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R o a d s a f ety - Safety restraints
The use of seat-belts has been one of the most
effective road safety measures ever implemented, saving more lives than any other
intervention. The lack or inappropriate use of
seat-belts and other safety restraints (child seats
and booster seats) have been shown to be risk
factors for the fatalities and injuries that result
from road crashes.
S E AT- B E LT W E A R I N G
Rates of seat-belt use vary between countries,
depending on the existence and enforcement
of laws:
— In 1995, front-seat wearing rates in European
Union countries ranged from 52% to 92%,
and rear-seat wearing rates from 9% to 80%.
— In the Canadian province of Saskatchewan,
the use of seat-belts among vehicle drivers
rose incrementally from around 70% in
1988 to more than 90% in 1994, while belt
use among front-seat passengers remained
slightly lower.
Use of seat-belts by car drivers/ front-seat
passengers in Source, Canada, 1987-1994
Percentage of drivers/front-seat passengers
wearing seat-belts
100
In low-income and middle-income countries
usage rates are generally much lower:
— In Kenya, a study found that only 1% of car
occupants injured in crashes were wearing
seat-belts.
— In Argentina, only 26% of front-seat passengers in Buenos Aires wear seat-belts.
Failure to use seat-belts is a major contributing
factor to road fatalities. The effectiveness of
seat-belts depends upon the type and severity
of the crash and the seating position of the
passenger.
Correctly used seat-belts reduce the risk of
death in a crash by approximately 61%.
— Seat-belt usage is substantially lower in fatal
crashes than in normal traffic. For example,
about 90% of drivers in Finland wear seatbelts, while driver seat-belt wearing in fatal
collisions is about 55%.
— Seat-belts are most effective in roll-over
crashes and frontal collisions, and in lower
speed crashes.
— Young male drivers use their seat-belts less
often than other groups and are also more
likely to be involved in crashes.
CHILD RESTRAINT USE
Drivers
The use of child restraints in motor vehicles
varies considerably between countries and is
90
mainly confined to use in high-income countries.
— The use of child restraints (child seats and
booster seats) can reduce infant death in car
crashes by 71% and toddler deaths by 54%.
80
Front-seat passengers
70
BANCO MUNDIAL
60
1987 1988 1989 1990 1991 1992 1993 1994
Year
Source: Koch et al, 1995
BANQUE MONDIALE
— Child restraints work in the same way as
adult seat-belts. The use of a restraint
depends on the age and weight of the child:
rear-facing seats are particularly effective for
young infants, forward-facing restraints are
appropriate for younger children and booster seats used with seat-belts are effective for
older children.
— The potential hazard of combining air bags
with rear-facing seats in the front seat of a
vehicle is well documented.
— There is a substantial amount of incorrect use
of both adult seat-belts and child restraints,
which markedly reduces their injury-reducing
potential.
W H AT C A N B E D O N E T O I N C R E A S E
THE USE OF SAFETY RESTRAINTS?
Seat-belts
— Seat-belt legislation is an effective way to
increase restraint use and reduce injuries.
Use of seat-belts can reduce the risk of
serious and fatal injury by between 43% and
65%. Seat-belts are most effective in frontal
crashes, which are the most common kind of
crash and often result in serious head injuries. The mandatory use of seat-belts is also
highly cost effective.
— Legislation on the use of safety restraints
must be accompanied by strict enforcement
in order to be effective. In Korea, usage rates
among drivers rose from 23% to 98% in
less than a year following a well-publicized
national police enforcement campaign and
the doubling of the penalty for non-use of
safety restraints.
— Seat-belt use legislation in low-income countries is still not universal and will become
increasingly important as car traffic levels rise
in these countries.
— Technological solutions to encourage belt
use are evolving and are starting to be fitted
to cars. These hold the promise of raising
usage rates to more than 90%.
Child restraints
— Mandatory child-restraint laws in the United
States led to a 13% increase in child-restraint
use, a 35% reduction in fatal injuries and a
17% reduction in all injuries.
— Laws mandating child restraints are effective
at increasing use, as are public information
and enforcement campaigns. However, good
protection requires that the type of restraint
used is appropriate for the age and weight
of the child. Child seats should not be placed
in front of air bags.
— Cost of child restraints is a factor that negatively influences their use, even in highincome countries where child restraint loan
programmes are common.
— Highly visible and well-publicized enforcement of mandatory seat-belt laws is effective
at increasing seat-belt use. In provinces in
France and Canada, compliance with seatbelt laws increased by 10–15% within one
year of implementing such high-profile
enforcement programmes.
— Primary enforcement (where a driver is stopped solely for not wearing a seat-belt) is
more effective than secondary enforcement
(where a driver can only be stopped if another offence has been committed).
WHO recommends that member countries set and enforce seat-belt
and child restraint laws for all vehicle occupants.
This information is taken from the World report on road traffic injury prevention. To download the report, or for more
information on road safety, please visit http://www.who.int/violence_injury_prevention or e-mail: [email protected]
© World Health Organization 2004. All rights reserved.

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