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While all States conduct annual observational surveys of seat belt use, these surveys generally occur during the day and only include drivers and front-seat passengers, leading to incomplete, and likely overestimates of, overall seat belt use in States (NCSA, 2022).

When police officers respond to crashes, they record seat belt use of the occupants involved in the crashes. In the case of severe or fatal crashes, belt use may be obvious based on the position or injuries of the occupants. However, in less severe crashes, these clues may not be visible, and seat belt use may be reported to the officers from the vehicle occupants themselves. Because failure to wear a seat belt is a violation in most States, unbelted vehicle occupants may report wearing their seat belts to avoid penalty. This could result in an over-reporting of seat belt use in less severe crashes.

An additional complication to complete occupant restraint data is the lack of detailed child restraint information. Many States include “child restraint” as one of the possible occupant restraint options on the crash report form. This ends up grouping all child restraint types into one category and limits the ability to determine if the restraint was appropriate for the child, if the restraint was installed correctly, or if the child was properly restrained.