Seat belts: personal choice or necessity?

The use of occupant restrains in motor vehicles has become an issue which has received increasing legislative attention in recent years. This has occurred due to the supposition that seat belt use would be effective in preventing automobile related fatalities and injuries. Twenty-five states and the District of Columbia now have mandatory safety belt laws in effect which have increased usage rates from 20% or less prior to enactment of the law to between 50% and 70% after implementation. Safety belts have proven effective in minimizing morbidity and mortality. In a study of four states enforcing mandatory usage and neighboring states without seat belt laws as a comparison, between 250 and 350 fatalities were prevented. This extrapolates to an estimated 12,000-15,000 lives saved nationally if restraints were mandatory. Nebraska is one of two states in which a seat belt law has been enacted and subsequently repealed. As a result of the repeal, seat belt usage dropped from 40% in 1986 to 29% in 1987 with an associated increase in injuries. The economic impact associated with this increase in accident related injuries is enormous. The Nebraska repeal campaign was based on the issue of individual rights versus mandatory safety requirements. As health care providers we need to examine the validity of personal rights in comparison to the documented impact of personal restraints on the morbidity and mortality of accident victims.