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Motor Vehicle Injury – Safety Belts: Laws Mandating Use


What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of 33 studies (search period through June 2000).

The review was conducted on behalf of the CPSTF by scientists from CDC’s Division of Unintentional Injury Prevention with input from a team of specialists in systematic review methods and experts in research, practice and policy related to motor vehicle injury prevention.


As of June 2017, there are seat belt laws in 49 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the Virgin Islands. New Hampshire, which does not have a seat belt law, does have a child passenger safety law that covers all drivers and passengers under 18 years of age. Current figures are available from the Governors Highway Safety Administration External Web Site Icon.

Summary of Results

More details about study results are available in the published evidence review pdf icon [PDF - 2.85 MB]..

The systematic review included 33 studies.

  • Fatal injuries decreased by a median of 9% (6 studies).
  • Nonfatal injuries decreased by a median of 2% (6 studies).
  • Fatal and nonfatal injuries combined decreased by a median of 8% (9 studies).
  • Observed safety belt use increased by a median of 33 percentage points (10 studies).
  • Police-reported safety belt use increased by 26 percentage points (2 studies).
  • Self-reported safety belt use increased by a median of 16 percentage points (4 studies)

Summary of Economic Evidence

An economic review of this intervention did not find any relevant studies.


Results from this review should be applicable to adolescents and adults, as most of the included studies looked at motor vehicle occupants who were at least 16 years old.

Evidence Gaps

CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

  • How do the level of enforcement and publicity influence the effectiveness of safety belt laws?
  • Does the severity of fines have any bearing on the effectiveness of the laws?
  • Do other penalties (e.g., license demerits) add to the effectiveness of the laws?
  • Do exemptions for certain vehicles and occupants reduce the effectiveness of the laws?
  • What are the cost-benefit, cost utility, and cost-effectiveness of interventions to increase safety belt use?

Study Characteristics

Included studies used self-reported and observational data.