The National Traffic and Motor Vehicle Safety Act was enacted in the United States in 1966 to empower the federal government to set and administer new safety standards for motor vehicles and road traffic safety. The Act created the National Highway Safety Bureau (now National Highway Traffic Safety Administration). The Act was one of a number of initiative by the government in response to increasing number of cars and associated fatalities and injuries on the road following a period when the number of people killed on the road had increased 6-fold and the number of vehicles was up 11-fold since 1925.
Contents |
The reduction of the rate of death attributable to motor-vehicle crashes in the United States represents the successful public health response to a great technologic advance of the 20th century--the motorization of America. Six times as many people drive today as in 1925, and the number of motor vehicles in the country has increased 11-fold since then to approximately 215 million[1] The distance traveled in motor vehicles is 10 times higher than in the mid-1920s. Despite this steep increase in motor-vehicle travel, the annual death rate has declined from 18 per 100 million vehicle miles traveled (VMT) in 1925 to 1.7 per 100 million VMT in 1997--a 90% decrease (Figure 1).[1]
Systematic motor-vehicle safety efforts began during the 1960s. In 1960, unintentional injuries caused 93,803 deaths[1]; 41% were associated with motor-vehicle crashes. In 1966, after watching 5 years of rising motor-vehicle-related fatality rates, the Highway Safety Act created the National Highway Safety Bureau (NHSB), which later became the National Highway Traffic Safety Administration (NHTSA). The systematic approach to motor-vehicle-related injury prevention began with NHSB's first director, Dr. William Haddon.[2] Haddon, a public health physician, recognized that standard public health methods and epidemiology could be applied to preventing motor-vehicle-related and other injuries. He defined interactions between host (human), agent (motor vehicle), and environmental (highway) factors before, during, and after crashes resulting in injuries. Tackling problems identified with each factor during each phase of the crash, NHSB initiated a campaign to prevent motor-vehicle-related injuries.
In 1966, passage of the Highway Safety Act and the National Traffic and Motor Vehicle Safety Act authorized the federal government to set and regulate standards for motor vehicles and highways, a mechanism necessary for effective prevention[2][3] Many changes in both vehicle and highway design followed this mandate. Vehicles (agent of injury) were built with new safety features, including head rests, energy-absorbing steering wheels, shatter-resistant windshields, and safety belts[3][4] Roads (environment) were improved by better delineation of curves (edge and center line stripes and reflectors), use of breakaway sign and utility poles, improved illumination, addition of barriers separating oncoming traffic lanes, and guardrails[4][5] The results were rapid. By 1970, motor-vehicle-related death rates were decreasing by both the public health measure (deaths per 100,000 population) and the traffic safety indicator (deaths per VMT) (Figure 2).[1]
Changes in driver and passenger (host) behavior also have reduced motor-vehicle crashes and injuries. Enactment and enforcement of traffic safety laws, reinforced by public education, have led to safer behavior choices. Examples include enforcement of laws against driving while intoxicated (DWI) and underage drinking, and enforcement of safety-belt, child-safety seat, and motorcycle helmet use laws[5][6]
Government and community recognition of the need for motor-vehicle safety prompted initiation of programs by federal and state governments, academic institutions, community-based organizations, and industry. NHTSA and the Federal Highway Administration within the U.S. Department of Transportation have provided national leadership for traffic and highway safety efforts since the 1960s.[2] The National Center for Injury Prevention and Control, established at CDC in 1992, has contributed public health direction[7][8] State and local governments have enacted and enforced laws that affect motor-vehicle and highway safety, driver licensing and testing, vehicle inspections, and traffic regulations.[2] Preventing motor-vehicle-related injuries has required collaboration among many professional disciplines (such as biomechanics has been essential to vehicle design and highway safety features). Citizen and community-based advocacy groups have played important prevention roles in areas such as drinking and driving and child-occupant protection.[6] Consistent with the public/ private partnerships that characterize motor-vehicle safety efforts, NHTSA sponsors "Buckle Up America" week, which focuses on the need to secure children in child-safety seats properly at all times.[1]
High-Risk Populations
Occupant-Protection Systems
Safety belts In response to legislation, highly visible law enforcement, and public education, rates of safety belt use nationwide have increased from approximately 11% in 1981 to 68% in 1997 (8). Safety belt use began to increase following enactment of the first state mandatory-use laws in 1984.[6] All states except New Hampshire now have safety-belt use laws. Primary laws (which allow police to stop vehicles simply because occupants are not wearing safety belts) are more effective than secondary laws (which require that a vehicle be stopped for some other traffic violation).[6][13][13] The prevalence of safety belt use after enactment of primary laws increases 1.5-4.3 times, and motor-vehicle-related fatality rates decrease 13%-46%.[13]
Child-safety and booster seats All states have passed child passenger protection laws, but these vary widely in age and size requirements and the penalties imposed for noncompliance. Child-restraint use in 1996 was 85% for children aged less than 1 year and 60% for children aged 1-4 years.[14] Since 1975, deaths among children aged less than 5 years have decreased 30% to 3.1 per 100,000 population, but rates for age groups 5-15 years have declined by only 11%-13%.[9] Child seats are misused by as many as 80% of users[15][16][17] In addition, parents fail to recognize the need for booster seats for children who are too large for child seats but not large enough to be safely restrained in an adult lap-shoulder belt[18]
Despite the great success in reducing motor-vehicle-related death rates, motor-vehicle crashes remain the leading cause of injury-related deaths in the United States, accounting for 31% of all such deaths in 1996 (CDC, unpublished data, 1999). Furthermore, motor-vehicle-related injuries led all causes for deaths among persons aged 1-24 years. In 1997, motor-vehicle crashes resulted in 41,967 deaths (16 per 100,000 population), 3.4 million nonfatal injuries (1270 per 100,000 population), and 23.9 million vehicles in crashes; cost estimates are $200 billion.[1]
The challenge for the 21st century is to sustain and improve motor-vehicle safety. Future success will require augmentation of the public health approach to 1) expand surveillance to better monitor nonfatal injuries, detect new problems, and set priorities; 2) direct research to emerging and priority problems; 3) implement the most effective programs and policies; and 4) strengthen interagency, multidisciplinary partnerships. Key public health activities will be to do the following:
Reported by: Div of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC.
Traffic Injury Prevention [2]