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CENTER

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H E A R I N G S

BEFORE A

SUBCOMMITTEE OF THE

_ S

COMMITTEE ON

VTERSTATE AND FOREIGN COMMERCE 

HOUSE OF REPRESE NTA TIVE S

EI GH TY -E IG HT H CONG RESS

FIRST SESSION

ON

H.R. 133

A BILL TO AMEND T ITL E III OF THE PU BLIC HE ALTH SERVICE

ACT TO ESTABLISH A NATIONAL ACCIDENT

PRE VENTION CENTER

AP RIL 9, 10, 1903

Printed fo r the use of the 

Committee on In te rs ta te and Foreign Commerce

97767

U.S . GO VE RN M EN T PR IN TIN G O FFIC E 

W ASH IN GTO N : 1003
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CO MM ITTE E ON IN TE RS TA TE AND FOREIGN COMM ERC E

OREN HARRIS, Arkansas, Chairman

JOHN BELL WILLIAMS, Mississippi

KE NN ET H A. ROBERTS, Alabama

HAR LEY O. STAGGERS, West Virginia

WALTER ROGERS, Texas

SAMVEL N. FRI EDEL, Maryland

TO RBERT IL MACDONALD, Massachusetts

GEOR GE M. RHODES, Pennsylvania

JOHN JARM AN, Oklahoma

LEO W. O’BRIEN, New York

JOHN E. MOSS, California

JOHN D. DINGELL, Michigan

PAUL G. ROGERS, Florida

ROB ERT W. HEM PHILL, South Carolina

DAN ROSTENKOWSKI, Illinois

JAMES C. HEALEY, New York

HORACE R. KORNEGAY, North Carolina

W. R. HULL, Jr., Missouri

GILLIS W. LONG, Louisiana

LIONEL VAN DEE RLIN, California

JOHN B. BENN ET T, Michigan 

WILLIAM L. SPR ING ER, Illinois 

PAUL F. SCHENCK , Ohio 

J. ARTHUR YOUNGER, California 

MILTON W. GLENN, New Jersey 

SAMUEL L. DEVINE, Ohio 

ANCHER NELSEN, Minnesota 

HASTINGS KEITH , Massachusetts 

WILLARD S. CUR TIN, Pennsylvania 

ABNER W. SIBAL, Connecticut 

GLENN CUNNING HAM , Nebraska^ 

JAMES T. BROYH1LL, North Carolina 

DONALD G. BROTZMAN, Colorado

W. E. Williamson, Clerk

Kenneth J. Painter, As sistan t Clerk

Professional Staff

Andrew Stevenson Sam G. Spal

Kurt Borchardt George W. P erry

S u b c o m m it tee on P u b lic H ea lth an d Sa fe ty

KENN ETH A. ROBE RTS, Alabama, Chairman

GEO RGE M. RHODES, Pennsylvania PAUL F. SCHENCK , Ohio

LEO W. O’BRIEN , New York ANC HER NELSEN, Minnesota

PAU L G. ROGERS, Florida DONALD G. BROTZMAN, Colorado

II
C O N T E N T S

Page

Tex t of H.R. 133_________________________________________________ 1

Rep ort of—

Agriculture De partm ent_______________________________________

Air Force------------- .----------------------------------------------------------------

Budget Bureau_______________________________________ ______

Civil Aeronautics Board_______________________________________

Commerce Department_______________________________________

Federal Aviation A gency--------------------------------------------------------

General Services Adm inistration________________________________

Health, Educatio n, and Welfare____________________ ___________

Interior De partm ent__________________________________________

Interstate Commerce Commission______________________________ 11

Post Office D epartme nt_______________________________________ 12

Sta tem ent of—

Chapman, Dr. A. L., represen ting Dr. C. L. Wilbar, secretary of 

health, Commonwealth of Pennsylvania, president of S tate & Ter ritorial Hea lth Officers Association_____________________________ 76

Cohen, Wilbur J., Assistant Secretary, Departme nt of Hea lth, Education, and Welfare_________________________________________ 13

Johnson, W. G., general manager, National Safety Council________ 61

Joliet, Dr. Paul V., Chief, Division of Accident Prevention, Public

Health Service_____________________________________________ 13

Moynihan, Daniel P., Assistan t Secretary, Policy Deve lopm ent and

Research, Dep artm ent of I abo r______________________________ 82

Prisk, Charles W., Deputy Dire ctor, Office of Highway Safety, Bureau

of P ublic Roads, U.S. De partm ent of Commerce________________ 57

Stapp, Col. John P., U.S. Air Force (Marine Corps), Deput y Chief 

Scientist, Aerospace Medical Division, Air Force Systems Command, Brooks Air Force Base, San Antonio, Tex_______________ 52

Terry, Dr. Luther L., Surgeon General, Public Health Service______ 13

Sta tem ent submitted by—

Allen, Dr. Merrill J., on behalf of the American Opto metric Associatio n______________________________________________________ 88

American Public Health Association by Dr. Edw ard Press, chairman,

accident prevention com mittee_______________________________ 134

Davis, Robert L., vice president, Davis Aircraft Products, Inc.,

No rthpor t, Long Island, N.Y________________________________ 133

Kidwell, Col. Gaylord B., U.S. Arm y (retire d)___________________ 138

Latimer, J. Austin, counsel for Autom otive Service Ind ustry

Associatio n________________________________________________ 136

Marsh, David M., manager, Association of Casualty & Sure ty

Companies________________________________________________ 133

Press, Dr. Edward, chairm an, accident prevention committee, on

behalf of th e American Public He alth Association______________ 134

Additional material subm itted to the comm ittee—

Allen, Dr. Merrill J.—

“ Certain visual aspects of the average modern American automobile,” by M. J . Allen, O.D____________________________ 116

“Daytime automobile windshield and dash panel characteristics,”

by M. J. Allen, O .D____________________________________ 120

Editorial comment, by Irving Ben nett, O.D_________________ 102

Figu re 1.—Transmission of the E ye _________________________ 94

Figu re 2.—Tria l Lens Diopters_____________________________ 95

Figu re 3.—Trial Lens Diopters_____________________________ 96

Figure 4.—Trial Lens Diopters_____________________________ 97

Figu re 5.—Trial Lens Diopters_____________________________ 98

Figure 6.—Pupil Dia meter_________________________________ 99

Figure 7.—Pupil Dia meter_________________________________ 100

Figure 8.—American Optometric F oundation Nig ht D riving A ptitude Questionnaire_____________________________________ 101

h i
IV CONTENTS

Additional material subm itted t o the committee—Continued 

Allen, Dr. Merrill J.— Continued

“Survey of research pertaining to motorists’ vision,” by Sidney P a s® 

A. M intz, O.D _________________________________________ 104

The relationship between night driving ability and the amount 

of light needed for a specific performance on a low-contrast 

target________________________________________________ 92

Cohen, Wilbur J.—

Accidents and Our He alth—a brief statistical sum mary------------ 22

Charts entitled—

Accidental death r ate _________________________________ 16

Accidental de ath rat e (by age)_________________________ 17

Accidental dea ths, principal causes (by ag e)------ ------------- 18

Hospital bed days, principal causes-------------------------------- 17

The accident problem in brief______________________________ 21

U.S. Public H ealth Service, research grants in the area of accident

prevention, ta ble _______________________________________ 47

Johnson, W. G.—

Effective mass communication for safety, a critical analysis of

pertine nt res earch ---------------------------------------------------------- 69

Quantitative analysis of traffic safety services of natio nal organizations, ch art------------------------------------------------ -------- — 65

The safety communications stud y---------------------------------------- 66

Joliet, Dr. Paul V.—

State physical exam ination requirements for new applicants for

driver licensing and renewals, tabl e----------------------------------- 38

State physical examination requirements for special licensing

cases, tabl e----------------------- ------------------------------------------- 39

Communications sub mitted to the committee—

Johnson, W. G., general manager, National Safety Council, letter

dated February 27, 1963---------------------------------- - - - ---------------- 62

Mann, James D., secretary-man ager, National Association of Motor

Bus Owners, le tte r dated April 8, 1963--------------------- -------------- 143

Smith, Wallace M., manager, mid-Atlantic office, American Mutual

Insurance Alliance, tele gram dated April 22, 1963---------------------- 142

Wallace, Dr. Paul F., let ter d ated April 1, 1963---------------------------- 143
NAT IONAL ACC IDENT PREV EN TIO N CENTE R

TUESDAY, APRIL 9, 1963

H o u se of R e pr e se n t a t iv e s,

S ubco m m it te e on P ub li c H ea lt h an d Safe ty

of t h e C om m it te e on I n ter sta te an d F o reig n C om mer ce ,

Washington, D.G.

The subcommittee met at 10 a.m., pursuant to call, in room 1334, 

Longworth Building, Hon. Kenneth Roberts (chairman of the subcommittee) presiding.

Mr. Roberts. The Subcommittee on Public Health and Safety of 

the House Committee on Interstate and Foreign Commerce will 

begin hearings this morning on H.R. 133, a bill which I introduced to 

amend title III of the Public Health Service Act, to establish a 

National Accident Prevention Center.

This Center would conduct, assist, and foster research, investigations, and studies relating to the causes of accidents and the methods 

of prevention.

It would also promote coordination of research, make available research facilities to be serviced through appropriate public authorities, 

make grants-in-aid to universities, hospitals, laboratories, and other 

public or private agencies, establish an information center on the 

causes and prevention of accidents, and so forth.

The bill is identical to the one I introduced in the 87th Congress, 

H.R. 133 of the 87th Congress. The subcommittee held extensive 

hearings on the bill last year, so I think it will n ot be necessary this 

time to go into as much detail.

However, we will be glad to have all the facts anyone cares to express on this subject. A copy of H.R. 133, together with the agency 

reports thereon, will be made a part of the record at this point.

(The material referred to follows:)

[H.R. 133, 88th Cong., 1st sess.J

A BIL L To amend title II I of the Pu blic Hea lth Service Act to establish a National Accident Preven tion 

Center

Be it enacted by the Senate and House of Representatives of the United States of

America in Congress assembled, Tha t title III of the Public Health Service Act is 

amended by adding a t the end thereof the following new part:

“P art I—National Accident Prevention Center

“purpose and establishment of center

“Sec. 381. In order to assist in the advancement, dissemination, and exchange of knowledge relating to the cause and prevention of accidents, there is hereby established in the Public Health Service a National Accident Prevention Center 

(hereinafter referred to in this part as the ‘Center’).
2 NATIONAL ACCIDENT PREVENTION CENTER

“ f u n c t io n s of t h e c en te r

“ Se c . 382. In carrying ou t the purposes of this pa rt the Surgeon General

shall—

“ (1) conduct, assist, and foster research, investigations, studies relating to 

the causes, and methods of prevention of accidents;

“ (2) promote the coordination of research and control program s conducted by public and priva te agencies, organizations, and individuals;

“(3) make available research facilities of the Service to appropriate public 

auth orities, and to hea lth officials and scientists engaged in special studies 

rela ted to the purposes of this p art ;

“ (4) make gran ts-in -aid to universities, hospitals, laboratories and other 

public or private agencies and institutions for such research projects relating 

to the purposes of this pa rt as are recommended by the Council, including 

grants to such agencies and institutions for the construction, acquisition, 

leasing, equipment, and main tenance of facilities necessary for such research;

“ (5) establish an information center on causes and prevention of accidents, 

and collect and make available, through publicatio ns and other appropriate 

means, inform ation as to, and the practical application of, activities carried 

on under this part;

“ (6) secure from time to time, and for such periods as he deems advisable, 

the assistance and advice of persons from the United States or abroad who are 

experts in the field of accident prevention.

“ a d m in is tr a tio n

“ Se c. 383. (a) In carryin g out the provisions of this pa rt all appropriate provisions of section 301 shall be applicab le to the autho rity of the Surgeon General 

and grants-in-aid for acciden t prevention and research and training projects 

shall be made only afte r review and recommendation of the Board made pursuan t 

to section 384.

“ (b) The Surgeon General shall recommend to the Secretary acceptance of 

conditional gifts, pu rsuant to section 501, for study, investigation, or research into 

the cause, prevention of accidents, or for the acquisition of grounds or for the 

erection, equipment, or maintenan ce of premises, buildings, or equipment necessary to carry out this part. Donations of $50,000 or over for carrying out the 

purposes of this pa rt may be acknowledged by suitable memorials to the donors.

“ Ac c id en t P r e v en tio n Advis ory B oa rd

“ Se c . 384. (a) (1) There is hereby established in the Public Health Service an 

Accident Prevention Advisory B oard composed of the Surgeon General or an officer 

designated by him who shall be chairman, and twelve members appointed by the 

Presiden t none of whom shall be Federal officers or employees. The appointed 

members, having due regard for the purposes of th is part, shall be selected from 

among representatives of various State, interstate, and local governmental 

agencies, of public or private interests affected by, or concerned with, accident 

prev ention as well as other individ uals who are expert in this field.

“ (2) (A) Each member appointed by the President shall hold office for a te rm of 

four years, except t ha t any mem ber appo inted to fill a vacancy occurring prior to 

the expiration of the term for which his predecessor was appointed shall be appointed for the remainder of such term . None of the members appointed by the 

Presiden t shall be eligible for reap pointm ent within one year after the end of his 

preceding term.

“ (B) Members of the Boa rd who are not officers or employees of the United 

States, while atte nding conferences or meetings of the Board or while otherwise 

serving at the request of the Surgeon General, shall be entitled to receive compensation at a rate to be fixed b y the Secretary of Health, Educatio n, and Welfare 

bu t not exceeding $50 per diem, including travel time and while away from the ir 

homes or regular places of business. They may be allowed travel expenses including per diem in lieu of subsistence as authorized by law for persons in the 

Governm ent service employed inte rmitte ntly.

“ (b) The Board shall advise, consult with, and make recomm endations to the 

Surgeon General on matters of policy relating to the activities and functions of 

the Surgeon General under this part.
NATIONAL ACCIDENT PREVENTION CENTER 3

“ (c) Such clerical and technical assistance as may be necessary to discharge the duties of the Board shall be provided from the personnel of the Public Health 

Service.

“ functions of board

“Sec. 385. The Board is au thorized— “ (1) to review research projects or programs sub mitted to or initiated by it relating to the study of the cause and prevention of accidents, and certify approval to the Surgeon General, for prosecution under section 382, of any such projects which it believes show promise of making valuable contribu­ tions to human knowledge with respe ct to the cause and prevention of 

accidents; “ (2) to collect information as to studies which are being carried on in the United States or any oth er country as to the cause and prevention of acci­ dents, by correspondence or by personal investiga tion of such studies, and with the approval of the Surgeon General make available such inform ation through the app ropriate publicatio ns for the benefit of agencies and organi­ zations (public or private), or any other scientists, and for the inform ation of 

the general public; “ (3) to review applications from any university, hosp ital, laboratory, or other institution, whether public or private, or from individuals, for grants- in-aid for research projects relating to the cause and prevention of accidents, and certify to the Surgeon General its approval of grants-in-aid in the cases of such projects which show promise of making valuable contributions to hum an knowledge with respec t to the cause and preve ntion of accidents; “ (4) to recommend to the Surgeon General for acceptanc e conditional 

gifts pursuant to section 501 of this Act; and “ (5) to make recommendations to the Surgeon General with respect to 

carry ing out the provisions of this part.

“appropriations

“Sec. 386. Appropriations to carry out the purposes of this p art shall be av ail­ able for the acquisition of land or the erection of buildings only if so specified, but in the absence of express limitation therein may be expended in the Distric t of Columbia for personal services, stenographic recording and tran slating services, by contract if deemed necessary, without regard to section 3709 of the Revised Statu tes ; traveling expenses (including the expenses of atte nda nce at meetings when specifically authorize d by the Surgeon General); rental, supplies and equip­ ment, purchase and exchange of medical books, books of reference, directories, periodicals, newspapers, and press clippings; purchase, ope ration, and maintenance of motor-propelled passenger-carrying vehicles; printing and binding (in addition to th at otherwise provided by law ); and for all other necessary expenses in carrying out the provisions of th is par t.”

Department of Agriculture,

Washington, D.C., Ap ril 9, 1963.

Hon. Oren Harris,

Chairman, Committee on Interstate and Foreign Commerce,

House of Representatives.

Dear Mr. Chairman: Th ank you for your lette r of F ebr uar y 14 giving us th e op portu nit y to rep ort on House bill 133. The bill is entitle d “To amend title II I of th e Public Health Service Act to establish a National Accident Prevention 

Cente r.” The purpose of the Center would be to assist in th e ad van cem ent, dissemination, and exchange of knowledge relating to the cause and prevention of accidents 

through research, investigations, and studies. The Depar tment of Agriculture is vitally inte rested in this subject and is devoting considerable effort to education al work on accid ent prevention, pa r­ ticu larly as it relates to farm and rural people. The Depar tment has conducted research within this area from tim e to tim e, but this has been limited by available resources. Accidents continue to kill or disable nearly a million farm residents annually, and cause needless suffereing and economic waste to both the agricul­ tural community and the Nation. Increased emphasis on the sa fety and produc­ tive efficiency of farm families is essential to assure a continuing abundance of 

food and fiber for the well-being of all our people.
4 NATIONAL ACCIDENT PREVENTION CENTER

This Department has authority to implement a continuing research and informational program in rural accident prevention through available appropriation 

channels and has no recommendation to make regarding the enactment of H.R. 

133 which would provide similar authority for other areas of governmental 

interest.

The Bureau of the Budget advises t ha t there is no objection to the submission 

of this report from the standpoint of the administration’s program.

Sincerely yours,

Orville L. Freeman, Secretary.

Department op the Air Force,

Office of the Secretary, 

Washington, D.C., April 8, 1968.

Hon. Oren Harris,

Chairman, Committee on Interstate and Foreign Commerce,

House of Representatives.

Dear Mr. Chairman: Reference is made to your request for the views of the 

Department of Defense with respect to H.R. 133, 88th Congress, a bill to amend 

title II I of the Public Health Service Act to establish a National Accident Prevention Center. The Secretary of Defense has delegated to the Department of 

the Air Force the responsibility for expressing the views of the Department of 

Defense.

The purpose of H.R. 133 is to establish in the Public Health Service a National 

Accident Prevention Center which would assist in the advancement, dissemination, 

and exchange of knowledge relating to the cause and prevention of accidents.

The Departm ent of Defense appreciates the general objective of establishing 

national facilities to conduct and promote the coordination of accident research, 

but defers to the Secretary of Health, Education, and Welfare as to the merits 

of establishing such facilities in the Department of Health, Education, and 

Welfare and as to the specific provisions of H.R. 133.

Enactment of H.R. 133 would not involve the expenditure of any Department 

of Defense appropriations.

This report has been coordinated within the Department of Defense in accordance with procedures prescribed by the Secretary of Defense.

The Bureau of the Budget advises that, from the standpoint of the administration’s program, there is no objection to the presentation of this report for th e 

consideration of the committee.

Sincerely,

Eugene M. Zuckert.

Executive Office of the President,

Bureau of the Budget,

Washington, D.C., April 8, 1963.

Hon. Oren Harris,

Chairman, Committee on Interstate and Foreign Commerce,

House of Representatives, Washington, D.C.

Dear Mr. Chairman: This is in reply to your request of February 14, 1963, 

for a report on H.R. 133, a bill to amend title III of the Public Health Service 

Act to establish a National Accident Prevention Center.

The overall objective of H.R. 133, as we interpret its provisions, is to provide 

additional legislative authority to the Public Health Service to enable that agency 

to more effectively carry out its current accident prevention activities. This objective would be met by establishing a National Accident Prevention Center in the 

Public Health Service, by establishing an Accident Prevention Advisory Board, 

and by authorizing the Surgeon General to carry out a broad range of research, 

control, promotional, coordinative, informational, and technical assistance 

functions.

The intent of the bill is not clear as to whether the National Accident Prevention Center is to be a specific organizational unit within the Public Health 

Service or whether a new facility is authorized for construction. The report you 

are receiving on this bill from the Department of Health, Education, and Welfare 

points out tha t the Public Health Service Act already provides broad authorization for establishment of organizational units and that the current flexibility thus 

afforded provides a better legislative basis for efficiently organizing service functions than would a specific statutory organizational unit.
NATIONAL ACCIDENT PREVENTION CENTER

With respect to authorizing the construction of a specific facility, the Public 

He alth Service Act now prov ides broad autho rity for the construction of addition al facilities when required to carry out service programs, and there fore such 

specific authorization as may be intended by this bill would app ear to be unnecessary.

With respect to th e broad sub stantive program authorities for research, promotion , control and other related activ ities which the bill would gra nt to the Public 

Health Service, the De par tment of Health , Education, and Welfare repo rt poin ts 

out th at, with the possible excep tion of au tho rity for training and special project 

grants, the existing sta tutory autho rity of the Public Health Service provides an 

adequ ate base for the deve lopm ent of service programs in the field of accident 

preventio n.

The activ ities of the Public Health Service in this field have expanded from a 

level of 5 employees and $49,000 in 1957 to 147 employees and $4.9 million pro ­

posed for 1964 under the bro ad research and technical assistance authorities 

alre ady available. In addition, the accid ent prevention program was raised to 

division status in the Bureau of S tate Services in 1961. This subs tantial increase 

in the accident prevention activities of the Public Health Service and the elevated organizational sta tus of the program indicates th at the Public Health 

Service has recognized the imp orta nce of the subject and has tak en appropriate 

steps, as the principal Fed eral health agency, to make its proper contribution to 

the total Federal effort in acciden t prevention and safety.

Reports to your comm ittee from a number of Federal agencies indicate serious 

concern th at some p arts of th e bill raise questions of duplica tion and overlapping 

of autho rity and responsibility as between the Public Health Service and other 

Federal agencies. Without repe ating the concerns detailed in the reports of other 

agencies, we would nevertheless agree in general th at the bill, in its present form, 

appears to authorize the Public He alth Service to engage in a number of activities 

now specifically authorize d to be carried out by other Federal agencies, and also 

appears to authorize the Public Health Service to coordinate such activities. 

Such broa d authority, by exte nding the role of the Public Health Service beyond 

its legitimate and par ticu lar concern in th e field of accident preventio n, would, in 

our opinion, be undesirable and would serve to unnecessarily complicate and b urden the effective functioning of the overall Federal effort in accident preventio n 

and safety.

Accordingly, while the Bureau of the Budget favors and has supp orted an 

effective Public Health Service program in accident preventio n, we do not believe 

th at any additional legislation is necessary at this time to enable the Service to 

develop and carry out its appro priate functions in th is field. Fur ther, we believe 

th at the bill raises serious question s as to the relationships and responsibilities of 

the Public Hea lth Service vis-a-vis other Federal agencies.

Sincerely yours,

Phillip S. Hughes,

Ass istant Director fo r Legislative Reference.

Civil Aeronautics Board, 

Washington, D.C., Ap ril 8, 1963.

Hon. Oren Harris,

Chairman, Committee on Intersta te and Foreign Commerce,

I loose of Representatives, Washington, D.C.

Dear Mr. Chairman: This is in further reply to your letter of February 14, 

1963, requesting a report by the Board on H.R. 133, a bill to amen d title II I of 

the Public He alth Service Act to establish a National Accident Prevention Center.

H.R . 133 would establish a new unit in the Public Hea lth Service to be known 

as the National Accident Preven tion Center. The functions of the Center would 

be administered by the Surgeon General, who, among other things, would be 

auth oriz ed to conduct investigations and studies relating to causes and methods 

of prev enting accidents.

The bill proposes a very comprehensive program in rela tion to the cause and 

prev ention of accidents. The Board looks with favor upon the general objective 

of the bill. While presumably not so intended, the coverage of the bill appears 

broad enough to include aircra ft accidents, which the Civil Aeronautics Board 

has the statutory responsibility of investigating under title VII of the Federal 

Aviation Act.
6 NATIONAL ACCIDENT PREVENTION CENTER

For this reason, the Board would be opposed to the legislation in its present 

form. In order to preserve the jurisdiction of the Board and preven t undesirable 

duplication, we recommend th at a new section 387 be added to H.R . 133, reading 

as follows:

“Sec. 387. The provisions of th is Act shall not be deemed to modify or repeal 

any provisions of the Federal Aviation Act of 1958, or to limit in any way the 

functions of the Civil Aeronautics Board relating to accidents involving civil 

aircraft, or rela ting to studies and investiga tions on matters pertaining to safety 

in air navigation and the preventio n of accidents. Nothing in this Act shall 

authorize the Surgeon General or the Accident Prevention Advisory Board to 

perform any of the accident investigative functions which are the sta tut ory 

responsibility of the Civil Aeronautics Board under the Federal Aviation Act of 

1958, as now or hereafter amen ded.”

Apart from the foregoing, we have no comm ent to make on the proposed 

legislation.

The Board has been advised by the Bureau of the Budget th at there is no 

objection to the submission of this rep ort from the s tandpo int of th e adm inistration’s program.

Sincerely yours,

Alan S. B oyd, Chairman.

General Counsel of the Department of Commerce,

Washington, D.C., Apr il 24, 1968.

Hon. Oren Harris,

Chairman, Committee on Interstate and Foreign Commerce,

House of Representatives, Washington, D.C .

Dear Mr. Chairman: This lette r is in fur the r reply to your reques t for the 

views of this Departme nt with respect to H.R . 133, a bill to ame nd title II I of 

the Public Health Service Act to esta blish a National Accid ent Prevention 

Center.

The bill would establish in the Public Hea lth Service a National Accident 

Prev entio n Cen ter which would have certain powers and duties with respect to 

research and investigations relating to the causes and prev ention of accidents. 

Our report is limited to the effect th at enactm ent of the bill would have on 

traffic acciden t prevention.

While this bill deals principally with the functions and orga nization of the 

Public He alth Service in the De partm ent of Health, Educatio n, and Welfare, 

the De partm ent of Commerce is fully in accord with the sta ted objective of 

furthering the advancem ent, dissemination, and exchange of knowledge relating 

to the preve ntio n of accidents. The intere st of this D epa rtm ent in this objective 

is dem onstrated in many ways, notably thro ugh programs of the Office of Highway Safety in the Bureau of Public Roads and by active par ticipation in the 

Interd epart me nta l Highway Safety Board. The Secretary of Commerce serves 

as Chairman of the Interd epartme nta l Highway Safety Board, recently activate d 

and operating under the term s of Executive Order 10898. The Boa rd functions 

as a means for coordination, thr ough voluntary agreement, of the policies, 

programs, and projects of the several Federal dep artm ents and agencies having 

responsibilities in the field of highway safety.

It is our understanding th at the intere st of the Public Health Service in this 

bill is dire cted toward three principa l provisions. The first is the proposed 

autho rity to establish within the Public Health Service an intram ura l research 

center for work in medical, clinical, and behavioral science aspe cts of accident 

prevention. To the extent tha t this w ork would be within the areas of responsibility and competence of the Public He alth Service, we believe th at the establishment of such a center would make an important contribution to the broad i nterdisciplinary effort required in highw ay safety.

H.R . 133 would also perm it the Surgeon General to make special project 

grants to underw rite research. It is understood th at while certain research 

autho rity in this area already exists, th at additional autho rity is required to 

carry forw ard developmental projects. A related feature of the bill would permit 

the Surgeon General to make training grants. Both of these provisions also 

seem warran ted.

It also appe ars th at the proposed grant of autho rity to the Surgeon General 

contained in H.R. 133 would authorize activities which might infringe upon the 

functions of the Office of Highway Safety in the Bureau of Public Roads of this 

Depar tment, and the coordinating functions of the Interd epartme nta l Highway
NATIONAL ACCIDENT PRE VENTION CENTER 7

Safety Board. In orde r to more accu rately identify the scope of the authority 

which would be gra nted, we suggest th at the bill be amended to insert, in the section relating to purpose and establishm ent, after the word “knowledge” on line 8 of page 1, the words "in the medical, clinical, and behavioral sciences.” Other tha n to suggest the above amen dment, the Department of Commerce would defer to the views of the Depar tment of Health, Education, and Welfare 

concerning H.R. 133. The Bureau of the Budget advises th at there would be no objection to the submission of this rep ort from the standpoint of th e adm inistratio n’s program . 

Sincerely,

Robert E. Gile s.

Federal Aviation Agency,

Office of the Administrator, 

Washington, D.C., April 15, 1965.

Hon. Oren Harris,

CAaz'rman, Committee on Interstate and Foreign Commerce,

House of Representatives, Washington, D.C.

Dear Mr. Chairman: This is in reply to your letter of February 14, 1963, 

requesting the views of this Agency on H.R . 133, a bill to amend title II I of the Public Health Service Act to establish a National Accident Prevention Center. We understand th at the Bureau of the Budget does not believe t ha t any addi­ tiona l legislation is necessary at this time to enable the Public Health Service to carry out its appro priate functions in this field. Certainly the Federal Aviation Agency has ade qua te legislative autho rity for secu ring information relating to aviation accidents. I therefore defer to the views of the Bureau with regard to 

the need for the proposed legislation. The Bureau of the Budget has advised th at there is no objection from the standpoi nt of the adminis tration’s program to the submission of this rep ort to 

your committee.

Sincerely,

N. E. H alaby, Administrator.

General Services Administration,

Washington, D.C., April 8, 196S.

Hon. Oren Harris,

Chairman, Committee on Interstate and Foreign Commerce,

House of Representatives, Washington, D.C.

Dear Mr. Chairman: Your letter of February 14, 1963, requested the views 

of the General Services Adm inistration on H.R . 133, 88th Congress, a bill to amend title III of the Public Hea lth Service Act to establish a National Accident 

Prev ention Center. GSA is currently represen ted on the Federal Safety Council reestablished by Executive Order No. 10990 of February 2, 1962, to advise the Secretary of Labor on the development and maintenance of safety organizations and programs in the Federal Government. The Council also establishes criteria, stan dards, and procedures designed to eliminate work hazards and hea lth risks, and to prevent 

injuries and accidents in Federal employment. In addition to the activities of the Federal Safety Council, the Secretary of Labor is engaged curren tly in developing and prom oting standa rds of industrial safety and health, and in assisting the several States in the preparation of indus­ trial safety codes and developm ent of state wide accident prevention programs. The subject bill, H.R . 133, proposes to establish a National Accident Preven­ tion Center in th e Public H ealth Service of the De par tment of H ealth , Education, and Welfare. The function s of the proposed Nation al Accident Preventio n Center appear to overlap those already vested in the Secretary of Labor. It is the view of GSA tha t the functions prescribed by the su bject bill arc more closely 

related to conditions of employ men t tha n to problems of health. Although GSA is in full accord with the objectives of H.R . 133, we do not favo r enac tment of this bill in its present form for the reasons stated above. It is not anticip ated th at H.R. 133, if enacted, would have any financial effect 

upon GSA operations.
8 NATIONAL ACCIDENT PREVENTION CENTER

The Bureau of the Budget has advised that, from the sta ndpoi nt of the adm inist ratio n’s program, there is no objection to the submission of this report to 

your committee.

Sincerely yours,

Bernard L. Boutin, Admin istrator.

Department of

Health, E ducation, and Welfare,

Washington, Ap ril 9, 1963.

Hon. Oren Harris,

Cha irman, Committee on Interstate and Foreign Commerce,

House of Representatives, Washington, D.C.

Dear Mr. Chairman: This letter is in response to your request of February 

14, 1963, for a report on 11.R. 133, a bill to amend title II I of the Public Health 

Service Act to establish a National Accident Preventio n Center.

The bill, identical to one of the same number we re ported on last year, would 

establish a National Accident Prev entio n Center in the Public Health Service. 

It would authorize the Surgeon General to conduct and foster research in the 

causes and methods of preven ting accidents; to prom ote the coordination of 

researc h and control programs conducted by public and private agencies and individuals; to make available the research facilities of the Service to others; to 

make grants-in-aid to universities, hospitals, laboratorees, and other public or 

priva te agencies for research projects in accident prevention, including grants for 

constructing, acquiring, leasing, equipping, and maintaining research facilities; 

to establish an inform ation cen ter and make available information on the causes 

and prev ention of accidents; and to secure the assistance and advice of persons 

from the United States or abroa d who are experts in the field of accident 

prevention.

The bill would also establish in the Public Health Service an Accident Pre ­

vention Advisory Board composed of the Surgeon General as Chairman and 12 

members appointed by the Preside nt. The Board would have responsibility for 

advising the Surgeon General on matter s of policy relating to the accident prevention activities of the Service, for reviewing and recommending action on 

applications for research grants, and for collecting a nd disseminating information 

on studies being carried out as to the cause a nd prevention of accidents.

The primary objective of H .R . 133, as we int erp ret its provisions, is to specify 

the role and responsibilities of the Public Hea lth Service in the field of accident 

prevention. We are entirely in accord with this objective.

The continuing high toll of injuries, deaths, and economic loss resulting from 

accid ents in the United States is one of the major health problem s affecting the 

American people today. Accidents are the leading cause of death among persons 

from 1 to 35 years of age. In t he 15 to 25 age group, accid ents account for more 

deaths than all other causes combined. It is therefore essential th at the Public 

Health Service, as the principal hea lth agency of t he Federal Government, concern itself w ith this majo r health problem and, in cooperatio n with other Federal 

agencies with su bstantial interests in the problem, make full use of its resources in 

developing improved protectio n against this major cause of death and disability.

For th e most part, the existing sta tut ory autho rity of th e Public Health Service 

prov ides an adequate base for the development of Service programs in the field 

of accident prevention. The only additional authorities which may be needed 

are for training grants and for special projects to stim ulate the development or 

dem onstration of new meth ods of accid ent prevention and control.

The activ ities of the Public He alth Service in the field of accident prevention 

have been substantially increased during recent years under the existing broad 

research and technical assistance auth orities in the Public He alth Service Act. 

The Public Health Service program currently being carried out covers accidental 

deaths and injuries occurring on the highways, in the home, and in public places 

such as recreational areas. The Public Health Service approach and its greates t 

contributio n to accident prev ention will be made through the study and elimination of accident causes which arise from the human element in the accident situation. Special atte ntion is being given to studying accidents of certain problem 

age groups such as poisoning in children and falls in the old er age group.

The proper study of many of the human variables associated with accidents 

does require special research facilities which we are now in the process of providing. For example, simulation equipment to study drivers is filing developed
NATIONAL ACCIDENT PREV ENTION CENTER 9

with funds provided by Congress in fiscal year 1963 and requested in fiscal year 1964. Similarly, program plans provide for staffing and equipping a project in St. Petersburg, Fla., for a stud y of accidents among the aged. Much more needs to be done by the Public Health Service as well as by many oth er governmental and nongovernm ental groups, however, in order to determine the causes and develop the preventive techniques which will be necessary for a fully effective 

national accident prevention program. H.R . 133 would serve the useful purpose of highlighting the functions and role of the Service with specific reference to accident p revention. There are, however, a num ber of features of the bill w hich we believe should be modified or clarified. It is not clear, for example, whether the int ent of the bill is to establish an organizational unit in the Public Health Service called the National Accident Prev ention Center or w heth er w hat is contemplated is to auth orize the construc­ tion of a facility to be know n by that name. The Public Health Service Act alre ady provides broad author ization for the Surgeon General with the approval of the Secretary, to establish organiz ational units below the Bureau level. This current flexibility of orga nizational arrangem ent provides, we feel, a better legislative basis for efficiently organizing the functions of the Service tha n would a sta tutory requirement for the establishment of a specific organizational unit. The act also now provides a utho rity to construct facilities as the y become needed 

to carry out Service programs. We are also concerned, as we sta ted in our report last year, th at some parts of H.R . 133 are so broadly state d as to raise a possible issue of duplicatio n of authority and responsibility of other Federal agencies. Accident prevention in its broadest sense is a legitimate and necessary concern of m any Federal departm ents. The Public Health Service has a par ticula r concern for the protection and promotion of health, of which accident prevention is an essential part. We feel, however, th at is should be made clear in the legislation th at the responsibilities assigned to the Service do not supersede or repeal the authorities of oth er Federal agencies for acciden t prevention activities within their own areas of responsibility. The Public Health Service Act as amended by Public Law' 87-838 provides autho rity for the Surgeon General to appoint advisory comm ittees for the purpose of advising him in connection with any of his functions. For this reason, addi­ tional authorization , such as is contained in H.R . 133 for the estab lishm ent of an Accident Prevention Advisory Board, w'ould not be necessary. In summ ary, we are in accord with and support the overall objectives of H.R. 133. We can provide such technica l assistance as your committee may wish in developing legislation pertaining to the role and functions of the Public Health Service. We assume, how'ever, th at your committee will elicit the views of other interested departm ents and agencies with respect to their functions and responsibilities in the field of accident prevention. We are advised by the Bureau of the Budget th at there is no objection to the presentation of this report from the standp oint of the administration’s program. 

Sincerely,

Anthony J. Celebrezze, Secretary.

U.S. Department of the I nterior,

Office of the Secretary, 

Washington, D.C., Apr il 9, 1963.

Hon. Oren Harris,

Chairman, Committee on Interstate and Foreign Commerce,

House of Representatives, Washington, D.C.

Dear Mr. Harris: lo u r committee has requested a report on H.R. 133, a bill to amend title II I of the Public Health Service Act to establish a National 

Accident Prevention Center. This Dep artm ent makes no recommendation regarding the enactment of H.R. 133, but should the com mittee favorably consider it, we recommend th at it. be amended to make it clear th at it does not duplicate the functions of the Bureau of Mines or other Federal agencies in the field of accid ent prevention. H.R. 133 amends title II I of the Public Health Service Act, as amended (42 U.S.C., sec. 241 et seq.) by adding a new part which authorize s the establishm ent of a National Accident Prevention Center in the Public Health Service for the purposes of assisting in the “advanc ement, : dissemination, and exchange of knowledge relating to the cause and prevention of accidents.” In addition, H.R. 133 authorizes the Surgeon General to make grants-in-aid for research projects and establishes an Accident Prevention Advisory Board.
10 NATIONAL ACCIDENT PREVENTION CENTER

Section 301 of the Public Health Service Act, as amended (42 U.S.C., sec. 241) 

provides as follows:

“T he Surgeon General shall conduct in the Service, and encourage, cooperate 

with, and render assistance to other app ropriate public authorities, scientific 

institutions, and scientists in the conduct of, and promote the coordination of, 

research, investigations, experim ents, demonstrations, and studies relating to 

the causes, diagnosis, treatm ent, control, and prevention of physical and mental 

diseases and impairments of man * * *.”

It is clear from the above stat ut e th at the Surgeon Gene ral is primarily concerned with environmental control of health problems and has developed an 

expertise in this field. The ter m “accident” encompasses both personal injuries 

and property damage. The gre at majority of accidents repo rted each year do 

not involve any personal injuries. Thus, while the concept of a National Accident 

Prevention Center may have merit, we question the advisability of its establishment in an agency which is not concerned with problems related to the causes 

of accidents to real or personal proper ty. Even in the case of personal injuries, 

much of the research connected with th e cause and prevention of accidents appears 

to be more nearly associated with the field of engineering than with the medical 

profession.

Section 384 of the bill establishes an Accident Preventio n Advisory Board for 

the purposes of advising, consulting with, and making recom mendations to the 

Surgeon General on matters of policy. Section 385 of H.R . 133 also authorizes 

the Board to review research projects or programs sub mitted to or initiated by 

the Board and certify approval to th e Surgeon General; to collect a nd disseminate 

information as to studies being carried on in the United States relating to the 

cause and prevention of accidents; to review applications for grants-in-aid for 

research projects under this legislation; to recommend acceptance of conditional 

gifts; and to make recommendations regarding the adm inistration of the act. 

