CHARLESTON, W.Va. -- The day that Gov. Tomblin signed the seatbelt law I was listening to certain responses to that law by individuals calling in to Hoppy Kercheval's morning talk show. Several people indicated they would not comply with the law, risking citation rather than being "forced" to do so by a government action.
I've given some thought to their reaction. It must be remembered that we are forced by public health and general welfare considerations to do a host of things for the common good. This includes speed limits, maintenance of vehicles, auto insurance for public liability, childhood immunizations, mandatory tuberculosis treatment and fluoridation of water.
In the 1920's Claire Straigh, a plastic surgeon, in response to having to repair many macerated faces caused by facial impacts to auto dashboards and glass, recommended the use of seatbelts. The impetus to standard seatbelt installation in automobiles was propelled by the Volvo Corp. who, after substantial crash tests, demonstrated marked benefit from seatbelt restraints.
Nils Bohlin's invention of the three-point safety belt in the 1950's began the general application of seatbelts by automobile manufacturing companies. The National Highway Traffic Safety Administration estimated seatbelts saved over 4,000 lives and prevented over 100,000 injuries a year. The reasons often given for not wearing seatbelts include the restricting nature of the belt and the fear of being unable to escape from the car in a fire or water accident. The modern seatbelt is so designed that it represents a gentle hug. The thought that one cannot escape from a seatbelt is quite ridiculous. I have fastened and unfastened my seatbelt over 50,000 times in the last 60 years, and not once did it fail to release. As a matter of fact, the seatbelt can be an assurance that you don't have a head impact that impairs your ability to reach down and push the release button. For those of you who fly commercial airlines or drive NASCAR, you are mandated to wear seatbelts.
It is useful to understand the types of injuries (often negligible) that may occur in those wearing seatbelts which include rib fractures, punctured lungs, bruised heart, perforated spleen and pelvic fracture. For the most part, those suffering such injuries, if taken to a reasonably staffed trauma center, can be patched and functioning well within two to three months. One can walk out of a hospital and resume a normal life.
On the other hand, when the car is careening at 60 miles per hour then suddenly stops, the human body, also going 60 miles per hour, is forced to stop. Unsecured by the firm hug of a seatbelt, the body is stopped by the face hitting the dash or the head as a battering ram colliding with the windshield. Perhaps more traumatic and often fatal injuries occur when thrown from the automobile. If one survives, often there are tragic head and neck injuries. A high cervical broken neck may result in quadriplegia and loss of respiratory function requiring a lifetime of ventilator dependency. With massive head injuries there can be protracted coma or even a vegetative state with significant loss of thought or motor function. The National Spinal Cord Injuries Statistic Center reports that these injuries result in costs of $100,000 a year and an abbreviated life expectancy of approximately 50 percent of that otherwise predicted.
Who pays for this individual's moment of legal defiance? Certainly not the victim. The $1.5 million to $3 million lifetime liability is paid for by the increase in auto and hospitalization insurance or taxes that are shifted to the individuals who buckle up their seatbelts and go to work.
The reason that 49 of 50 states now have seatbelt laws, either primary or secondary, is that by any thoughtful assessment the use of seatbelts results in four tremendous benefits. Foremost, it saves lives. Secondly, it very significantly reduces invalidism and general dependencies. Third, it reduces the need for the family or loved ones a lifetime of care and financial loss. Finally, the general public does not have to bear the burdens of the additional costs for care and lost productivity.
Thank God the Legislature and governor did a no-brainer and passed the seatbelt law. It has been determined that in those states which have passed a primary law over 85 percent of auto occupants comply. That 85 percent will be released from the belt restraint, survive, and for the most part continue a productive life. The 15 percent who, for various reasons, fail to buckle up will be scraped from the dash or windshield or, more ominously, end up a crumpled mass ejected from the car at the roadside and carried off to the morgue or for a prolonged period of intensive care and rehabilitation and/or invalidism.
Gaziano is a Charleston physician.