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Seat Belts and Child Restraints

The World Report on road traffic injury prevention, published by WHO and the World Bank in 2004, details the key road injury 'risk factors', the major contributing factors to road crashes and injury severity, including drink driving; lack of helmet use; seat belt non compliance; excessive speed; and poor infrastructure design and management. The World Report recommends practical actions to mitigate these factors. The international road safety community including the World Bank, FIA Foundation, GRSP and the Commission for Global Road Safety strongly supports and advocates for the WHO recommendations, in its work in low and middle income countries.

Mandatory seat-belt use has been one of road injury prevention's greatest success stories and has saved many lives. Occupant restraints first began to be fitted in cars in the late 1960s, and the first law on their mandatory use was passed in Victoria, Australia, in 1971. By the end of that year, the annual number of car occupant deaths in Victoria had fallen by 18%, and by 1975 by 26%. Following the experience of Victoria, many countries also introduced seat-belt laws, which have led to many hundreds of thousands of lives saved worldwide.

The use of seat-belts continues to be the most important form of occupant restraint. Measures to increase their use - by means of legislation, information, and enforcement are central to improving the safety of vehicle occupants. When used, seat-belts have been found to reduce the risk of serious and fatal injury by between 40% and 65%. To learn more about the benefits of seat belts and child restraints, see this WHO fact sheet.

Costa Rica
Costa Rica is an example of a country that has successfully applied road safety policies that were consciously modelled on the best practice of industrialised countries. In 2003-4 the country mounted a major public awareness campaign to promote seat belt use. The campaign 'Por Amor' was developed by the Ministry of Transport, the National Road Safety Council, the national Insurance Institute, and the Automobile Club of Costa Rica with support from the FIA Foundation. The campaign was supported by national television adverts, and was closely linked to the introduction of a new seat belt law. The legislation was passed in April 2004 and was followed by a campaign of police enforcement. The target of the campaign was to achieve a seatbelt wearing rate of 70%. However, the combination of the campaign and police enforcement raised seatbelt use for drivers from 24% to 82%, and recorded fatality rates in the same period dropped by 13%.

The campaign has been evaluated. Please click here to download the report.

The level of seat-belt use is influenced by: whether there is legislation; if it is complemented by publicity campaigns and to what degree the law is enforced.

Following announcement of a new seat belt law on July 1, 1992 in Argentina, the car drivers' wearing rate increased from 6% to 32% without any kind of enforcement. However, with no enforcement of the law the rate dropped quickly down to 13%. In November the same year the Chief of Police announced that "the following day they would control seat belt use, and there would be penalties" usage rate went up to 36%. But seat belt use was never controlled seriously though and wearing rate fell again. In September 2004 a lot of advocacy and campaigning from a national road safety NGO during the 90ties, paid off. Serious enforcement and public information campaigns was put in place and the wearing rate for drivers in Buenos Aires increased to 86% at the end of 2004! To learn more about the seat belt initiative click here to access a paper presented by Dr. Alberto Silveira, Luchemos Por La Vida, at the Road Safety on four Continents Conference in Poland October 2005.

Seat-belts had been available for 20 years in Europe before their use was enforced by law, often with dramatic results. In the United Kingdom, for instance, front seat-belt usage rose from 37% before the introduction of the law to 95% a short period afterwards, with an accompanying fall of 35% in hospital admissions for road traffic injuries. The wide variation in seat-belt use in European Union countries means that substantial further savings - estimated at around 7000 deaths annually - could be achieved if the usage rate was raised to the best that exists globally. In 1999, the best rates for seat-belt use recorded in high-income countries were in the 90-99% range for front-seat occupants, and in the 80-89% range for those in rear seats.

Many people still do not realise how dangerous it is not to wear a seat belt in the back of a vehicle. In a crash at 30mph, if the passenger is unrestrained, they will hit the front seat, and anyone in it, with a force of between 30 and 60 times their own body weight. Such an impact could result in death or serious injury to both themselves and to front seat occupants.

Another strategy to increase the use of seat belt wearing is incentives programmes (can be combined with enforcement). In these programmes, seatbelt use is monitored and seat-belt wearers are eligible for a reward. The rewards may range from a meal voucher or lottery ticket to sizeable prizes such as video recorders or free holidays. In general, such programmes appear very effective and have a high level of acceptance. To learn more about incentive programmes in transport, please download the article by Morrison et al "What are the most effective ways of improving population health through transport interventions? Evidence from systematic reviews" J. Epidemiol. Community Health, May 2003; 57: 327 - 333.

The United Nations Economic Commission for Europe (UNECE) has published a draft recommendation in April 2006: REVISION OF THE CONSOLIDATED RESOLUTION R.E.1: Increasing the use of seat belts and child restraint systems: encouraging legislation, information and enforcement of seat belts. The draft recommendation will be suggested for adoption by the member countries when it has been approved by the UNECE Inland Transport Committee, Working Party on Road Traffic Safety (WP1).

In June 2006 a supplement to the above recommendation was published:

THE UNECE WP1 has furthermore done a survey on seatbelt use and legislation for all it member countries as well as a number of African countries:

To view all the country statistics and the full survey from the UNECE, please click here.

Seat-belt use is very low in many low-income countries. In many places it is not even possible to belt up if you are a back seat passenger. The fitting of anchorages and seatbelts are covered by various technical standards worldwide and in most countries these standards are mandatory for cars. However, there is anecdotal evidence that a half or more of all vehicles in low-income countries may lack functioning seat-belts.

The FIA Foundation published in 2004 a seat belt campaign toolkit in association with GRSP. The toolkit was researched and compiled by TRL. The toolkit gives practical guidance on which type and design of seat belt should be considered for front and rear seat. Guidance is also provided for appropriate child restraint systems. For those countries that already have seat belt legislation but where wearing rates are low, advice is given on how rates can be improved by the use of enforcement techniques, education programmes, publicity campaigns and incentive schemes.

The toolkit also provides key stakeholders with a checklist of actions to ensure, through legislation, that vehicles manufactured or sold within any country are fitted with seat belts that have been tested and approved by an independent Approval Authority based on United Nations Regulations. A recommendation is given on the most suitable standard. You can access all the documents on vehicle standards through the UNECE and its Working Party on Passive Safety.

Sakhalin, the Russian Federation
The Sakhalin Island (Russia) seatbelt campaign was initiated as it is known that seat belt wearing rates are low on Sakhalin. The campaign led by Sakhalin Energy Investment Company Ltd using the FIA Foundation toolkit contained public information, legislation and enforcement elements and was implemented in two phases. First an awareness campaign was launched to address why seatbelts should be worn. Secondly, and most critically, an enforcement campaign was launched to reinforce the fact that the use of seat belts is law. The campaign was launched in November 2005 for a period of 3 months. Research conducted after the first month of the campaign showed an increase in wearing rates in urban areas (Yuzhno-Sakhalinsk) from 3.8% to 19.9% and on rural roads from 26.8 to 55.8%. The campaign is now in its second stage.