We believe that the functions of the Board under this section of the bill will 

duplicate the functions of the Surgeon General under section 382. Further, we 

question the desirability of giving an advisory board such specific functions when 

the members will n ot be Federal employees and may not meet often enough to 

properly carry out these functions. Accordingly, we suggest th at section 385 

be deleted.

H.R . 133 in its present form would duplicate activities conducted by the 

Secretary of the Interior, through the Bureau of Mines. The act of May 16, 

1910, as amended (30 U.S.C. sec. 3) established the Bureau of Mines. Section 2 

of th at act provides:

“I t shall be the province and du ty of the Bureau of Mines, with the approval 

of the Secretary of the Interior, to conduct inquiries and scientific and technologic 

investigations concerning mining, and the preparation, treatm ent, and utilization 

of mineral substances with a view to improving health conditions, and increasing 

safety * * * in the mining, quarrying, metallurgical, and other mineral industries; * * * and to dissem inate information concerning these subjects * *

Since its establishment, the adv ancement of health and safety, collection of data 

on causes of accidents, and the conduct of educational programs in accident prevention in th e mineral and allied industries, and in mines in particu lar, have been 

responsibilities of major concern to th e Bureau of Mines. The Bureau’s staff has 

developed an expertise in these fields not duplicated in any other agency. The 

Bureau’s success in collecting da ta on causes of accidents and in accident prevention training in the mineral industries, which is based on these data and on 

results of investigations and technica l research by the Bureau, has long been 

recognized by the Congress, by other agencies of the Federal and State Governments, and by the mineral industries.

The accident prevention problems of 1he mineral industries in underground 

operations are peculiar to those industries and not susceptible to attack by 

techn iques applicable in indu stries operating surface intsallatio ns. This was 

recognized bv the Congress in the legislation establishing the Bureau of Mines 

and in subsequent legislation t ha t conferred inspection and enforcement authority 

upon the Bureau in respect to its safe ty program in coal mines. See the Federal 

Coal Mine Safetv Act, as amended (30 U.S.C. 451 et seq.). The Federal Coal 

Mine Safety Act, supra, provides th at the Secretary of the Interior, acting through 

the Burea u’ shall collect and report data on accidents in coal mines th at result in 

personal injury. The Public H ealth Service also recognizes these facts as demonstrated bv a memorandum of understanding, dated Jan uary 1962, which provides 

that the Public Health Service shall conduct the medical phases of health studies 

in the mineral industries and the Bureau shall conduct the engineering phases of 

such hea lth and safety studies.
NATIONAL ACCIDENT PREVENT ION CENT ER 11

The pr es en t he al th and sa fe ty ac tivi ties of th e Bur ea u of Mines are pe rfor m ed by about 700 em ploy ees an d r eq ui re a n an nu al e xp en ditur e of $8,95 3,0 00 (e st im at e fo r fiscal ye ar 1964). The se ac tivi ties includ e all th e fu nc tion s of th e pr op os ed N at io nal Ac cid en t P re ven ti on Cen ter w ith re sp ec t to th e mineral in du st ries , ex ce pt for th e auth ori ty to m ak e gr an ts-in- ai d un de r se ct io n 382 (4) of th e bill. We ha ve no t foun d th a t su ch auth ori ty is ne ce ssary to car ry out effecti ve ly ou r pr og ra m s for colle cti on of d a ta on ac cide nts an d for th e pre ven tion of ac ci de nts. Thi s D ep ar tm en t, th ro ugh th e Burea u of Mi nes , be lie ve s it is be st qu ali fie d to pr ov id e an d ev al ua te Fed er al par tici pat io n in ac ci de nt pr ev en tion pr og ra m s re la ting to all min eral in du st ries . Thu s, unles s th e bil l is am en de d to ex clu de ex pres sly th e min eral in dust ri es an d su ch oth er ac ci de nt pre ven tion ac tivi ties , which are th e le gi tim at e and ne ce ssary co nc ern of oth er Fed er al agencie s, we 

be lie ve it will re su lt in ne ed less du pl ic atio n of eff ort. The Bur ea u of th e B ud ge t ha s ad vise d th a t th er e is no obj ec tion to th e pre se n­ ta ti o n of th is re port from th e st andpoin t of th e adm in is tr ati on’s pr og ra m . 

Sincere ly yo urs,

K e n n e t h H ol um , 

Ass ista nt Secre tar y of the Inter ior .

I n ter sta te C o m m er ce C o m m is si o n,

Of f ic e o f t h e C h a ir m a n, 

Wa shing ton , D.C., Ma rch 25, 1963.

H on . Or en H a r r is ,

Ch airm an , Com mittee on Interstate and Foreig n Comm erce,

Ho use of R epresentative s, Was hing ton, D.C.

D e a r C hair m an H a r r is : Y our le tt er of Feb ru ary 14, 1963, ad dr es se d to th e 

C ha irm an of th e Co mmiss ion an d re qu es tin g co m m en ts on a bill, H .R . 133, in tr oduce d by Con gr es sm an Rob er ts , to am en d title I I I of th e Pu blic H ealt h Se rvice Act to e stab lish a N ational Acc iden t Pre ven tion C en te r, ha s been re fe rred to ou r co m m ittee on le gi slatio n. Afte r co ns id er at io n by th a t co m m itt ee , I am 

au th ori ze d to su bm it th e follo wing co mmen ts in its beh al f: H .R . 133 wo uld am en d th e ab ov e- m en tion ed act so as to es ta bl ish a N at io nal A cc iden t Pre ve nt io n C en te r in th e Pu blic H ealth Servi ce. In brief , th e f un ct io ns of th e pr op os ed C en te r wou ld be to co nd uc t, pr om ot e, and co or di na te re se ar ch and in ve stig at io ns in to th e ca us es an d pr ev en tion of ac ci den ts ; to m ak e th e re se ar ch fac ilitie s of th e Publ ic H ea lth Se rvi ce av ai la bl e fo r su ch pu rp os es ; to m ak e gr an ts -in- ai d to in sti tu ti o n s and oth er p ri vate or pu bl ic ag encie s enga ge d in su ch re se ar ch pr oj ec ts ; to est ab lish an in fo rm at io n ce nte r; and to secu re th e ad vi ce an d as sistan ce of ex per ts in th e field of ac ci de nt pre ve ntion. The bil l also pr ov id es fo r th e es ta bl is hm en t in th e Pub lic H ealth Se rvi ce of an A cc id en t Pre ve nt io n Adv isor y Boa rd . The Boa rd wou ld be he ad ed by th e Su rgeo n Gen era l, as ch ai rm an , or an officer de sign at ed by hi m for th a t pu rp os e, and wou ld co ns ist of 12 ad dit io nal mem be rs ap po in te d by th e Pre si den t (non e of who m ar e to be Fed er al em pl oy ee s) , to be s elec ted from am on g re pr es en ta tive s of va riou s Sta te , in te rs ta te , and loca l go ve rn m en tal ag en cies ; pu bl ic an d p ri vate in te re st s co nc erne d w ith o r a ff ec te d by acc id en t p re ven tion; and i nd iv id ua l ex pe rts in th e field . Besides its gen er al f un ct io n of ad vising , co ns ul ting wi th, an d m ak in g re co m m en da tion s to th e Su rg eo n Gen eral w ith re sp ec t to his du ties in th e oper a­ tion of th e Cen ter, th e B oa rd wou ld be specifically ch ar ge d w ith th e du ties of revi ew in g ac ci de nt pre ven tion re se ar ch pro je ct s an d ce rtifyi ng its ap pr ov al of th os e which it de em s m er itorious ; co lle cti ng an d m ak in g av ai la bl e in fo rm at io n on st udie s of ac ci de nt ca us es and pr ev en tion ; an d revi ew in g ap pl ic at io ns for gra nt s- in -a id an d ce rtifyi ng it s ap pro val of th os e pro je ct s which sh ow pr om ise of m ak in g va lu ab le co ntr ib uti ons to hum an kn ow led ge in th e field of ac ci de nt 

pre ven tion . D et er m in in g th e causes of, an d fin ding th e mea ns of pre ven t ing, ac ci de nts ha s be co me a m att er of se rio us co nc er n in th is co un try. Am ong th e ar ea s of hum an acti v it y in wh ich th e ac ci den t pr ev en tion pr ob lem ha s rece iv ed special att en ti o n ar e in dust ri al , farm , ho me , min e, ra di at io n, w at er ca rrier, air cra ft , railw ay , an d high w ay ha za rd s. Eac h of th ese area s is now in some m ea su re th e su bje ct of in te re st and resp on sibi lit y of var io us dep ar tm en ts or ag en cies of th e Fe de ra l G ov er nm en t, includ ing th is Co mmiss ion. The ar ea of m os t im m ed ia te co nc ern to th is Co mm iss ion is, of co urse , th a t of pr om ot in g ra ilro ad and m ot or ca rr ie r sa fe ty . W ith re sp ec t to ra ilro ad s, its resp on sibi lity includ es th e ad m in is tr at io n an d en fo rc em en t of th e se ve ra l Saf et y Ap pli ance Ac ts, th e H ou rs of Service Ac t an d th e Lo co motive In sp ec tion Ac t. As to m ot or ca rriers , th e Co mm iss ion is au th ori ze d to prescribe re gu la tion s go ve rning th e qu al ific at io ns an d max im um
12 NATIONAL ACCIDENT PREVENTION CENTER

hours of service of employees and the safety of operation and equipment. With 

respect to common carriers, whether by rail or highway, the Commission administers the so-called Trans portation of Explosives Act.

We believe t ha t the encouragem ent and coordination of research in the field of 

accident causes and preventio n which the proposed Center and Advisory Board 

would undertake would be of benefit to all of the Federal agencies concerned with 

accident prevention, and also to oth er agencies, organizations, and individuals. 

The proposed financial assistan ce to the research projects, in the form of grants-inaid, would, of course, provide tangib le encouragement in this imp ortant field. 

The results and findings of the researchers, duly published and made available 

to those interested and concerned, should be useful to all those charged with 

promoting safety and reducing accidents of all types. In addition, the making 

available of research facilities, the maintenance of an information center, and the 

advice and assistance of experts—all of which are contem plate d by th e bill—would 

be of material benefit.

Illu strative of the potential usefulness which the Center could be to this Commission is th e fact tha t in the discharge of its responsibilities in the field of motor 

carrier safety the Commission often needs the counsel and advice of experts on 

such ma tters as standa rds of eyesight, hearing, and the effects of organic, nervous, 

and functional diseases on the huma n body. It also needs information as to the 

effect of fatigue and drugs on driv ing ability. Research in such areas promoted 

and aided by the Center a nd Advisory Board would und oubtedly be of benefit to 

this Commission in its task of pre scribing m otor carrier safety regulations.

While we favor the objectives of this proposed measure, we believe, at least 

insofar as this Commission is concerned, tha t it should be amended to make it clear 

th at nothing contained therein shou ld be construed as affecting its jurisdiction in 

the fields of railroad and motor carrier safety, or as requiring submission of proposed regulations, for which the Commission has sta tutory responsibility, to the 

Surgeon General, the Center, or the Advisory Board, for prio r approval.

Editorially, it is not clear wha t is intended by the reference made to “the 

Council,” in line 19, page 2, of the bill. Elsewhere in the bill t he duty of recommending the recipients of grants-in-aid is placed upon the proposed Advisory 

Board. It appears, therefore, th at reference to “th e Council” was inadve rtent, 

and th at a phrase such as “the Accident Preventio n Advisory Board, hereinafter 

provided for,” should be sub sti tuted in lieu thereof.

If amended as suggested above, we would have no objection to the enactment 

of H .R. 133.

Respectfully submitted.

Committee on Legislation. 

Laurence K. Walrath, Chairman,

Rupert L. Murphy.

Post Office Department,

Office of the General Counsel,

Washington, D.C., Apr il 8, 1968.

Hon. Oren Harris,

Chairman, Committee on Interstate a nd Foreign Commerce, House of Representatives,

Wash ington, D.C.

Dear Mr. Chairman: This De partm ent has given consideration to the request 

for a rep ort on H.R. 133, a bill to amend title II I of the Public Hea lth Service 

Act to establish a National Accident Preventio n Center.

This measure would estab lish within the Public Health Service a National 

Accident Prevention Center which would:

1. Conduct, assist, and foster research, investigations, studies relating to 

the causes, and metho ds of preve ntion of accidents;

2. Promote the coordination of research and control programs conducted 

by public ana private agencies, organizations, and individuals;

3. Make available research facilities of the Service to app rop riate public 

authorities, health officials, and scientists;

4. Make grants-in-aid to universities, hospitals, laboratories and oth er 

agencies and institutions for such research projects;

5. Establish an inform ation center on causes and prevention of accidents, 

and collect and make available, such info rma tion ;

6. Secure the assistance and advice of persons who are experts in the field 

of accident prevention.

The bill would also establish an Accident Preventio n Advisory Board with the 

Surgeon General, or an officer designated by him, as Chairman, and 12 non-
NATIONAL ACCIDENT PREVENTION CENTER 13

Federal employee members who are concerned with th e accident prevention field. The Board would review resea rch projects or programs, review and make recom­ mendatio ns for grants-in-aid and make recom mendations t o the Surgeon General with respect to carrying out the program. This De partm ent recognizes th e need for positive action to reduce accidents and to eliminate the causes of accidents, and wholeheartedly agrees with the principles of the bill to coordinate research and control programs and assist in the advancem ent, dissemination, and exchange of knowledge concerning the causes and prevention of accidents as it relates not only to Federal agencies bu t to private agencies, organizatio ns, and individuals as well. However, H.R . 133 as presently drafted is not clear with respect to th e 

following areas: (1) The general language of the bill indicates th at the fields of traffic and in­ dustrial accidents (where program ing applies primarily to damage to equipment or property) are included, as well as those accidents posing medical problems. The placement of this program within the Public Health Service would appear to imply limited jurisdiction with respect to the health and medical areas only. (2) It is understood th at several Departm ents and agencies of the Federal Government, such as the De partm ent of Labor, Depar tment of Interior, In ter­ sta te Commerce Commission, Federal Aviation Agency, and others already have statutory authority and responsibility in accident prevention with respect to the operation of the Federal Governm ent, State governments and priv ate business. The responsibilities of these agencies involve many of the functions identified for the Nation al Accident Preven tion Center such as research, investigations and studies relating to the causes and methods of accident preventio n, the dissemina­ tion of inform ation on all aspe cts of the preventio n of accidents, and the like. It does not appe ar th at the proposed legislation differentiates between those responsibilities which are alre ady assigned to D epartments and agencies and those 

which would be assigned to the Public Hea lth Service. It is believed that unless the responsibilities of the agencies involved are clarified a situation could develop which would result in duplication of effort and conse­ quent added expense in the operatio n of an accident prevention program. In addition, numerous administra tive problems would be created among th e various Federal agencies required by 5 IJ.S.C. 784(c) to operate a safety promotion 

program. We have been advised by the Bureau of the Budget th at from the standp oint of the adm inistration’s program there is no objection to the submission of this 

rep ort to the committee.

Sincerely yours,

Louis J. D oyle, General Counsel.

Mr. Roberts. Our first witness will be Mr. Wilbur J. Cohen, Assista nt Secretary of the Department of Health, Education, and Welfare. He is accompanied by Dr. Luther L. Terry, Surgeon General 

and Dr. Paul V. Joliet, Chief, Division of Accident Prevention. Mr. Secretary, we are glad to have you appear before our subcommittee and you may proceed with your statement.

STATEMEN T OF WILBUR J. COHEN, ASS ISTANT SECRETARY,

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE,

ACCOMPANIED BY DR. LUTHER L. TERRY, SURGEON GENERAL,

AND DR. PAUL V. JOL IET , CHIEF, DIV ISIO N OF ACCIDENT

PREVENTION

Mr. Cohen. Thank you.

Mr. Chairman, as you indicated, I am accompanied by the distinguished Surgeon General of the Public Health Service, Dr. Terry, and by the Chief of the Division of Accident Prevention in the Public Health Service, Dr. Paul V. Joliet. We are available to answer any 

questions tha t the subcommittee might wish to make. I appreciate this oppo rtunity to present to you the views of the 

Departm ent of Health, Education, and Welfare on H.R. 133, a bill to

97707—e; 2
14 NATIONAL ACCIDENT PREVENTION CENTER

establish a National Accident Prevention Center in the Public Health 

Service.

I know tha t the members of this subcommittee, through your intensive study of the accident problem in all its aspects, are very familiar 

with the scope and ramifications of the problem.

However, I would like to outline briefly some of the principal factors, as we see them, in order to put my discussion of the bill itself 

into proper context.

The history of the advancement of medical science illustrates over 

and over that the major obstacle to progress has often been a tendency to regard the problem—whatever it was—as unconquerable. 

This has been the case with almost every disease we have overcome 

or substantially reduced by the process of research, investigation, application, analysis and refinement.

Tliis has equally been the case with accidents. Public opinion, not 

only in the United States bu t throughout the civilized world, has 

tended to regard accidents as an unfortunate occurrence to be accepted as inevitable.

I do not believe th at we who are officially concerned with the problem of the public health, can accept over 90,000 deaths and some 45 

million injuries every year without intensifying the efforts now underway to reduce this constant, tragic toll and loss in our community.

On the basis of our admittedly brief experience in treating accidents 

as a health problem, we know t ha t many, and probably most, of these 

accidental deaths and injuries can be prevented. The national significance of the above figures is brought into sharper focus if we look 

at the type of accidents which add up to these dreadful totals.

First, let us examine the deaths. These include 15,000 children 

under 15 years of age—more than the total of deaths in tliis age group 

from the next four leading causes combined.

For people 15 through 35 years of age, accidents continue to be the 

principal killer—with about 24,000 deaths. In 1 year, more than 

28,000 Americans between the ages of 35 and 65 and 24,000 of our 

senior citizens 65 years of age and older, lose their lives by accidents. 

These tragedies are repeated year after year, with only slight variance.

Now, let us consider injuries. Each year some 45 million American 

men, women, and children sustain accidental injuries severe enough 

to require medical care or to incapacitate them beyond the day of 

injury.

Thousands of these injuries produced lifelong handicaps, including 

blindness, loss of limbs, and disfigurements. Accidents are the leading 

cause of impairments in the United States. Each year over 2 million 

persons are hospitalized for the treatment of accidental injuries.

The economic loss from accidents is over $13 billion every year. 

Part of this loss is visible to everyone who drives along our country’s 

streets and highways. Much of it is not, however, except to the victims, their families, and medical and hospital personnel.

When you consider the toll that accidents inflict among our young 

people from whom the Nation must draw the bulk of its productive 

strength, you see a loss of life every year greater than the size of an 

Army division.

When you consider the accidental casualties among our senior 

population, you see a loss of experience and mature judgment tha t no 

nation can long afford.
NATIONAL ACCIDENT PREVENT ION CENT ER 15

The Public Health Service has long been concerned by this needless 

toll of death and disability and is engaged in developing certain preventive measures. Before I go on, Mr. Chairman, with your permission, I would like 

to show you these charts tha t we have prepared, which present somewha t the same information, but in a more graphic form.

The first chart shows the accidental death rate in the United States 

from 1935 to the present and the rate is computed per 100,000 population. You will see that the top red line, which is the total of all accidental 

deaths, has been going down somewhat as a rate, so tha t we have 

been making some progress, but the significant factor is that the rate 

with respect to deaths due to motor vehicles has been remaining fairly 

consistent. Tha t remains an area for very important research. I think this chart demonstrates two important factors: That the 

accident rate can be brought down by study and research, and work 

and community action; and tha t we still have a lot to do with respect 

to work on the motor vehicle area. This second chart looks a t the problem from the number of hospital 

bed-days that are required to take care of different kinds of diseases 

or disabilities. In this case we have a rather interesting fact; that 

accidents take up 20 million bed-days in hospitals per year.

Twelve percent of the total bed-days of hospitals in the United 

State s at the present time are occupied due to accidents, whether 

they are fatal or nonfatal. The impressive thing is tha t this is larger than taking care of the deliveries of the 4 million babies which are 

born each year. It is more than the hospital bed-days caused by 

people who have heart disease. It is more than four times the number of bed-days required to take care of cancer, and more than 12 

times the number of bed-days caused to take care of diabetes. You 

have some appreciation here of the tremendous load that accidents 

cause in terms of not only using hospital beds, but also the skilled 

personnel that is required to provide service in the hospital. The third chart demonstrates an interesting point: How the accidental death rate varies by age. You will notice from this chart tha t 

the accidental rate is very high, of course, when children are very 

young, and then it is low during the period of the age from 1 to 7 or 8, 

when I suppose the paren ts are very solicitous of the welfare of their 

children and very careful about them.

As they become teenagers, you can see that the death rate from accidents begins to go up very appreciably. When a young boy or girl is 15 or 20 years old, and his parents have spent $15,000 or $20,000 to 

educate him so tha t he will be a productive citizen, to have his life snuffed off at age 20 or 24, means the loss of productive capacity of about $500,000 in terms of the loss of the contribution of that individual after society has invested so much in his education and preparation. This is a tremendous loss.

When we look at accidental deaths by age and by cause, we find 

tha t there are significant differences, and this shows the areas of 

research that would be necessary to undertake to find out how to 

prevent these deaths.

In the first group, for the children under 1 year, the largest single 

factor is inhalation and ingestion causing suffocation, tragedies which 

you read about quite frequently in the newspapers.
16 NATIONAL ACCIDENT PREVENTION CENT ER

For the group 1 to 14 years old, this large bar here shows motor 

vehicles as the principal cause of death, but drowning, and water 

transport, and fires are very large. The need for community-type 

programs to deal with these young people is very important.

Two-thirds of the accidental deaths in the age group 15 to 24 are 

caused by motor vehicles. Research in the motor vehicle area as 

to what will bring down the fatalities among young people when they 

get into a motorcar, is one of the most fruitful avenues that we have 

to decrease this wasteful economic loss among our young people.

Another area tha t certainly shows the need for further research 

and development is among our aged people. Fifty-five percent of 

their accidental deaths are caused by falls. I think that when you 

get into it, you will find that it is not as simple as it may seem. Is it 

the physiological development of the individual tha t causes him to 

fall, or does the fall cause the fracture or the death? And a lot more 

needs to be done with respect to the causative factors as to why so 

many of our senior citizens do not die of old age in the traditional 

sense, but die because they fall. This get us into the whole problem 

of the restructuring of our homes and our offices so that old people 

won’t slip or fall in the bathtub, and preventive measures that can be 

built into homes and offices.

This last chart illustrates the place of nonfatal injuries. The 

important thing here is t hat nearly half of these injuries occur in the 

home, and so again research is necessary to determine what is it tha t 

causes these accidents in the home and what can be done to prevent 

these accidents in the home.

As to the family or the human factor, certainly those are worthy of 

very considerable research.

Mr. Roberts. At this point, Mr. Secretary, without any questions, 

I would like you, if you would, to offer these charts for inclusion in the 

record.

Mr. Cohen. Thank you, Mr. Chairman.

(The charts follow:)

ACCIDENTAL DEATH RA TE

’6 o
NATIONAL ACCIDENT PREVENTION CENTER 17

HOSPITAL BED D A Y S - prin cip al causes

(PER 100,0 00 population)
18 NATIONAL ACCIDENT PREVENTION CENTER ACCIDENTAL DEATHS-principal CAUSES BY AGE _________ _________ <j_________ ______________ 100%

o o l
NATIONAL ACCIDENT PREVENTION CENTER 19

Mr. Roberts. Thank you.

Mr. Cohen. This focus of Service interest and program activity 

lies in the importance of scientific research as the basis for planning 

and developing effective accident prevention measures—and particularly research relating to the human factors in accidents and in 

accident prevention.

I do not mean to imply that accident-prevention research is an 

entirely new or recent concept. Much valuable work has been done 

in some fields for many years.

For the most part, however, this research has concentrated on 

making things relatively safe for humans to use. This includes research into the design of equipm ent and materials to reduce their 

inherent hazards for humans.

Of course, as I implied, a lot more needs to be done in tha t area. 

However, regretfully, not as much attention has been given to human 

behavior that causes or invites accidents. Yet, those who have studied 

accident prevention believe that the principal cause of accidents is 

human behavior.

Until recently the importance of human factors has been reflected 

primarily in campaigns designed to make people “safety minded” 

through training and education. Many of these campaigns have had 

beneficial results.

Unfortunately, the scientific d ata on which effective campaigns or 

other preventive measures can be based is limited at present. We 

need a great deal more research into the physiological, psychological, 

and environmental factors t ha t make people act as they do.

What is particularly needed is an interdisciplinary research effort 

tha t will combine and coordinate the skills of research specialists in 

the various health sciences.

Among these sciences are pediatrics, geriatrics, preventive medicine, 

physical medicine, biomathematics (including computer programing), 

physiology (particularly stress physiology), and behavioral sciences.

Some facts we need are already being uncovered by basic and 

applied research into the sciences related to health. But, these 

findings must be analyzed and related to the requirements of accident prevention. In addition, we have recently begun to see the rich 

potential available in health and related research institutions for 

studies directed specifically toward major causes or forms of accidental death and injury.

In some instances, effective research will require special equipment 

or facilities. This is particularly true where the researcher needs 

to observe human behavior in very dangerous situations.

By stimulating the actual performance situations, we can make these 

tests without danger to the participants. An example, which has 

previously been discussed with your committee, is the need for a 

high fidelity driving simulator in research directed toward the causes 

of traffic accidents.

Such a simulator would allow us to put many drivers through 

identical tasks and individual drivers through a variety of tasks. 

The hazards to the test drivers and others, which would be unavoidable if this were attem pted in actual traffic situations, could be 

eliminated.

Such a device would help us analyze the effects of driving under 

varying conditions, such as the influence of drugs, alcohol, fatigue, 

and other physiological factors. Thus, we could:
20 NATIONAL ACCIDENT PREVENTION CENTER

Substitute scientific facts for the subjective opinions which must 

govern our attitudes toward these factors today;

Discover whatever actual limitations on driving ability might be 

imposed by various chronic or acute diseases or other physical 

disabilities; and

Test the effects of such physiological and psychological factors as 

attitudes, emotions, and other motivational factors; and, study intensively the interactions that take place between the driver, the 

vehicle, the roadway, and other aspects of the environment.

In addition to automotive safety, which has deservedly received a 

major share of public concern, there are many other fields of accident 

prevention which deserve increased attention and in which sound 

research could lend, in our opinion, to the saving of m any lives and 

the prevention of many crippling injuries.

Accidents in the home constitute another problem area in which 

research should yield beneficial results. These include such common 

mishaps as falls, electrical shock, burns, and wounds inflicted by 

knives, firearms, and utensils.

Here too, a variety of physiological, psychological, and environmental factors appears to be involved which we have lacked the research capability to explore adequately.

We also need to investigate such lifesaving techniques as resuscitation, proper storage of household medicines and other substances, and 

safer occupancy of the various kinds of human habitation.

With the increasing amount of leisure time available to the average 

American, we have witnessed an increasing number of deaths and 

injuries among those who engage in skiing, skin and scuba diving, 

hunting and camping, swimming and boating, amateur and professional sports like baseball and football, and boxing, I will add, and 

even gymnastics.

Public knowledge and use of the technique known as “drownproofing” could probably save many lives, among both swimmers and 

nonswimmers.

These are only a few illustratons of areas in which scientific research 

can open the way to progress in accident prevention. I hardly need 

add that such research—like research in other fields—must later be 

translated into programs of action before its full value can be realized.

This will require such intervening mechanisms and procedures as 

to the publication and dissemination of research findings, the conduct 

of experimental and demonstration programs, and the training of 

personnel in new accident-prevention concepts and techniques.

This brief projection of the needs and opportunities for research in 

accident prevention indicates the primary focus of accident-prevention 

interest and planning within the Public Health Service.

Before we continue, let me say tha t the Public Health Service itself 

cannot and should not conduct all needed research, nor is this a field 

in which miraculous results can be quickly achieved.

On the contrary, this is an area where the talents, resources, and 

interests of many agencies—both governmental and voluntary—can 

contribute to a common goal, and many years will pass before some 

of our most difficult accident-prevention problems can be solved.
NATIONAL ACCIDENT PREVENTION CENTER 21

The interest and purpose of the Public Health Service are to make 

certain that its own intramural research potential—and the potential 

of its programs for the stimulation and support of research by nonFederal agencies and organizations—will be fully utilized in a broad 

atta ck on accidental deaths and injuries.

I would like to ask your permission, Mr. Chairman, to insert 

something in the record here. We have compiled some new statistical 

evidence with regard to the accident problem which I think your 

committee might find of value.

Mr. Roberts. Without objection th at will be included in the record.

(The material referred to follows:)

T h e Ac c id e n t P roble m in B r ie f

Accidents leading cause of death for persons 1 to 35 yeais of age

Num ber of accidental dea ths (1960)______________________ 93, 806 Persons injured ann ually________________________________ 45, 000, 000 Persons bed disabled by injury ___________________________ 10, 227, 000 Persons receiving medical care for injuries_________________ 37, 671, 000 Persons hospitalized by injuries__________________________ 1, 979, 000 Days of restricted act ivity_______________________________ 459, 963, 000 Days of bed disability__________________________________ 113, 539, 000 Days of work loss______________________________________ 83, 773, 000 Days of school loss_____________________________________ 11, 894, 000 Num ber of emergency room visit s________________________ 10, 000, 000 Num ber of hospital bed days____________________________ 20, 000, 000 Hospital beds required for trea tm en t--------------------------------- 50, 000 Hospital personnel required for tre at m en t_________________ 68, 000 Annual cost of accidents________________________________ $14, 500, 000, 000

E X T E N T O F TH E PR OBLEM

Deaths

Today accidents are the leading cause of d eath between ages 1 and 35. In this age span, far more people die from accidents each y ear tha n from any of the other leading causes, such as h eart disease, cancer, or influenza and pneumonia. There are about 90,000 accidental dea ths each year. Almost 75 percent of these dea ths are from one of th e four leading types of accidents: Motor vehicle accidents cause about 40 percent; falls cause abo ut 20 percent; fire and explosion cause 

about 7 percen t; drowning causes about 5 percent. Approximately 3 million man-years of life are lost each year because of accidental 

deaths.

Nonfatal injuries

About 45 million persons (more than 1 person in 4) are injured annually according to the U.S. Natio nal Health Survey. Of thos e injured each year a bo ut 19 million are injured in a nd about the home. Motor vehicles injure 4 million, and 8 million are injured while at work. Of those who are injured, about 37 million receive medical care and 10 million 

are bed disabled.

Disability

Annual losses resulting from injur y include abo ut 400 million days of restricted 

act ivity and abo ut 100 million days of bed disability.

Costs

The National Safety Council es tim ates th at accidents cost $13.6 billion in 1960. Of this total , $8.1 billion was att rib utab le to injuries resulting from accidents. Persons injured by accidents impose a heavy burden on our hospital facilities. The num ber of emergency room visits is estim ated at 10 million and abo ut 1.7 million persons are hospitalized for tre atm ent of inju ry each year. Each year accidents result in abo ut 16.5 million hospital bed-days and require the equivale nt 

of about 50,000 hospital beds and 68,000 full-time personnel.
22 NATIONAL ACCIDENT PREVENTION CENT ER

Ac cid en ts an d O ur H e a l t h— A B r ie f Sta tis tic a l S um mar y

how a c c id e n t s a ff e c t th e n a t io n ’s h ea l t h

Accidental deaths

Accidents are fourth among the leading causes of dea th in the United State s. 

Only heart disease, cancer, and vascular lesions of the cen tral nervous system 

tak e more lives. About 3 million man-years of life were lost because of accidents 

in 1958.

Among young people 1 to 35 years of age, accidents are the leading cause of 

death . In the age group 15 to 24 years they caused more than one-half of all 

dea ths in 1959.

There were 92,080 accidental deaths in 1959. The death rate for accidents 

was 52.2 per 100,000 population. Almost 75 perc ent of these death s were from 

one of the four leading types of accidents: Motor-vehicle accidents caused more 

than 40 percent (37,910 deaths); falls caused more than 20 percen t (18,774 dea ths ); 

fire a nd explosion caused about 7 percent (6,898 death s); drowning caused abo ut 

5 perc ent (5,046 deaths).

Nonfatal injuries

About 45 million persons are injured annually according to the U.S. National 

Health Survey. (Based on 3 survey years, July 1957-June 1960.)

More than one person in four is injured annually. (Based on 2 survey years, 

Jul y 1957-June 1959.)

Of those who are injured, about 37 million receive medical care, 10 million are 

bed disabled, and 1.7 million are hospitalized. (Based on da ta for various survey 

years.)

Annual losses resulting from these injuries include abo ut 400 million days of 

restric ted ac tivity , abo ut 100 million days of bed disability, and about 100 million 

days lost from work. (Based on the survey year, July 1957-June 1958.)

MOT OR V EH IC L E A C C ID EN TS AN D T H E N A T IO N ’S H EA LTH

Deaths

Motor vehicle accidents caused the death of 37,910 persons in the United States 

in 1959. The death rate for such accidents was 21.5 per 100,000 population. 

In 1958 about 1.4 million man-years of life were lost as a result of motor vehicle 

accidents.

Death from motor vehicle accid ents is much more common among males t ha n 

among females. Male dea th rates were almost thre e times as high as female 

dea th rate s in 1959. (For the 20-24 year age group, male dea th rates were five 

times as high as female dea th rates.)

About four-fifths of all the motor vehicle death s in 1959 occurred among male 

you ths aged 15-24.

There were 7,282 pedestrians among those killed by motor vehicles in 1959. 

Males aged 65 and over accounted for almost one-fourth of these, although they 

constitute less than 4 percent of the population.

Nonfatal injuries

The National Health Survey estimates that about 4 million persons are injured 

annually in motor vehicle accidents. (Based on 3 survey years, July 1957-June 

1960.)

More than one-fourth of all these injuries occurred to persons 15-24 years of 

age—the age group with the highest rates. (Based on 2 survey years, July 

1957-June 1959.)

More tha n one-half of those hospitalized by injuries are injured by motor 

vehicles. (Based on the survey year July 1957-June 1958.)

Among the annual losses due to motor vehicle accidents are about 90 million 

days of restricted activity, more t ha n 25 million days of bed disability and abo ut 

30 million days lost from work. (Based on the survey y ear Jul y 1957-June 1958.)

HOW A C C ID E N T S A FF E C T T H E H EA LTH O F C H IL D R EN

Deaths

Accidents are the leading cause of death in childhood, after the first year of life. 

About 15,000 children die each year in an accident.

Accidental deaths are almost 30 percent of all death s for ages 1 to 4, and abo ut 

40 pe rcen t for ages 5 to 14.
NATIONAL ACCIDENT PREVENTION CENTER 23

Motor vehicle accidents, drowning, and fire and explosion are the most common types of fatal accidents in childhood. Together they cause more than half of th e 

accidental dea th toll.

Nonfatal injuries

The N ation al Hea lth Survey estimates t ha t about 16 million children are injured each year. About one-third of all persons injured are children under 15. (Based 

on 2 survey years, July 1957—Jun e 1959.) About 60 percent of these children are in jured in and about the home. (Based 

on 2 survey years, July 1957—June 1959.) One child in every ten hospitalized, is there because of an injury. More than 200,000 children have imp airm ents caused by injury. (Based on th e survey year, 

July 1957-June 1958.) Injur ed children experience more than 40 million days of restricted a ctivity and 10 million days of bed-disability annually. About 13 million schooldays are lost each y ear because of injuries. (Based on th e survey year, July 1957-June 1958.)

HOW A C C ID EN TS A FF E C T TH E H EA LTH OF T H E AGED

Deaths

The re were 24,845 accid ental dea ths among persons 65 and over in 1959. The accidental death rate for these aged persons was 161.6 per 100,000 population— 

more than three times the rat e for all ages. Although less than 10 percen t of the population was 65 or over in 1959, more than one-fourth of the accidental deaths occurred among thi s age group. They experienced almost three-fourths of all fata l falls, almost one-third of all pedes­ trian deaths, and more than one-fourth of the death s from fire an d explosion. For older people, falls, motor vehicle accidents and fire and explosion are the most common types of accidental death. Together they casued abou t 85 percent 

of all accidental deaths of those 65 and over in 1959.

Nonfatal injuries

About 3 million older persons are injured annually, according to National Health Survey estimates. (Based on 2 survey years, July 1957-June 1959.) Over two-thirds of these injuries occur in and abo ut the home. (Based on 2 

survey years, July 1957-June 1959.) Injur y rates for older women are twice as high as those for older men. (Based 

on 2 survey years, July 1957 -June 1959.)

HOM E A C C ID E N T S AND TH E N A T IO N ’S H E A L T H

Deaths

Accidents in and abo ut the home caused more t han one-fourth of all accidental deaths in 1959. There were 23,020 death s from such accidents reported, and the total number is estimated to be as high as 28,000 ann ually (including an 

estima te for deaths with place no t reported.) The home and its premises are the scene of almost two-thirds of all accidental dea ths of children under 5, and alm ost one-half of the accidental deaths of persons 

65 an d over. Accidents in the home are responsible for more tha n three-fo urth s of all deaths from fire and explosion, almost two-thirds of those from poisonous gases and vapors, and about one-half of the deaths from falls, solid and liquid poisons, 

and firearm accidents.

Nonfatal injuries

About 19 million persons are injured in and about their homes each year, according to National Health Survey estimates. (Based on 3 survey years, 

July 1957-June 1960) Eac h year these accidents injure twice as many persons as work accidents and four times the num ber inj ure d in motor vehicle accidents. (Based on 

3 survey years, July 1957-June 1960.) Children and aged persons have the highest home injury rates. Among children, boys have higher rates than girls. Women 65 years and over have rates much higher than men of the same age. (Based on 2 survey years, July
24 NATIONAL ACCIDENT PREVENTION CENTER

Deaths and death rates for the leading types of accidents, United States, 1959

Typ e o f accide nt

N um ber of 

de at hs

Ra te per 

100,000 

population

All types ___ __________________________________________________________ 92,080 52.2

Motor v eh icle_____________________________________________________ 37,910 21.5

Fal ls ............ ............... . ................................................................. ..................... 18,774 10.6

Fire a nd ex plo sio n_________________________________________________ 6,898 3.9

D ro w n in g .. __ ___________________________________________________ 5,046 2.9

Fi re ar m . . _ __________________________________________________ 2,258 1.3

In ha la tion a nd in gestion 1__________________________________________ 2.189 1.2

M ac hi ne ry ________________________________________________________ 1,970 1.1

All oth er t ypes_______________________ ___ ____ ____________________ 17,035 9.7

1

 I nh al at io n an d ingestion causing ob stru ction or suffoc atio n.

Accidental deaths and death rates by age, United States, 1959

Age

N um be r of 

de at hs

Ra te per 

100,000 

population

All ag es_____________ _________ ____________ ______________ _____ ______ 92,080 52.2

Und er 5__________________________________________________________ 8,748 

6,511 

13,269 

19,666 

18,937 

24,845

104

44.2 

18.5 

56.0

42.3 

52.8

161.6

5 to 14_____ _______ ____ ____ ______________________ ________ ____

15 to 24................... .......................................................... ............ .............................

