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Several years ago while doing a site visit, I rode with a supervisor. As we approached one of their posts, I said, “Look at that!” He said, “The rig is clean and all of their lights are on.” I replied, “They’re not wearing seatbelts.” What do you think of the Culture of Safety for that organization?  A supervisor did not even notice this major safety violation. Take it a step further. Don’t we all have the responsibility to recognize, and correct unsafe behaviors?  Would you ride with an un-belted driver? Would you drive a vehicle in which occupants were not properly restrained?  When I teach the NAEMT Safety Course, I find there is a distinct minority of EMS providers who still refuse to buckle up.

Data on seatbelt usage

Data derived from the responses of 85,000 workers, in 21 states, to the 2013 Behavioral Risk Factor Surveillance System, revealed the impact of primary seatbelt laws. In states with such laws, drivers may be stopped and given citations for not wearing seatbelts in the absence of other violations. States with secondary seatbelt laws, allow officers to ticket for not wearing seatbelts only if another violation has been committed. In states with primary seatbelt laws 10.4% of respondents reported “not always” using a seatbelt. It was 23.6% in states with secondary seatbelt laws. The industries with the greatest incidence of infrequent seatbelt use were: construction (14.1%); legal (14%); installation, maintenance, and repair (12.8%); protective services (12.7%); and farming, fishing, and forestry (12.7%). Overall, 11.5% of Americans do not always buckle up. Although between 1975 and 2014, the DOT estimates that 330,507 lives were saved by seatbelt usage. If everyone involved in the crashes were seat-belted, an additional 378,983 lives could have been saved. We’ve made progress. Observed seatbelt use increased from 58% in 1994 to 88.5% in 2015. The states with the best seatbelt compliance are: Oregon (98%), Georgia (97%), California (97%), Alabama (96%), Minnesota (95%), Washington (95%), Illinois (84%), and Nevada (94%). Those with the worst are: South Dakota (69%), New Hampshire (70%), Montana (74%), Arkansas (74%), Massachusetts (77%), and Virginia (77%).

The cost of motor-vehicle crashes is staggering. A 2010 NHTSA study showed a direct cost to society of $242 billion. When pain and suffering were added, the cost climbed to $836 billion. During the same study period, seatbelts saved 12,500 lives, prevented 308,000 injuries, and saved $50 billion. Unbelted passengers cost $10 billion.

It is estimated that we who are not involved in crashes, pay for more than three-quarters of all crash related costs. The costs come from higher insurance premiums, taxes, travel delays, and excess fuel consumption related to traffic delays. Since insurance companies pay about a third of their crash costs for medical bills, the cost of liability is affected by medical costs. According to the aforementioned 2010 NHTSA study, an accident in which a person is critically injured costs $3.3 million in medical bills, property damage, and lost wages. For a fatality, it soars to $5.3 million.

Translate dollars lost into quality of life. Greater cost equates with greater pain.  We continue to preach that safety is a 24/7 responsibility.


  • Jensen, C. “Road Report; The three seconds that save lives” Consumer Reports, August, 2016, pp.61-66.
  • “Some workers not buckling up, CDC says”, Safety + Health, August 2016, page 16.
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