurisdictions that have primary seat
belt laws continue to have high seat belt use. In the
U.S., 33 states and the District of Columbia have primary seat belt laws and use is 85 percent. Safety belt
use is approximately 62 percent in tribal reservations,
and those with primary seat belt laws have the highest use. All Canadian provinces have primary seat
belt laws, with 95 percent use.
Regarding the use of safety belts in motor vehicles,
the ACS recognizes the following:
•Safety belts are the most effective safety device in
preventing serious injury and death in motor vehicle
•Appropriate safety belt use reduces the possibility of
ejection and the risk of death in vehicular crashes.
•Safety belt use varies significantly by age, gender, ethnicity, and time of day. Youth, males, Native Americans,
and rural area occupants are among the lowest safety
belt users and the highest mortality rate populations.
•Safety belt use reduces the risk of fatal injury for front
seat passengers by 45 percent and the risk of moderate
to severe injury by 50 percent.
Banerji A, Canadian Paediatric Society, First Nations, Inuit
and Metis Health Committee. Preventing unintentional
injuries in indigenous children and youth in Canada.
Paediatr Child Health. 2012; 17( 7):393.
Chaudhary NK , Tison J, Casanova TM. Evaluation of
Maine’s safety belt law change from secondary to
primary enforcement. Final Report, National Highway
Traffic Safety Administration, Washington, DC. DOT HS
Centers for Disease Control and Prevention. Injury
prevention and control: Motor vehicle safety. Tribal
road safety: Get the facts. Available at: www.cdc.gov/
Motorvehiclesafety/native/ factsheet.html. Accessed
November 6, 2015.
Community Preventative Services Task Force. Use of
safety belts: Primary (vs. secondary) enforcement laws.
Available at: www.thecommunityguide.org/mvoi/
safetybelts/ enforcementlaws.html. Accessed November
Governors Highway Safety Administration. Seat belt laws.
November 2015. Available at: www.ghsa.org/html/
stateinfo/laws/ seatbelt_laws.html. Accessed November
Sen A, Mizzen B. Estimating the impact of seat belt use on
traffic fatalities: Empirical evidence from Canada. Can
Public Pol. 2007; 33( 3):315-336.
Transport Canada. Seatbelt use continues to rise: Transport
Canada surveys. Press release. January 26, 2011.
Available at: news.gc.ca/web/article-en.do?nid=616509.
Accessed November 6, 2015.
U.S. Department of Transportation. National Highway
Traffic Safety Administration. 2006 seat belt use
estimate for Native American tribal reservations. May
2008. Available at: www.nhtsa.gov/DOT/NHTSA/
Files/810967.pdf. Accessed November 6, 2015.
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The American College of Surgeons (ACS) Committee on Trauma (COT) Subcommittee on Injury
Prevention and Control prepared the following statement. The purpose of the statement is to
educate surgeons about the important differences between primary and secondary laws and
to encourage surgeons to support primary restraint legislation in their respective states. The
ACS Board of Regents approved the statement at its October 2015 meeting in Chicago, IL.
Statement on safety belt laws