25 to 44___________________________________________________________

45 to 64___________________________________________________________

65 and ov er_ _ . _____ _ ___ _________________ ________________

Not s ta te d____ . . __ _ . ______________________________

Source: Dea ths—V ital Statistics of t he U ni te d Sta tes , 1959—Nationa l Office of Vita l Sta tis tic s. Pop ulati ons—C urren t Po pu latio n Reports, Bu reau of th e Census series P-25, No. 212.
NATIONAL ACCIDENT PREVENTION CEN TER 25

Leading types of accidental death by age and sex, United States, 1959

AU

ty pe s

M ot or

veh icl e

Fa lls

Fire 

an d 

explo ­

sio n 1

D ro w ning

Fi rearm

In ha la ­

tio n a nd 

ingestio n »

Ma ch inery

All

ot he r

ty pe s

All age s......... ............ 92,08 0 37 ,910 18,774 6,8 98 5,0 46 2,25 8 2,1 89 1,9 70 17,03 5

M al e................ - 63, 639 28,06 4 9,3 03 3,9 37 4,2 79 1,97 6 1,3 25 1,90 1 12, 854

Fe m al e................ 28,441 9,84 6 9,4 71 2,96 1 767 282 864 69

U nd er 5 ...................... 8,7 48 1,8 42 521 1,27 4 727 93 1,3 85 71 2,83 5

M al e.................. - 4,9 80 1,0 24 336 656 481 58 801 50 1,5 74

Fe m al e................ 3,7 68 818 185 618 246 35 584 21

5 to 14...........- .........- 6,51 1 2,7 19 184 753 1,2 04 449 63 135 1,0 04

M ale ________ 4,6 44 1,8 50 130 315 1,01 1 396 38 123 781

Fe m al e_______ 1,8 67 869 54 438 193 53 25 12

15 to 2 4..................... - 13,269 8, 96 9 274 331 1,0 64 602 39 224 1,7 66

M ale ________ 11, 015 7,2 57 249 215 988 539 35 217 1,5 15

Fe m al e_______ 2,2 54 1,7 12 25 116 76 4 7 251

25 to 4 4................. . 19, 666 10,35 8 1,0 85 1,1 72 935 558 155 619 4,7 84

M a l e ........ ......... 15,8 55 8, 09 6 867 804 848 479 100 605 4,0 56

Fe m al e_______ 3,8 11 2,26 2 218 368 87 79 55 14 728

45 to 6 4.........- ............ 18,9 37 8,26 3 2,9 22 1,4 72 743 422 255 694 4,16 6

M a l e .................. 14,233 5,93 6 2,1 42 904 635 384 166 681 3,38 5

Fe m al e_______ 4,7 04 2,32 7 780 568 108 38 89 13 781

65 a nd ov er ................ 24,845 5,7 27 13,7 77 1,8 90 347 133 291 226 2,4 54

M al e. _______ 12, 822 3,8 76 5,5 70 1,03 7 292 119 185 224 1,5 19

Fe m al e_______ 12,0 23 1,8 51 8,2 07 853 55 14 106 2 935

N ot st at ed ................. 104 32~ IT 6 26 1 1 1 26

MftlP 00 25 9 6 24 1 1 24

"C/vm nl n 14 7 2 2 1 2

» Fi re a nd e xplo sion of c om bu sti ble m at er ia l, 

a I nhal at io n an d ing est ion caus ing o bs tr uc tion or s uffoca tion.

Source : V ita l Sta tis tic s of the U ni te d Sta te s, 1959, N at io na l Office of V ita l St at is tic s.
26 NATIONAL ACCIDENT PREVENTION CENTER

Death rates for the leading ty pes of accidental death by age and sex; United Slates, 1959

[R ate s p er 100,000 p opula ti on]

All

ty pes

M o to r

veh ic le

F al ls

F ire 

an d 

explosion •

D ro w nin gF ir earm

In h ala ­

ti o n an d 

inge sti on 2

M ac hi ner y

All

oth er

ty p es

A ll a ges___________ 52 .2 21 .5 10.6 3. 9 2.9 1.3 1.2 1.1 9. 7

M ale __________ 73. 2 32 .3 10. 7 4. 5 4. 9 2.3 1. 5 2. 2 14. 8

F em ale ________ 31 .8 11.0 10.6 3. 3 . 9 .3 1.0 . 1 4. 7

U n d er 5 ___________ 44. 2 9. 3 2.6 6. 4 3. 7 . 5 7.0 4 14 3

M a le __________ 49. 4 10 .2 3. 3 6. 5 4. 8 . 6 7.9 . 5 15 6

F em ale ................ 38 .8 8. 4 1.9 6. 4 2.5 . 4 6.0 . 2 13.0

5 t o 14_____________ 18.5 7. 7 .5 2.1 3. 4 1. 3 .2 . 4 2 9

M a le .............. . 25 .9 10 .3 .7 1.8 5. 6 2.2 4. 4

F em ale ................ 10.9 5. 1 .3 2. 5 1.1 .3 . 1 . 1 1.3

15 to 2 4____________ 56.0 37 .8 1. 2 1. 4 4. 5 2. 5 .2 . 9 7 5

M ale __________ 93 .5 61 .6 2.1 1.8 8. 4 4. 6 .3 1. 8 12.9

F em ale ________ 18.9 14. 4 .2 1.0 .6 . 5 0 . 1 2. 1

25 to 4 4____________ 42 .3 22 .3 2.3 2. 5 2. 0 1.2 .3 1 3 10.3

M ale _______ _ 69 .7 35 .6 3. 8 3. 5 3. 7 2. 1 .4 2.7 17.8

F em ale ________ 16.0 9.5 .9 1.5 . 4 .3 .2 . 1 3.1

45 t o 6 4____________ 52 .8 23 .1 8. 2 4.1 2.1 1. 2 .7 1. 9 11.6

M ale __________ 81 .8 34 .1 12.3 5. 2 3. 6 2.2 1.0 3.9 19. 4

F em ale ________ 25. 5 12. 6 4. 2 3.1 .6 .2 . 5 . 1 4. 2

65 a n d o v er________ 161.6 37 .2 89 .6 12.3 2. 3 .9 1.9 1.5 16.0

M ale __________ 184.1 55 .6 80 .0 14.9 4.2 1. 7 2.7 3.2 21 .8

F e m a le .. ............ 142.9 22 .0 97 .6 10.1 .7 .2 1.3 0 11. 1

■ F ir e an d ex pl os io n of co m b u st ib le m a te ri al.

2

 I n h ala ti o n a nd inges tion c ausi ng o b str u c ti o n or su ffoc at io n.

Sour ce s: “ V it al S ta ti st ic s of th e U n it e d S ta te s, 1959” a n d “ C u rr en t P o p u la ti o n R eport s, ” Se rie s P-2 5, 

N o . 212, B ure au o f th e C en su s.

Persons injured: 1 Estimated number by class of accident and extent of disability—

United States annual average, Ju ly 1957 -Ju ne 1960

[N u m b ers i n th ousa nds]

C la ss o f a cci den t

E x te n t of d is ab il it y

T o t a l 2 M oto r 

ve hi cle 3

W ork 3 H om e O th er

T o ta l pe rs on s in ju re d ................. . ................... ........... ......... 45,187 4,3 88 8,250 19,068 13,481

W it h a c ti v it y rest ri ct io n ( m edic al ly a tt e n d e d or no t) .

B ed d is ab li n g _________ _______________________

26,3 33 2,7 19 3.920 10,988 8,7 06

10,350 1,37 0 1,350 4,090 3,5 40

M ed ic al ly a tt e n d e d ......... ............... . ............. . 8,0 30

2,3 20

1,22 4

146

1,069

281

3,0 66

1,024

2,671 

N o t m ed ic al ly a tt e n d e d _____________ ____ 869

N o t bed dis abli ng______________________ . . 15,983 1,349 2,5 70 6.898 5,1 66

M ed ic al ly att e n d e d _____________ _______ 10,143 

5,840

953

396

1,898

672

4,009

2,889

3,283

N o t m ed ic al ly a tt e n d e d ___ ______________ 1,883

W it h o u t ac ti v it y re st ri ct io n (m ed ic all y a tt e n d e d ). . . 18,854 1,66 9 4,3 30 8,08 0 4.77 5

* T hese e st im at es ar e bas ed u p o n 3 y ears o f a co nti n u in g s am pl e su rv ey o f th e ci vilia n n o n in sti tu ti o n al 

p o p u la ti o n re si di ng i n th e U nit ed S ta te s. E sti m ate s ar e ba se d on in te rv ie w s of a m in im um of 36,000 h ou se ­

hold s co nta in in g ap pro xim at el y 115,000 per so ns per y ea r. E ach s ta ti sti c is a d ju ste d to offic ial U .S . B ure au 

of th e C en su s popula ti on figur es to m ak e t h e sam pl e e st im ate s clo se ly r ep re sen ta ti v e of th e to ta l popula tion 

b y ag e, sex, c ol or , a nd r es id en ce . P er so ns in ju re d in cl ud e o n ly tho se pe rs ons e xp er ie nc in g in ju ri es ca usi ng 

1 or m or e day s of r es tr ic te d a c ti v it y o r r eq u ir in g m ed ic al a tt en ti o n . F or fu rt h e r des cr ip tio n an d q ua lifica ­

ti o n s se e “ H ealt h S ta ti st ic s F ro m th e U .S . N ati o n al H ealt h S u rv ey ,” se ries B-8 .

2

 F ig ure s m a y n o t ad d t o t o ta ls s h o w n b ec au se o f roundin g.

3

 “ M o to r veh ic le ” he re in clu des a ll accid ents in w hi ch a m oto r ve hi cle w as in volv ed re ga rd le ss of w het her 

th e v eh ic le w as in m ot io n o r s ta n d in g s ti ll , i .e ., p er so ns i n ju re d w hile w ork in g o n ve hi cles a nd ped est ri an s 

str u ck b y m ov in g veh ic les a re b o th in clu d ed . " A t w ork ” in cl ud es all ac cid en ts oc cu rr in g w hile th e pe rs on 

w as a t w ork a t h is jo b o r b usi nes s, ex cep t th ose a cci den ts in volv in g m o to r ve hi cl es .

So ur ce : U .S . N at io nal H ealt h S u rv ey .
NATIONAL ACCIDENT PREVENTION CENTER 27

Persons injure d'.1

 Estimated numbers by age, sex and class of accident— United

States, ann ual average, Ju ly 1957 -Ju ne 1959

[N u m b ers in th ousa nds]

C la ss of accid en t

Age an d sex

T o ta l 3 M o to r 

v e h ic le 3

A t \\ o rk 3 H om e O th er an d 

u n k n o w n

A ll age s__________________ ________ _________ ____ 46,3 88 4,1 73 8,2 64 19,960 13, 992

M ale . _______ _____ ____ _____________ ______ 26,811 

19,577

2,8 39

1,334

6,7 83

1,481

9,363 

10, 598

7,82 7 

6,165 F em ale __________________________ _________ ____

U nder 5____________________________________________ 5,6 22 130 (<) 4,0 89 1,404

M ale _________________________ _____________ . 3,63 6 

1,986

77

53

(

4

)

(‘)

2,816 

1,273

744

F em ale ___________ ____ ______________________ 661

5 t o 14____________ _______ _________________________ 10,763 432 89 5,644 4,599

M ale ______________________ _______ _____________ 6,5 92 

4,17 1

264

168

59

31

3,585

2,059

2,685

1,914 F em ale _____________ . _______________________

15 to 24 ___________________________________________ 6,756 1,073 1,415 1,594 2,67 5

M ale _________________________________ _________ 4,3 33

2,42 3

716

357

1,1 62

254

626

968

1,830

F em ale ________________________________ _______ 845

25 to 44 _________________________________________ 11,788 1,491 4,1 22 3,4 72 2, 704

M ale .................................. ....................... ............................ 7,09 3 

4,6 95

1,126

365

3, 486 

635

995

2,478

1,486

F em ale _________________________________________ 1,218

45 t o 6 4________________ ____ _________________ ___ 8,1 09 865 2,381 2,870 1,993

M alo ____________________________ _____________ 4,2 33

3,8 76

559

306

1,871

510

808

2,062

995

F em ale ________ ______ _______________________ . 998

65 a n d o ver _________ ________ ______________________ 3,3 52 184 258 2,293 618

M a le . _________________________________________ 925

2,428

98

86

205

53

534

1,760

88

F em ale ............ .................................. ........... ...................... 530

1 T hese est im ate s ar e ba se d up o n 2 yea rs of a co n ti n u in g sa m pl e su rv ey of t h e civ il ia n n o n in sti tu ti o n al 

p o p u la ti o n re si din g in th e U nited S ta te s. E sti m a te s ar e ba se d on in te rv ie w s of a m in im u m of 36,000 

hou se ho ld s co n ta in in g ap pro xim at el y 115,000 p er so ns per ye ar. E ach sta ti sti c is a d ju ste d to off icial U .S . 

B ure au of t h e C en su s p o p u la ti o n fig ur es to m a k e th e sa m pl e esti m ate s clos ely rep re sen ta ti v e of th e t o ta l 

p o p u la ti o n b y ag e, sex, co lor, an d re si de nce . Per so ns in ju re d in clu de only th ose per so ns ex pe rien ci ng 

in ju ri es ca usi ng on e or m or e day s of restr ic te d a c ti v ity or re q u ir in g m ed ic al a tt e n ti o n . F o r fu rt h er des cr ip ­

ti o n an d qual if ic at io ns see “ H ealt h S ta ti sti c s F ro m th e U.S . N ati o n al H ealt h S u rv e y ,” Se rie s B-8 .

2

 Fig ure s m a y n o t ad d to to ta ls sh ow n bec au se of ro undin g.

3

 “ M o to r veh ic le ” he re in cl ud es al l a ccid ents in w hic h a m oto r ve hi cle w as in v o lv ed reg ar dl es s of w heth er 

th e v eh ic le w as i n m otion or sta n d in g s ti ll , i. e., per so ns in ju re d w hile w ork in g o n ve hic le s an d ped est ri an s 

str u ck b y m ovin g v eh icles are b o th in clu d ed . “ A t w ork ” in clu des all acci den ts o cc urr in g w hile th e p er so n 

w as a t w ork a t hi s jo b or bu sine ss , ex ce pt th o se ac ci den ts in volv in g m oto r ve hi cl es .

4

 N o t appli cable .

So ur ce : U n p u b li sh ed d a ta fro m th e U .S . N ati o n al H ealt h S urv ey .
28 NATIONAL ACCIDENT PREVENTION CENTER

Persons inju re d: 1 Estimated rates by age, sex, and class of accident— United States,

annual average, J uly 1957-Jun e 1959

[Rates per 1,000 persons per year]

Class of Accident

Age and sex

T ota l3

Motor 

veh icle3

At

work 3 Home

Other

and

unknown

All ages_________________________ __ _________ 273.1 24.6 48.6 117.5 82.4

Ma le. __________________________________ 324.5 34.4 82.1 113.3 94.7

Female___ _____ ______________ . . . . . . . . . . . . . 224.5 15.3 17.0 121.5 70.7

Under 5_____________________________________ 288.3 6.7 (9 209.7 72.0

Ma le. _____________ _____________________ 366.1 7.8 («) 283.5 74.9

Fem ale_____ ____ ________________________ 207.6 5.5 (9 133.1 69.1

5 to 14 ............................................. ................ 318.4 12.8 2.6 167.0 136.0

M ale. __________________________________ 382.2 15.3 3.4 207.8 155.7

Fem ale. _________________________________ 251.9 10.1 1.9 124.4 115.6

15 to 24 _ _________________________ _____ 313.9 49.9 65.7 74.1 124.3

Male .. ______ ______________________ 431.1 71.2 115.6 62.3 182.1

Fem ale__________________________ ________ 211.2 31.1 22.1 84.4 73.7

25 to 44 _____ _______ .. _____ ___ 258.6 32.7 90. 4 76.2 59.3

Male ............................ . ................................. . 324.6 51.5 159.5 45.5 68.0

Female. ________ ________ _______________ 197.9 15.4 26.8 104.4 51.3

45 to 64 ______ ________ _____________________ 233.3 24.9 68.5 82.6 57.3

Male ......................................................... .............. 251.1 33.2 111.0 47.9 59.0

Fem ale. . ______________________________ 216.5 17.1 28.5 115.2 55. 7

65 an d over__________________________________ 228.5 12.5 17.6 156.3 42.1

Male. __ ______ ________________________ 138.3 14.7 30.7 79.9 13.2

Female_______ _____ ___________________ _ 304.3 10.8 6.6 220.6 66.4

• These estimate s aro based upon 2 years of a continuing sa mple surv ey of the civilian non institutional

C

opu lation residing in the United S tates. Estimates are based on intervie ws of a minimum of 36,000 houseolds containing approximately 115,000 persons per year. Each sta tist ic is a dju sted to official U.S. B ureau 

of the Census populatio n figures to make the sample estimates closely representative of the total population 

by age, sex, color, and residence. Persons injured include on ly those persons experiencing injuries causing 

1 or more da ys of restricted a ctivity or requ iring medical attention . For further description and qualifications see “Health Statistics From th e U.S. Nationa l H ealth Surv ey,’’ Series B-8.

1

 Figures may not add to totals sh own because of rounding.

3

 “ Motor vehicle” here includes all accide nts in which a motor vehicle was involved regardless of whether 

the vehicle was in motion or sta nding stil l, i.e„ persons in jure d while w orking on vehicles and pe destrians 

struck by moving vehicles are both included. “At w ork” includes all accidents occurring while th e person 

was at work at his job or business, except those accidents involving motor vehicles.

* N ot applicable.

Source: Calculated from unp ublishe d d ata provided by the U.S. N ational H eal th Survey.

COST OF ACC IDE NTS

The National Safety Council estim ates th at accidents cost $13.6 billion in 1960. 

Of this total, $8.1 billion was attributa ble to injuries resulting from accidents, 

broken down as follows:

Wage loss______________________________________________ $4, 100, 000, 000

Medical expense________________________________________ 1, 000, 000, 000

Overhead cost of insu rance_______________________________ 3, 000, 000, 000

In addition to these injury costs, property damage in motor vehicle accidents 

cost an estim ated $2.2 billion, property destroyed by fire amo unts to $1.1 billion, 

and property damage and loss of production caused by work accidents cost $2.2 

billion.

The total amount of compensation paid under workmen’s compensation laws 

in 1959 was about $1.2 billion. Of this am ount about $400 million was for medical 

and hospital costs, and a bout $800 million for wage compensation.

Non fatal injuries result in the loss of about 100 million workdays annually.

Persons injured by accidents impose a heavy burden on our hospital facilities. 

The number of emergency room visits is estim ated at 10 million and abo ut 1.7 

million persons are hospitaliz ed for treatm ent of injury each year. Each year 

accidents result in a bou t 16.5 million hospital bed-days and require the equivalent 

of about 50,000 hospital beds and 68,000 full-time personnel.
NATIONAL ACCIDENT PREVENTION CENTER 29

Accidental death rates by State, United States, 1959

[R ate s p e r 100,000 p opula tion]

[U n it ed S ta te s : 1 N u m b e r of d ea th s, 92,080; ra te , 52.2]

R a n k a n d S ta te R ate N u m b e r 

of d e a th s

R an k an d S ta te R ate N u m b er 

of de ath s

1. A la sk a____________ ______ 115.2 220 26. W ash in g to n .......................... 56.7 1,602

2. N e v a d a .. _____________ 89 .6 251 97 N eb ra sk a 55.5 808

3. N ew M ex ic o_____________ 86.0 756 28. I o w a . . . _________________ 55.4 1,556

4. W yom in g_______________ 84.3 269 29. In d ia n a __________________ 55.2 2^561

5. M o n ta n a ______________ 83.7 575 30 N o rt h C ar olina 55.0 2,493

6. A rizo na__________________ 73 .8 910 31. Ten nes se e_______________ 54.8 L9 19

7. Id ah o ___________________ 70 .6 469 32. U ta h ____________________ 54.2 477

8. M is si ss ip pi______________ 70.0 1,530 33. C al ifor ni a __ _ . 53.2 7,78 7

9. O k la h o m a______ _____ _ 67.8 1,542 34. M in n eso ta _______________ 52.8 1,794

10. A rk an sas________________ 67.7 1,181 35. V ir gin ia _________________ 52.1 2,079

11. S outh D a k o ta ___________ 64 .2 441 36. M ain e___ ____ __________ 51.0 484

12. A la b a m a ..._____________ 62 .9 2,0 09 37. W is co ns in _______________ 50.0 2,005

13. S outh C aro li n a__________ 62 .8 1,517 38. D is tr ic t of C olu m bia 49.8 ’418

14. O re gon ___ ______________ 62.3 1,101 39. O hi o_____________________ 49.0 4,749

15. L ouis ia na............ ................... 61 .5 1,946 40. N ew H am p sh ir e_________ 48.8 289

16. V erm o n t________________ 61.0 227 41. M assa ch u sett s___________ 48.2 2,386

17. M is so u ri ............ ..................... 60 .8 2,581 42. M ary la n d _______________ 45 .8 1,388

18. N o rt h D a k o ta ___________ 59.8 384 43. M ic h ig an . ______________ 45.8 3,645

19. G eo rg ia ___________ ______ 59.5 2,2 84 44. P en n sy lv an ia ____________ 45.0 5,101

20. K e n tu c k y _______________ 58.8 1,838 45. D ela w are ________________ 43.2 196

21. C olo ra do________________ 58.6 986 46. Illinoi s___________________ 42.7 4,359

22. W est V ir gin ia ___________ 58.5 1,14 9 47. N ew Y ork . . __________ 41.4 6,832

23. K an sas__________________ 58. 4 1,24 9 48. N ew J ers ey . _______ ____ 38.4 2,277

24. F lo ri d a__________________ 57.9 2,7 56 49. C o n n ecti cu t________ ____ 37.7 '91 0

25. T exas __________ _____ ___ 57.8 5,50 1 50. R ho de Is la n d .. _________ 33 .5 293

» D a ta fo r to ta l U n it ed S ta te s in clu des A la sk a b u t exc lu de s H aw aii .

So ur ce : D e a th s, V it al S ta ti st ic s of th e U n it e d S ta te s, 1959, N O V S . P o p u la ti o n , C u rren t P o p u la ti o n 

R ep o rt s, s er ie s P . 25, N o. 210, B u re au of t h e C ensu s.

Death rates from motor vehicle accidents by State, United S tale s, 1959

[R at es p er 100,000 p op ul at io n]

[U nited S ta te s : 1 N u m b e r o f d ea th s, 37,910; ra te , 21.5]

R a n k a n d S ta te R ate

N u m ­

b er of 

d ea th s

R an k an d S ta te R ate

N u m ­

ber of 

dea th s

1. N e v a d a ............ ............... ....... 48 .2 135 26. In d ia n a ______________ 23.9 1,109

2. N ew M ex ic o.......................... 43.5 382 27. Ten ne ss ee . . 23.9 837

3. W y o m in g ............... ......... . 41.7 133 28. M is so uri _________________ 23.8 1,010

4. M o n t a n a ...................... ....... 36. 1 248 29. F lo ri da 23.6 1,124

5. A ri zo na__________________ 35 .7 440 30. V er m ont 22 .3 83

6. Id a h o ___ ______________ 33 .0 219 31. W ash in gto n . . 22.0 620

7. S outh D a k o ta ...................... 32 .5 223 32. M in n eso ta _______________ 21.7 737

8. A la b am a____ ____ _______ 28 .2 900 33. O hio ........ ............................... 20.5 1, 993

9. A rk an sas..... ......... ................. 28 .2 491 34. W isco ns in 20.5 824

10. O k la h o m a....... ....................... 28.1 ’ • 640 35. V ir g in ia __ 20.2 806

11. O re gon............. .................... 27 .7 489 36. M ic hig an 19.8 1, 575

12. N o rth C aro li n a____ _____ 27.4 1,241 37. W es t V irgi nia 19.8 390

13. T exas _________ ____ _____ 26 .9 2,5 57 38. N ew H am psh ir e 18.9 112

14. S outh C aro li n a.................... 26 .8 648 39. M a ry la n d -. 18.0 546

15. K a n sa s............. ....................... 26 .6 570 40. D ela w are .. . 17.4 79

16. M is s is s ip p i. ................... .. 26 .6 582 41. Il li n o is ______ 16.9 1, 724

17. C al if orn ia _________ ______ 26.1 3,8 23 42. A la sk a___________________ 16.8 32

18. U ta h ......... ............................... 26.1 230 43. P en n sy lv an ia 16 3 1 846

19. N o rt h D a k o t a ................... 26.0 167 44. M ai ne ___________ 15.7 149

20. G eo rg ia .................................... 25 .7 987 45. N ew Y or k 14.1 2,334

21. L o u is ia n a_______ ____ ___ 25 .3 802 46. N ew J er se y 12.9 764

22. Io w a__________ __________ 25 .0 702 47 M as sa ch use tt s 12.5 620

23. C olo ra do ................................. 24 .4 410 48. C onnec ti cut 12.0 289

24. K e n tu c k y .......... . ......... ....... 24 .2 755 49. D is tr ic t of C olu m bia 11.1 93

25. N e b ra sk a................................ 24.1 351 50. R ho de Isla n d ....................... 10.2 89

1

 D a ta fo r to ta l U n it ed Sta te s in cl ud es A la sk a b u t ex cl ud es H aw ai i.

So urce: D eath s, V ital Sta ti st ic s of th e U n it e d S ta te s, 1959, N O V S . P o p u la ti o n , C u rr en t P o p u la ti o n 

R ep ort s, se ries P . 25, N o. 210, B ure au o f t h e C ensu s.

9 7 7 6 7 — 6 2 --------3
30 NATIONAL ACCIDENT PREVENTION CENTER

Death rates from accidents other tha n motor vehicle accidents by State, United

States, 1959

[R at es per 100,000 p opula tion]

[U nited S ta te s : 1 N u m b e r of d eath s, 54,170; ra te , 30.7]

R an k a n d S ta te R ate

N u m b e r

of

d ea th s

R an k a n d S ta te R ate

N u m b er

of

dea th s

1. A la s k a .. .____ ___________ 98.4 188 26. N o rt h D a k o ta ...................... 33 .8 217

2. M o n ta n a ________________ 47.6 327 27. V ir gin ia _________________ 31 .9 1,273

3. M is si ss ip pi______________ 43.4 948 28. K an sas__________________ 31 .8 679

4. W yom in g____ __________ 42.6 136 29. S outh D ak o ta ___________ 31 .7 218

5. N ew M ex ic o_____________ 42.5 374 30. N eb ra sk a_________ ______ 31 .4 457

6. N ev ad a____ _____ _______ 41.4 116 31. In d ia n a__________________ 31 .3 1,452

7. O k la h o m a_______________ 39.7 902 32. M in nes ota _______________ 31.1 1,057

8. A rk an sas________________ 39.5 690 33. Ten ne ss ee _______________ 30 .9 1,082

9. D is tr ic t of C o lu m b ia _____ 38.7 325 34. Tex as ___ ______ _________ 30 .9 2,944

10. V erm o n t_________ _______ 38 .7 144 35. I o w a ___________________ 30 .4 854

11. West. V irgi nia 38.7 759 36. N ew H am p sh ir e................ - 29 .9 177

12. A r iz o n a ._____ _ _______ 38.1 470 37. W is co ns in _______________ 29 .5 1,181

13. I d a h o . . ____ ___ _____ _ 37.6 250 38. P en n sy lv an ia ____________ 28 .7 3,255

14. M is s o u ri_______ _____ _ 37.0 1,571 39. O hi o______ ______________ 28 .5 2,75 6

15. L ouis ia na________________ 36.2 1, 144 40. U ta h ___ ________________ 28.1 247

16. Sou th C aro li n a___ ______ 36.0 869 41. M ary la n d . ____________ 27 .8 842

17. M assa ch u sett s___________ 35.7 1,7 66 42. N ort h C aro li n a__________ 27 .6 1,252

18. M ain e___ _____________ . 35.3 335 43. N ew Y ork _______________ 27 .3 4.498

19. A la b am a________________ 34.7 1,109 44. C al ifor ni a________________ 27.1 3,964

20. W as hin gto n . . ___ 34. 7 982 45. M ic hig an ________________ 26 .0 2,070

21. K en tu ck y . . . . . ____ 34. 6 l,ft83 46. D el aw ar e________________ 25 .8 117

22. O r e g o n .__ _ __ ________ 34.6 612 47. Il li n o is .. _______________ 25 .8 2,635

23. F lo ri d a__________________ 34.3 1,632 48. C o n n ecti cu t_____________ 25 .7 621

24. Colo ra do________________ 34.2 576 49. N ew J ers ey . ____________ 25 .5 1,513

25. G e o rg ia ____ _____ ______ 33.8 1,2 97 50. R ho de Is la n d ____________ 23 .3 204

1

 D a ta for t o ta l U n it ed Sta te s in clu des A la sk a b u t exc lu de s H aw ai i.

So ur ce : D eath s, V it al S ta tist ic s of th e U n it e d S ta te s 1959, N O V S . P o p u la ti o n , C u rre n t P opula ti on 

Re[ X)rts, s er ie s P . 26, N o. 210, B ure au of th e C en su s.
DEATH RATES FROM ACCID ENTS

United States, 1959

D .C .

Source: NO VS and Bureau of the Census

Death Rates per 

100,000 Population 

H 62.9 and over E Z 2 57.3 - 62 .8 □ 3 49.4 - 57.2 

I - I Less than 49.4

NATIONAL ACCIDENT PREVENTION CENTER

HEW-111

CO
DEATH RATES FROM MOTOR VEHICLE ACCIDENTS 

United States, 1959

Source: NOVS and Bureau of the Census U .S .P .H .S ., Division of Accide nt Prevention

NATIONAL ACCIDENT PREVENTION CENTER
DEATH RATES FROM AC CIDE NTS OTHER TH AN MOT OR VEHICLE AC CID ENTS 

United States, 1959

D .C .

Source: NO VS and Bureau of the Census U .S .P .H .S ., Division of Acc id en t Pre ven tion

Death Rates per 

100.000 Population 

MBS 37 .9 and over 

ES3 33 .8 - 37 .8 

EZ23 28.6 - 32 .9 

I 1 Less than 28.6

NATIONAL ACCIDENT PREVENT ION CENTER

HEW -111

CO
34 NATIONAL ACCIDENT PREVENTION CENTER

Mr. Chairman, I have undertaken to define in general terms the 

interests, objectives, and programs of the Service in the field of accident prevention because that—as we interpret it—is the principal 

purpose of the chairman’s bill, H.R. 133.

As was pointed out in our Dep artm ent’s report on the bill, H.R. 133, 

as written, adds no substantial new program autho rity to that already 

available to the Service under existing statutory provisions. I would 

however, add specificity to some general authorities, thus underscoring and focusing public attention—and the attentio n of research 

workers in the health sciences—on the particular needs and objectives 

of accident-prevention research.

We believe tha t such action by the Congress could contribute in 

this field, as it has in other fields of research, to the further advancement of programs already authorized and established.

We have also pointed out in our report several provisions of H.R. 

133, as introduced, which would require substantial revision. The 

only point tha t we believe requires reiteration and emphasis in this 

stateme nt today is the need for revision or clarification of those provisions of the bill which might be so construed as to limit or subordinate 

the accident-prevention research interests and responsibilities of other 

Federal departments and agencies.

As I indicated earlier in this statement, the field of accident prevention, including accident-prevention research, is very broad and 

diversified, it requires the resources of many agencies and individuals, and particularly many agencies and individuals in the Federal 

Government.

No one organization or agency could possibly conduct an allembracing program of its own or undertake the central planning and 

coordination of the efforts of other agencies.

Therefore, whole Public Health Service activities in this field could 

be strengthened through specific legislative emphasis along the lines 

of H.R. 133, with the amendments proposed, any such legislation 

should give due recognition to the parallel interests and programs of 

other agencies in the field.

This concludes my general statement, Mr. Chairman. T shall be 

glad, however—with the assistance of the Surgeon General, Dr. Terry, 

and Dr. Paul V. Joliet, the Chief of our Division of Accident Prevention—to answer any questions your committee may have regarding 

our present and projected activities in this important field, which your 

bill deals with.

Mr. Roberts. Thank you, Mr. Secretary.

We appreciate your statemen t on this bill. I want to congratulate 

you too on the charts which you presented for the benefit of the 

committee.

I was particularly impressed with the fact that it seems that when 

our youngsters begin to drive automobiles, that is when the curve 

takes its upward swing, and I wondered if you would agree with that, 

tha t apparently when they start to drive automobiles this onset of 

terrific loss of life seems to make itself known.

Mr. Cohen. Mr. Chairm an, you are raising a problem which is 

very close to my heart. I have three teenagers driving a car at the 

present time and, of course, as a parent, I am well aware of the anxiety 

and distress that both my wife and I have each time one of our children 

drives the car.
NATIONAL ACCIDENT PREVENTION CENTER 35

As parents we have tried to instill in our children the sense of responsibility in having this death defying vehicle in their hands.

On the other hand, I must admit tha t not everything is under the 

control of the particular driver because there are other drivers on the 

road and there are other obstructions, and so on. I am sure all p arents are concerned about this. It is so tragic, as I said, to have children reach the age of 18 or 20 and then see their life snuffed out just 

as they are ready to embark on their life’s work after society has spent 

years in educating them and their parents have invested so much.

I think it certainly is an area tha t we ought to do a lot more in. 

Leaving out the m atte r of the love and affection for our children, just 

from the standpoint of economics to the country, a great deal of additional research could be justified in preventing this tremendous loss.

If this driving simulator tha t we have been talking about in an 

accident research prevention center could just simply reduce a small 

part of th at loss, 1 think the return on the investment would be very 

great.

Perhaps the Surgeon General would like to say something on that.

Dr. Terry. Mr. Chairman, I think one is struck on repeated occasions by incidences which occur, and just in this morning’s paper I 

think you may have noticed an article about the death of five teenage 

girls in Baltimore in an automobile accident.

We realize tha t we will never make automobiles completely safe, 

but, for instance, in reading this article in the paper, without having 

any more specific information about it, 1 was struck with wanting to 

know what had happened.

The driver was not killed. I believe he was the only occupant of 

the car who was not killed and after the accident, according to the 

report in the paper, related tha t his brakes failed.

Of course, I do not know whether the brakes actually did fail or 

whether this was a human failure, whether this individual had something wrong with him and he should not have been driving, or whether 

this was an automobile that had mechanical defects and should not 

have been allowed on our s treets and highways.

] think this is an example of the sort of tragic incidences which 

occur every day and I thin k tha t our experience has shown very well 

in so many instances, many of them can be prevented by proper 

studies and application of existing information in the field.

Mr. Roberts. Actually, from the standpoint of physical alone, 

the teenager should be the best driver we have. Wouldn’t you agree 

with that?

Dr. Terry. That is right, sir. At th at age their reflexes are bette r 

and from the pure physical standpoint, they should be the best, once 

they have learned to drive.

Mr. Roberts. Doctor, would you think that this type of prevention center would cost a great deal of money, or do you have any 

cost estimates?

Dr. Terry. Yes, sir. We have some cost estimates, Mr. Chairman. 

I think it all depends on what one thinks of in terms of the actual 

things which are to be incorporated into such a center. For instance, 

the type of the center th at we are thinking of in the research laboratory 

estimates, it is estimated t ha t such a building would cost in the neighborhood of $8,500,000. This would be facilities to include laboratories 

for study, an area in which the simulator would be placed.
36 NATIONAL ACCIDENT PREVENTION CENTER

As I think you are aware, Mr. Chairman, we have received the 

support from the Congress already to begin the early stages of development and acquisition of a driving simulator. This is a complicated 

device tha t has to be developed and it will take several years yet 

before it will be available, but at the same time through the support 

of the Congress we have been able to get funds to sta rt on this program, and this would be included in a part of this, as well as track 

facilities about the building which would be used for studies of the 

reaction of individuals to practice actual circumstances in driving.

Mr. Roberts. Do you contemplate tha t the simulator would be a 

part of the Accident Prevention Research Center?

Dr. Terry. Yes, sir. It would be a very key pa rt, but it would by 

no means be the entire Center. In other words, there would be many 

other laboratories of physiological, chemical, and other types which 

are necessary to support the work around the simulator and to support 

studies in other areas, such as home accidents, in which one would be 

able to mockup certain situations and study within such a center.

Mr. Roberts. Dollarwise, what do we spend per capita in this field 

of automotive highway research?

Dr. Terry. I don’t have the exact figures, Mr. Chairman, on the 

automotive.

Mr. Roberts. Do you have them overall?

Dr. T erry. I have them overall for accident prevention, and, as 

you realize, this year our budget is $3,660,000 in this area of accident 

prevention, which represents-----

Mr. R oberts. About $2. Is it not, per capita?

Dr. Terry. About 2 cents per capita.

Mr. Roberts. Two cents, I mean.

Dr. Terry. This is in comparison, for instance, to the area of the 

heart where we are spending 85 cents; cancer, 88 cents; in terms of 

research, development, and application in those fields.

Mr. Roberts. As pointed out, I believe by the Secretary, this 

field which we are talking about, the field covered in H.R. 133, is now 

the leading cause of death in the teenage group. You used the figures 

of what? Fifteen to twenty-four?

Mr. Cohen. Yes; 15 to 24. The motor vehicle was 67.7 percent. 

Is that the one you had reference to, Mr. Chairman?

Mr. R oberts. Yes.

This is a group, I believe, you mentioned, as the group tha t we will 

have to look to to draw our future leadership?

Mr. Cohen. Tha t is certainly true. I recall when I was teaching 

at the University of Michigan tha t it would appall me, tha t at the 

end of the school year after the students had graduated, there would 

always be three or four traffic deaths tha t grew ou t of some kind of 

celebration or some other event jus t after these students had graduated, 

just on the embarkation of their work.

There are many aspects that I think need more research. It is 

true th at there needs to be continuous work on highway safety.

I think another area is the question of the use of alcohol and the 

kinds of laws that we have with regard to accidents when people are 

driving under the influence of alcohol.

Th at is an area of research tha t needs further work. Studies of the 

door locks on automobiles has been productive. You can reduce the 

extent of deaths and injuries by a number of things, including, as
NATIONAL ACCIDENT PREV ENTION CENTER 37

we have seen, seat belts, and improved door locks. I have reason to 

believe that if we apply ourselves to this ma tter, we can do so. One point, Mr. Chairman, was not made in my statem ent, but I think should be of interest to your subcommittee. The extent to which the State health departments are working on accident preven­ tion is very spotty in the United States a t the present time. We only have 15 States tha t have a full-time person in their public health departments that is dealing, in a full-time way, with accident prevention. That gives you some rough idea that we are not yet at the point where the States recognize th at you have to have people 

who are working on this all the time. In 36 other States, we have part-time personnel, and I think that there is a great deal yet that remains to be done to stimulate and encourage the State health departments to undertake this as a more 

major function of their responsibility.

Mr. Roberts. Do you have any figures as to the number of States 

which require physical examinations of drivel's on renewal?

Dr. J oliet. The most recent to require this was Pennsylvania, sir. I believe Oregon has such a law. We can get a listing for you. 

Those are the two that I know of offhand.

Mr. Roberts. I would like to have you supply that for the record.

(The following material was submitted for the record:)

The accompanying cha rts indicate: (а) State physical examination requirements for new applicants for driver licensing and renewals (obtaine d from Internatio nal Association of Chiefs of 

Police), and (б) State physical examination requirements for special licensing cases (ob­ tained from American Optical Survey of State Requ irements for Motor Vehicle 

Opera tors).
38 NATIONAL ACCIDENT PREVENTION CENTER

State physica l exam ination requirements f or new applicants for driver licensing and

renewals

Ac uity Color Dep th Periphe ral Renewals

A.C .D.P.i

1. Alabam a__________ ______________ Y »______ Y ............

2. Alaska____ _____________________ Y............. . Y ............ Y Y

3. Arizona......... ................ . ..................... Y...... ........ Y.

4. Arkansa s_________________________ Y _______ Y______ Y. . Y

5. C alifo rn ia ...__________ _____ ____ Y ............ Y.

6. Co lor ado.____ _____ _____ _______ Y .......... Y ............ Y .. . Y.

7. Con nec ticu t______ ______ _____ ___ Y_______ Y_______ Y . Y

8. D el aw ar e..................................... Y .. Y Y

9. District of Co lum bia.................. ........... Y ............ Y _______

10. Flo rida________________________ _ Y._ ......... Y Y Y

11. Georgia_______ _______ ___________ Y............. Y Y Y.

12. Hawaii___ _____ ____________ Y _____ Y Y Y

13. Idaho_______ ____________ . . Y.............. Y Y Y Y.

14. Illinois_______ ______________ . Y _____ Y Y.

15. Indiana_____ _____________ . . . . Y_______ Y.

16. Iowa__________________________ Y______ Y Y Y Y.

17. Kan sas_________________ _____ _ Y_______ Y Y Y

18. Ke ntuc ky _____________________ . Y ______ Y Y

19. Lou isiana ............ . .............. ................ Y_______ Y ............ Y Y Y.

20. Maine_____ _____ _____________ Y_______ Y .......... Y Y

21. M a ry la n d -___ _______ __________ Y _______ Y ........... Y Y Y.

22. Massachuse tts___________________ Y ............ Y ............ Y

23. Michigan __________ _____ ______ Y.............. Y ......... Y Y.

24. Minne sota ............................................. Y........ . Y .. Y Y

25. Mississippi....................... . ................. Y........... Y ............ Y Y

26. Miss ou ri-............................. Y_______ Y Y Y

27. Mo nta na...... ................ . Y ............. Y. . . . Y Partial.

28. Nebraska_____ ___ .. . Y ............ Y............ Y

29. Nevad a.................................. Y. Y Y Y.

30. New Hamp shire................... Y............... Y............ Y Y

31. New Jers ey........... ..................... Y_______ Y............ Y. Y. Partial.

32. New Mexico..... ...................... Y. Y Y. Y Y.

33. New York.. ______ ____ _ _ . Y............. Y

34. North Carolina........................... Y............... Y.............. Y. Y. Y.

35. North Da kota........... ................. Y............... Y........... . Y. . Y. . Y.

36. Ohio_______ Y............. Y. Y Y Y.

37. Oklahoma__ Y............. Y_.._ Y Y

38. Oregon....................... . .................... Y______ Y. . Y. Y Y.

39. Pen nsy lva nia.............. Y............. Y........... . Y. Y. Y.

40. Rhode Island .. Y............... Partial.

41. South Carolina...... ........... Y............... Y. . . . . . . Y.

42. South Da ko ta............. ...... Y...... ........ Y.............. Y. Y.

43. Tennessee........ ..................... Y............... Y___ Y Y

44. Texas__________________ _ Y ........... Y............ Y. Y

45. U ta h .. ............ . .............................. Y ._ ........... Y._ . Y. Y.

46. Vermont........ . .......................... . ... Y............... Y ............. Y. Y. Y.

47. Virginia........... .................................. Y........... Y._ Y Y. Y.

48. Washin gton ........... ..................... ........... Y............. Y. Y Y. Partial.

49. West Virg inia.......................... ............. Y............... Y_. .

50. Wisconsin...... ....................... Y_______ Y. .. Y. Partial.

51. Wyoming......................... . . Y............... Y .. ..

52. Gu am .....................................................

53. Puerto R ic o ...... ....................... Y ......... . Y_. . Y. . Y. Y.

54. Virgin Islands _______________ ____

1

 A—Acu ity. C—Color. D—Depth. P—Peripheral. 

’ Y—Yes.
NATIONAL ACCIDENT PREVENT ION CENTER 39

State physical exa min atio n requirements fo r special licen sing cases

After

cer tain age

Physical

lim itation

After convicted of 

negligence

After

compla int

After

suspen ­

sion

After

revocation

Accident

repeate rs

1. Al abam a.. ___________ X X

2. Alask a.. _____________ Over 70.. . X X X X

3. Arizona ........................... . Over 65__ X X X X X X

4. A rk an sa s_____________ X X

5. California____ ________ X_______ X X X X X X

6. Colorado_______ ______ X X X X X X

7. Con nec ticu t.................... . X X X X X

8. Delaware ________ X X X X

9. Di strict of Columbia........

10. Florida_______________

Over 65__ X X

X

X

X

X

X

X

X

X

X

11. Georgia_______________ X X X X X X

12. H aw ai i.. ____ _________ X X X X X X

13. Id ah o.. X

14. Illinois_______________ Over 70__ X X X X X

15. In dian a__ Over 75 -. X X X

16. Iowa ____ ____________ X X X X X X

17. Kan sas______ _________ X X X X X X

18. Ke ntucky .................. ...... X X X X X X

19. Louisiana >_ __ X 1 year

X

X

20. Maine . ____________ Over 80 .. X X X X X

21. M ary la nd....................... Over 70.. . X X X X X X

22. Massachusetts ______ X X X X

23. Michiga n_____________ X X X

24. Min nesota. ___________ X X X X X X

25. Mississippi.................... . X X X X X

26. Mis souri______________ X X X

27. Mo nta na............... ........... X X X X X X

28. Ne bra ska ___ __________ X X X X X

29. Ne vada______________ X X X X X X

30 New Hampshire Over 80__ x X X

31. New Je rsey___________ X X X X X X

32. New Mexico _________ X X X X X

33. New Y ork. __________ X X X X X X

34. No rth Caro lina___ ____ X X X X X X

35. North Dak ota _______ Over 70 .. X X X X X X

36. Ohio_________________ X X X X X X

37. Oklahoma......................... X X X X X X

3S Oregon X X X X

39 Pen nsylvania L 1st license X X X

40 Rhode Island _________ Over 70 .. X

41. South Carolina________ X X X X X X

42. South Da kota................... X _______ X X X X X X

43. Tennessee................. ........ X X X

44 Texas X X X X

45 Utah X X

46. Vermont _____________ X ............. X X X X X X

47 Virginia X X X

48. Washington _________ X X X

49. West Virginia_________ X X X X X

50 W is c o n sin X X X

51 Wyom ing

5?

53 Puerto Rico ________

54 Virgin Islands_________

1

 Pen nsy lva nia periodical physical e xamination suspended pending legislative review.

Dr. Terry. Mr. Chairman, I would like to mention in relation to 

the figures that Mr. Cohen gave you here, you might notice tha t 

there were 51— 15 that have full time and 36 that have part time, 

actually amounting to 51 because this includes Guam, Puerto Rico, 

and the Virgin Islands, which means this: Tha t with 53 in the table 

for consideration, actually there are two States, and they are not the territories either, tha t do not have either part-time or full-time personnel a t the State level devoted toward accident prevention.

Mr. Roberts. I would like to ask the Secretary if he thinks this is 

a healthy situation for States not to require physical examinations 

on renewals.

Mr. Cohen. Perhaps Dr. Terry and Mr. Joliet want to comment 

on this. I feel that it is a matter tha t we certainly ought to do a great deal more research on before we finally decide what needs to
40 NATIONAL ACCIDENT PREVENTION CEN TER

be done, both with respect to further consideration of the individual 

and the examination of the automobile.

Those are two areas 1 think in which there is a great deal of controversy. Some States provide for examination of people over 65. 

This is interesting to a lot of the State legislators. But in principle, 

if tha t is good for people over 65, I think i t is good for people under 

65, because we all know that the variation in human capacity and 

performance is very great for people under 65 as well as for people 

over 65.

Mr. Roberts. Actually, we do require, do we not, pilots of planes, 

and I suppose marine pilots and locomotive engineers, and we require drivers of vehicles in Interstate Commerce, tha t is trucks 

th at are under the licensure of the ICC to pass certain physical 

standards?

Air. Cohen. I would like to say this, and then perhaps Dr. Terry 

would comment. I think we would all agree with the objective of 

that, and yet, I think we are a t tha t stage in development of accident 

prevention tha t we don’t reallv know what those standards ought 

to be.

Mr. Roberts. We have no place to go. Actually the ICC points 

out that they have no place to go for any information tha t is based 

on scientific research. Isn’t tha t true?

Mr. Cohen. Yes. Commercial airplane pilots are very much up 

in arms over this so-called arbitrary ruling tha t at age 60 they can’t 

fly any more. I wouldn’t want to comment for or against it, but 

the point tha t I am tryin g to make is simply tha t we need to know 

a lot more about human capacities and how to set standards before 

we make a final judgment.

We are probably in the accident prevention field today where we 

were 15 years ago in cancer.

In other words, we have a lot of very fundamental work to do to 

assemble all this knowledge and information, and once it can be 

assembled, I think tha t competent scientific people then can begin 

to set standards that the States and different people in different 

areas can use.

Is that a fair statem ent, Dr. Joliet?

Dr. J oliet. That is a very eminently fair statement. You can 

see the work th at has been done in advancing the safety and quality 

of highways by developing the Inte rstate System. There is no 

comparison of these highways with what we knew when we were kids. 

However, drivers have not improved as the highways have. Nothing 

like a comparable advance has been made in determining who may 

or who may not drive cars from the standpoint of physical or mental 

limitations.

Mr. Roberts. I would like also to ask you if in the event of approval 

of this bill, you would see any infringement on such activity of the 

Inte rior Department, as minimum safety, or any infringement on 

the work of the Federal Aviation Agency, or upon the traditional role 

of the Department of Commerce through the Bureau of Public 

Records, or any other Federal agencies whose present jurisdiction 

would be divested by this bill, that is, with the amendments or suggestions which you have made in your statement.

Mr. Cohen. Mr. Chairman, the way I read the bill it neither is 

intended nor is there anything explicit which I think infringes on the
NATIONAL ACCIDENT PREV ENTION CEN TER 41

jurisdiction of these other areas tha t the Federal agencies are working 

on and in which they are doing very fine work.

I would, however, feel tha t if you were going to pass legislation, in 

order to avoid tha t difficulty, the statute should be made very clear 

tha t this is not intended to supersede the responsibilities of these 

agencies which have a specific responsibility in either mine safety, 

or occupational injury, or pilots, or any such areas. As I read the 

bill and as I read your hearings before, what you are looking for is 

a research function in the Federal Government which has already 

been given to the Public Health Service, which will attem pt to pool 

all of the information available throughout our society and make it 

available to everyone and thus coordinate research in such a way 

tha t it will be more useful to everyone and accelerate the progress we 

made in this field without any duplication.

I think if the committee repo rt or the statute were to make tha t 

clear there would not need to be any concern on the pa rt of those other 

Federal agencies.

Mr. Roberts. Do you see any infringement or interference tha t 

could be promoted by this bill in the activities of such organization as 

the National Safety Council, which is a privately run nonprofit 

organization?

Mr. Cohen. Mr. Chairman, I think tha t there is nothing in this 

bill that interferes with the work of the National Safety Council or 

any other of the very fine nongovernmental agencies th at are working 

in this field.

This problem is no different from the problem we have in, let us 

say, setting up a National Cancer Institute and its relationship to 

the many health agencies concerned with cancer.

We have a very fine working relationship between the public and 

private agencies. It is no different from setting up the National 

Heart Institute and giving it the responsibility for research, and it 

works fine with all the nongovernmental agencies in the heart field.

It is no different from the new institute tha t you were most responsible in creating last year, the National Institute of Child Health 

and Human Development, which has just been set up under Dr. 

Terry’s supervision, tha t is going to work in the whole area of human 

development.

It works splendidly with all of these private organizations. I 

think if you look at all of the National Institute s of Health under Dr. 

Terry’s supervision and guidance, one of the key objectives of his 

administration and the Department is that the Federal Government 

shall do those things tha t are difficult for private groups to do, because 

of their cost, because of the assemblage of various numbers of scientific personnel tha t are in shortage, and then make this information 

available to the voluntary agencies so they can undertake the education, the community action, bringing this knowledge right down to 

the people in the local community, undertake the safety campaigns, 

and undertake the dissemination of this knowledge. This bill does 

not in any way conflict with th e work of the National Safety Council 

or any similar organizations that are working in this field, but rather 

I think, because of its enactm ent and highlighting, this would give 

greater prominence and public support to the fine work tha t they are 

doing at the present time.
42 NATIONAL ACCIDENT PREVENTION CENTER

Mr. Roberts. Would we, by the enactment of this bill, be recognizing these tremendous numbers of deaths and injuries as an epidemic 

and be taking an epidemiological approach to this problem as we do 

with heart disease, cancer, and all of these other killers and cripplers 

of mankind?

Mr. Cohen. You stated it very well. I think you might put it this 

way. Th at same argument that justifies our concentrating and intensifying our research work in cancer, or in heart, or metabolic 

diseases, is beginning to show th at we ought to intensify our efforts in 

accident prevention in the same way. For manv, many years people 

thou ght that all of these scourges were just a small part of life, couldn’t 

be prevented, and tha t mankind just had to bear this burden.

We know now tha t many of these diseases and disabilities and accidents are preventable. We know tha t with the help of competent 

scientific research, ways can be found to overcome them, and if we 

invest money and concentrate the manpower in tryin g to find out 

the causes, we can prevent them. I think we are on the threshhold 

with accident prevention just as we have been with these other great 

diseases.

Mr. Roberts. Dr. Terry?

Dr. Terry. Mr. Chairman, in relation to the National Safety 

Council and its interest, I would merely like to point as an example 

to our recent experience over the past few years, particularly the 

last 2 years, with our seat belt campaign.

As you realize, the National Safety Council, the American Medical 

Association, and the Public Health Service have taken the original 

initial role in promoting s eat belts for the protection of our people in 

automobiles.

More recently we have been joined by important groups like the 

Federation of Womens Clubs. Many of the scientific organizations 

have taken it up in support and I think this merely serves to bring out 

that when one focuses attention on a matter for which we already have 

the basic information and know how to apply it, Federal interest and 

participation will not stifle the interest of the people in voluntary 

groups at either the National, State, or local level, but rather will 

stimulate and support it, and we have been most happy with the support we received from the Advertising Council, for instance, in this 

campaign.

I think certainly no one of these organizations could have done anything like what we have already accomplished in this field. It is a 

joint effort. I think this sort of legislation would help to focus 

interest at the official Government level and would help us in collaborating with other Government agencies who have responsibilities 

and interest in this, as well as the voluntary scientific organizations 

which also have an interest throughout the country.

Mr. Roberts. 1 know that you join this committee in its feeling 

of pride tha t we are now seeing a campaign to install seat belts tha t 

will run into the millions this year th at just a few years ago was in the 

low thousands.

I do appreciate the fine part of the Public Health Service, and I 

believe the National Education Association and the manufacturers 

also, in promoting this campaign and 1 think certainly we will see 

some fine results of this activity.

Dr. Terry. Mr. Chairman, in relation to the manufacturers, I 

thin k we will find tha t any time that the state of information is so
NATIONAL ACCIDENT PREV ENTION CEN TER 43

developed that really effective safety measures can be incorporated 

in the manufacture of vehicles, the industry will do it. I think the demonstration in terms of what has taken place in the seat belts is 

one of the obvious ones. This points again back to the fact that in so many of these areas we 

need much more research and much more basic information.

Mr. Roberts. I might say in that connection, the then chairman 

has been visited by at least two, and I believe three, manufacturers that they plan to make seat belts available in all new cars, which I think will do a great deal through the promotion of the use of belts. I have hoped tha t they would include the back seat, because it is my own personal opinion t ha t passengers in the back seat are really in more danger, and particularly tha t seems to be the place where the children are, and many times they are less protected than the driver 

and the passenger right in the front seat. I might say in tha t connection we hope to hear tomorrow from some 

of the manufacturers and members of the Seat Belt Council who, I hope, will tell us of some new developments in the uses of shoulder 

harness and design especially for children.

Thank you, gentlemen, very much.

I know you are quite busy, and we appreciate your time.

Mr. O’Brien?

Mr. O’Brien. T have one technical question. On page 2, line 19, 

of the bill, it refers to the Council and 1 was wondering what Council tha t is. The bill doesn’t specify and the thought occurred to me th at perhaps it was a typographical error, tha t we were referring to the 

National Accident Advisory Board.

Mr. Cohen. 1 think that is correct, sir. 1 think that in some other 

cases in the Public Health Service, the word “Council” is used and 

in this “Board” is used. I think, as I read it, it is intended that tha t either meant the Board 

or change the “Board” to “Council.”

Dr. Terry. As a ma tter of fact, Mr. O’Brien, we have expressed 

the idea tha t we thought tha t such an advisory group would fit in better to our pattern and our nomenclature if it were referred to as a Council rather than a Board, because it would function in much the 

same manner as our other national advisory councils function.

Mr. O’Brien. We could change the word “Board” later in the bill?

Dr. Terry. That would be our preference, sir.

Mr. O’Brien. Mr. Secretary, I was very much interested in your 

testimony and 1 am in sympathy with the bill, but one of the things tha t concerns me in all these fields is the question of translating research into action. You mentioned heart, and cancer, and so forth. When you achieve a breakthrough in those fields, you immediately 

have a group of dedicated people who are in touch with patients, with hospitals, and so forth, and the stream moves rapidly. Isn’t it a fact tha t after all this research, 90 percent of our problem is still 

going to be the political courage or iniative of State legislatures in 

dealing with these problems, particularly motor vehicles? You mentioned these psychological tests, and so forth. What is 

a legislature going to do about the young person who apparently can drive much better than the older person, but is also inclined to take a thousand and one more chances than the older person? Will 

a legislature have the courage to weed out the cowboys, if you will, 

from the list of licensed drivers?
44 NATIONAL ACCIDENT PREVENTION CENTER

Mr. Cohen. I am glad you mentioned that, Congressman, because 

we are now in the area of implementation of the knowledge we have 

and, you know, some people say quite frequently about our human 

problems, “We already have more information than we know how to 

effectively use.”

I would say tha t the legislatures, and I would include the county 

supervisors, and I would include the city councils and the mayors, 

and I would include the judges in this, have to get a lot tougher.

If I were a State legislator or if I were a judge, I certainly would be 

a lot tougher than most are today with regard to removal of license 

of people who drive under the influence of alcohol.

I think, when a man gets into a $5,000 vehicle and goes out on a 

highway tha t has cost maybe well over a million dollars a mile, and 

endangers himself and everyone else driving on this public highway 

by driving under the influence of alcohol, he ought to be dealt with 

very sternly.

Mr. O’Brien. Collectively, that fellow is much more dangerous 

than a drunken pilot in an airplane?

Mr. Cohen. Absolutely.

Mr. O’Brien. He couldn’t lose his license just like that?

Mr. Coiien. In an airplane there is usually a second or a third copilot tha t can take over, b ut we allow people to drive this dangerous 

instrument, and then many times, after he has injured himself, injured property, injured other people, he can get right back in that car 

a few hours later and go ahead and endanger himself and other people. 

I think tha t the legislatures have to be tougher with penalties, and 

the individual judges should be tougher with regard to the discretion 

tha t they have when a person is found driving under the influence of 

alcohol.

if you can buy the drink, in my opinion, you can pay for a taxicab 

to take you home.

Mr. O’Brien. Mr. Secretary, tha t leads to my second question, 

which has to do with what we are doing with the knowledge we have 

now; apparently not enough. Isn’t it possible that in the course 

of this research as things are developed which are satisfactory to 

those engaged in the research then we should at that stage from time 

to time, bring in the various motor vehicle commissioners and chairmen of the legislative committees who would have direct jurisdiction 

over the necessary legislation and translate these things as they are 

developed as effectively as we have translated this seat belt thing, 

which 1 agree with the chairman and Dr. Terry has been spectacular.

I found it already all around me now, people voluntarily having 

these things put in for the protection of their children and themselves. 

It seems to me if we just go into research and say we have all these 

things to learn, there is going to be a tendency on the part of the 

legislators and the public, if you will, to wait for some distant day 

when they have a complete program.

Could the ones who will have to translate research into action be 

brought in along the way?

Mr. Cohen. I think they must be, Mr. Congressman. I think 

that you have to do several things. You have to do your research. 

Then you have to train personnel tha t is competent to translate that 

research into local programs. Then you have to have a health 

education program that translates it to everybody, including pro-
NATIONAL ACCIDENT PREVENT ION CENTER 45

fessional and nonprofessional people. In the course of th at we have 

to have the technical services tha t will bring all of these national 

organizations into some kind of working arrangement in this country, 

so tha t these standards and these ideas arising from the research are 

translated into local action.

As the Surgeon General said, the Federal Government shouldn’t do 

that alone. It should be a joint enterprise, with the attorneys general, 

the judges, the State highway commissioners, and the secretaries of 

state tha t give the licenses. We have to work with the various groups 

that set standards with respect to the sentencing of violators. This 

is a tremendous undertaking. We just haven’t scratched the surface 

in this area at all, bu t unless it is a joint undertaking, unless we 

cooperate, this research isn’t going to get down to John Jones in the 

community and be effective, and tha t is what we would like to do.

Mr. O’Brien. I agree with you, Mr. Secretary, and I might cite 

as an example of not doing something in an area where we have 

knowledge the present controversy over that support tha t you injected 

into your prepared text, boxing. Everybody knows tha t boxing is 

no longer boxing. It is slugging.

You are in there to knock the other fellow senseless and I hardly 

think tha t the result could be called an accident, but nevertheless, it 

is called an accident and we are doing nothing abo ut it. Tha t is why 

I speak of the courage a t the legislative level, no t just the State, but 

sometimes at the national, which is lacking. I might even say in 

anoth er field, more or less in a joking way, I think the greatest boobytrap we have today so far as accidents are concerned is this modern 

luxury, the b athtub.

Nobody seems to do anything about it, and it seems to me that 

when you reach a certain age it is quite a chore to get out of a bathtu b 

safely.

Mr. Cohen. There have been a few devices that I have noticed. 

I have gone to visit some of the old-age homes where accidents in the 

bathtub are a very significant thing, and there are a few rather very 

simple things if they are built in with the specifications of the nursing 

home or the private home tha t can certainly reduce these falls.

The handles at the side of the bathtubs, the rubber mats, the lowering of the tub so that the lifting of the body doesn’t cause a slip, or the 

elimination of the electrical outlets too close to the bathtub. I am 

reasonably certain, as you say, if we get some of this knowledge as we 

have been trying to do to the architect and to the city planners a lot 

of tha t can be prevented.

Mr. O’Brien. And if we apply the same public relations technique 

along the way tha t we have to seat belts I think we can accomplish a 

lot of these things. I have in mind, and perhaps I haven’t stated it 

too well, along the way bring in these people who are responsible for 

translating this into action and with respect to everything developed 

along the way, lets get it into action without waiting for the full 

program. Thank you, Mr. Chairman.

Dr. Terry. In that respect, Mr. Chairman, it is my interpretation 

that paragraph 5 of section 382 in the bill would give us such authorization in terms of the collecting of and making available information 

through publications and other appropriate means, so that we have 

interpreted this as being within the sphere of possibilities, Mr. 

O’Brien.

97 76 7— 63- 4
46 NATIONAL ACCIDENT PREVENTION CENTER

Mr. O’Brien. I hope, Doctor, that you apply tha t provision to the 

hilt because I think it would be most helpful.

Mr. Roberts. I would like to ask just one other brief question and 

that is you mentioned the fact tha t there are apparently few full-time 

people in the State health departments. Is it not ture tha t we are 

faced with a shortage of trained researchers in this particular field of 

accident prevention?

Dr. Terry. Yes, sir; I think we definitely are, Mr. Roberts. I 

thin k this is one of the very important limits of this provision, is the 

question of training. I don’t mean in those States, for instance, 

where they do not have full-time people or do not have any persons 

at all devoted to this, that there aren’t some people available, but 

obviously the shortage in this area is very severe because we have 

practically no training devoted to this particular area of accident 

prevention.

Mr. Roberts. Actually, could not such a facility serve as a basis 

for training people in this field and then they could be available 

through scholarships and grants to go out into universities, and 

colleges, and to the public health departments of the States for this 

type of work?

Dr. Terry. Such a center certainly should not only train, but it 

should train trainers as well in terms of being the center which would 

help foster. We would not think by any means th at all of the training would be restricted to such a center, because we would expect to 

carry on through various institutions, schools and so forth, also 

training programs there with training grant support, either individually or to the institutions, however it might be most appropriate, 

but we do need to focus a lot of attention on training as well.

Mr. Roberts. There is one other thing, Mr. Secretary, I would 

like you to supply for the record and tha t would be a list of grants 

that" have been made to institutions for research in this particular 

field and I would like, if possible, you to cover these grants for the 

past 10 years.

Mr. Cohen. We will supply whatever we have in tha t area for the 

record, Mr. Chairman.

(The following information was furnished for the record:)
NATIONAL ACCIDENT PREV ENTION CENTER 47

U.S . Public Health Service— Research grants in the area of accident prevention

Project title and grant num ber Instit ution and investigator(s) Years of 

support

Amoun t

1. Home Injury Survey—No. RG-2919. University of Michigan: Velz and 

Hemphill.

Prof. Clarence J. Vclz, D epart me nt 

of Env iron mental Health, School 

of Public Health, University of 

Michigan, Ann Arbor, Mich.

1951-52 $55,512

2. Studies of Children Showing In jury 

Patterns—No. M-790.

Tula ne University: Ma rcus__________

Irwin M. Marcus, M.D ., 3629 

l’rytan ia St., New Orleans, La.

1954-57 111,728

3. Autom otive Crash In ju ry Re ­

searc h—No. AC-47 (fo rm erly 

RG-4367).

Cornell University: (1) Moore; (2) Kraft, 

Wolf, an d Campbell.

Rob ert A. Wolf, director, Automotive Crash Injur y Research of 

Cornell University, 316 Ea st 61st 

St., New York, N.Y.

1956-62 668,662

4. Effects of Carbon Monoxide as an 

Atmospheric Pollutan t on Health 

as Indicated by Rela tionship to 

Auto Accidents in an Urban 

Area—No. RG-5005.

University of Michigan: Cook and 

Clayton.

Prof. Warren A. Cook, De partm ent 

of Industrial Health, School of 

Public Hea lth, University of 

Michigan, Ann Arbor, Mich.

1957-58 59,110

5. Labo ratory Study of Accidents— 

No. M-1381.

University of N orth Dakota: Ammons 

and Ellingson.

R. B. Ammons, Ph. D., Mo nta na 

State University, Missoula, Mon t.

1957 1,812

6. Human Be havioral Factors in Auto ­

mobile Driving Safety, phase I— 

No. M-1508.

George Washington University: Mosel, 

Hu nt, and Goldstein.

Prcf. James N. Mosel, De partm ent 

of Psychology, the George Washington University, W’ashington, 

D.C.

1957 18, 245

7. Family Injury Survey—No. AC-79 

(formerly M-1928).

Connecticut State Depar tment of 

Health: (1) Keehn; (2) Tu tles and 

Waxman.

Alexander .1. Tutles, M .D ., div ision of medical services, State 

dei>artment of h ealth, State office 

building, Hartford, Conn.

1957-60 208,402

8. (a) Accidental Poisoning as a Casefinding Procedure; (6) Childhood 

Accidental Poisoning—a Com ­

mu nity Study—AC-48 (formerly 

RG-5343).

San Jose (Calif.) city health department: 

Bissell, Mclnnes , and Clark.

Dwight M. Bissell, M.D., city 

health d epa rtm ent, 151 West M ission St., San Jose, Calif.

1958-62 65,557

9. California Accident Repeater D river 

Scales—No. AC -78 (for m er ly 

M-2353).

University of Southern California: 

Guilford and Schuster.

J. P. Guilford, Ph . D., Depar tment 

of Psychology Graduate School, 

University of Southern California, 

University Par k, Los Angeles, 

Calif.

19.58-59 27,684

10. Experimental Case Studies of 

Traffic Accidents—No. AC-61 

(formerly RO-5359).

Northwestern University: Baker and 

Banks, et al.

Mr. J. Stannard Baker, Traffic In ­

stitute Transp orta tion Center, 

Northwestern University, 1804 

Hinman Ave., Eva nston, Ill.

1958-60 188,100

11. Eva luation of Available Traffic 

Accident Records—No. RG-5361.

Georgia Departme nt of Public Hea lth: 

Terrell and Steed.

Mr. James C. Terrell, service of biostatistics, division of adm inistration and finance. State department of public health, Atlanta, 

Ga.

1958-59 24, 608

12. Causes of Auto Accidents of Adolescent Drivers—No. AC-67 (formerly RG-5577).

Harvard University; Gallagher and 

Moore.

J. Roswell Gallaghei, M .D ., the 

adolescent unit, the Children's 

Hospital Medical Center, Boston, 

Mass.

1958-60 92, 340

13. Carbon Monoxide and Its Relatio n 

to T ra ff ic A c c id e n ts —N o. 

RG-5959.

N at io nal San itat io n F oundat io n: 

Vaughan, Cook, an d Clayton.

Hen ry F. Vaughan, Ph . D., the 

National Sanitatio n Foundation , 

School of Public Health, University of Michigan, Ann Arbor, 

Mich.

1958 21,400

14. Hu ma n Factors Related to Farm 

Acc id en ts in M is so ur i—N o. 

AC-44 (formerly’ M-2407).

University of Missouri: Mc Namara and 

Gad alia.

Robert L. McNamara, Ph. D., Department of Rural Sociology, 

College of Agriculture, University 

of Missouri, Columbia, Mo.

1959-61 103, 442
48 NATIONAL ACCIDENT PREVENTION CENT ER

U.S. Pub lic Health Service— Research grants in the area of accident prevention— Con.

Project title and grant number Institut ion and investigator(s) Years of 

supp ort

Amount

15. Evaluatio n of Highway Traffic 

Sa fety Motion Pictures —No. 

AC-68 (formerly RG-5786).

16. Field Experimen tal Studies on 

Accidental Trauma —No. AC-19 

(formerly R 0-5937).

17. Accident-inducing characteristics of 

motor vehicles—No. AC-1 (former ly R0-6073).

18. Research on fatal highway collisions—No. AC-49 (formerly RO - 

6084).

19. Epidemilogy of childhood acciden ts—No. AC-2 (formerly RQ - 

6090).

Michiga n State U niversity: Merrill and 

Twyford.

Irv ing R. Merrill, Ph . D., Director 

of Television Research, University of California Hospital, San 

Francisco Medical Center, San 

Francisco, Calif.

Cornell University Medical College: 

McCarroll.

Jam es R. McCarroll, M.D., Division of Epidemiologic Research, 

Dep artment of Pu blic Health and 

Preventive Medicine, Cornell 

University Medical College, 1300 

York Ave., New York, N.Y. 

Publi c Service Research, Inc.: (1) Dunlap, (2) Schrieber.

Dr . Rob ert J. Schreiber, Public 

Service Research, Inc., 91 Prospect 

St., Stamford, Conn.

Ha rvard University: Moseley and 

Ford.

Alfred L. Moseley, Dep artment of 

Legal Medicine, Medical School, 

Harvard University, Boston, 

Mass.

1959-60

1959-64

1959-61

1959-63

20. Skill decrement in continuous 

driving—No. AC-50 (formerly 

RG-6091).

21. Safety devices for automotive vehicles—No. AC-69 (formerly KO - 

6284).

22. Driving behavior and traffic acciden ts—No. AC-53 (formerly RQ - 

6359).

California State Department of Public 

Hea lth: (1) Corsa and Manheimer, 

(2) Manheimer and Mellinger.

Dea n I. M anheimer, Bureau of Matern al and Child Health. State 

Department of Public Health, 

2151 Berkeley Way, Berkeley, 

Calif.

Michiga n State University: Barch and 

Forbes.

Dr . Abram M. Barch, Departme nt 

of Psychology, Michigan State 

University, Eas t Lansing, Mich. 

University of Minn.: Ry an __________

Prof. James J. Ryan, Mechanical 

Engineering Dep artment, University of Minnesota, Minneapolis, 

Min n.

1959-62

1959-62

1959-60

23. Effects of acceleration on the hu man 

skeleton—No. AC-54 (formerly 

RG-6384).

24. Aviation crash injury research—No. 

AC-3 (formerly RG-6506).

25. Role Image of the State police 

trooper—No. M-2957.

26. Im pact Attenuation in Prote ction 

Against Concussions — AC-51 

(formerly RG-6094).

Mass Communication and Group 

Discussion T echniques—No. AC52 (formerly RG-6296).

Hu man Factors in Traffic Accidents 

No. AC-55 (formerly RG-6550).

University of Michigan: Greensh ields..

Dr . Bruce D. Greenshields, D epa rtment of Civil Engineering, College 

of Engineering, the University of 

Michigan, Ann Arbor, Mich. « 

Wayne State University: Lissner and 

Evans.

Prof. Herbert R. Lissner, Engineering Mechanics Dep artm ent, College of Engineering, Wayne State 

University, Detroit, Mich.

Fli ght Safety Foundation, Inc.: (1) 

Hasbrook, (2) Kraft an d Gregg.

Mr. Merwyn A. Kraft, Flight Safety 

Foundation, Inc., 468 Park Ave. 

South, New York, N.Y.

Michigan State University: (1) Preiss, 

(2) Howell.

Dr. Joh n Howell, Dep artment of 

Sociology and Anthropology, 

Michigan State University, East 

Lansing, Mich.

Snell Memorial Foundation, Inc.: 

Snively and Chichester.

Dr. George G. Snively, SnelPMemorial Foundation, Inc., 2315’Stockton Blvd., Sacramento, Calif.

Dri vers Safety Service, Inc.: Henderson 

and Plutchik.

Dr. Harold L. Henderson, Drivers 

Safety Service, Inc., 298 Broadway, New York, N.Y .

Hawaii Departme nt of Health: Spicer. 

Dr. Robert A. Spicer, division of 

mental health, dep artment of 

hea lth, Kinau Hale, Post Office 

Box 3378, H onolulu, Hawaii.

1959-61

1959-63

1959-63

1959

1960-64

1960-61

1960-62

$25,321

315,639

170,973

809,820

332,986

49,268

97,750

63,740

173,672

282,056

18,112

40,870

17,754

79,060

27.

28.
NATIONAL ACCIDENT PREVENTION CENTER 49

U.S . Pub lic Health Service— Research grants in the area o f accident prevention— Con.

Pro ject title and gran t num ber Instit ution and investigator(s) Years of 

support

Amount

29. Research in General Aviation 

Safety—No. AC-70 (formerly 

RG-6688).

Fligh t Safety Foundation, Inc.: K raft—- 

Mr. Merw yn A. Kra ft, Flight 

Safety Foundation, Inc., 468 Park 

Ave. South, New York, N.Y.

1960 $77,622

30. Rockland Cou nty Child Injury 

Pre ven tion Project—No. AC-56 

(formerly RG-6717).

He alth Research, Inc.: Schlesinger and 

Dickson.

Dr. Edward R.Schlesinger, division 

of special health services, State 

dep artment of health, 84 Holland 

Ave., Albany, N.Y.

Michigan State University: Whitel aw ...

Joh n L. Whitelaw, The Libr ary, 

Michigan State University, Ea st 

Lansing, Mich.

1960-63 121,538

31. Bibliography of highway traffic 

safety literatu re—No. AC-77 

(formerly RG-6763-A).

1960 2,300

32. Critique of needed research on child 

accident prevention—No. AC-71 

(formerly RG-6798-A).

New York University: Brody......... ........

Dr. Leon Brody, Center for Safety 

Education ,New York University, 

Washington Square, New York, 

N.Y.

1960 2,300

33. Tra nsp ortation human factors: Pa rt 

I. Physica l forces—No. AC-57 

(formerly RG-6819).

University of California, Los Angeles: 

Mathewson, H ulb ert and Wojcik.

Prof. John H. Mathew son, Ins titute 

of Transp orta tion and Traffic 

Engineering, School of Engin eering, University of California, 405 

Hilgard Ave., Los Angeles, Calif.

1960-62 115,287

34. Relatin g driver education to accident-avoiding behavior—No. A C58 (formerly RG-7025).

Publi c Service Research, Inc.: Jacobs 

and Barinack.

Dr. Joseph E. Barinack, Pub lic 

Service Research, Inc., 91 Prospect St., Stamford, Conn.

1960-61 144,786

35. Effect of enforcement on driving 

behavior—No. AC-59 (formerly 

RG-7044).

Int ern ati on al Association of Chiefs of 

Police: (1) Shumate and Crowther; 

(2) Smith .

Mr. R. Dean Smith, field service 

division. Int ernationa l Association of Chiefs of Police, Inc., 1319 

18th St. NW ., Washington, D.C .

1960-61 161,774

36. School-Age Accidents and Education—No. AC-72 (formerly RG - 

7011).

Na tional Education Association: Abercrombie and Key.

Mr. S. A. Abercrombie, Nat ional 

Commission on Safety Education, 

Nationa l Edu cation Association, 

1201 16th St. NW ., Washington, 

D.C.

1960-62 121,161

37. Development of a Criterion for 

Driver Behavior—No. AC-18 

(form erly RG-7051).

Col umbia University: Shoben.................

Dr . Edw ard J. Shoben, Teachers 

College, Columbia University, 525 

West 120th St., New York, N.Y .

19G0-63 57,699

38. Mea suring Teacher Effectiveness 

in Driver Edu cation—No. AC-62 

(formerly RG-7365).

Columbia University: Ma lfetti_______

Dr . James L. Malfetti, Teachers 

College, Colu mbia University, 

525 West 120th St., New York, 

N.Y .

1960-61 35,938

39. Automobile Collision Injury Expe ri m en ts : Side im pa cts—No. 

AC-60 (formerly RG-7050).

Un iversity of California, Los Angeles: 

Mathewson, Severy, and Siegel.

Prof. John H. Mathewson, Institu te of Tran sportation and Traffic 

Engineering, School of E ngineering, University of California, 405 

Hilgard Ave., Los Angeles, Calif.

1961-62 49,984

40. Automobile Accident and Injury 

Pre ven tion Studies—No. AC-73 

(formerly RG-7822).

Un iversity of California, Los Angeles: 

Mathewson, Severy, a nd Siegel.

Prof. John II. Mathewson, Institute of Transportation and Traffic 

Engineering, School of Engineering, University of California, 405 

Hilgard Ave., Los Angeles, Calif.

1961-65 648, 842

41. Group Dynam ic Stu dy of Driver 

Attitud es and Driving Behavior— 

No. AC-64 (formerly RG-7958).

George Washington University: Hu nt 

an d Schlesinger.

Dr . Lawrence E. Schlesinger, Departm ent of Psychology, the 

George Washington University, 

Washington, D.C.

1961-63 270,000

42. Pro tective Materials and Athletic 

Injury Prevention—No. AC-65 

(formerly RG-8105).

Un iversity of California, Davis: Kovacic, a nd Snively.

Prof. Charles R. Kovacic, Depar tme nt of Physical Education, 

University of California, Davis, 

Calif.

1961-64 48,079
50 NATIONAL ACCIDENT PREVENTION CENTER

U.S. Public Health Service— Research grants in the area o f accident prevention— Con,

Pro ject title and grant num ber Institut ion and investigator(s) Years of 

supp ort

Amount

43. Driver decisions in highway acciden ts—No. AC-66 (formerly RQ8106).

Institute for Research, Inc.: Stover, 

Burne tt, and Slivinske.

Dr. Robert E. Stover, Human Factors Section, Instit ute for Research, Inc., Post Office Box 60, 

State College, Pa.

1961-64 $173,884

44. Visual signal conspicuity—No. AC - 

46 (formerly M-4945-A).

American Inst itute for Research: Yor k. . 

Dr. Cyru s M. York, behav ioral 

research program, American Institute for Research, 1808 Adam s 

Mill Road NW ., Washington 

D.C.

1961 2,306

45. Automotive accident ins tru me nta ­

tion stu dy—No. AC-9 (formerly 

RQ-8771).

Labo ratory for the Stu dy of Sensory 

Systems, Inc.: Baldwin.

Mr. Howard A. Baldw in, Laboratory for the Stu dy of Sensory Systems, Inc., 4242 East Speedway, 

Tucson, Ariz.

1962 20,297

46. Enforcement effect on traffic accide nt generation—No. AC-8 (former ly RQ-8742).

Indiana U niversity: Shumate and Crowther.

Mr. Robert P. Shum ate, Depar tmen t of Police Adm inistration, 

Indiana University, 618 Ea st 3d 

St., Bloomington, Ind.

1962-63 152,398

47. Relationship between vision tes t 

scores and driving record—No. 

AC-15.

University of California, Los Angeles: 

Mathewson and Burg.

Prof. John H. Mathewson, Ins tit ute 

of Transportation and Traffic En ­

gineering, School of Engineering, 

University of California, 405 lli lgard Ave., Los Angeles, Calif.

1962-64 174,970

48. Role of the drinking driver in traffic 

accidents—No. AC-16.

Ind iana University: Borkenstein........ .

Mr. Robert F. Borkenstein. Departmen t of Police Adm inistration, 

Indiana University, 618 East 3d 

St., Bloomington, Ind.

1962-63 71,863

49. Driving behavior as affected by 

alcohol—No. AC-20.

Indiana University: Forney and Hug hes. 

Dr. Robert B. Forney, De partm ent 

of Pharmacology and Toxicology, 

School of Medicine, Ind ian a University, 1100 West Michigan St., 

Indianapolis, I nd.

1962-64 78,598

50. Susceptibility to monotony as an 

accident predictor—No. AC-25.

San Jose State College: M cB ai n. ...........

Dr. William N. McBain, Psyc hology Dep artm ent, San Jose State 

College, San Jose, Calif.

1962-64 30,315

51. Driving and connotativ e mea nings—No. AC-29.

Colum bia University: Tho rndike and 

Malfetti.

Dr. Robe rt L. T horndike, Teac hers 

College, Columbia University, 

525 West 120th St., New York, 

N.Y.

Michigan State University: Allen--------

Dr. Terrence M . Allen Depar tment 

of Psychology, Michigan State 

University, East Lansing, Mic h.

1962-64 118,898

52. Multiv ariate analysis of traffic accident records—No. AC-30.

1962 21,937

53. Accident prevention thro ugh observation of drivers—No. AC-33.

American Inst itu te for Research: Ha hn . 

Mr. Clifford P. Hahn, hum an relations research program, American 

Ins titute for Research, 1808 Adams 

Mill Road NW ., Was hington, 

D.C.

1962-66 85,595

54. Factors affecting public acceptance 

of seat belts—No. AC-37.

California State Departme nt of Public 

Health: Manheimer and Mellinger. 

Mr. Dean I. Manheimer, Bureau of 

Maternal and Child Health, Division of P reventive Medical Services, State De par tment of Pub lic 

Health, 2151 Berkeley Way, 

Berkeley, Calif.

1962-63 131,471

55. Simulatio n of traffic flow on a digital 

computer—No. AC-80.

Ind iana U niversity: Shu m at e. ............. .

Mr. Robert P. Shumate, Department of Police Adm inistration, 

Ind iana University, 618 Ea st 3d 

St., Bloomington, Ind.

1962-64 231,793

56. Epidemiology of tractor power takeoff accidents—No. AC-12.

State University of Iowa: Kn app and 

Berry.

Mr. L afayette W. Knapp, Jr., Insti ­

tute of Agricultural Medicine, 

Departme nt of Hygiene and Preventive Medicine, State University of Iowa, Iowa City, Iowa.

1962 16, 721
NATIONAL ACCIDENT PREVENTION CENTER 51

U.S. Public Health Service— Research grants i n the area o f accident prevention— Co n.

Project title and grant nu mber Instit ution an d inves tigator (s) Years of 

supp ort

Amoun t

57. Prediction of highway accidents— 

No. AC-24.

University of Missippi: Mc Guire_____

Dr. Frederick L. McG uire, Division 

of Psychology, De partm ent of 

Psychiatry, the University of 

Mississippi Medical C enter, Ja ckson, Miss.

1962-65 $134,143

58. Investigation of variab ility in driving performance on the highway — 

No. AC-28.

Ohio S tate University: Rockw ell______

Dr. Thom as II. Rockwell, Department of Ind ustrial Engineering, 

the Ohio State University, 156 

West 19th Ave., Columbus, Ohio.

1962-64 110,262

59. Effect of glare on simulated nig ht 

driving—No. AC-87.

Purdu e University: Tiffin__ _________

Dr. Joseph Tiffin, De partm ent of 

Psychology, Purdu e University, 

Lafayette, Ind.

1962-63 26,502

60. Man-mac hine compatibility in ver y 

low a ltit ude flight—No. AC-92.

Ohio State University: Galipault and 

Briggs.

Mr. Joh n B. Galipa ult, School of 

Aviation, the Ohio State University , Ohio State University Airport, Box 3022, Co lumbus, Ohio.

1962-63 81,068

61. Experimental studies of whip lash 

injuries—No. AC-00099.

Tulane University: Wickstrom and 

Martinez.

Dr. Jack K. Wickstrom, Department of Surgery, School of Me dicine, Tula ne University, New 

Orleans, La.

1962-63 115,234

62. Automo tive crash inju ry research— 

No. AC-00101 (continuation of 

AC-47).

Cornell Aeronautical Laboratory , Inc.: 

Wolf and Campbell.

Mr. Robe rt A. Wolf, Director, Automotive Crash Injury Research, 

Cornell Aeronautical Laboratory , 

Inc., Post Office Box 235, Buffalo, 

N.Y.

1963-67 1,598,138

63. St ud y of traffic phenomena throu gh 

digital simulation —No. AC-00106.

Midwest Research Instit ute : Levy.........

Dr. Sheldon L. Levy , Ma thematics 

and Physics Division, Midwest 

Research Institute, 425 Volker 

I)r., Kansas C itv , Mo.

1963-65 135,898

64. Causes of death in autom obile accidents —No. AC-00107.

University of Michigan: Ilue lke and 

Gikas.

Dr. Donald F. Iluelke, D epart me nt 

of Anatomy, Medical School, the 

University of Michigan, Ann 

Arbor, Mich.

1962-63 8,832

65. Inv estigation of lead intoxication in 

childre n—No. AC-00108.

Washington Univ ersity: Vie tti and 

Berry.

Dr. Teresa J. Vietti, School of Med icine, Washington University, 500 

South Kingshighway, St. Louis, 

Mo.

1963-65 53,698

66. Driver tests as a means of accident 

reduction—No. AC-00109.

American Institute for Research: Slivinske and Anderson.

Dr. Alec J. Slivinske, Los Angeles 

Office, American Institute for 

Research, 11607 Washington Pl., 

Los Angeles, Calif.

1962-64 117,079

Mr. Roberts. Thank you.

Mr. Cohen. I have jus t been looking over some of these gran ts 

while you were speaking and a number of them are very interesting, 

and have great possibilities. The list shows tha t there is promise in 

this area for solving some of these problems.

Mr. Roberts. Again we are very grateful to you, Mr. Secretary, 

and to Dr. Terry and Dr. Joliet for your appearance here today.

Dr. Terry. Thank you.

Mr. Cohen. Thank you, Mr. Chairman.

Mr. Roberts. Our next witness is Col. John P. Stapp, U.S. Air 

Force, Deputy Chief Scientist, Aerospace Medical Division, Air Force 

Systems Command, Brooks Air Force Base, San Antonio, Tex. Colonel, it is a genuine pleasure to welcome you to our hearing.
52 NATIONAL ACCIDENT PREVENTION CENTER

Colo nel Stapp has had a dis tinguished career in th e field of acciden t 

preventio n researc h and is a ma n who has pu t toge ther mo st of the 

knowledge th at we have in the field of spac e an d wha t the human 

bo dy could endure. He ha s con ducted various exp erime nts with the 

roc ket-sled dec eleration an d has done a treme ndous job in this field, 

and I always feel it is a gr ea t privilege to have him appear here as a 

witness.

Colonel, we are del igh ted to hav e you.

STATEMENT OF COL. JOHN P. STA PP, USAF (MC), DEPUTY CHIEF

SCI ENTIST, AEROSPACE MEDICAL DIVISION, AIR FORCE SYSTEMS COMMAND, BROOKS AIR FORCE BASE, SAN ANTO NIO,

TEX.

Colonel Stapp. Th an k you, Mr. Ch airma n. M ay I make a stat emen t, sir, to begin with?

Mr. R oberts. Yes, sir.

Colo nel Stapp. A letter da ted April 8, 1963, expresses the position 

of th e Dep artm en t of Defense with reg ard to H.R. 133. I will quote 

from this letter, the th ird pa ra gr ap h:

The Department of Defense appreciates the general objective of establishing 

national facilities to conduct and promote the coordination of accident research, 

bu t defers to the Secretary of Health, Education, and Welfare as to the merits of 

establishing such facilities in the Department of Health, Education, and Welfare, 

and as to the specific provisions of H.R. 133.

Therefore, spe aking on behalf of the Defense Dep ar tm en t I wish 

to c ommend a nd con cur in the s tatemen t pres ented by the Hon . W ilbur 

J. Coh en on beh alf of the Dep ar tm en t of H ealth , Ed uc ation, and Welfare . He rea fte r I will be spe aking as a priva te citizen an d scie ntis t.

In the first place, we are aware of thi s acc ide nt de ath problem be ­

cau se it is no longer ove rshado wed by epidemic dise ase death s which 

ha ve come under control throug h the use of vaccines, che mo the rap y, 

an d antibiotics, derived fro m researc h programs sponso red in man y 

cases by the U.S. Pub lic Hea lth Service. We ha ve every reason to 

hope t h at the same res earch me tho ds pra cticed b y the same org anizatio n will be no less effective in dealing with the accid ent pre vention 

problem.

Ou r oth er reason for being acute ly aware of accid ent death s is th at 

th ey rise with the increa sing numb er of automobiles. A very simple 

solution would be to do aw ay with privately owned auto mob iles, 

hazardous sports, and dangero us occupation s, bu t I do no t think th at 

this dem ocracy would go for such an app roach.

Th e alt erna tiv e is t o ap ply th e tried m eth ods of U .S. Pub lic He alth 

Serv ice to accident preven tio n. Fo rty thousan d lives lost last year, 

ha lf of th em people less than 40 years of age, is a h igh price for n egl ect ­

ing this problem.

Th is bill, H.R. 133, is an am endm ent of tit le III of the exis ting 

Pu blic He alth Service A ct, laid ou t in the tra ditio na l pa tter n of o ther 

suc h bills for dealing w ith preventiv e med ical problem s.

Th is bill recognizes th e responsi bility of the U.S . Pub lic Hea lth 

Service in acc ide nt preven tio n and empo wers th e Pub lic Hea lth 

Service to tak e ap prop ria te action ju st as it has successfu lly in th e 

pa st with ma ny other he alth prob lems. This appro ach and this 

Go vernme nt res ponsibility is in accordance with pre ced ents of re-
NATIONAL ACCIDENT PREVENTION CENTER 53

sponsibility for loss of life at sea, assigned to the Coast Guard, and 

with prevention of loss of life in aerial accidents, which has been an area of responsibility of FA A and CAB. Other governments have dealt with the responsibility for accident prevention quite successfully.

Sweden, with a population of 7 million, has 1 million automobiles, and fewer than 10,000 accidents a year, which is about a 1-percent accident rate for the number of automobiles, and a very low injury 

and loss of life rate even on a relative basis compared with ours. We can look within our own armed services. In the U.S. Air Force the Office of the Inspector General is responsible for flight 

safety, ground safety, and missile safety. In the ground safety activity by applying the approach of collecting and disseminating information and advice, carrying on safety campaigns and using what research information was available, they have succeeded in the last 7 years through 1961 in cutting the loss of life from automobile accidents down from more than 700 to less than 400 per year. This is an example of the effectiveness of accident preven­ tion in pilot plant experiment compared to the size of the total population of the United States. Some of the investment in accident prevention and safety research can be charged to what we have already saved with successful epide­ miology research. To present the problem of death and injury 

by mechanical force graphically let me cite the following facts: A 170-pound astronaut on an Atlas missile can go from the launch­ ing pad to a velocity of 17,500 miles an hour in 5 minutes %oth seconds, or to a velocity of 24,500 feet per second in 301.4 seconds. If you take half his weight times the velocity squared you get the 

kinetic energy. In this journey he has acquired 51 billion footpounds of kinetic energy with no injury or harm. Three of our astronauts have made the round trip with no ill effects. If you were to take the same individual with no protective devices, bare-headed, and drop him 10 feet flat on his back on a concrete floor, he will attain a velocity of 6^ miles an hour and his body 

will be stopped in about one-hundredth of a second. This amounts to only 51,000 foot-pounds of kinetic energy, but his skull can be fractured in two one-thousandths of a second on impact 

and his chances of surviving such a fall are in doubt. In this fall he has experienced 100,000 times less kinetic energy than he did in as­ cending into orbit, and this exposure has occurred in one thirtythousandths of the time tha t it takes for him to go into orbit. In rocket sled experiments with the volunteer subject going from 154 miles per hour to 34 miles per hour in a quarter of a second, a 120-mile-an-hour speed change in one-fourth of a second, he withstands 2,550,000 foot-pounds of kinetic energy change. This is 50 times more kinetic energy change than the astronaut experienced in being dropped 10 feet to the concrete floor and it takes place in 25 times the duration of the astron aut’s impact on the concrete floor. 

This kinetic energy change can be withstood without injury. Some­ where between the orbiting astronaut and the astronaut dropping on the concrete floor are combinations of kinetic energy change and duration which can be safely sustained. On the basis of knowing this spectrum of kinetic energy change versus durations we can make 

recommendations on safe limits of human exposure.
54 NATIONAL ACCIDENT PREVENTION CENTER

Much more researc h ha s been done and still needs to be due on 

optim um packaging and res tra ining of the body and on energy 

absorbing devices to take d angerou s kin etic e nergy -dura tio n com binations and at tenu ate the m into surviv able and nonin juriou s exposures.

Th is basic research which need s to be carried ou t falls very ap ­

prop ria tely within the scope of H.R. 133. I could go on and cite 

nume rous oth er basic and applied research pro blems th at need to be 

don e in the field of crash prote cti on. The Ho norab le Wilbur J. Cohen 

gave you an excellent exp osition on some pro blems for rese arch in 

accid ent preven tion .

W ith b oth of th ese lines of research applied to the accid ent problem 

we are bound to have a gro win g accumulation of success in dealing 

with the very high r at e of acc ide nts and with the high rates of i njury 

an d loss of life th at co ns titute an enormou s loss in useful lives and in 

inco me, and even in tax rev enue for this Na tion.

T hat concludes my stat em en t. Th an k you.

Mr. R oberts. Th ank you, Colonel. 1 was pa rti cu larly impressed 

with yo ur sta temen t, aside from the fact th at the Air Force has cu t 

its loss of lives I believe b y alm ost 50 perce nt, and I belie ve you sta ted 

from ove r 700 down to in the neig hborhood of 400 lives, aside from the 

hu man e conside rations, loss of head of a fam ily or the heart ache and 

th e suffering th at such a loss also brings with it.

As a m at ter of dollars an d cen ts inv estm ent how much would you 

estim ate th at the Air Fo rce sav ed the U.S. Go vernme nt in cu tting 

th at loss 50 perc ent ?

Colonel Stapp. Since the se were people in uniform, no t the ir fam ­

ilies, bu t jus t the mem here of t he Air Force, if 300 fewer of them died, 

multip ly that by $40,000 an d I th ink th at you come to a reas onable 

estim ate of the saving.

Mr. R oberts. Acc ording to the way I have calcu lat ed it, it would 

be in the neig hborhoo d of $12 million, would it not?

Colo nel Stapp. Yes, sir.

Mr. R oberts. And this impro vem ent has come ab ou t in the past 

year?

Colonel Stapp. Past 7 y ears, throu gh 1961.

Mr. R oberts. Tha t is a $12 million sav ing a nnually ?

Colo nel Stapp. Yes, sir, and we hope to do be tte r.

Mr. R ober ts. How long were you in charge of the autom otive 

cra sh rese arch pro ject th at the Air Force con ducted?

Colo nel Stapp. At Ed wa rds and Hollom an Air Force Base we began 

pro gra ms on air craft cra sh sur viv al and escape from aircra ft, the 

sam e me thods and the sam e huma n tole rances app lied in case of 

aut om obile and ground vehicle accidents. There fore we did specific 

res earch in th at area from 1955 throu gh 1958. Th e overall program 

on cra sh researc h began in 1947 and stil l con tinu es.

Mr. R oberts. At th e tim e you were in cha rge of th at program 

wha t was your annual bu dg et?

Colo nel Sta pp. T beli eve it was abo ut $30,000 a year specifically 

on autom obile c rash resear ch. Of course we were using salvage au to ­

mobiles, the ones th at could not be sold because the motors would 

no t run . The refo re, we tow ed them in our cra sh sim ulation exp erime nts .

Mr. R oberts. Were othe r servic es conducting sim ilar type program s, or was this the only one w ithin the arm ed serv ices a t th at tim e?

Colo nel Sta pp. Th is was the only one in the arm ed services.
NATIONAL ACCIDENT PREVENTION CENTER 55

Mr. Roberts. It is my understanding tha t this was the basis for 

the factual data that has been successfully used in the successful 

orbiting of our astronauts. I won’t say most, but I will say a great 

deal of information came out of this crash program. Is tha t correct? 

Is tha t a fair statem ent?

Colonel Stapp. Yes, sir, that is right. In some of the rocket 

sled runs simulating aircraft escape conditions in flight, velocities 

attained and the durations of accelerations in horizontal track runs 

corresponded to those of vertical rocket launches.

Mr. Roberts. That program is not in existence at the present time, 

is it, Colonel?

Colonel Stapp. The automobile crash program is not in existence.

Mr. Roberts. It has been abandoned because of lack of funds?

Colonel Stapp. It was discontinued when submitted for funding 

in 1958.

Mr. Roberts. Is there any similar program now being conducted 

by any of the services that you know anything about in the automotive field?

Colonel Stapp. Not specifically in the automotive crash area.

Mr. Roberts. Is not this loss of life common o the other services 

just as it is to the Air Force?

Colonel Stapp. Yes, sir, and so is the information which we obtained from our investigations and which was made available to 

other branches of the Armed Forces and to the automotive industry.

Mr. Roberts. The old cars were nonsalvageable vehicles that were 

made available on a free basis?

Colonel Stapp. T hat is right. They were ones that could not be sold.

Mr. Roberts. By the industry?

Colonel Stapp. No, by the salvage yards of the Air Force.

Mr. Roberts. Again I want to thank you very much for your 

appearance and your fine presentation tha t you always make. Mr. 

O’Brien.

Mr. O’Brien. Colonel, I am quite fascinated by those figures. 

With respect to these people whose lives were saved, these drivers 

that were instructed, in this young category, weren’t they the ones 

tha t without too much discipline on the highways are responsible 

for very heavy percentage of accidents?

Colonel Stapp. Yes, sir. Further, a very interesting comparison.

1 have the figures for the year 1961. Only 12 deaths occurred in 

official vehicle accidents during tha t year. The remainder of the 

deaths, in the order of 300 a year occurred in private vehicle accidents 

with vehicles driven or occupied by members of the Air Force.

Mr. O’Brien. I assume that the research, and advice, and so forth 

had a great deal to do with it, but wasn’t discipline a factor in there 

too?

Colonel Stapp. I think the discipline made the difference between 

the 15 deaths in official vehicles, driven under orders and 300 someodd private vehicles driven at the discretion of the owner.

Mr. O’Brien. But even in the private vehicle there was a reduction?

Colonel Stapp. Yes, sir, a reduction compared with previous years 

of the Air Force.

Mr. O’Brien. Tha t could have been, in addition to the research, 

a carryover of the discipline because there would be a way of punishing 

the fellow?
56 NATIONAL ACCIDENT PREVENTION CENTER

Colonel Stapp. I think, tho ugh, th at the disc ipline fac tor has 

rem ain ed fairly co nstan t.

Mr. O’Brien . Yes. W hat I am ge tting at is th at with research , 

an d we are app lying this to young people and old er people who are 

no t in the arm ed serv ices, the re has to be some form of discipline or 

loss of privilege ha nd -in -han d with the research .

Colo nel Sta pp. Ab ou t the same in civilian life as we hav e in the 

Arm ed Forc es actua lly bec ause the same vio lation s meet ab ou t the 

sam e pun ishme nts.

Mr. O’Brien . In ad ditio n, they hav e to face a com manding officer 

af te r it is over.

Colo nel Stapp. M an y men have to face the ir wives after it is over 

too.

Mr. O’Brien . Or wives face the ir hus ban ds. Colonel, one final 

quest ion . You me nti oned Sweden. Do you ha pp en to know wh at 

th e answer is t her e th at they have such a rem ark able reco rd com pared 

with ours?

Colonel Stap p. Yes, sir. 80 per cent of the aut omobiles in Sweden 

are equipped wi th se at belts, and in addition , m ost of them have a 

dia gonal body str ap going ove r the outsid e sho uld er and attach ed to 

th e side post of the car. In Sweden the pe na lty for drivin g while 

intoxica ted , and the re the intoxication level is considered to be, I 

belie ve, 70 pa rts pe rcen t versus the 150-200 par ts perce nt of blood 

alcohol level c onsidered in tox ica tion h ere, is th at th ey go to jail for up 

to 3 mo nth s and have to go thr ough com plete driver training before 

being eligible to apply for a d riv er’s license and take a test in ab ou t 3 

years.

As a resu lt the re are lot s of women driver s in Sweden. Th ey are 

gr ea tly app rec iated after partie s.

Mr. O’Brien . Tha nk you very muc h, Colonel.

Mr. R oberts. Colonel, th an k you very mu ch for your sta temen t.

Colonel Stapp. I th an k you.

Mr. R oberts. Since the House of Re presen tat ives is meetin g this 

aft ern oon the hearing will be recessed until tom orrow at the sam e 

tim e in the same he aring room at which tim e we will have othe r 

im po rtan t witnesses on H .R . 133.

(Whereu pon, at 11:50 a.m. the hea ring was recessed, to reco nvene 

at 10 a.m., Wedne sday, April 10, 1963.)
NATIONAL ACCIDENT PREVENTION CENTER

W ED N E SD A Y , A P R IL 10, 19 63

H o use of R e pr e se n t a t iv e s,

S ubcom m it te e on P u blic H ea lt h an d S a fe t y

o f t h e C om m it te e on I n t e r st a t e an d F o reig n C o m m erce,

Washington. D.C.

The committee met at 10 a.m., pursuant to recess, in room 1334, 

Longworth Building, Hon. Kenn eth Roberts (chairman of the subcommittee) presiding.

Mr. R o b e r t s. The subcommittee will please come to order.

The subcommittee is resuming hearings on H.R. 133 and our first 

witness today will be Mr. Charles W. Prisk, Deputy Director, Office of 

Highway Safety, Bureau of Public Roads, U.S. D epartment of Commerce.

Mr. Prisk, we are glad to have you appear before the subcommittee.

STATEMENT OF CHARLES W. PRISK, DEPUTY DIRECTOR, OFFICE

OF HIGHWAY SAFETY, BUREAU OF PUBLIC ROADS, U.S. DEPARTMENT OF COMMERCE

Mr. P r is k . Mr. Chairman and members of the subcommittee, I am 

Charles W. Prisk, Deputy Director, Office of Highway Safety, Bureau 

of Public Roads, U.S. Dep artm ent of Commerce.

I appreciate this opportunity to appear again before your committee and to present some of our views on H.R. 133. This bill, as 

you well know, would establish a National Accident Prevention Center 

in the Public Health Service as a means of stimulating accident research 

and related operating programs.

The remarks I shall offer will deal entirely with the highway traffic 

accident prevention phases of H.R. 133. The Dep artm ent of Commerce defers to the views of the Department of Health, Education, 

and Welfare insofar as other accident prevention areas of this bill are 

concerned.

The principal mission of the Bureau of Public Roads, in the Department of Commerce is, as you know, to administer the Federal highway 

program.

We are becoming increasingly aware tha t the effects of the large 

Federal investment in highway improvement are of the greatest importance to safety and efficiency in highway transpo rtation.

An important organizational adjustment in the structure of the 

Bureau of Public Roads was made about a year ago to strengthen the 

contribution of the Bureau to safety in traffic accident prevention 

efforts.
58 NATIONAL ACCIDENT PREVENTION CENTER

The Office of Hig hway Sa fety now has a stat us eq uiv alent to th at 

of othe r majo r org ani zation al un its in the Burea u of Public Roads. 

I t is for th is reason, of course, th at we ha ve a deep in terest in the 

legislation you are considering today.

The Dep ar tm en t would like th e comm itte e to un de rstand clearly 

th at it has no wish to oppose accid ent pre vention activ ities in the 

Public Hea lth Service. Fro m ou r long stud y of the traffic accident 

problem , as a pa rt of highwa y tra ns po rta tio n, we reco gnize it as one 

th at req uir es con trib utions from the know ledge and experience of 

ma ny d iscip lines—those in the life sciences as well as those in physical 

sciences.

Perhaps the most common mi sund ersta nd ing of the traffic acc ident 

pre ven tion field is th at it is the province of some one skill or agency. 

Traffic acc ide nts do no t happen exc ept as driv ers, vehicles, an d highways are invo lved.

We see in the provisions of H.R . 133 an in tent to bro ade n the total 

Feder al contr ibu tio n tow ard the solution of a m ajo r dom estic problem 

th at r esults in needless loss of life, uncounted yea rs of suffering, and a 

tru ly severe economic im pact on the Nation’s welfare.

In spite of all the pre senta tio ns th at have been so ably ma de before 

this subcom mi tte e by so ma ny pers ons, I do ub t th at there has ye t 

been a full estim ate of t he ex tent of this serious prob lem.

Re cent research perform ed by the Burea u of Pub lic Ro ads—a nd 

perha ps thi s is why I int erj ected m y r ese rva tions—in coopera tion with 

the Illinois Division of Highw ays, revealed th at the direct cost— this is 

out -of-po cke t cost—of traffic acc ide nts in th at S tate a mo un ted to, in a 

rec ent ye ar, 0.97 of a cen t per pas sen ger car-mile, or the eq uiv alent of 

an added tax of 8 cents per g allon of gasoline.

Th ere is no fully satisfac tor y wa y to estim ate the indirect cost of 

traffic accid ents bu t our findings from the Illinois stud y an d oth ers of 

a sim ilar na ture, made in coopera tion with othe r State s, sug ges t th at 

the usu al dollar estimates may be on the low side. In an y event, the 

dir ect costs alone are great eno ugh to cause very serio us concern.

To come more specifically to th e provisi ons of H.R. 133, ou r princi ­

pal re actio n is th at the legisla tion is wr itten in such broad ter ms as to 

autho rize activ ities th at could unneces sarily duplicate repson sibilities 

and pro gra ms of the Bu rea u of Publi c Roads dealing wi th high way 

safety.

How ever, we feel th at the re are fundam ental valu es in some portions of the bill, and propose in this statem en t to empha size these 

pos itive chara cte ristics, with th e hope th at a late r actio n of the 

comm itte e will res ult in sharpe r definition of its total scope.

In our opinion , H.R. 133 wou ld be tter serve the cu rre nt need s if 

it were to ide ntify the fun ction of the prop osed Nationa l Acciden t 

Preventio n Ce nter more prec isely. I t seems only rea son abl e th at an 

acc ide nt pre vention au thor ity situ at ed in the Public Hea lth Service 

should be defined in terms of the medical, clinical, and beh aviora l 

sciences wi th which th at agency deals.

It is obvio us to all stu de nts of highway saf ety th at mu ch more 

official atten tion needs to be focuse d on many aspects of traffic acc ide nt 

prevention. Th us, while the c om pet enc e of the Public Hea lth Service 

to deal wi th safety from the stan dp oi nt of the medical and othe r life 

sciences is an acknowledge d virtu e of H.R. 133, so too is it im po rtan t 

th at there b e no subordination, directly or ind irectly, of the programs
NATIONAL accident prev en tion cent er 59

tha t draw on the physical sciences as they operate to increase the 

safety of the highway and the vehicle.

Among Federal agencies, the Bureau of Public Roads is a recognized 

primary source of specialized knowledge on highway and traffic engineering aspects of safety, and we in turn recognize the Public H ealth 

Service as an auth ority in the area of human factors.

Each department undoubtedly has a valid interest in the vehicle. 

However, it is most important to realize th at both agencies would fall 

short of their responsibilities to highway safety if they were to overlook 

the interplay of the highway, the vehicle, the driver, and the environmental conditions.

In the instance of the Public Health Service, I believe tha t traffic 

accidents have been looked upon as a matter of public health, whereas 

in the Bureau of Public Roads we view them as deficiencies of the 

highway transportation system.

These two viewpoints are easily reconciled when there is a sufficient 

understanding of the respective areas of responsibility and interest in 

the two agencies.

I am glad to report that good progress is being made now through 

frequent staff contacts on program plans, both for traffic safety 

research and traffic safety operations.

In a larger area the Interdepartmental Highway Safety Board, 

which was activated hist year, has contributed in vigorous fashion to 

this improved coordination of the Federal effort in highway safety.

The Interdepartm ental Board represents the interests of the seven 

major Federal agencies having highway safety responsibilities. A 

working staff of technical specialists of these agencies meets regularly 

for the exchange of ideas and knowledge concerning their respective 

programs.

In addition to this improved communication on programs of the 

Federal agencies, a body of policy agreement is gradually being developed by the Board’s staff, and this also will have a lasting benefit 

for future coordination of Federal efforts in highway safety.

The Secretary of Commerce serves as Chairman of the Interdepartmental Board and the Office of Highway Safety in the Bureau of 

Public Roads provides its secretariat, so we have seen a t close range 

the responsible product of this new jo int interest in safety now developing among the several Federal departments and agencies concerned.

It appears tha t a principal aim of H .R. 133 would be to provide 

the Surgeon General with the authority to make special project grants.

These could cover such activities as a special investigation of emergency medical care for highway traffic accident victims. The Office 

of Highway Safety in the Bureau of Public Roads has a parallel interest in this type of problem from the viewpoint of the highway and 

the many services essential to its successful and safe operation.

We would support this portion of the legislation because of its 

potential for achieving practical solutions for a wide range of troublesome areas.

Another provision of H.R. 133 would authorize the Public Health 

Service to make grants for training in accident prevention.

We can easily agree on the importance of an additional supply of 

competent scientists, and believe that the effect of the training grants 

would be to attrac t useful workers in great numbers to the accident 

prevention field.
60 NATIONAL ACCIDENT PREVENTION CENTER

Our Office of Highway Safety has recently established a limited 

program for highway safety trainees as a means for supplementing 

the present scarce supply of competent manpower in the field.

The Department of Commerce has had remarkable success with its 

other training programs in the highway field and we would therefore 

commend this provision of H.R. 133.

In summary, I would repe at tha t the Department of Commerce is 

sympathetic with the inte nt of the bill, and with the strengthening of 

accident prevention programs in the Public Health Service. However, 

as stated, we believe that the functions of the proposed National 

Accident Prevention Center should be more precisely identified.

Thank you, Mr. Chairman.

Mr. Roberts. Thank you, Mr. Prisk.

The Chair would certainly like to compliment your De partment and 

the Secretary for getting the Interdepartmental Board set up and 

active and we are hoping, of course, tha t the fine work t hat has been 

done in the D epartment will be expanding.

I thin k this statement is a somewhat different approach from the 

stateme nt that was made by the Department, with reference to this 

bill last year, that is, the last session. 1 take it tha t with the changes 

that you have suggested so as not to infringe on the jurisdiction of the 

Bureau of Public Roads and the Department of Commerce, or maybe 

I should say that the other way, you would go along with the bill, as 

I understand your position.

Mr. Prisk. This essentially is the case. I think tha t the judgments of the Department of Health, Education, and Welfare with 

respect to the needed amendments along with the Department of 

Commerce letter and the suggestions I have presented here, would 

cover the situation.

Mr. Roberts. I appreciate very much your statement, and your 

appearance. The gentleman from Minnesota?

Mr. Nelson. Thank you, Mr. Chairman.

Perhaps this would not be regarded as a question, but one of the 

perplexing things to me, and I am sure that you may be aware of these 

problems as I am, is yesterday we were given this book of statistics on 

persons injured in the home.

Here I have a Government bulletin from the Department of Agriculture on Safety: “Watch Your Step, Avoid Farm Accidents”, 

bulletins all over the place, and the thing that perplexes me a b it is, 

if the Department of Health, Education, and Welfare is in a position 

to make a survey on injuries in a home, it would seem to me they 

would also be in a position to examine what other agencies of the 

Government are doing the same thing.

The thing I don’t want to do is to become involved in setting up 

another agency to do something tha t some other agency is already 

doing and get a duplication with more and more agencies of the Government operating.

I am in sympathy with the idea of trying to find out what is being 

done and where and get it sort of coordinated, but we have to pick 

and choose between what is already being duplicated, and what we 

are trying to do in this bill, I don’t know, but it is perplexing because 

we get bulletins all the time.

I want to thank you for your statement. I think it is very well 

put together and certainly one tha t indicates a good deal of study 

relative to this bill.
NATIONAL ACCIDENT PREVENTION CENTER 61

I haven’t any further questions, Mr. Chairman.

Mr. Roberts. I might say this in passing to the gentleman from 

Minnesota. He has touched on what I consider to be one of the main objectives of this type of bill, to pull together some of the activities tha t have in the past been scattered all over the lot. I think that we can avoid a great deal of duplication of effort by this 

bill. I think it probably lends itself to some amendments.

Mr. N elsen. If the gentleman would yield, the point I would like 

to make is if the HEW provides the personnel to accumulate informa­ tion like this, which they can, it seems to me it would be very simple for HEW also to check over what other agencies are doing and get them into a report with the personnel they have rather than setting 

up more agencies at this point. I am in sympathy with the chairman in his objective, but I am won­ dering if it can be done u nder present arrangements, and I think it is worth discussing and I am sure we will in executive session at a later 

point.

Mr. Roberts. I than k the gentleman. Thank you, Mr. Prisk.

Mr. Prisk. Thank you.

Mr. Roberts. Our next witness is Mr. W. G. Johnson, general 

manager, National Safety Council, 425 North Michigan Avenue, 

Chicago, 111. Mr. Johnson, we are glad to welcome you to our hearings. We always found you to be very willing to cooperate with the committee in its efforts to achieve bet ter results in the area of Safety and Public 

Health. I know from your knowledge and long experience with the problems that this committee faces, tha t you are able to make a very fine 

contribution and we are very happy to have you.

STATEMENT OF W. G. JOHN SON, GENERAL MANAGER NATIONAL 

SAFETY COUNCIL

Mr. J ohnson. Thank you, sir. Mr. Chairman and members of 

the committee, my name is W. G. Johnson. I am general manager of the National Safety Council. In order tha t there be no mis­ understanding of the National Safety Council’s position regarding H.R. 133, I will begin by stating tha t the National Safety Council’s position remains unchanged from this committee’s hearings February 

6. 1962. I have said on numerous occasions tha t it was highly unfortunate that certain objectionable features of H.R. 133 were clouding the principal issue—the need of the U.S. Public Health Service for an 

intramural Research Facility or Laboratory. We have been delighted to receive reports of public statements by the subcommittee chairman outlining the U.S. Public Health Service need for a research center, because these statements seem to indicate tha t the subcommittee chairman shares our view tha t a research 

center or facility or laboratory is the primary need. The National Safety Council, therefore, urges tha t H.R. 133 be amended to eliminate the features objected to last year, and the Council then believes tha t the very strongest public support can be 

marshaled for the research facility.
62 NATIONAL ACCIDENT PREVENTION CENTER

In an effo rt to clar ify the Co un cil’s strong supp ort for a research 

facility or lab orato ry, I wrote to the sub com mittee chairma n on 

Fe br ua ry 27, 1963. Unless the sub comm itte e chairma n considers niv 

letter too inform al for th e comm ittee record. I would ask th at the lette r 

and acc om panying Council s tate men t he mad e a p ar t of thi s record.

J would r ead at this time sim ply one short sen tence w hic h crysta llizes 

the Na tio na l Safety Council’s str on g supp ort—

In or de r to pr ov id e a co nt in ui ng pro gra m of di re ct ed an d ap pl ie d research to 

de ve lop so lu tion s to ac ci de nt pr ob le m s, th ere shou ld be es ta bl is he d in th e Pu blic 

H ealth Se rvice an Acc iden t Pre venti on Res ea rch Lab or at or y.

Mr. R obe rts. W ith ou t objec tion, the letter will be ma de a pa rt 

of the rec ord .

(Th e le tter referred to follows:)

N at iona l Saf et y C ou ncil, 

Chicago, III., February 27, 1963.

H on . K en n eth A. R ob er ts ,

Ch air ma n, Subco mm ittee on Pu bli c He alth and Sa fet y, Committee on Inters tate and

Foreign Commerce U.S. Ho use of Itepresentaii ves, Wa shing ton , D.C.

Dea r K e n : Pr io r to A1 C hapm an’s dep ar tu re , we ha d seve ral discussio ns of th e

ne eds of th e Pu blic H ea lth Se rvice . Fro m th es e dis cussions, plus th e te st im on y 

yo u rece iv ed on H .R . 133, we ha ve co me to feel th a t th e att ach ed sugg estio ns 

wo uld fill a m aj or rem aini ng g ap in Pub lic H ea lth S erv ice a uth ori za tion an d wo uld 

also fulf ill th e p rinc ip al o bjec tiv es of H .R . 133. In dra ft in g th e att ach ed rec om ­

m en da tion s we ha ve als o rel ief he av ily on “ An aly sis of R es po ns ib ility an d C ap abi lity of th e Pu blic H ea lth Service in Acc iden t P re ven ti on,” a re p o rt by Ope ration s Res ea rc h, In c., dat ed J une 11, 1958 .

I als o fee l th a t th es e su gg es tio ns es se nt ia lly fulf ill th e re co m m en da tion s tw ice 

mad e by th e Acc iden t Pre ve nt io n A dv isor y Com m ittee of th e U. S. Pu bl ic H ea lth 

Servi ce, an d wo uld un do ub te dl y ha ve th e en th us ia st ic su pport of th a t grou p.

We hav e fo rm ed no ju dgm en t as to w he th er a fo rm al Boa rd of th e ty pe pr opo sed in H .R . 133 or th e pr es en t A cc iden t Pre ve nt io n Adv iso ry Com m itte e of 

U.S . PH S is th e b ett er in st ru m enta li ty fo r sup ervision of a ll U.S. P H S a cc id en t p re ­

ve nt io n ac ti vit ie s (in clu ding th e pr op os ed la bor at ory ). Fro m my part ic ip at io n in 

th e A cc iden t Pre ve nt io n Adv iso ry C om m itte e, I ’d sa y it ha s th e ca pa bi lit ies for 

di sc ha rg in g any resp on sib ilitie s pl ac ed up on it. How ev er, we th in k yo ur ex pe rience an ti th e ex pe rie nc e of th e U.S. P H S sho ul d gu ide on th is poin t.

I sh al l be in W ashing ton nex t week, and sh all ph on e yo u on M on day to see if 

we ca n get to get her s om e tim e on T ues da y.

If th es e sugg estio ns m ee t w ith your ap pr ov al , I feel co nf id en t we can ra th er 

qu ic kl y de ve lop br oa d an d st ro ng su pport for th is es se ntial im pro ve m en t in 

Pub lic H ealth Servi ce ca pa bilit ies.

B es t re ga rd s.

Sinc erely ,

W. G. J oh ns on ,

General Manag er.

So me el em en ts of leg isl ati on ne ed ed to es ta bl ish a Pu blic H ealt h Se rvi ce Accident Pre venti on Re search L ab ora to ry —

1. In or de r to prov ide a conti nuin g pro gr am of di re ct ed an d ap pl ie d re se arch 

to de ve lop so lu tio ns to ac ci de nt pr ob le m s, th er e sh ou ld be es ta blish ed in th e 

Pub lic H ealt h Service an Acc iden t P re ven tion Res ea rch Lab or at ory .

2. In ca rr yin g o ut th e ab ov e pur po se , th e Su rgeon Gen eral should b e au th or ized 

to —

(a) co nd uc t a co nt in ui ng in tr am u ra l rese arch p ro gr am in t h e b asic m ed ica l, 

cli nica l and be ha vior al scien ces so di re ct ed as to m ee t re se ar ch needs wh ich 

be co me ev id en t in th e nond ir ec te d gr an ts-in- ai d rese ar ch pro gr am s or in th e 

co nduct of ac ci de nt pr ev en tion pr ogr am s;

(5) as si st in th e co or di na tion of rese ar ch pr og ra m s co ndu ct ed by pu blic 

and pri vate agenc ies, org an iz at io ns , an d indi vi du al s;

(c) m ak e av ailable re se ar ch fa cilit ies of th e L ab ora to ry to ap pro pri at e 

pu bl ic au th or itie s, an d to h ealt h officials an d sc ie ntists en ga ge d in spe cial 

st udie s re la te d to th e pu rp os es of th e L ab ora to ry ;
NATIONAL ACCIDENT PREV ENTION CENTER 63

(</) secure from time to time, aud for such periods as he deems advisable, the assistance and advise of persons from the United States or abroad who 

are experts in the field of accident prev entio n; (e) establish and maintain research fellowships in the Laboratory, with such stipends and allowances (including travel and subsistence expenses) as he may deem necessary to train research workers and procure the assistance of research fellows from the United States and abr oad ; (/) provide training and instruction, and establish and main tain trainee- ships in the Lab ora tory in matters relating to the s tud y of, causes of, an d the development of means of preventing accidental d eaths and injuries, with such stipends and allowances (including trav el and subsistence expenses) for 

trainees as he may deem necessary. 3. The Surgeon General should be authorized to acce pt conditional gifts for study, investigation, or research into the causes and preventio n of accid ental dea ths and injuries, or for th e acquisition of grounds or for the erection, equipment, or maintenance of premises, buildings, or equipment of the Laboratory. 4. Appropriations shou ld be authorized for acqu isitio n of land, erection of buildings, procurement of equipment, adequa te staffing, and other expenses necessary to the establishment and operation of the Lab oratory .

Mr. J ohnson. In further support of the need for a research facility, 

I would like to introduce into the record a somewhat more lengthy statement which is currently under consideration by the Accident Prevention Advisory Committee of the U.S. Public Health Service. This statement grew out of a meeting of the committee March 6 and 7. The state ment and resolution are at this time being distributed to the members of the committee for final approval. Consequently, I am unable to say on this date tha t the resolution is final. On the other hand, the discussions at the meeting were such as to indicate that the intent of the resolution will receive almost unanimous approval of the committee. I can say today that the draft resolution does represent the viewpoint of the National Safety 

Council.

I submit the draft resolution.

(The resolution referred to follows.)

The Advisory Com mittee reaffirms its conclusions as to the necessity for the estab lishm ent of U.S. Public Health Service Accident Prevention Research Facilities. It recomm ends th at (a) steps be taken to clarify as fully as possible the purpose and objectives of the facility for other Federal and State agencies and private groups partic ipa ting in accident prev ention activities, (b) th at such 

Facilities be established as soon as possible. The purpose of seeking such facilities and staff for directed in-house research in the basic medical, clinical and behavioral sciences is to meet the day-to-day obligations and specific long- and s hort-term objectives essential to the fulfillment of the mission of th e U.S. Public Health Service Division of Accident Prev ention. The research to be accomplished within the Facilities, by its scientific staff and , when appropriate, by Federal. State, and local visiting scientists, is to provide a program of applied research directed toward the deve lopment of solutions to specific problems in sup port of public health accident prev ention operations and services; provide for program continuity and effectiveness of directed research and grants operations; develop and maintain the necessary high degree of professional proficiency of th e staff. Accordingly the Accident Prevention Advisory Com mittee makes the following 

recommenda tions:

R eso lu tio n

“1. That the U.S. Public Health Service und erta ke to clarify the purpose , intent, and plan of operation for a Public Health Service Accident Prevention Research Facility to increase the understa nding of the concept of such a facility among Federal, State, and private* groups sharing in the overall responsibilities for accident prevention and planning an d conducting complementary a ctivities in the various fields of safety research and operating program s.
64 NATIONAL ACCIDENT PREVENTION CENTER

“2. Th at the U.S. Public He alth Service should proceed as expeditiously as 

possible to develop and operate U.S. Public Health Service Accident Prevention 

Research Facilities with an adequ ate staff to conduct continuing in-house research 

in the basic medical, clinical, and behavioral sciences looking t owa rd development 

of new or improved methods of prevention of accidental injury and death essential for support of U.S. Public Health Service accident programs and services.”

Specifically, it is th e judg ment of the Accident Prevention Advisory C ommittee 

th at the facilities for applied research in accident prevention should provide for 

essential experimental studies such as are listed as examples below.

(а) Laboratory research on: normal biological and disease mechanisms; 

physiological and psychological bases of behavior; and physical and mental 

grow th and maturation as r elated to accident prevention.

(б) Clinical studies on: performance, behavior, physical condition, inca pacitation, impairments, aging and disease as variables in accident causation.

(c) Feasibility or preliminary studies of various research approaches for accident preventio n program development and for validation of repo rted findings.

(d) Measurements and description of human capabilities under the conditions 

they will be exercised, i.e., practical real life situa tions as rela ted to accid ent 

prevention.

(e) Computer studies of the influence of the variables in accident causation 

and prevention.

(/) Simulation studies of the requirem ents, behavior a nd performance in potentially hazardous tasks an d situations, and in accident preventio n measures.

The signifiance of this draft resolution for the subcommittee’s deliberations lies, I believe, in two points:

1. The resolution endeavors to make it clear tha t a research facility 

is a necessary element for the fulfillment of the mission of the U.S. 

Public Health Service, Division of Accident Prevention. The Division cannot adequately perform its assigned tasks without the research facility.

2. The resolution provides in concise form an outline of the kinds 

of intram ural research projects which could be undertaken in the 

basic medical, clinical, and behavioral sciences, and thus make an 

important contribution to our knowledge of accident prevention.

If the subcommittee’s record of H.R. 133 remains open for the next 

month or so, I would suggest tha t the subcommittee get the final 

action of the Public Health Service Advisory Committee on this resolution, including a committee roster indicating the members who are 

giving their active support to this resolution.

Strong support for interdisciplinary accident prevention research 

facilities was given just yesterday when the President’s Committee 

for Traffic Safety approved the report of its Research Subcommittee, 

and this important report now becomes a p art of the action program 

of the President’s Committee.

1 might say, sir, tha t the Committee met at the White House with 

the President and this re port was a part of those proceedings.

The Research Subcommittee of the President’s Committee has 

worked for several years to prepare a basic policy statement on the 

role of research in traffic accident prevention. 1 would strongly urge 

that this subcommittee obtain copies of this new report, which is now 

at the printer’s, because I know you will find that it is a valuable 

foundation for your subcommittee’s consideration of many present 

and future problems in the area of research.

The report recommends, among other things, that we should 

“develop interdisciplinary accident prevention research facilities on a 

national basis.”

This, in effect, gives supp ort to the idea tha t there should be an 

Accident Prevention Research Facility in the U.S. Public Health

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Service, but it does not in any way imply tha t there should not be 

other research facilities in other departm ents as may be appropriate.

For example, needs of the U.S. Bureau of Public Roads for engineering research facilities should receive attentio n at the proper time.

A furth er indication of the need for research was contained in an 

important report which the American Bar Association, Northwestern 

University and the National Safety Council jointly presented to this 

subcommittee in March of 1957.

The basic analysis of services of national traffic safety agencies has 

just been brought up to date by the Executive Committee of the 

Council’s Traffic Conference meeting in New York, April 3.

1 would like to supply the latest copy of the services chart for the 

subcommittee’s records. The chart shows that research is inadequate 

even for present needs in such important matters as sound uniform 

laws, accident records, school programs, police traffic supervision, 

traffic courts, driver license, vehicle inspection, and public education. 

Research is judged to be inadequate for future needs in the important 

matters of highway engineering, traffic engineering, and vehicle 

engineering.

1 hope that tha t chart can again be a matter of record with the 

committee as it was in 1957.

Mr. R oberts. Without objection, it will be included.

(The chart referred to faces this page.)

Mr. J ohnson. In considering how some practical examples of 

research needs could be made most impressive to this subcommittee, 

it occurred to me tha t a few comments on research matters in the 

States represented by the subcommittee members would have 

particular interest.

Congressman Rhodes, as well as other members of the subcommittee, will recall tha t the State of Pennsylvania made a pioneering 

effort to utilize periodic medical examinations as a p art of its program 

for driver improvement and control.

Now the Pennsylvania administration has found i t necessary to at 

least temporarily suspend this program, and one of the underlying 

weaknesses was found to be the lack of adequate research to support 

medical standards for driver licensure.

In Congressman O’Brien’s State of New York we have an excellent 

example of the value of an intramural research facility within State 

government. Dr. William Haddon on the staff of the State health 

department has conducted many studies and analyses found to be 

extremely valuable within State government in determining sound 

public policies; for example, in the important matter involving the 

drinking driver.

Congressman Rogers is perhaps familiar with the fact tha t in 

Florida, the U.S. Public He alth Service has been able to make limited 

resources available for a Saint Petersburg study of accident problems 

in the older age group. This is an intramural accident prevention 

research facility, but its development has been greatly handicapped 

by lack of funds.

Congressman Schenck will be pleased to know tha t Ohio State 

University has just released a preliminary report of a very helpful 

study of the problems of slow-moving vehicles.

'Phis project supported by the Automotive Safety Foundation 

will very likely produce a new and more effective warning sign to be 

displayed on slow-moving vehicles.
66 NATIONAL ACCIDENT PREV ENTION CENTER

The Minnesota State Highway Department is using 1)6 percent 

Federal highway aid money to conduct studies on accident prevention, 

and from the State of Minnesota, we have had strong support and 

cooperation, particularly from A. J. Schwantes, head of the Dep artment of Agricultural Engineering, University of Minnesota.

Just a week ago in a meeting of the research committee of the 

National Safety Council. Dr. Schwantes again expressed his strong 

feeling th at there is need for additional research in agricultural safety. 

I am confident tha t he could give Congressman Nelsen and the other 

members of this subcommittee an excellent appraisal of farm safety 

needs. We have initiated a most interesting project in Colorado, a project 

which Congressman Brotzman and the subcommittee as a whole will, 

I am sure, want to follow very closely. This is a study of the effectiveness of safety communications. The National Safety Council 

and the Insurance Institute for Highway Safety are sponsoring this 

study. We shall finance the preparation of a basic paper by Harold Mendelsohn, Ph. D., professor and director of research, School of Communication Arts, University of Denver. This paper will be subjected to the critical review of 18 distinguished 

scholars in the field of communications. At a workshop scheduled 

for Denver in September, approximately 60 communications specialists will, then, endeavor to lay down guidelines for mass communication research on safety and to outline additional areas which require 

research and study.

Judging from the rather lengthy list of organizations which are 

cooperating in this study, there is widespread feeling tha t the guidelines developed are likely to be valuable in health and other fields 

extended well beyond the safety interest.

I submit for subcommittee reference a description of this study and 

call your attention to the fact th at this is precisely the type of valuable 

assessment of knowledge which could be conducted by an intram ural 

research facility and the facility would thereby play an important 

part in translating research into practical accident prevention measures.

(The material referred to follows:)

T he S a fe ty C o m m u nic a tio n s Stu dy

(Sponsored by Na tional Safety Cou ncil, Insurance In st itute for Hi ghwa y Safety) 

Septe mb er 1962-Septem ber 1963 

P U R P O S E

Th ere is an imm ense am ou nt of sa fety inf orm ation bein g dis semi na ted in the

Un ite d St ates . It is the N atio n’s mos t pub licized cause.

Co untless org ani zat ion s hav e de vo ted themselv es to thi s effo rt, utiliz ing ma ny,

varie d, an d often contradic tory approaches. The to ta l effort is ch aracteriz ed by 

an almost to ta l absence of any kind of syste ma tiz ed safety com mu nic ations 

ap pr oa ch .

Th e purpose of the stud y is to dev elo p cri ter ia (guidelines and sta nd ards) for 

safety comm unica tions. This task has nev er been un derta ken. Th e final stud y 

repo rt, to be publishe d in book form, “ Guidelines and St an da rd s for Safety 

Co mmu nic ati on s,” (working title) pro mises to be a lan dm ark in com mu nic ations.
NATIONAL ACCIDENT PREVENT ION CENTER 67

PRO C E D U R E

1. Steering committee

A study steering committee will be responsible for planning, coordination, and 

managem ent of the study. It will be composed of r epresentative s of the spon ­

soring and cooperating organizations. One of the National Safety Council representatives, John Naisbitt, director of public information, will serve as stu dy 

director and chairman of the steering committee. Staff work will be done by 

National Safety Council personnel, under the direction of the study director.

2. Research advisory committee

The following public opinion research specialists, among the most outstan ding 

in the country, have agreed to serve on an advisory committee for the safe ty 

comm unications study. All are members of the American Association for Public 

Opinion Research (as is the stu dy director).

Raymond A. Bauer, professor, Harvard Graduate School of Business Administration. One of the top social psychologists in mass communications in the 

country . Was head of mass communication studies with t he Russian Research 

Institute at Harvard Univ ersity. Is director of the Space and Society Division 

of the American Academy of Arts and Sciences.

Leo Bogard, vice presiden t and director of research, Bureau of Advertising, 

American Newspaper Publishers Association. Formerly director of research, 

McCann-Erickson, Inc. Author of the standard text on mass communications, 

“The Age of Television.”

Donald Cahalan, executive vice president, Nowland & Co., Inc., Greenwich, Conn., which is a marketing and communication research agency. Cahalan 

is a social psychologist who has worked in the field of communication resea rch 

for 20 years. Recently he authored the paper “ Motivational and Educational 

Aspects of Drinkin g-Driving.”

Ira H. Cisin, direc tor of research, George Washington University. Perhaps thi s 

country ’s top statisticia n in research design. Formerly direc tor of Human 

Relations and Resources Organization.

Melvin A. Goldberg, vice p resident and director of research. National Association 

of Broadcasters. Formerly direc tor of research for Westinghouse Broadcasting and Associate Director of Research for the U.S. Information Agency. Samuel R. Guard, direc tor of research, No rth Advertising Agency. Formerly 

research supervisor, Marplan, Inc., research division of Interpublic (McCannErickson).

Elihu Katz, professor of sociology, University of Chicago. One of the to p theoriticians in the field of mass communication. He is au tho r (with Paul F. Lazersfeld) of “Personal Influence,” one of the landmark studies in mass comm unications.

Joseph T. Klapper, director of social research, Columbia Broadcasting Corp. 

Form erly director of comm unication research in the behavioral research 

service of General Electric Co. He has served on the faculties of the University of Washington, Stan ford , City College of New York and Brooklyn Polytechnic Institute. He is th e autho r of “ The Effects of Mass Communications” 

(an analysis of research in the effectiveness and limitations of mass media in 

influencing the opinions, values, and behavior of their audiences), and is preside nt of the American Association for Public Opinion Research.

Dean I. Manheimer, director of research, California Sta te Department of Health. 

Form erly director of the Bureau of Applied Social Research, Columbia University.

Also: Leonard Kent, vice president and director of research dep artment, Needham, 

Louis & Brorby, Inc.

James L. Malfetti, executive officer, safety research and education project at 

Teachers College, Columbia University.

Irving S. White, director, Creative Research, Inc.

Harold Mendelsohn. (See foo tnote below.)
68 NATIONAL ACCIDENT PREV ENTION CENTER

S. Initial stage (basic paper)

An outstanding public opinion researcher has been engaged to und ertake 

the 8-mo nth assignment of making a critical survey and analysis of the considerable public opinion research lite rature (well over 1,000 studies), relating it 

to the effective comm unication of safety messages, and the draftin g of a basic 

pap er on guidelines and stan dards for safety comm unications.1

This initial presymposium paper will deal with the avenues of communication 

(newspapers, magazines, radio, television, posters, face-to-face, etc.) and content 

approaches, including:

General vs. specific Humor

Exp licit vs. implicit Threat-appeal (scare)

Order of presentation Emotional vs. factual

Negative vs. positive Repetition

Pre stige-authority approach Duration of effect

Slogans Believability

The initial paper will be addressed to five objectives:

To develop a comprehensive bibliography of m aterials pertaining to the effective communication of safety messages (abstracted according to a standardized 

procedure using standardized criteria) and to establish a reference file on studies 

in thi s field to be used currently as well as in the future.

To describe critically the scope and dep th of the current sta te of empirically 

derived knowledge relating to the effective communication of safety messages.

To generate principles of effective communications for safe ty and to document 

such principles from the research th at has been done in the communications of 

persuasion.

To develop guidelines for prog raming in safety.

4. Developmental stage (critique papers)

In Jun e of 1963, th e basic paper, developed in the initial stage (above), will be 

sent to 18 specialists in the fields of social research, psychology, sociology, press, 

broadcasing media, advertising, and safety public information. (Accompanying 

the basic paper will be a back ground paper on the nature of the highway traffic 

safety problem—which will be given major emphasis in the study, outlining what 

we in traffic safety are trying to accomplish in term s of knowledge, attitude, and 

behavior.) Each of the 18 specialists will from his own perspective evaluate the 

basic pap er and develop additio nal m aterial.

5. Plenary stage (symposium)

A. Participants.— Symposium partic ipa nts will be limited to approximately 60 

traffic safety inform ation specialists; communication theorists, researchers and 

academicians; and press and media specialists (from radio, television, newspapers, 

periodicals). It will include the 18 noted above. The symposium will be held 

September 16 and 17 a t the University of Denver.

B. Symposium format.— All partic ipa nts will receive the basic paper (and the 

traffic safety background paper) in Jun e of 1963. All p articipants will receive 

the critique pape rs by September 1, 1963.

The symposium will be divided into three workshop panels meeting three times. 

Each panel will have approximately 20 participants, with balanced repre senta tion 

from the a reas outlined above.

In each of three sessions of each panel two critique pape rs will be summarized 

by their respective authors, each to be followed by discussion. (Note th at while 

during the symposium period, each panel will specifically discuss only six critique 

papers with the auth ors, all particip ants will have had a prio r opportu nity to 

read all 18 critiq ue papers an d can inte grate the information accordingly.) Each 

panel will have a chairman and a secretary (to be selected by the steering committee.)

* Dr. Harold Mendelsohn, Denver Un iversity, widely known and respected sociologist in the field of 

commun ications, has agreed to take on thi s assignment. Dr. Mendelsohn is professor and director of 

research in the Radio-Television De partm ent of the University of Denver. Dr . Mendelsohn has had 

extensive experience in all phases of com munications research as associate director, Marketing and Social 

Research Division, the Psychological Co rp., associate director of m arketing communications research, 

McCan n-Erick son, Inc., advertising; research associate, Bu reau of Social Science Research of the American 

University, Washington, D.C .; an a as a survey ana lyst with the Inte rnational Broadcasting Service of 

the U.S. State Department. Dr. Mendelsohn has writte n nu merous articles on communications research 

and public opinion. His pape r on evaluating the process of comm unications effect received an award for 

original research proposals recently from th e Television Bureau of Advertising. Dr. Mendelsohn received 

the P h. D. from the Graduate Facu lty of the New York School for Social Research; the M .A. from Columbia 

University; and the B.S. from th e City College of New York.
NATIONAL ACCIDENT PREVENTION CENTER 69

The symposium will conclude with a plenary session at which the thre e chairmen will report on the ir respective panel discussions.

6. Final report

The final report, to be prepar ed immediately following the symposium, will be a distillation of the basic paper, the background paper, the critique papers, and the panel discussion (all of which will be tap e recorded). Working with a com­ mittee of the symposium, the study director will be responsible for the final report.

7. Budget

The approximate costs for the study are as follows:

Initial search and basic pa pe r____________________________________ $14, 000 Travel and accommodations for 10 academicians------------------------------ 3, 400 Honorariums for pap ers_________________________________________ 2, 500 Symposium accommodations_____________________________________ 300 Mimeographed materials and postage-------------------------------------------- 2, 000 Other pri nting_________________________________________________ 1, 000 Publishing of proceedings in book fo rm____________________________ 5, 000 Presymposium meetings_________________________________________ ”00 Staff tra ve l____________________________________________________ 1> 300 Staff overhead_________________________________________________ 11. 300 Miscellaneous__________________________________________________ 300

To tal_______ _____ _____________________________________ 42,700

Safety Communications Stu dy Sponsored by National Safety Council Insurance 

Institu te for Highway Safety in cooperation with—

The Advertising Council, Inc. 

Advertising Research Fou ndation, Inc. 

American Association of Motor Vehicle 

Adm inistrators

American Association of Retire d Persons 

American Automobile Association 

American Bar Association 

American Cancer Society 

American He art Association 

American Medical Association 

American National Red Cross 

American Newspaper Publishers Association

American Public Health Association 

American Truck ing Associations, Inc. 

Association for Aid of Crippled Children 

Association of American Railroads 

Auto motive Safety Fou ndation 

Chambe r of Commerce of the United 

States

Columbia University, safety research 

and education project at Teachers 

College

Council of State Governments 

Intern ational Association of Chiefs of 

Police

National Association of Broadcasters 

National Edu cation Association 

National Foundation 

National Hea lth Council 

National Highw ay Users Conference 

National Society for Crippled Children 

and Adults

National Society for the Prevention of 

Blindness

New York University, Center for Safety 

Education

Northwestern Univ ersity, Traffic Insti ­

tute and Transpo rtation Center

Television Bureau of Advertising 

U.S. Bureau of Public Roads 

U.S. Public Health Service

E ffec tiv e Mass Comm unication for Safety—A Critical Analysis of

P er tine nt Resea rch

(A research prospectus sub mitted to th e N ation al Safety Countil by th e University 

of Denver)

IN TR O D U C TIO N

In light of its ever-increasing activ ities in safety, the National Safety Council has commissioned the University of Denver to und erta ke a critical analysis of pertinent research in mass comm unications for the following purposes: “To develop a comprehensive bibliography of materials pertaining to the effective communication of safety messages (abstracted according to a standard ­ ized procedure using standa rdiz ed criteria) and to establish a reference file on stud ies in this field to be used currently as well as in the future .
70 NATIONAL ACCIDENT PREVENTION CENTER

“To describe critically the scope and depth of the current state of empirically 

derived knowledge relating to the effective communication of safety messages.

“To generate principles of effective communications for safety and to document such principles from the research th at has been done in the communications 

of persuasion.

“To develop guidelines for programing in safe ty.”

In addition, the stud y to be und ertaken will serve as a position document 

to background a national conference on safety comm unications to be convened 

und er Natio nal Safety Council auspices in the fall of 1963.

Finally, it is hoped th at the study will serve to generate scholarly interest in 

the communications problems th at are involved in producing and disseminating 

safety communication effectively.

The project will be carried ou t in two phases—an inform ation-gathering phase 

and an analysis and interp retation phase.

Traditiona l techniques of library research will reflect the majo r effort in the 

inform ation-gathering phase.

Supplementing the library research effort will be an at tem pt to uncover researches that have not been published but which have been conducted by business 

groups, welfare organizations, academic institutions, governm ental bodies, and 

priva te research organizations. This effort will involve b oth formal and informal 

correspondence, meetings, and talks.

The process envisaged is one where one lead (e.g., an article containing a 

bibliography) points to others in sort of a snowballing effect.

At the point where information (1) begins to duplicate itself extensively and 

(2) becomes scant and extremely difficult to come by, f urther gathering of information will be discontinued.

All information is to be (1) noted, (2) cataloged, (3) cross-referenced, and (4) 

abstracted according to a stand ardized procedure using standardize d criteria.

A filing system will be set u p with an eye to (1) providing easy access to m aterials for the project and (2) to serve as a repository for fu ture research efforts in th e 

area of communicating effectively for safety.

Before undertaking an analysis of the material to be gathered, these works 

th at are found to be irrelev ant, based upon questionable methodologies, or merely 

confirmative of minute and specific findings th at have been previously developed 

and elaborated upon will be excluded from the analysis.

The analysis and interp retation itself will be conducted within a general social 

psychological frame of reference th at will seek to pull together variables relating 

to personality and social predispositions, perception, learning, motivation, actiondisposition, and “effects” in terms of systematic organizing principles.

The analysis and interp retation phase will culminate in a full narrative write up 

th at will describe in detail the procedures adopted, the findings, the generalizations that emerge from the findings, and guidelines for possible actions.

To a great extent the proje ct’s success will depend on the cooperation of the 

many people who are concerned with the effective communication of traffic 

safe ty messages. To these people the study now turns for suggestions, ideas, 

comments and criticisms, and for sources of inform ation and researches. All such 

will be received most gratefully.

AR EAS OF INVESTIG ATIO N

I. The need to define objectives for safety propaganda

All too often the objectives set for a mass communications program are unrealistic in terms of what they can actually accomplish. More often tha n not 

mass communications objectives either are n ot made explicit or are overam bitious 

rega rdin g the behaviors the y can induce, maintain , or change.

Without explicit statem ents of communications objectives, it is almost impossible to evalua te w hether communicatio ns u nder specific circumstances are effective 

or not.

Where explicit statem ents of objectives are available to guide evaluation, it is 

necessary to examine how realis tic these objectives are in term s of our knowledge 

about the effects th at can be produced by mass communications.

The study to be under taken at the University of Denver will explore in detail 

the kinds of objectives th at a program of mass comm unications in traffic safe ty 

can pursue with some promise of effectiveness. Within this rubric, careful 

consideration will be given to the following:

A. The complexes of variables, among which mass communications are but one, 

th at can influence proper safe ty behavior.
NATIONAL ACCIDENT PREVENTION CENTER 71

B. The concept of th e mass communications “campaign” and the accomplish­ ment of short-term results as con trasted to the long-term persevering communi­ cations programs th at can look forward to longer-range results. C. Problem s relating to gross satura tion of mass audiences versus pinp ointed 

comm unication appeal to specified subaudiences. D. Problems relating to th e creatio n of prior favorable climates of opinion tha t will serve to set the stage for greater ultimate receptivity of sa fety messages. E. Problems relating to the “tw o-step flow” of communications from the mass medium source through th e interve ntion of opinion leaders or peers to the ultim ate 

message recipient.

II. The application of communication theories to mass communication for safety

A thoroug h critical review of theories in mass communication as they pertain to 

comm unication for safety will be underta ken. Among the theories to be discussed, analyzed and assessed are the following: A. Behavioristic learning theories as propounded by Miller, May, Dollard, 

and Lumsdaine. 1. Learning from the mass media results from four principa l psychological conditions—motivation, stim ulus, participation, and reenforcement. B. Mechanistic information theories expounded by Wiener, Shannon, and 

Schramm. 1. Comm unication effect is a function of encoding, entropy, redundancy, 

noise, channel capacity, and decoding. C. Barrow ’s relative potency the ory. The effectiveness of a message is rela ted to the power of its symbols to overcome “interference” and to be comprehended. D. Lewin’s field theory. If behavio r represents a reorganization of the in­ dividual’s perceptual or cognitive field then comm unication is capab le of affect­ ing such reorganization to some degree. According to the manne r in which the 

field is organized, the individual will act. E. Festinger’s theo ry of cognitive dissonance. The existence of dissonance (i.e. inconsistency between the individual’s beliefs, attitu des , values, etc., and what he experiences in the environm ent) is psychologically uncomfortable. Conse­ quently where dissonance exists, the individual will either seek situations and information which will reduce it, or he will actively avoid situ ations a nd inform ation th at are likely to increase dissonance. F. Mendelsohn’s activ e response theory. Action-inducing communications are cum ulative in their effects. Before action-inducing comm unications can influence behavior they must induce—cum ulatively—learning, emotion, and 

action disposition among th eir audiences. G. Personality Theories of McClellan d and Atkinson. Stimulus streng th (i.e. communications) must be related to individuals’ motives and expectatio ns in 

order to be effective. H. Sociological “phenomonistic” theories of Klapper, Katz, Riley, Wright. Mass communications operate within a social nexus of complex variables. Con­ sequently , where changes in taste, opinions, or behaviors are contemp lated mass comm unications alone can be expected to be relatively ineffectual.

III. Audience characteristics and dynamics that may serve either to implement or to

inhibit effectiveness in mass communication for safety

It is evident from past research experineces in mass communication th at the audiences for various comm unications “select themselves ou t” in term s of prior interest, beliefs, attitudes , values, sentimen ts, group identifications, self-images, psychological “blocks” and the like. As a consequence, it has been noted th at much public info rmation and pro pag and a “falls upon deaf e ars.” Th at is to say, the very people who are considered prime targ ets for activation and conversion in most insta nces are least likely to be exposed to and to be affected by such communications. Thus, for example, we find in political campaigns th at Demo­ crats will tend to listen and react to the arguments propounded by the Democratic Party , while Republicans will be most likely to att end and rea ct to GOP argu­ ments; members of m inority groups will generally a tte nd and re act to pro tolerance propaganda in far greate r proportions than will those manifesting racial and ethnic prejudicies; the b etter educ ated r athe r tha n the poorly educate d will tend to view 

“ed uca tion al” television. If this holds true for mass comm unication in traffic safety, it is a ltogether likely th at th e v ery group of drivers who contribute disproportionately to traffic accident incidence is the group th at neither customarily exposes itself to sound traffic safety messages, nor reacts favo rably to such message when exposure occurs 

either consciously or by chance.
72 NATIONAL ACCIDEN T PREVENTION CEN TER

This is not to say that the self-selection principle is “negative” to the point of 

rendering mass communication for safety hopeless. Here, it should be recalled 

tha t safety messages no doubt serve to reenforce those people who are normally 

concerned with the problem, and continual reenforcement is generally salutory. 

In addition, in supplying the interested and informed with salient information 

and arguments, these very groups (e.g. teachers) can be mobilized to “reach” the 

uninformed and disinterested indirectly via interpersonal channels of communication rather than directly through the mass media.

The study to be undertaken will be addressed to a thorough exploration of the 

self-selection principle as it appplies to the effective communication of safety 

messages.

Here attention will be given to the factors that influence audience interest 

versus apath y; to the problems of motivation; to the mechanisms of psychological 

defense against propaganda; and to the dynamics of “persuasibility” ; to the 

dynamics of projection and “disidentification” (e.g., traffic accidents always 

happen to the “other g uy ”) ; to the influences of peer group pressures (e.g., nobody 

in my gang ever pays attention to those “square” speed limit signs); to the dynamics of cognitive dissonance touched upon above; to the possibility of overcommunication so that “being informed” begins to substitute for “doing somethin"” about a phenomenon (i.e., the concept of the narcotizing dysfunction of 

mass communication); to dynamics of interpersonal dissemination of mass 

communication.

In addition, attention will be given to the differential mass media habits of 

teenagers, adult men, and adult women so that determinations of optimal media 

usage to reach subgroups can be made.

IV . The relative effectiveness of variant content approaches and appeals in mass

communication for safety

Past research in mass communications has indicated tha t certain forms and 

techniques of content presentation appear to be related to persuasiveness. Among 

the more important and oft-discussed materials within this rubric are those 

summarized and discussed by Joseph T. Klapper in his book, “The Effects of 

Mass Communications” (p. 113):

“ 1. Presenting only one side of an argument, as compared with presenting both 

sides;

“ 2. Drawing explicit conclusions as compared to leaving the conclusions 

implicit;

“ 3. ‘Threat’ appeals;

“ 4. Repetition and cumulative exposure;

“ 5. ‘Canalization’ and providing release from tension;

“ 6. Order, emphasis, organization, and the like.”

Although the University of Denver study will review these mechanisms and 

devices as they may apply to mass communication for traffic safety, it is planned 

to explore many other problems relating to persuasive content forms and devices.

For example, attention will be focused upon slogans, humor, literal versus 

fanta sy treatment, the concept of brevity in relation to attention span, color, 

emphasis, vague versus explicit treatment, illustration, captioning, sound, analogy, generalization, exaggeration, exposition versus dramatization, audience 

benefit, layout, rational versus emotional appeal, testimonial.

Particular attention will be paid to attention-getting and attention-holding 

devices in terms of the dynamics of perception.

The presentation to be developed within the overall category of effective content approaches will be organized around a discussion of the concept of mass 

communication “appeals” plus an exploration of the necessity for the propagandist to assume and maintain control over his communication so that all elements of content are integrated to serve the specific objectives to which such 

content may be addressed.

A N A L Y S IS AN D IN TE RPR ET AT IO N

The purpose of this study is not one of merely presenting the wide array of 

materials that is available in mass communication research. Such surveys have 

been done and have been done well.

Rather, it will be the purpose of this study primarily to draw upon empirically 

derived information with an eye to developing sound guidelines for the production of effective mass communications in safety.

The sources to be examined will be experiments, surveys, exploratory researches 

and descriptive researches tha t have been conducted in the fields of safety, psy-
NATIONAL ACCIDENT PREV ENTION CENTER 73

chology, physiology, anthropology, sociology, propagan da, public information, 

education, advertising, and hea lth. Particular attention will be given to case histories of pertine nt mass comm unication programs, campaigns, and techniques th at have proved to be particularly successful as well as particu larly unsuccessful. Here, considerable atte ntion will be given to detailed analyses of the factors th at made for the successes and the failures for the bearing they may have on mass 

communication or traffic safety. A b yproduct of this study will be an examination of what is not known as well as w hat is known. Thus, the s tud y will serve to codify our ignorance about areas in effective safety communications. Such a “codification of ignorance” should serve to focus future research attentio n upon significant problems calling for clarification as well as directing future research atte ntion away from those prob ­

lems about which abundan t information already exists. Analyses will proceed from statem ents of problems to the theoretical contexts from which they have evolved to the test hypotheses th at they have generated to the empirical procedures th at hav e been used to study them to the conclusions th at have resulted from inve stiga tion to the pertinence of such conclusions for 

the effective communication of traffic safety propaganda. Hopefully, this analytic system will generate patterns of insights th at will be generalizable to comm unicating effectively for safety. These insights will be translated into principles th at in turn will be synthesized into guidelines for communications actions to be contemplate d by the various individuals and groups 

who are involved in communicating effectively for traffic safety.

Mr. J ohnson. We have an example of the value of intramural 

research capacities in our own organization. We have one mathematician continuously assigned to the important m atte r of correlating 

and showing relationship between the present safety measures and 

the actual death rates obtained by the States. This is a type of investigation which is practical only as a directed 

staff operation, inasmuch as the operating data are all a part of the 

continuing program of the National Safety Council.

This type of research project could not practically be assigned to 

a university. I know th at similar needs to evaluate the effectiveness 

of State and local health departm ent programs make mandatory the 

establishment of similar research facilities within the Public Health 

Service. I conclude by again urging, on behalf of the National Safety Council, 

that the subcommittee amend H.R. 133, provide the U.S. Public 

Health Service with the research facility it requires, and I assure 

the subcommittee that we believe an amended bill will attra ct broad 

and widespread public suppo rt and can, in the years to come, reflect 

the greatest credit on the work of this subcommittee.

Mr. Roberts. Thank you, Mr. Johnson. I noted that in one portion of your statement, T believe, in connection with the Minnesota 

examples, you cited the fact that presently the highway department 

is using about 1% percent of Federal highway moneys to carry on 

some of the studies that you mentioned?

Mr. J ohnson. Tha t is right.

Minnesota is typical of what is being done in, I believe, all of the 

States. I was given the information tha t they are using the 1%

percent funds to make a study of accident frequency in Minnesota 

counties. They have a study underway on the relationship of driver age to 

traffic accidents in Minnesota, and they are conducting one study of 

farm tractor accidents upon the highways.

Mr. Roberts. Do you believe tha t H.R. 133 can be amended so 

as n ot to interfere with the functions of your organization?
74 NATIONAL ACCIDENT PREVENTION CENTER

Mr. J ohnson. Yes, sir; I think tha t we outlined the points tha t 

we felt were objectionable last year and if those objections were considered and the amendments properly drafted, this would have our 

very strong support.

Mr. R oberts. Do you believe tha t these amendments would also 

protect other private nonprofit organizations engaged not in similar 

work, but in some phases of work in which the Safety Council is 

engaged in?

Mr. J ohnson. Yes, sir; I believe so. If, for example, it were 

made clear tha t the research is in the medical, clinical, and behavioral 

sciences, this would also protect the statutory functions of other 

governmental agencies. It would meet the objections that some of 

the governmental departments have raised.

Mr. R oberts. Here in discussion, Mr. Nelsen referred to the farm 

safety problem. Do you believe that this type of research facility 

could be of some benefit in the field of accident prevention on the farm?

Mr. J ohnson. Yes; I am quite certain it could and would. Our 

farm safety group conducted a special conference on farm research 

and outlined the kinds of projects that our farm conference feels 

need to be conducted.

The Department of Agricidture is a very prominent member of 

our farm safety conference and they endorse this s tatemen t of needs.

There are some kinds of research projects tha t can profitably be 

conducted by the Department of Agriculture but equally there are 

types of projects involving human factors that could well and should 

be conducted in a research facility by the Public Health Service.

I know’ as a matter of personal experience tha t the Department of 

Agriculture does not have enough money to do this kind of research 

nor does it have the assembly of skills, and they would have no 

objection.

On the contrary, I am sure there would be the strongest support 

for a Public Health Service attack on some of these problems tha t 

our farm conference outlined.

Mr. Roberts. Of course, in mentioning the contribution tha t is 

made by the 1% percent of highway funds we talk, I am sure, about 

the interstate part, do we not, primarily?

Mr. J ohnson. The Federal aid money?

Mr. Roberts. Do you feel that there is a great problem involving 

rural roads as far as the picture of highway traffic accidents is 

concerned?

Mr. J ohnson. There are problems, engineering and other problems, 

in connection with the interstate system.

However, I think the problem tha t is perplexing to many of us 

today is the question of the rural roads off the State highway system.

As traffic steadily builds up, the secondary roads and the tertiary, 

the local rural roads, are carrying a larger and larger volume of traffic. 

It is a fact tha t these roads are under the jurisdiction of county 

highway departm ents and in some States under township road 

supervisors.

The engineering staffs of these ageciens are inadequate. They 

don’t have the necessary budgets to do a proper job of signing. 

They don’t use, in many cases, uniform signs.

We believe tha t a great deal more attention needs to be given, 

and I think this can come, particularly, through farm organizations,
NATIONAL ACCIDENT PREV ENTION CENTER 75

to the fact tha t you need public support for a better traffic safety 

job at the county level, particularly in the rural counties.

Mr. Roberts. Do you believe that, if this bill were enacted with 

the amendments which you suggested, your organization could 

cooperate and work with such a facility and mutual benefit would 

be derived?

Mr. J ohnsoi . I most certainly do.

Mr. Roberts. Thank you again, Mr. Johnson, for your statement, 

and I wish to have all of the exhibits included in the record, which 

Mr. Johnson amended to his statement.

Mr. Nelsen?

Mr. Nelsen. A question or two.

In the bill there are grants-in-aid for universities, hospitals, and 

laboratories, and other public and private agencies. In your judgment what is the more important, the grants-in-aid, or the accumulation of the information to make it available? Which of the two is the 

most needed endeavor as far as you feel in the safety program—the 

accumulation of this information, or additional money to colleges, 

universities, and what have you?

Mr. J ohnson. The bill as drafted provides autho rity to make these 

grants-in-aid for research.

Mr. Nelsen. Yes.

Mr. J ohnson. This authority the U.S. Public Health Service 

already has and tha t particular feature of this draft of the bill is, as I 

understand it, totally unnecessary. The critical need is for a research 

facility, which would mean that they would have on their own staff a 

corps of scientists who can then be directed to stud y a particular 

problem.

As research builds up from a variety of sources, we have gaps of 

information. Under the free and uncontrolled university research 

system, you cannot instruc t the university to study this particular 

problem.

But when you have your own staff corps of scientists you can instru ct them and direct them to analyze this particular gap.

Therefore, this research facility would be very important. Finally, 

to come to your last point, it is very important tha t these results be 

translated into practical administrative guides.

Mr. Nelsen. I know in your chart here tha t there are gaps. 

Almost every column indicates activity in some area, hut there are 

gaps in individual areas. Overall, you find a pretty complete coverage, but the accumulation of this information and making it available 

is something that in your judgment is a necessity to make it available.

The reason I ask the question about the grants is that we are hearing 

bills every day to do very worthwhile things.

When we sit down and mark up a bill we have to take into account 

the overall picture and pick and choose a little bit. What I want to 

be sure we do is to make available services tha t are presently in 

existence and at a minimum of duplication.

I do feel tha t the accumulation of this information is important 

and, as has been pointed out, we have available funds for grants-inaid in research now, and the main thing then could be the accumulation and correlation of this information.

I want to thank the gentleman for his great interest in this problem 

and we do appreciate the contribution tha t has been made by organ-
76 NATIONAL ACCIDENT PREVENTION CENTER

izations such as yours, and it is hard to beat things that are done on 

the basis of an organization such as yours with the contributions to 

the cause.

Thank you.

Mr. Roberts. Thank you, Mr. Johnson.

Mr. J ohnson. Thank you.

Mr. Roberts. Because of the pressure of the House meeting at 11, 

and the fact tha t two of the witnesses on the list today are from this 

area, I am going to take next Dr. Albert L. Chapman, Director of the 

Bureau of Planning, Evaluation, and Research, Pennsylvania D epartment of Health, representing the Association of State and Territorial 

Health Officers.

Dr. Chapman had a long and distinguished career in the Public 

Health Service, was Chief of the Division of Accident Prevention 

before he left the Federal Government to join the Commonwealth of 

Pennsylvania and has been a leader in this field.

He is the author of a very fine book on this subject and has been 

one of the strongest supports of this legislation. I might say, Dr. 

Chapman, it is with great pleasure tha t we welcome you back to our 

hearings and we miss you. We hope you are happy in your present 

work and we are glad to have you.

STATEMENT OF DR. A. L. CHAPMAN, REPRESENTING DR. C. I .

WILBAR, SECRETARY OF HEALTH, COMMONWEALTH OF PENN ­

SYLVANIA, PRESIDENT OF STATE AND TERRITORIAL HEALTH

OFFICERS ASSOCIATION

Dr. Chapman. Thank you very much, Congressman Roberts.

Mr. Chairman and members of the Subcommittee on Health and 

Safety of the House of Representatives, I am Dr. A. L. Chapman, 

Director of the Bureau of Planning, Evaluation, and Research, of the 

Pennsylvania State Departm ent of Health, formerly Chief of the 

Accident Prevention Division of the U.S. Public Health Service.

I am here today representing Dr. C. L. Wilbar, Secretary of Health 

of the Commonwealth of Pennsylvania and President of the Association of State and Territorial Health Officers.

Dr. Wilbar testified in favor of H.R. 133 to establish a National 

Accident Prevention Center last year and deeply regrets his inability 

to be here today.

The primary purpose of the proposed National Accident Prevention 

Center, as I understand it, is to mobilize personnel, facilities, and other 

resources that are needed to conduct research into the basic causes of 

accidents so that more effective counter measures may be developed.

Such research, both basic and applied, is clearly indicated if the 

present annual toll of accidental deaths and injuries is ever to be 

decreased.

Before the communicable and contagious diseases could be brought 

under control it was necessary to mobilize many kinds of researchers 

to identify the basic cause of each disease and to establish, beyond a 

shadow of a doubt, the way in which the disease was spread.

Prior to this scientific mobilization to combat the spread of epidemic 

diseases, smallpox, cholera, yellow fever, typhoid fever, and many 

similar diseases decimated community after community.
NATIONAL ACCIDENT PREVENTION CENTER 77

Today these once-dreaded diseases have been controlled but they 

could not have been controlled if necessary basic research had not 

been done to point the way to effective controls.

The situation facing this Nation today relative to accidents is much 

the same as the situation relative to the infectious and contagious 

diseases was in 1900.

Not enough is known about the basic causes of accidents—about 

the human factors tha t contribute substantially to the accident 

equation.

Essentially people cause accidents. Accidents don’t just happen. 

Environmental factors, of course, play their part, but it is quite 

evident tha t a healthy, well-conditioned, well-trained person can 

perform with a remarkable degree of safety even in many unsafe 

environments.

Physical factors such as disease and disability have been indicated 

as important contributors to accidents.

Psychological factors such as various emotional state s—anger, fear, 

grief, worry—have been blamed.

And physiological factors such as the effects of certain types of 

medication, fatigue, alcohol, and other toxic substances have been 

suggested as important causes of accidents.

All of these human factors have been indicated but their guilt has 

not been proven beyond a reasonable doubt, at least not to the complete satisfaction of many importantly placed decisionmakers.

Without such proof it has been very difficult to motivate public 

health administrators, public officials, and the public to support the 

types of actions that will be needed if the current epidemic of accidents 

is to be seriously challenged.

Needed proof can best be obtained through a concentration of 

research workers, laboratory equipment, and other resources in a 

national research center where scientists with various competencies 

and skills can work together, perhaps for the first time on a large scale, 

to discover what really causes accidents.

Then universities will be encouraged to conduct accident prevention 

research from which substantial new and applicable knowledge will 

emerge.

Once this vital knowledge about accident causation has been 

scientifically developed there is every reason to believe that it can be 

translated into action by various groups and agencies.

This application of new knowledge can bring about a dramatic 

reversal of present trends in accidental deaths and injuries.

One of the reasons why scientific research in accident causation has 

lagged behind research in heart disease, cancer, and other diseases, is 

tha t there have been very few places where a scientist could be trained 

to do accident prevention research.

A national accident prevention center, well equipped, staffed with 

senior scientists of repute, would provide an excellent training facility 

for future researchers.

It is absolutely essential to provide adequate research training 

facilities for researchers in accident prevention. Without such 

facilities accident prevention research on the scale of heart disease 

or cancer research will never be feasible.

During the past 30 years, due to the zeal and untiring efforts of the 

National Safety Council, State and local safety councils, police and 

97767—63----- 6
78 NATIONAL ACCIDENT PREVENTION CENTER

fire departments, health departments, and many highly motivated 

individuals, accidental death rates have declined.

Over the years the accidental death rate has declined from a peak 

of 86.0 deaths per 100,000 population in 1917 to 52.3 deaths per 

100,000 population in 1958. This represents a relatively small but 

still significant decline.

This decline was largely due to a drop in non-motor-vehicle accident death rates which fell from 78.2 deaths per 100,000 population in 

1917 to 30.2 deaths per 100,000 in 1958.

Efforts to improve occupational safety have been unusually effective, particularly since World War II. Death rates from work 

accidents have declined steadily.

Motor vehicle death rates however, failed to follow a similar 

pattern. Since 1900, the steady increase in the number of cars on the 

road, the increased number of miles driven, and the increased speed 

and power of automobiles (coupled with the abuse of this power) 

combined to raise motor vehicle death rates to a level of 30.8 deaths 

per 100,000 population in 1937.

The reaction to this alarming rise in motor vehicle death rates was 

of sufficient magnitude to bring into being certain control measures 

which somewhat relieved the situation.

Motor vehicle death rates then dropped slowly until they reached 

a plateau between 21.0 and 24.0 deaths per 100,000 population.

Apparently the point of diminishing returns has now been reached. 

Until research on a significant scale provides a breakthrough, it is 

unlikely tha t any further significant drop in motor vehicle death rates 

can be expected in the near future.

In the development of solutions to any major public health problem, 

there are five steps tha t h ave to be taken. These steps are as essential in developing methods for controlling accidental deaths and injuries as they were in controlling typhoid fever and smallpox.

1. Data must be collected and analyzed. This data may be collected in the field or in the laboratory.

2. Apparent relationships must be critically examined by skilled 

scientists to discover causative factors.

3. Hypotheses must be developed based on these investigations and 

analyses. They must then be tested under scientifically controlled 

conditions.

4. Control measures can then be developed on the basis of proven 

hypotheses.

5. Finally, as control measures are proven to be effective in actual 

practice, they can be incorporated into effective control programs.

The economics of accident prevention suggests that additional 

financial support for research to identify the true causes of accidents, 

would be more in the natu re of an investment than an expenditure.

The problem of accidents is a big and costly one. It involves over 

90,000 deaths a year, 46 million accidental jnjuries, and an estimated 

cost to the Nation of well over $12 billion a year.

Contrasted to the high cost of accidents is the relatively small 

amount of high quality research tha t has been undertaken in this field.

I would like to read a brief statement by Dr. Ross McFarland, 

whom you all know so well, about the quality of accident research. 

It was contained in “Hum an Variables in Motor Vehicle Accidents: 

A Review of the Literature.”
NATIONAL ACCIDENT PREVENT ION CENTER 79

I quote, “A great deal of the published literature in the field of vehicular accidents represents a limited and, in many instances, a 

superficial analysis. “A further defect of the literature is the high incidence of repe­ titious material, poorly controlled experimental studies, and oversimplification of the basic causes of accidents.” There are two obvious reasons for the inadequacy of accident 

prevention research today—lack of suitable facilities in which to 

conduct the complex, interdisciplinary type of research tha t is needed to effectively study accident causation and a lack of facilities in which competent research candidates can be trained to do accident prevention research. The establishment of the proposed National Accident Prevention Center would go a long way toward filling this important gap in the 

Nation’s research armamentarium. Some reduction in the number of accidental deaths and injuries can be achieved by the conscientious application of the limited amount 

of knowledge now in our possession. In Pennsylvania, for example, a 13-point safety program is in effect. Education is its keystone. An interesting and in some ways a unique facet of this comprehensive program involves the periodic physical 

examination of drivers. By means of these examinations, drivers with certain major diseases or severe disabilities which render them unfit to drive are taken off 

the road. Fourteen persons are now employed by the Pennsylvania State Health Department in its environmental safety program and the full-time position of traffic epidemiologist was established 5 years ago. I mention these facts in passing as evidence of the growing interest in accident prevention on the part of many State and local health 

officers and practicing physicians. If and when effective control programs are developed tha t are based on sound scientific research findings and investigations, I am confident they will receive strong support from and will be quickly applied by State and local health officers across the Nation with the 

support and backing of physicians. In conclusion, I wish to thank you, Mr. Chairman and members of this committee for the privilege of appearing here today to endorse H.R. 133 and to assure you of the continuing support of the State and territorial health officers in the excellent effort you and your subcommittee are making to insure the safety of the American people.

Mr. Roberts. Thank you, Dr. Chapman. I am deeply grateful to you for your statement and for your continued interest in this field. You mentioned tha t in the overall picture, and I believe you singled out these by inferences, improvement has been made in industrial 

safety. Why is it tha t we fail to have the same effort or motivation in the highway traffic accident picture tha t we have had in the industrial 

picture?

Dr. Chapman. There are several factors there that are quite 

obvious, Mr. Chairman. One is th at industry is in business to make 

a profit, and accidents decrease their profits. Therefore, they have committed a substantial amount of money to research, experiments, and investigations in ways of making the job
80 NATIONAL ACCIDENT PREVENTION CENTER

safer to do. The result of this expenditure for research, and investigations, and experimentation in industry has paid off in providing a 

safer working environment; better education of the workers; and 

better motivation for the worker to behave in a safe fashion.

Mr. Roberts. I think that answers the question very well. Why 

is it that the same eff ort has n ot been made in the homes, do you think?

Dr. Chapman. Industry is controlled in a very tight fashion. The 

American people live in a democracy and each individual has a right 

to decide for himself what to do or not to do.

Therefore, what he does is largely motivated by the leadership tha t 

is offered to him in his home locality. Today this type of leadership, 

the type t hat you find in industry, has been unavailable, plus the fact 

tha t the investigations and research in home safety have not been 

done t ha t have been done in industrial and occupational safety.

Mr. Roberts. Do you think th at the gap in the home safety picture 

would be somewhat filled by the creation of this type of research 

facility in the Public Health Service?

Dr. Chapman. I have no do ubt about it, sir.

Mr. Roberts. I believe th at the last time you appeared with reference to this bill, Dr. Porterfield was with you, and I remember distinctly the part of the discussion which dealt with the setting up of 

poison control centers which has been a very fine effort.

I personally know of the tremendous contributions that these 

centers have made and the feeling of security tha t they give a family 

when the little one gets in touch with a poisonous material, or cleaner, 

or detergent of some kind.

Do you believe that this Center, as envisioned in H.R. 133, and some 

of the suggested aims, could operate to the mutual benefit of the public 

and also at the same time neither interfere nor infringe on the fine 

work th at is being done by many private nonprofit organizations?

Dr. Chapman. Yes, sir. I thin k you have evidence here today 

from Mr. Johnson’s testimony that the mechanisms exist for coordinating the efforts of the various groups that are doing such excellent 

work in safety, investigation, and control.

T think the problem is a hypothetical one in that the resources today 

committed to the research and control of accidents are extremely 

small in relation to the size of the total problem they are trying to 

tackle, and I think that the mechanism exists for coordinating these 

efforts. The impetus should be less on keeping people from doing 

accident prevention tha t in increasing the contrbution of each of these 

groups in the accident prevention field with the necessary voluntary 

coordination that is now in evidence.

Mr. Roberts. Thank you very much, Dr. Chapman.

Mr. Nelsen?

Mr. Nelsen. I notice that the accident ratio was about 30.8 

accidents per 100,000 population and that has now leveled off to 21 to 

24 deaths per 100,000.

I wondered what is the percentage in Pennsylvania in view’ of your 

rather extensive program. Have you any figures on the Pennsylvania 

situation?

Dr. Chapman. On the Pennsylvania situation?

I have data relating to motor vehicle death rates. These are considerably below average in Pennsylvania. In Pennsylvania in 1962 

there were 3.9 motor vehicle de aths per 100 million vehicle miles.
NATIONAL ACCIDENT PREV ENTION CENTER 81

In the United States as a whole in 1962 there were 5.3 motor vehicle 

deaths per 100 million vehicle miles.

Mr. Nelsen. Thank you. In the instance of Pennsylvania, to 

what do you attribute this remarkable achievement? The physical 

examinations, or examinations of automobiles, or highway construction? Have you any further analysis of that?

Dr. Chapman. I would be remiss if I tried to inject my own personal thinking into the situation. However I could call attention to 

the fact, though, tha t great emphasis has been placed on highway 

safety in the State of Pennsylvania in the last few years.

A 13-point safety program has been set up. A great deal of educational work has been done. The State Police have begun to use radar. 

They have a no-fix policy on traffic tickets.

They have a program of examinations for drivers. They have 

taken many drivers from the road as a result of their admission to 

mental hospitals, or having epilepsy, or participating in traffic offenses 

which involve irresponsibility. I think all of these factors combined, 

have resulted in an improvement in the picture.

Mr. Nelsen. Physical examinations aside, do you find quite a 

large number of drivers that need to be removed from the road? 

Has that shown up as a very contributing factor in accidents?

Dr. Chapman. Of the 1,438,000 drivers who were requested to be 

examined, 28,000 were n ot granted their licenses.

Of these, 5,765 returned their license because they wrote in and said 

in effect, “ I am not fit to drive and I don’t choose to be examined.”

These 1,283 were rejected as a result of physical examinations and 

6,603 had their licenses suspended after an accident, afte r admission 

to a hospital, or after a full special investigation. There is a big 

drop out from this program.

This not only involves those who are barred because of the examination, but also those who recognize they couldn’t pass it and voluntarily 

turned in their licenses or those who for other reasons don’t show up, 

sir.

Mr. Nelsen. On examination of motor vehicles, do you find a large 

number that are taken off the road as a result of the checking of the 

motor vehicles?

Dr. Chapman. I don’t have those statistics with me, b ut the number runs about parallel to the numbers in those States that have compulsory examination laws.

Mr. Nelsen. You mentioned the highway construction program 

and the safety factors involved in construction. I would like to call 

your attention to the fact tha t one of your top engineers is my uncle 

in the State of Pennsylvania.

Dr. Chapman. We are very proud of the highway system in 

Pennsylvania.

Mr. Roberts. If he is doing his job as well as the gentleman from 

Minnesota does at shooting turkey, he is doing a good job. Thank 

you very much.

Dr. Chapman. Thank you.

Mr. Roberts. We have had one bell, which signifies tha t the House 

is meeting, but the Chair is very anxious to try to finish today and I 

am going to ask the next witness, the Assistant Secretary for Policy 

Development and Research of the Department of Labor, Mr. Daniel 

P. Moynihan, if he would give us his testimony at this time.
82 NATIONAL ACCIDENT PREVENTION CENTER

Mr. Moynihan certainly needs no introduction in this field. He has 

worked at the State, private, and Federal level, is the author of very 

fine articles on the subject, and I think qualifies in this field and we are 

certainly happy to have you, Mr. Secretary.

STATEMEN T OF DANIEL P. MOYNIHAN, ASSISTANT SECRETARY,

POLICY DEVELOPMENT AND RESEARCH, DEPARTMENT OF

LABOR

Mr. Moynihan. Mr. Chairman, I know t hat you will be aware of 

the great personal satisfaction it is to me to appear before this committee of Congress.

I have followed your work for more than 5 years now. I have 

watched the careful, scrupulous, persistent and it is necessary for me 

to say fearless, manner in which you have approached a vast and 

incoherent, and singularly intractable subject.

You have done what, no university, no Department of Government, 

has been able to do. You have quite transformed our understanding 

of the nature of the problem of accidental deaths and injuries.

It would be out of place for me, Mr. Chairman, to presume to commend you for your work, but as a sometimes professor of political 

science, I will say that students of American Government would find 

it instructive to contrast the results which your committee has obtained on the basis of a most modest expenditure of funds with the 

results of far more extensive efforts by agencies of local, State, and 

Federal governments.

As you know, sir, the administration has been most conscious of the 

work of your committee and most concerned to make use of the many 

insights which you have developed, particularly in the field of traffic 

safety.

During the 1960 presidential campaign, President Kennedy stated, 

and I quote: “Traffic accidents constitute one of the greatest, perhaps, 

the greatest, of the Nation’s public health problems.”

He added that the interstate highway program provides an excellent 

opportunity for the Federal Government to begin fulfilling its responsibilities in the field of highway safety.”

As you know, the administration has since established the Office of 

Highway Safety in the Bureau of Public Roads, the Department of 

Commerce, and has moved ahead on many fronts against this pervasive problem.

H.R. 133, providing for the establishment of a National Accident 

Prevention Center, is, of course, identical to the bill with tha t number 

introduced by you in the 87th Congress.

Mr. Charles Donahue, the Solicitor of Labor, appeared before your 

committee on February 21, 1962, and stated tha t the Department of 

Labor had every sympathy for this important and salutary measure, 

as he described it.

On tha t occasion Mr. Donahue provided the committee with an 

excellent summary of the various responsibilities of the Department 

of Labor in the field of safety.

Secretary Wirtz has addressed a brief but similar statement to Congressman to Oren Harris, the chairman of the Interstate and Foreign 

Commerce Committee, and I will not burden you to repeat this material, but I will be pleased to answer any questions which may have 

since occurred to you.
NATIONAL ACCIDENT PREVENTION CENTER 8 3

I wou ld like to addre ss my rem ark s to the gen era l problem of accide nt resear ch as we in the Dep ar tm en t of La bor see it, although no t 

nec essarily from the point of view of our dep artm en tal resp ons ibilities.

One of the lead ing res earch scientists in thi s field, Dr. William 

Ha dd on , J r., the D ire cto r of the epidemiology res ide ncy prog ram of th e 

New York State D ep artm en t of He alth, defines acci dents sim ply as the 

“u nexpected occurre nce of in ju ry .”

He iden tifies two gen era l classes of accidents:

Fi rs t, tho se caused by inte rfe ren ce w ith normal whole body o r local 

body ene rgy exchange. An example wou ld be suffoc atio n on the 

form er level, fro stb ite on th e latte r.

Secondly, “ the d eliver y to th e body of am ou nts of energy in excess 

of the corresponding local or w hole body i njur y thresh olds .”

Th ere are a t lea st five forms of this second class of acc idents: Those 

res ultin g from m ech anical energ y, as for instan ce, m otor vehicle accide nts; thermal energy, as in seco nd or third degree bu rn s; elec trical 

energy, as in ele ctrocution; ionizing radiation, as an overdose of 

X-ray s; and finally, chemic al ene rgy pro duced by th e wid e va rie ty of 

chemicals develo ped b y mod ern science or by the mo re classifical plan t 

and anim al toxins. (Poison ivy would be an example of that.)

Wh en yo ur comm itte e fir st beg an to inq uir e into th e subje ct it 

wou ld ha ve been nec essary for a witness such as my self to say th at 

while w e know acciden ts will ha pp en, ju st how often an d to whom w as 

a m at te r for con side rable spe cul ation.

Th is is no longer the case, th an ks to the Nationa l Hea lth Surve y 

cond ucted by the Dep ar tm en t of He alth, Ed uc ation, an d Welfare.

In the period of July 1959 t o J une 1961, for ex ample, som e 44,995,000 

me mb ers of the civilian no nins titutiona l populat ion incurre d injuries 

of on e kind of a nothe r. Abo ut 18.8 million of the inj uries occurred in 

the hom e, 8.1 million too k pla ce on the job, 4.7 millio n occ urred in 

motor vehicle accidents.

It would appear th at pe rhap s one pers on in five is injur ed in the 

course of the yea r. On the su bjec t of the cost of in jury , we are not 

nearl y so well informed, even at the level of mac roec onomics.

The Na tio na l Safety Council est im ate s th at the to ta l cost of accidents an d accid ent al injuries and death s in the Un ite d States during 

1961 was $14.5 billion.

This is a c onservat ive fig ure, as it oug ht to be. The Sa fet y Council 

is car efu l not to ap pe ar to exaggerate the dim ensions of the problem 

in orde r to increase its i mpo rta nc e.

The am ou nt of $14.5 billion rep res ented 2.8 percen t of the gross 

na tio na l prod uc t of the Un ite d St ates in 1961. Ou r inc lination in 

the Dep artm en t of La bor would be to raise th at am ou nt to at least 

3 percen t of the GN P.

I do n’t have to point ou t to you th at for the period 1957 to 1962. 

the an nu al increase in GN P was running at only 3 per cent a year: 

accid ents were in a sense de priving us of ou r gro wth, or mu ch cf it.

I would also add th at $14.5 billion, the low figure I me nti oned earlier, 

was in excess of the to tal ex pend itu re for research and develop me nt 

by Go vernme nt, indu str y, an d nonprofit insti tutio ns in th at year.

It was o nly s ligh tly less th an the exp enditure for all new building s, 

and ab ou t equ aled the pu rch ase price of all new and used cars.

Accid ent s are very much a household problem for the Federal 

Go vernme nt. We hav e some 110,000 injuries a ye ar repo rte d under
84 NATIONAL ACCIDENT PREVENTION CENTER

the Federal Employees Compensation Act, which is administered by 

the Departm ent of Labor.

Last year we expended $46 million from the compensation fund for 

injuries to Federal-civilian employees. We have reason to believe 

tha t the number of injuries that occur is greater than those tha t are 

reported.

For example, in the Post Office in fiscal 1962, their Safety Division 

reported 84,000 injuries for its employees, although only 49,000 were 

reported under the Compensation Act.

This would mean t hat one postal employee out of seven was injured 

on the job during this period.

Studies by the Department of the Interior indicate that indirect 

costs of injuries are at least equal to the direct costs. In the Department of Defense, accidents are a problem of considerable proportion, 

as you would expect.

It would appear tha t in 1960, the overall cost of accidental injury 

and death to active-duty military personnel and their dependents was 

in the neighborhood of $285 million.

Property damage cost would double this figure, so that the total 

would amount to something like 1 percent of the Defense budget. 

Injuries and deaths to active-duty personnel only in motor vehicle 

accidents came to $83 million, in direct costs, with property damage 

probably an equivalent amount.

In general, something like half the total cost of accidents is accounted for by motor-vehicle accidents. Our information about the 

cost of motor-vehicle accidents is by no means complete or adequate, 

but the problem is so large tha t a fair idea of its dimensions can be had.

In the course of the next 5 years, which is 1963 to 1967, inclusive, 

we would be willing to predict that the total cost of motor-vehicle 

accidents will come to some $42 billion.

Something like 190,000 to 195,000 persons will be killed and considerably more will be disabled.

The question of concern to this committee is what to do. We know 

about the cause of accidents and what are we likely to learn about 

the cause of accidents and what are we likely to learn about their 

prevention?

I reply t ha t quite a bit is known about accident prevention as an 

applied technique, and the record of industrial safety quite substantiates this fact.

However, very little is known about the etiology of accidents and 

it would be my judgment that the absence of basic research data on 

this subject is now beginning to retard our progress.

We have gone about as far as you can go in the “hard hat and 

goggles” approach to the problem. The next breakthrough will 

require a far more sophisticated understanding of the nature of the 

problem.

I would judge that at least two factors can be identified which have 

held us back in this field. The first is th at while we define accidents 

as unexpected events, they do in fact, seem to have an explanation. 

Most of these explanations are tautological: You say, “I fell because 

I slipped,” but somehow they satisfy curiosity and they allay fear. 

The nagging sense of mystery and of danger which led men thousands 

of years ago to begin the stud y of infectious diseases, has simply not 

grown up around the subject of accidents, even though the morbidity
NATIONAL ACCIDENT PREVENT ION CENTER 85

and the mortality resulting from accidents is jus t as real as that 

resulting from infectious diseases.

The second factor that I would identify is probably related to the 

first. The study of accidents has so far attracted only a very few 

persons from the learned professions. The result is tha t so far very 

little has been learned about the subject.

Here and there the field of accident prevention has touched upon 

the data of a recognized profession and almost always with excellent 

results.

As Congressman Nelsen would agree, the highway engineers have 

performed miracles by the simple application of the rigorous standards 

of their calling.

These standards provide for elaborate methods of analysis and 

testing and, most importantly, for strict accountability for failure.

Should a major bridge on the interstate highway system collapse 

one night, you can be sure tha t the engineering profession will in short 

order determine why it happened and who was responsible, but if the 

traffic safety campaign should fail utte rly to achieve its announced 

objectives, the likelihood is not a word will be said about it.

Indeed, the authors are likely to continue to take credit for their 

efforts as if the campaign had been a vast success. There is simply no 

tradition of self-criticism in this field. Without tha t criticism there 

is unlikely to be much progress.

Traffic safety happens to be the area in which most accident prevention activity has occurred, therefore, it provides most of the bad 

examples. Let me cite an important one here. Highway accidents 

began to be a significant source of morbidity and mortality in the 

United States about one half century ago. About a generation ago, 

they reached epidemic proportions and have continued at tha t level 

since.

In an effort to keep with the problem, for little more than a generation agencies of local, State, and Federal Governments have been 

compiling statistics about, accidents, injuries, and deaths with a diligence and industry seems to grow as the years go by.

But tha t has been an almost wholly uncritical effort. As a result, 

it has been almost wholly useless. It is my impression, and it is the 

firm opinion of research workers for whom I have the greatest regard, 

that with perhaps one or two exceptions all the vast accumulation of 

data about, automobile accidents over the past half century has contributed almost nothing to our understanding of the cause and prevention of accidents.

It is worth calling to the attention of the committee tha t it was 

only 3 years ago tha t the first scientific information about the nature 

of pedestrian fatalities was published in this country, and this information was obtained by the deceptively simple process of stopping 

some 200 persons who happened to be walking the streets of New 

York City at certain times and places.

There are not more than a handful of research reports in this field 

of the quality customary in other scientific fields, and almost all of 

these have been developed by non-Government groups, generally 

using non-Government data.

(Here, I would exclude the Cornell Crash Inju ry Research Studies, 

which are perhaps a special case.) The general rule may be laid down 

that in no field th at I know of, is the disproportion so gre at between
86 NATIONAL ACCIDENT PREVENTION CENTER

expenditure on d ata collection and similar efforts and the production 

of scientific acceptable results.

Just to intercede with one point, it is not jus t tha t I feel tha t we 

neven’t learned anything from this data collection process. This 

is a more serious m atter than simply the failure to obtain new information. I fear that we have been mislead by such data, and we 

find ourselves in the position described by the old saying that, “I t’s 

not ignorance tha t hurts so much as knowing all those things that 

ain’t so.”

Accident statistics have, for example, shown that some drivers 

have more accidents than others, which has led most Government 

agencies in this field to assume there is something special about the 

multiaccident drivers, although in fact, most of them may be nothing 

more than innocent victims of the Poisson Distribution.

The simple fact is that data collection is not research. The collection of undependable data is not much of anything.

However, the great bulk of our expenditures in this field for half 

a century have been confined to this area. I believe the committee 

would be alarmed to learn how meager are the efforts we make in 

other directions.

The best information obtainable by the Bureau of Labor Statistics 

is at the present time in the United States there are only about 

50 competent researchers engaged in basic research in the accident 

prevention field.

The National Safety Council, for example, has on its staff only 

two persons engaged full-time in accident research and only one of 

these persons is presently a Ph. D. The other will be.

These are very scarce people to come by. This brings me to the 

subject of a National Accident Prevention Center. As you know, 

Mr. Chairman, within the administration, there are people who are 

anxious to see progress in this field who are as yet uncertain as to 

what precisely would be the best institutional arrangements for 

making such progress.

I would prefer to leave tha t to persons be tter qualified than I to 

judge such matters. However, I do most emphatically wish to 

support your concern that something be done.

The Nation needs a center of some kind where persons can be 

trained and gain experience at the professional level in the field of 

accident prevention research.

If we are to get past the 50 mark, as it were, such an effort must 

be made. I assume furth er tha t such an effort must be directly 

related to the medical profession, as much as this may pain our friends 

in the behavorial sciences, although they, of course, will be much 

involved.

It is my understanding this view is held by a significant number of 

medical doctors, although I cannot attest to t ha t statement.

I would, however, quote Dr. Haddon once more who wrote recently:

The time has come, to stop regarding injury causation and research as somehow 

mystically difficult and different from the sequences with which we have long 

successfully dealt in the infectious disease and other areas, since there is no 

convincing evidence tha t this is the case other than its frequent assertion.

It would be my hope tha t agencies such as the Department of 

Labor would become much involved in assisting in such research 

and also th at we would have even a larger role in applying the results.
NATIONAL ACCIDENT PREVENT ION CEN TER 87

I would ask the forbearance of the committee to expand for just 

one last moment on these possibilities.

Two items. First, an example from the field of traffic safety. One 

of the most pressing concerns in this field is th at of the design of passenger cars. As th e committee has abundantly demonstrated, very 

little is known about the relation of design to accidents and injuries. 

We do know tha t in 1960, for example, I believe the number is 

nearly one licensed motor vehicle out of seven was involved in a 

traffic accident. Last year, your committee heard testimony that between onequarter and two-thirds of all automobiles manufactured in the United 

State s are sooner or later involved in a personal injury accident.

We have also recently had an excellent study that indicates compulsory motor vehicle inspection may significantly reduce accident rates.

All these factors point to the probable importance of automobile 

maintenance.

Now, there were in 1960, some three-quarters of a million automobile mechanics employed in the United States. About a third 

worked in the service department of new and used car dealers. Another third worked in repair shops. The remaining third worked in 

gasoline service stations, for manufacturers, and others.

Over the next decade, we will have to train between 350,000 and 

400,000 new mechanics to make up for natural attrition s and to provide for the increase in the total number of motor vehicles at a ratio 

of 1 mechanic for about every 90 vehicles.

It is an interesting fact tha t, while we have very high standards of 

apprenticeship and licensing in service trades, as plumbing and 

electrical work, in general, these requirements have not been adopted 

in the field of automobile maintenance.

But this surely should no t mean that we have no established standards whatever, although I fear this is generally the case.

It seems to me, therefore, tha t it would be an excellent thing if we 

were to learn more about what is now the level of training of automobile mechanics and what, if any, public standards of training ought 

to be set.

I would think we ought to also learn a great deal more about the 

relationship of automobile design to efficient maintenance in terms of 

the skills and training of the mechanics’ work force.

Is it possible, for instance, to mass produce automobiles that require 

more maintenance skill than the current work force possesses? If so, 

ought we to change the design, retrain the work force, or both?

These are questions where basic and applied research meet. I am 

sure the Department of Labor would be most interested to join in a 

study of this kind insofar as it concerns the Manpower Development 

and Training Act, the occupational safety movement, and, of course, 

Federal Safety Standards.

The Department of Labor would also, for example, be most interested to learn more about the problem of injuries to older workers.

In his recent message on aid to our senior citizens, President 

Kennedy expressed the concern of the administration that older 

workers be permitted to continue in employment as long as they 

needed and wished to do.

He said, ‘'Denial of employment opportunities to older persons is 

a personal tragedy. It is also a national extravagance, wasteful of 

human resources.”
88 NATIONAL ACCIDENT PREV ENTION CENTER

If we are to carry o ut thi s policy, it would seem mo st im po rtan t to 

learn mo re ab ou t acc ide nts to old er workers, of which falls are a 

majo r catego ry.

Mr. Ch air ma n, I have bu rd en ed you with more stat istic s th an are 

perha ps n ecessary. This is an occupatio nal ha zard of Dep ar tm en t of 

La bo r employees.

I do, how ever, trus t th at these ha ve given you some fu rthe r ass urance th at you are directing yo ur at te nt io n to a pro ble m of massive 

pro portio ns.

No one can say for certa in to wha t ex tent the pro ble m can be 

dim inis hed .

However, it seems to me th at we have every reaso n to hop e th at it 

will. To cite a possibi lity, I can conceive th at 15 ye ars from now, 

Am eric ans will look back at th e pro blem of moto r veh icle acc idents 

to da y mu ch as we look ba ck a t th e epidemics of influen za and cholera 

which once too k such a toll of life in an earlier America.

It m ay be we are poised here a t the beginning of a gr ea t new b ran ch 

of medicine, of science, and of th e art of contro lling m an ’s environ me nt.

If th at pro ves to be the case, th e Na tio n will be pe rm an en tly in 

your debt.

Tha nk you very much.

Mr. R oberts. Th an k you, M r. Sec retary .

We appreciat e your st at em en t and especially I appreciat e the 

co mp lim entar y rem ark s you made ab ou t the wor k of our sub ­

com mittee .

It is an are a where frus tra tio n is the rule and no t th e exception. 

I t is he art wa rm ing to hear a person of your experien ce an d stat ur e 

express an opinion th at we are some day going to find som e answ ers 

in thi s field.

Th is is the second quorum call and I would like to con tinue this 

aft ern oon with the hearing .

I kno w you are very busy an d I am no t going to ask you to come 

back for que stio ns, bu t I will tr y to get perm ission for the subcom ­

mittee to sit here this aftern oon.

We will tr y to resu me our heari ng at 2 o’clock in the sam e hearing 

room .

Mr. Nelsen?

Mr. N el se n. No que stio ns.

Tha nk y ou very much.

Mr. R obe rts. Th an k you, Mr. Sec retary .

(The following inf orm ation was subm itted for the rec ord :)

St a t e m e n t on B eh a lf o f t h e A m er ic a n Opto m e tr ic A sso c ia tio n by

M e r r il l J. A l l e n , P h. D.

Mr. Chairman and members of the committee, my name is Merrill James Allen. 

I am professor of opto metry at Ind ian a University, with the fac ulty of which I 

have been associated since the division of optometry was formed in 1953. I am 

a native of Texas, obtained m y preoptometric education at Texas University and 

my professional education in opto metry at Ohio State University. I was awarded 

my bachelors degree in 1941, m aste rs degree in 1943, and Ph. D. in 1949, all from 

Ohio State University . My educatio n was interrupted by 2 years of duty in the 

Navy, first as a seaman second class and later as ensign and lieute nant (j.g.). I 

now hold the rank of lie utenan t commander, U.S. Naval Reserve.
NATIONAL ACCIDENT PREV ENTION CENTER 89

During the p ast 4 years I have been engaged in research und er a Public H ealth 

Service gra nt to study children’s vision and a 5-year Air Force con tract to study 

certain accomm odation prob lems of vision. In 1960 I conducted a 1-year stu dy 

for the Air Force on visual performance and high luminosity connected with 

various ophthalmic filters. La st year I was a ppointed director of research for the 

American Optometric Foundation motorists night vision research gra nt to 

Ind ian a University.

In addition to my membership in the American Optometric Association, I am 

a member of th e American Academy of Optometry, the Association for Research 

in Ophthalmology, the American Association of University Professors and the 

American Association for the Advancem ent of Science. I have designed ma rke table instrum ents for vision testing, teaching, and recording. I have authored 

more than 65 articles dealing with various aspects of visual research which have 

been published. My activities include lecturing and television appearances in 

thi s cou ntry and one for the Can adia n Broadcasting Co. Much of my time has 

been devoted to research in the field of accide nt prevention, particu larly th at having to do with automobile accidents.

My appearance is on behalf of the American Optometric Association. Las t 

year V. Eugene McCrary, O.D., now a trustee of th at association, testified in 

supp ort of a similar bill with the same number, then pending before the 87th 

Congress. His testimony is available to this committee and I shall not repe at it.

Our association’s inte rest in accid ent preventio n covers practically the entire 

period of its existence. At the present time it has committees dealing with the 

subjects of occupational vision, which is particularly concerned with accident 

prevention in industry, a com mittee on visual problems in aero nautics and space, 

anoth er on visual problem s of children and youth, and also the comm ittee on 

motorists vision and highway safe ty which is vitally concerned with the visual 

problems which confront the motorist. Our activities in this par ticu lar field 

have been outstanding and in 1960 the association received the United Sta tes 

Chamb er of Commerce Award for Public Service Activity by Associations, based 

upon our contribution to traffic safety.

Like many natio nal organizations, the wives of our members have organized 

wh at is known as the auxiliary. This group has collected money, conducted 

edu cational programs and jointly with th e All St ate F oun dation, conducted three 

colloquia at Michigan Sta te University, the first in 1960, the second in 1961 and 

the third last year. All of thes e have been wrell at ten ded and pu blicly acclaimed 

for the contribution to highway safety as affected by vision.

We have a six-point prog ram which, if fully developed, should greatly reduce 

the terrific toll of life, physical suffering, and p rop erty damage resulting from the 

use of motor vehicles on our highways. Before outlining this program, let me 

assure you th at only a very sm all percentage of the individual automobile drivers 

will be denied their licenses. Our premise is based upon the education of the 

driver, an adequate examination of his visual capabilities w ith correction where it 

is needed, the improvement of the vehicle, its lighting both inte rior and exterior, 

and road markers.

Specifically, the six points in our program are—

1. Driver educ ation and licensing.

2. Visual fitness of the operato r, with periodic physical reexamination.

3. The effect of alcohol, pep pills, tranquilizers , and antihisto mines on 

the driver ’s vision.

4. The effect of speed and fatigue on vision.

5. Lighting, both inte rior and exterior.

6. The effect of aging.

In some of these fields considerable work has been und ertake n bu t in others it 

is largely in the planning stage. In all of them furth er work remains to be done. 

Only last December the Jou rna l of the American Optometric Association carried 

a series of articles which included “Survey of Research Pertain ing to Motorists 

Vision” by Sidney A. Mintz, O.D., a member of Presiden t Kennedy’s Traffic 

Safety Committe e and also the association’s committee on motorists vision and 

highway safety; also one of my articles on “Certain Visual Aspects of the Average 

American Automobile”—repo rt of a study conducted under the American 

Optometric Foundation motorists night vision research grant to Indiana University. These two articles and the editorial concerning them , I would respe ctfully suggest be made a pa rt of the hearing sof this committe e. Last December 

Time magazine did me the honor of devoting a column in its December 21 issue 

per tainin g to my studies on automobile design as rela ted to vision.
90 NATIONAL ACCIDENT PREVENTION CENTER

A no th er one of m y ar ticl es a ppeare d in th e F eb ru ar y 1963 iss ue of th e AmericanJo u rn al of O pt om et ry and Archive s of th e Am eri can A ca de m y of O pt om et ry . 

T his ha s to do w ith “ Visua l E nvironm en t fo r D ay tim e D riv in g— Day tim eA ut om ob ile W inds hield an d D as h Pan el C har ac te rist ic s. ” I ha ve a co py of th is 

ar ticl e, w hich I will leav e w ith th e co m m itte e fo r su ch us e as th ey may de sir e to 

m ak e of it.

I ha ve als o bro ugh t w ith me Bul le tin 336 of th e H ig hw ay Re search Boa rd 

en ti tl ed “ N ig ht V isib ili ty ,” 1962, pu blishe d by th e N at io nal Aca de my of Scienc e 

— N at io nal Res ea r h Cou nc il. "You will no te th a t seve n mem be rs of th e co mm it te e ar e mem be rs of th e opt om et ri c fa m ily and th re e of th em ar e mem be rs of 

fa cu ltie s of ou r sch ools an d colle ges of op to m et ry . A no th er is a fo rm er c ha irm an 

of th e as so ciatio n’s co m m itte e on m ot ori st s’ vision and high way sa fe ty . Yo u 

gen tlem en m ig ht be in te re st ed in th e a rticles en titled “ Le nses f or N ig ht D rivin g.” 

“ Visio n a t Levels of N ig ht R oad Il lu m in at io n” an d “ T ra nsi ent A dap ta tion cf 

th e Eye s of a M ot or is t.”

T hre e gr ea t area s of re se ar ch in th e visu al as pe ct s of m oto ri ng ne ed to be p u rsu ed .

F ir st is th e m at ch in g of m an an d mac hi ne for optim um pe rfor man ce . Auto 

ve hicles are th e way th ey ar e, from th e visu al en gine ering st an dpoin t, be ca use 

th ere ha s be en in ad eq uate co m m un ic at io n be tw ee n th e vision la bora to ry and th e 

au to m ob ile m an uf ac tu re rs . In str u m en t pa ne ls ar e po or ly disp laye d, im pr op er ly 

light ed , an d be se t w ith g lare o bj ec ts. W inds hields inc lude d is to rtio n, s om e a bs or b 

to o muc h lig ht, an d some hav e an no yi ng in te rn al refle ction m os t vis ible a t nigh t. 

M os t pr ov id e un ne ed ed g la re f ro m a dja cen t s ur face s th a t ar e to o high ly r eflec tiv e, 

an d so me pe rm it un ne ce ss ar y sk y glare. The ob st ru ct io ns to vis ion of th e hi gh ­

w ay scen e a re am az ing, a nd inc lu de co rn er po sts , stee ring w heels, re ar v iew m irr or s, 

ex ag ge ra te d fr on t bo dy co nt ou rs , low ere d sid e do or tops , se ve re dis to rton , and a 

m ultip lici ty of accessories su ch as co mpa ss, bab y shoes, rel igi ou s fig urine s, 

fox ta ils, co tto nb alls, etc. etc. T he p os iti on o f t h e e yes in th e ca r va rie s fro m s om e dr iv er s pe ering ben ea th t h e 

st ee ring wh eel to ot he rs cr ou ch in g to see below th e to p of th e windshield . In 

ad ditio n, th e op tion is perm it te d of si tt in g w ith on e’s he ad pr ac tica lly to uch in g 

th e lef t door, so t h a t th e lef t co rn er p os t is alm os t in the c ente r of th e field of vie w.

T he second ar ea is th e e valu ation of sig na l an d ru nn in g lights fro m th e poin t of 

vie w of inf or m at ion co nte nt , co nfus ion, th e p os sibilit y of actu al ac ci de nt c ausa ti on 

from un su sp ec ted fa ul ts in here nt in th e pre se nt s ys tem , an d t h e prob lems of po or 

at m os ph er ic visib ility. T he th ir d ar ea is th a t co nc er ne d w ith th e hum an el em en t in dr iving. Thi s 

in cl ud es rese arch in to th e pr ob le m s of po or visio n, m on oto ny, fa tig ue , hyp notic 

eff ects, di stra ct io ns , and th e qu al ific at io ns for dr iv ing day or nigh t. The hum an 

vari able on th e hi gh way cannot be ov erlook ed , and th ough m uc h is kn ow n, 

m uc h mo re wo rk ne ed s to be do ne . A t th e pr es en t tim e m uc h em ph as is is be ing di re ct ed nat io nal ly to w ar d si m ula to rs th a t pr ov id e opport unit ie s to st udy th e en tire dr iv in g si tu at io n. This 

ne ed s to be done, as it re pre se nts a po ssibl e so ph is tica tion ov er th e st ep -b y-s te p 

la bora to ry ap pr oa ch . How-ever, before to ta l dr iv in g si m ul at ors can be of real 

use, th ey m us t be ba se d on a so ph is tica te d au to m ob ile th a t ha s been co rrec ted 

fo r its kn ow n visu al fa ult s as lear ne d from simple la bora to ry ex pe rim en ts. To 

us e a si m ul at or ba se d on our pre se nt dr iv in g eq uip m en t is merely a co stly an d 

difficult att em p t to re pr oduc e th e sim ple la bora to ry ex pe rim en ts, m an y of which 

have al re ad y be en do ne, an d th eir re su lt co uld be ap pl ie d direc tly to driving.

We a t In dia na U niv er si ty Divisi on of O pt om et ry ar e pr og ra m in g sim ul at io n 

ex pe rim en ts a t th e p re sen t’ ti m e to st udy fog ligh ting pr ob le m s am on g ot he rs . 

The se ex pe rimen ts ar e n o t co nta m in ate d by an effort a t to ta l sim ul atio n of th e 

dri vi ng ac t; hence, th e d a ta ar e easil y an al yz ed an d ch ea pl y ob ta in ed . O th er 

st udie s un de rw ay , als o su pport ed by th e Am eri can O pt om et ric Fou nd at io n, 

in cl ud e th e inf lue nce of ch ro m os tere op sis on nig ht di st an ce ju dg m en t, winds hield 

dis to rt io n, da sh pa ne l vis ib ility, au xi liar y lig ht in g fo r in cr ea sing ni ght dr iv in g 

vi si bi lity an d im pr ov ed sign als fo r fog.

We ha ve ne ithe r th e fu nds no r th e m an po wer to undert ake rese arch in th e 

are as of to ta l si m ul at io n nor in m an y of th e pr ob le m are a topi cs men tio ne d in 

th e pr ec ed in g six par ag ra phs. Pe op le ar e be ing killed ev er y da y be ca use of in ­

sufficient rese arch on th e vi su al as pe ct s of dr iv in g and th e pr op er ap pl ic at io n of 

th a t research .
NATIONAL ACCIDENT PREV ENTION CENTER 91

I am co nv ince d th a t fa ilur e to see an ac ci de nt de ve loping is n o t ju st a hu m an 

failu re, b u t is a co m bi na tio n of fa cto rs so comp lex th a t a trem en dous effort in th e 

la bora to ry and in in dust ry wi ll have to be mad e to solve it. Su ccess ca n mea n 

th a t m an y of us, now des tine d to be come merely a high way st ati st ic , ca n be 

sp ar ed .

I am also leav ing w ith th e com m itte e a bo ok let pu bl ishe d by th e as so ciatio n on 

th e su bje ct of “ Vision an d D ri vin g” th e au th o r of which is R obert C. Sneller, 

O.D . wh o was th en ch ai rm an of th e C om m itte e on M oto rist Vis ion an d Highw ay 

Saf et y and is now tr ust ee co nsu lt ant to th a t co m m itte e.

l o u m ig ht als o be in te re st ed in th e nat io nal su rv ey of au to m obile dr iv er s 

vis ion w hich was unde rt ak en by o u r asso ciation and is still in prog ress. The 

de sc ript iv e folder, w ith its co nte nts , is he re fo r your use.

M ay I ca ll your att en ti o n to fiv e of th e im port ant vis ion skills on e ne ed s fo r 

dr iv in g:

1. Di sta nce ac uity.— A bi lit y to focu s an d see cle arly w ith ea ch ey e se par at el y 

an d both ey es to ge th er , part ic ula rl y a t a di stan ce of m an y fe et or yar ds. Pro bab ly th e m os t im port ant vis ion sk ill fo r dr iv ing, it is es se nt ia l fo r seeing da ng er, 

re ad in g ro ad sig ns in tim e an d fo r gen er al adapta tion to dr iv in g co nd iti on s.

2. De pth percep tion.— Abilit y to co rr ec tly ju dg e di stan ce s bet w ee n yo urse lf an d 

ot her ob je ct s, especia lly whe n both ar e in motion. Thi s is es se nt ia l for pa ssing 

oth er ca rs in th e fac e of on co ming traffic an d fo r m an eu ve ring from one lan e to 

anoth er am on g mo ving vehic les on st re ets an d high way s. Deficienc y in th is sk ill 

is one of th e m os t comm on de fects fo und am on g dr iv ers.

3. Field of vision.— Abilit y to see ov er a lar ge ar ea w ithout m ov in g ei th er yo ur 

ey es or your he ad , so metim es ca lle d “loo king out of th e co rn er s of you r ey es .” 

This, of co urse , is ne ed ed to dete ct cr os sr oa d tra ffic, ped es tr ia ns a t th e ro ad side o r. 

in te rs ec tions , to check tra ffi c a t your re ar th ro ug h m irro rs and to get th e ge ne ral 

dr iv in g pi ct ure .

4. Muscle balance.— Abilit y to p o in t yo ur ey es si m ul ta ne ou sl y w ith ease a t a 

give n obje ct . Th is is es se nt ial fo r go od two- ey ed vis ion , ac uity, depth p er ce pt ion 

and field of vis ion .

5. Night vis ion skills.— The abil it y to see un de r low illu m in at io n be yo nd th e, 

ra ng e of your ow n he ad lig hts, ab il it y to see ag ai nst gl ar e of on co min g he ad ligh ts, 

an d th e ab il it y to reco ve r qu ickl y fr om gla re af te rw ar ds . N ig ht vis ion de pr eciates ra pid ly aft er 40 ye ar s of age. In adequate nig ht visio n larg ely ac co un ts for 

th e gre ate r nu m be r of ac ci de nts which ha pp en a t nig ht th an duri ng th e day tim e.

A re ce nt te st with screen ing in st ru m ents of th e vis ion of 3,00 0 dr iv er s in 25 

Sta te s co nd uc te d un de r th e au sp ices of ou r as so ciatio n in di ca te s th a t 1 out of 

ev er y 5 dr iv er s, with or w ithout glas se s, ha s a t le as t one vis ion de fe ct which 

aff ects safe dr iv ing. An d mi llion s of th es e dr iv er s are una w ar e of th eir sh ort ­

comings.

D is ta nc e ac uity, one of th e m os t im p o rt an t vis ion r eq ui re m en ts fo r safe dr iving, 

ca n be co rr ec te d, if de fective, th ro ugh eyeglas ses in m os t ca ses. On ly a few 

dr iv er s cannot ha ve the ir d ista nc e acuit y r ai se d to a sa fe level th ro ug h professio na l 

ca re. O th er de fects can eit her be co rr ec te d or co m pe ns ated fo r if th e dr iv er 

kn ow s his sh or tcom ings .

Some ey eg lasse s pres cribed for o th er pu rp os es are not su ited fo r dr iv in g. In 

such cases a sp ec ial pr es cr ip tion ca n im pr ov e th e dr iv in g vis ion of th e wearer..

The re ar e twro ot he r area s in ad dit io n to traffi c sa fe ty to wh ich we wo uld call 

yo ur att en ti o n , na mely ac ci de nt s in vo lv in g ch ildr en ’s vis ion and th os e invo lving 

th e ag ed .

The opto m et ri c pro fessi on , pro ud of th e co nt ri bution wh ich it ha s mad e and 

is no w m ak in g to w ar d ac ci den t pre ven tion on a na tio nw id e ba sis in all area s. 

A t th e sa m e tim e we reali ze th a t m uc h re m ains to be do ne an d wou ld be hap py 

to serv e th e N at io n th ro ug h a N ational Acc iden t Pre ve ntion C ente r if Co ng res s 

au th or iz es on e to be es ta bl ishe d. We ha ve no fixed po sitio n as to w he th er it 

sh ou ld be m ad e a p art of th e Pu blic H ealt h Se rvi ce or w he th er it sh ou ld fu nc tio n 

und er some oth er G ov er nm en t ag en cy . Ou r main co nc ern is th a t th e visu al 

fa ctor s th a t co ntr ib ute to ac ci de nt s sh ould be re du ce d to a m in im um , th er eb y 

minim izi ng it as a co nt ri bu ting fa ct or to ou r ac ci de nt toll.

In co nc lusio n, perm it me to as su re you th a t ou r professio n will co nt in ue its. 

serv ice in th e in te re st of sa fe ty . I t has been a privile ge to appear be fore th is 

co m m ittee. If th er e is an y addit io nal in fo rm at io n yo u de sir e, I will be ple ased, 

to fu rn ish it.
92 NATIONAL ACCIDENT PREVENTION CENTER

[Presented before the Night Visibility C om mittee of the H ighway Research B oard , Ja nu ary 1963, Washington, D.C.]

T h e R e l a t io n s h ip B e t w e e n N ig h t D r iv in g Ab il it y and t h e Am ount o f

L ig h t N eed ed fo r a S p e c if ic P er fo r m a n c e on a L ow C o n tr a st T arget

(By Me rril l J. Allen, O.D ., Ph. D., an d William M. Lyle, O.D ., M. Sc., American

Op tom etr ic Fo un datio n M otorist s Vision Research Gr an t, Div isio n of Op tom ­

etry , In dian a Un ive rsity, Blo om ing ton , Ind .)

T hat ma ny people have difficu lty seeing at nigh t often ha s bee n noted and it 

is gr atify ing to know th a t man y drive rs will no t dri ve a t nigh t because the y 

believ e th ey do no t see as well as they should.

It has rec ently been show n (1, 2, 3) th at th e transmission of th e eye is pro gressive ly red uced with age, see figure 1(1). Th is coupled with th e red uction in th e 

average p up il size with a ge can p rodu ce a ma rke d red uction in retin al illuminat ion 

in th e old er drive r. It may be assume d th at a specific level of r etinal il lum ina tion 

m us t be mainta ine d at all ages for some stan da rd level of hig hw ay nig ht visual 

perfo rm ance. Inasmu ch as individu al differences pre clu de a predict ion of vis ual 

per form ance, it is des irable t o me asure an y loss by some e asily admi nis ter ed test. 

Th e resu lts of such a t es t, if expr ess ed in th e am ou nt of lig ht needed for a specific 

vis ua l ta sk can be meaningf ul to lig hti ng engin eers, legisla tors, autom obile licensing agencies, insura nce agencies, ophth alm ic practition ers, etc . Such a visu al 

perfo rm ance te st would autom atically in clu de th e effects of sc at te r and absor ption 

in th e ocula r med ia an d retin al lay ers, and th e effects of o pti cal irregula rities and 

errors of refrac tion. Ot her factor s suc h as th e level of ad ap ta tio n, etc ., would 

also be include d.

Th e te st rep orted here con sists of fou r lines of let ters. Th e top two lines of 

le tter s s ub tend an angle of 10 min. a t 3 m ete rs (eq uiv ale nt to 3/6 Snellen nota tio n). 

Th e bo tto m two lines of le tte rs s ub tend a visual angle of 5 min. a t 3 m eters. The 

sec ond line of larg e le tte rs has a co nt ra st of 10 p erc ent. Th e la st line of small 

le tte rs has a co ntrast of 20 p erce nt.

An 11-inch square ph otog raph ic film is tr ansil luminated by tw o 60-w att tung ste n 

lam ps in a lig ht box. An opal plas tic sheet diffuses t he l igh t from t he bulbs before 

it reaches th e film. To minim ize th e effect of room illum ina tion, a 20 percent 

tra nsmiss ion gra y filter cove rs th e ph oto graphic target. Th e lum ina nce of the 

le tter background with filter in pla ce is varia ble from zero to 100-foot lam berts. 

A ph oto grap hic lig ht mete r was inse rte d into a hole in th e side of th e box to 

me asu re th e lig ht level. By me asu rin g th e lig ht level directl y, th e electri cal 

circuitry nee ded is gr eatly simplified.

An eff ort was ma de to ev al ua te th e influence of sev era l varia ble s using this 

te st as a measu re of visual per form ance. Since we alr eady kno w ma ny of the 

vis ual factors and their i nter relatio ns hips (1, 2, 3, 4, 5, 7), th e purpose of th e dat a 

ob ta in ed here is to dete rm ine th e ab ili ty of this instru men t to ma ke such me asu reme nts .

Th e way in which refra ctive errors affect nigh t visual perfo rm ance is seen in 

figu res 2-5. It is ap pa re nt th a t op tim um per formance with th e least light is 

ob tain ed withi n only a sh or t rang e of diop tric powers. Th e curves are labeled 

to indica te 5 min. te st lette rs (20 /20); 10 min. te st lette rs (20 /40); 100 percent 

co nt ra st (high) ; 20 pe rcen t co nt ra st (20/20 low); and 10 pe rc en t co ntrast (20/40 

low). Fo r each trial lens the illum inati on was increased un til th e pa rti cu lar line 

of l et te rs could be r ead. Lu mi nance levels in f oot lam berts are o btaine d by multiply ing th e ordin ate sc ale value s by 0.22.

In figu re 4, th e wide r ange of ac ce pta ble lens p owers as well as th e erratic perform ance of this subje ct resu lt from his larg e mo noc ular am plitu de of accommoda tio n. When he was req uir ed to maintain bin ocula r vision (fig. 5) as he wou ld 

while drivin g, his per formance w as generally be tte r, bu t o ver a mu ch sma ller lens 

pow er range. This is exp lain ed by the nor mal inter relat ion ship between accommod ati on an d convergence.

Figu res 6 and 7 show th e effe cts of pup il size upon th e lig ht nee ded for th e 

va rio us visual tar ge ts. Th e pu pil dia me ter s on th e X axis are arrang ed accord ­

ing to th ei r squ are s (area) . Th e nee d for more lig ht with pupil s below 3 millime ter s is mo st evide nt. Pat ie nt s being trea te d for glauco ma with miotics will 

be ha nd ica pp ed as ind ica ted , du e to t he res ult ing p upillary constriction. On th e 

othe r ha nd th e failure to accept less illu minan ce with pupil sizes larg er th an 3 

millim ete rs is un do ub ted ly du e to th e aberratio ns intro du ced (ak in to fig. 2-5) 

an d to th e presence of a Sti les-Craw ford effec t in photo pic vision which redu ces 

th e efficiency of th e ray s from th e ma rgi n of t he pup il.
NATIONAL ACCIDENT PREVENTION CEN TER 93

In order to determine the characteristics of the population as measured on 

this apparatus, 12 instrum ents have been built and are being used routinely in 

optometric offices on adults of driving age. So far the few results obtained show 

an age dependency as one would predict, and even show some correlations with 

some of the questions being asked of these people. Figure 8 is the questionnaire 

used. Each answer choice has a number value which is used in totaling the 

score. Since a great deal of data is expected in the next few months, further 

comments are out of place at the present time.

SU M M ARY AN D CONCL USIONS

A tes t is described and results presented to show that this instrument is capable 

of measuring at least two of the several factors that can increase the need for 

greater task illumination. The 10 percent contrast test letters perhaps best 

simulate the contrast of objects often encountered at night. The 20/40 level is 

representative of vision requirements of most drivers’ licensing agencies. The 

brightness levels at which these letters can be recognized with an optimum visual 

apparatus are not far removed from those being contemplated and actually used 

in highway lighting systems (6). Even a moderate visual impairment will likely 

necessitate an increase in the illumination required to see a low contrast object 

on the highways at night to amounts above those currently available.

From the work of other investigators and from the data presented here, one 

may conclude that a less than optimum visual apparatu s can perform satisfactorily 

with sufficient light. The conditions for drivers visual acuity testing provide 

high illumination and high contrast and cannot be expected to indicate poor nighttime visual performance. Indeed if a person barely passes the regular 20/40 test, 

he must surely have a very poor visual performance a t night, whatever may be 

his visual disability.

REFER ENC ES

1. Boettner, A. E., and J. R. Wolter, M.D., Transmission of the Ocular Media. 

Technical Documentary Report No. MRL-TDR -62-34, Wright-Patterson Air 

Force Base, Ohio, May 1962. Also in Investigative Ophthalmology, vol. 1, 

No. 6, December 1962, pp. 776-783.

2. Said, F. S., and R. A. Weale, The Variation With Age of the Spectral Transmissivity of the Living Human Crystalline Lens, Gerontologia, vol. 3, No. 4, 

1959, pp. 213-231.

3. Weale, R. A., Retinal Illumination and Age, Transactions Illuminating 

Engineering Society (London), vol. 26, No. 2, 1961, pp. 95-100.

4. Fortuin, G. J., Visual Power and Visibility, Doctoral Dissertation, Rijksuniversiteit Te Groningen, 1951.

5. Richards, Oscar W., Seeing for Night Driving, Journal of the American 

Optometric Association, vol. 32, No. 3, October 1960, pp. 211-214.

6. Rex, Charles H., Effectiveness Ratings for Roadway Lighting, Preprint 

No. 36, General Electric Co., Hendersonville, N.C., 1962, p. 9.

7. Richards, Oscar W., Night Driving Seeing Problems, American Journal of 

Optometry and Archives of the American Academy of Optometrv, November 

1958.

97 76 7 O— 6: 7
WAVEIENGTH MIL LIM ICR ON S

to

4*

NATIONAL ACCIDENT PREVENTION CENTER
NATIONAL ACCIDENT PREVENTION CENTER 95

TA RG ET BACKGR OUND LUM INAN CE 

X ( 0 .2 2 ) - F t . L a m b e rts
96 NATIONAL ACCIDENT PREVENTION CENTER TA RG ET BAC KGROUND. LU LUN ANC E X ( 0 . 2 2 ) = F t . L a m b e r t s

TR IAL LENS DIOPTERS
NATIONAL ACCIDENT PREVENTION CENTER 97
98 NATIONAL ACCIDENT PREV ENTION CENTER TAR GET BACKGROUND LUMINANC E X ( 0 . 2 2 ) = F t . L a m b e r t s

TRIA L LENS DIOPTERS
NATIONAL ACCIDENT PREV ENTI ON CENTER 99

TA RG ET BAC KGR OUN D LU MI NA NC E

X ( 0 .2 2 ) = F t . L a m b e r ts

1 2 3

PU PIL DIAMETER (mm)
100 NATIONAL ACCIDENT PREVENTION CENTER TAR GET BACKGROUND LUMIN ANCE X ( 0 .2 2 ) = F t . L a m b erts

PUP IL DIAMET ER (mm)
NATIONAL ACCIDENT PREVENT ION CENTER 101

F ig u r e 8

Examiner_______________________ Da te_________

A m eric a n Opto m etr ic F o u n d a tio n N ig h t D r iv in g A p t it u d e Qu e s t io n n a ir e, 

F or m 11-12-62

N am e-------------------------------------- Age -------- Questionnaire s co re_______

N.V .P.T . Scores: 20/40 a ) ___ ft L.; 20/40 b ) ____ ft. L.; 20/20 a ) ____ ft. L

20/20 b ) ___ ft. L.

Encircle patie nts answers. Add numbers in parentheses t o obtain his qu estionnaire score.

1. What pa rt of y our driv ing is at night? (1) None; (2) %; (3) % or more.

2. Do you find it more difficult to drive at night? (1) Yes; (2) Same; (3) No.

3. Do you prefer driving on lighted or on unlighted highways? (1) Ligh ted;

(2) Either; (3) Unlighted.

4. Is your night driving abi lity as good now as it was 10 years ago? (1) No;

(2) Same; (3) Better.

5. Do you think your car needs brigh ter headlights? (1) Yes; (2) Don’t know;

(3) No.

6. Which time of day is th e most difficult for you to drive? (1) Night; (2) Twilight; (3) Same.

7. Do you avoid night driv ing because of your eyes? (1) Yes; (2) Sometim es;

No.

8. Do you prefer th at someone else drive for you at night? (1) Yes; (2) Sometimes; (3) No.

9. Do you like more ligh t for reading than you did when you were younger?

(1) Yes; (2) No.

10. Do you have difficulty walking outdoors at night? (1) Yes; (2) Sometimes;

(3) No.

11. Do you thin k you are a safe night-tim e driver? (1) No; (2) Average; (3) Yes.

12. Would you be a fraid to rid e w ith a driver who sees no b etter th an you do now?

(1) Yes; (2) Perh aps; (3) No.

13. Do you see streaks or rings around lights at night? (1) Yes; (2) Sometimes;

(3) No.

14. Do you see double at night? (1) Freque ntly ; (2) Sometimes; (3) Never.

15. Do you mostly drive near the center white line? (1) Yes; (2) No.

16. Do you slow down because of th e glare from oncoming headlights? (1) Usually; (2) Sometimes; (3) Never.

17. Do distan t objects seem blurred at night? (1) Yes; (2) Sometimes; (3) No

18. In equal traffic conditions which is most tiring? (1) Nig ht driving; (2) Day

driving.

19. Do red taillights dazzle you at night? (1) Yes; (2) Sometimes; (3) No.

20. About how many miles do you drive in a year? (1) Less tha n 8,000; (2) 8,GOO15,000; (3) 15,000 or more.
102 NATIO NAL AC CID EN T PR EV EN TION CE NT ER

E d i t o r i e i l C o m m e n t

E

ARLY IN 1957 the AOA throug h its 

Motorists’ Vision and Highway Safety 

Com mittee and its Woman’s Auxiliary 

laun ched an ambitious n ation wide survey of 

driver’s vision, a survey tha t had as its final 

objective 100,000 completed vision and 

driving records.

A series of special forms, adapted to 

standa rd available visual screening devices, 

were designed for use in the survey and 

a uniform test procedure was ado pted. Resultant data were to be analyzed and interpre ted via electronic comp uters at the 

Division of Optometry, Indiana University.

Enthusiasm for the voluntary vision 

screening survey was immediate. Portable 

screening equipment was set up in scores 

of communities in twenty-five states.

Drivers were invited to have the ir vision 

tested by standard techniques, without 

charge or obligation. The tests were administered by laymen, but supervised by licensed vision specialists. Almost all nontechnical details were handled by women’s 

organizations—members of the W omen’s Auxiliary of the American Opto metric Association, National Home D emonstration Council, 

and the Women’s Division of the Automotive Safety Foundation. Both men and 

women drivers were tested, and in abou t 

the same proportions as licenses are held 

by male and female drivers.

A pilot study, encompassing 3000 licensed 

drivers, accounted for some inte resting statistics. Percentages of drivers fou nd to fall 

below acceptable standards on the major 

visual requirements tested include d: ina dequ ate dep th perception, 22%; inad equ ate 

acuity, 21%; lateral phorias, 17%; vertical 

phorias, 13%; and inadequate field of vision, 

10%.

By Irving Bennett, O.D., Editor 

1316 Sixth Ave., Beaver Falls, Pa.

A g reat many conclusions could easily be 

draw n from the pilot survey. But the 3000 

sample was really not enough and the broad ­

er study was initiated.

In order to achieve the goal, each state 

was assigned a quo ta . . . a quota determined by the num ber of AOA members in 

the state m ultiplied by 10.

To date, afte r five years of effort, we report disappointingly th at less than 10,000 survey forms have been completed and returned. And these 10,000 forms emanate 

from bu t 13 states and the District of Columbia, the latter being the only one to 

exceed its assigned quota. Interest runs high 

in the District: thanks to the Society, its 

Auxiliary and the Woman’s League for T raffic Safety, there are several additional forms 

ready for transmittal, enough to place the 

District in a position double its quotal

The research value of the national survey 

of driver’s vision is u nquestioned. An article 

in this Journal poin ts out conclusively that 

insufficient research has been performed to 

establish licensing standards. The AOA survey can be relied upon for precise information that w ill lead to additional research and 

the establishment of proper standards.

The public relations value of the survey 

is tremendous. Concern for the wholesale 

slaughter on the highw ays has caused national, state and local leaders to explore 

every avenue to improve highway safety. If 

inadequate vision is, or is not, determined 

as a decisive factor, the public service of 

the survey study will most assuredly result 

in excellent relations for the profession.

The Journal is constantly in receipt of 

news stories of vision screening programs 

conducted by local societies at state fairs, 

in eye mobiles, at pub lic gatherings. How
NATIONAL ACCIDENT PREV ENTION CENTER 103

easy it would be to transform these screening programs into the nationwid e survey by 

using the prescribed forms a nd getting some 

additional information! The data would be 

invaluable; the increased effort would be 

small.

In addition to optom etric groups, ther e 

are many individuals, committees and organizations seeking action programs for tra ffic safety. These may well direct the ir activities toward “vision for driving” goals and 

join in with the nationwide survey.

Your encouragement would help indeed.

Self-Employed Pension Programs

A joint communication from the AOA 

Departmen ts of Legal Affairs and National 

Affairs to all state associations deserves repeating here.

Although the President signed H.R.10 

(now Public Law 87-792), the Inte rnal Revenue Service has not yet even indicated 

when it would promulgate the regulation s 

for its administration. Nevertheless, numerous plans for the self-employed both acting 

as individuals and through their organizations such as AOA are being offered by various sources.

The Board of Trustees at its mee ting 

in St. Louis on November 4, 1962 a ppo inte d 

a special committee to consider any plans 

that might be submitted to it but dete rmined 

to take no action prior to the issuance of 

the regulations by the I.R.S.

Individuals who desire to avail the mselves of the provision of this new law have 

all of the calendar year 1963 to decide upon 

wha t plan they will adop t and to make their 

initial payments. There is no need for haste.

It is recommended, therefore, tha t affiliated organizations and individual mem bers 

wait for AOA information bulletins which 

will be issued from time to time. Do not be 

stam peded or high pressured into taking any 

action at this time.

Unified Health-Welfare Departm ent?

Generally speaking, the profession of op ­

tometry is h eld in high regard by individual 

state dep artm ents of welfare, and optometric 

cooperation with these departments has always been on a high and respected level. 

Unfortunately the same is not the case in 

state departm ents of hea lth where control 

is exercised by members of the medical pro ­

fession, who, in many instances, fail to rec ­

ognize or utilize optometric services even 

when those services would be beneficial to 

the public.

We are, it appears, at the dawn of a 

period of rapprochm ent and cooperation between h ealth and welfare. There are already 

several notable examples of consolidated or 

joint activity. Optometrists must look forward to the day not too far in the offing 

when departm ents of welfare and departments of health work together under one 

superstruc ture.

Leona Baum gartn er, Commissioner of 

Health for the City of New York, in a recent presentation before the American Public Welfare Association analyzed the trends 

in the direction of consolidation. Joint health 

and welfare departm ents already exist in 

Maine, Missouri, Puerto Rico, Alaska and 

New Hampshire, note d Dr. Baumgartner, 

and Maryland, the District of Columbia and 

Kentucky have health departm ent administered programs of medical care for welfare 

recipients. Says the Commissioner: “With 

the exception of Maryland, none of these 

health dep artm ent adm inistrate d programs 

has reached the state of comprehensiveness 

that is desired in good medical care pro ­

gram . . . in New York City, we have 

achieved comprehensiveness”.

With th e aging of our population , with the 

decline of infectious disease and marked 

increase in chronic illness, with health care 

costs rising at a rapi d rate, look for moves 

on a state governmental level to increase 

public health and welfare services and, at 

the same time, endeavor to improve operational efficiency. An attempt to unify welfare and health departments will be a nation ­

al trend.

It behooves all optom etrists to work for 

improved services to the needy public, to 

sanction and assist in attainin g governmental 

efficiency at the lowest cost but, at the same 

time, prot ect the public’s righ t to a free 

choice of practitioner. ■ ■ ■
104 NATIONAL ACCIDENT PREVENTION CENTER

Survey of research pertaining to motorists’ vision

S ID N E Y A . M I N T Z , O . D .

T

HE PEOPLE OF THE United States 

have been subjected to years of commercial advertising on the ease of driving 

automobiles and, unfortunately, the speed 

with which they can be driven. Horsepower 

ratin gs of automobile engines have been 

constantly increased for “get-aw ay” and 

passing power. Sped and facility of driving 

hav e been watchwords in the advertising. 

Shift in Responsibility

It becomes the task of safety experts, editorial writers, motor vehicle inspectors and 

an army of police to make drivers cognizant 

of their responsibilities. In a constantly 

maintained program of education, engineering, enforcement and re-examination, the responsibility for safe driving is shifted somewh at from officials of th e State to the drivers 

themselves. Driver responsibility would also 

ten d to emphasize the realization that driving ability is not something which comes 

spontaneously with the acquisition of a small 

printe d card. It is something that must be 

developed through training and experience. 

Roads are being re-designed and improved, 

thus leading to new situations. Old roads, 

even though familiar to the drive r, pres ent a 

hazard with the increase in the num ber of 

cars. Constantly changing environments 

would lead us to re-examine periodically, 

our abilities to cope with ever-changing situations.

•Member, AOA Committee on Motorists’ Vision 

and Highway Safety; chairman, NJOA Motorists’ 

Vision Committee; member, President Kennedy’s 

Traffic Safety Committee; chairman, Paterson 

Traffic and Safety Commission.

The average driver feels that he is a safe, 

efficient driver. He feels that he cannot be in 

an accident or cause one. He desires that 

safety measures be instituted for others, 

those who are not as safe and competent at 

driving as he is. T his is a consistent premise 

that all safety experts must accept in their 

thinking and planning. This paper is concerned with the vision requirements for the 

operation of motor vehicles. It concerns the 

driver from the applicant for a learner’s permit to the experienced driver.

Lack of Research for “Standards”

Surveys have demonstrated that the majority of accidents occur with experienced 

drivers. Minnesota found that 61% of drivers involved in accidents had been driving 

more than 10 years. Oklahoma found 45% 

of drivers in accidents had 11 years or more 

of driving experience. This could lead to the 

conclusion t hat re-examination may be ne eded at some poin t afte r the initial license is 

granted.

Vision is a prim e necessity to a driver. 

The efficiency of vision changes with age 

both from a functional and a pathological 

standpoint. No other function is so important to a driver as his vision. Yet, this sense 

is completely neglected after a cursory 

screening of drivers for visual acuity at the 

time of the initial application for licensure. 

For many years the literature, state laws, 

and speakers at various safety conferences 

have referred to “acceptable” minimum vision standards for the operator of a motor 

vehicle. These “stand ards” a re more or less
NATIONAL ACCIDENT PREVENTION CENTER 105

acceptable and are in use by state motor 

vehicle depa rtments. After going throug h 

thousands of pages of literature, we find 

very little actu al basic research to prove or 

substantiate the basis for any of the accepted vision standards.

No research in depth has ever been done 

on visual acuity in relation to safe driving 

or driving ability. T he Supreme Court of the 

State of Iowa recently held tha t the sta te’s 

minimum vision s tandard of 20 /30 is reasonable. After his usual examination, the eye 

practitioner can generally predict the ind ividual’s vision ability for driving. In the ab ­

sence of responsible research, this is the 

most reliable criterion available.

It must be noted tha t experience has demonstrated tha t drivers who have visual or 

physical impairments of long standing are 

usually safe drivers, because they hav e 

learned to compensate for thei r deficiencies. 

It cannot be said, however, tha t these dri vers operate und er the same conditions as 

those who function without handicaps. They 

usually choose the time, place and con ditions und er which they will drive.

Minor Deficiency to Major Proportion

In California, a check of the visual acuity 

of drivers in a 20-29 age group (58 in numbe r), who were involved in fatal accidents, 

demo nstrated that 72.4% had 20/2 0 visual 

acuity or bette r and that only 12% had major defects of vision.1

 T he significance of the 

superiority of good vision compared to poor 

vision in fatal accident cases is not high, as 

a critical ratio of 2.1 indicates. A critical 

ratio of 0.8 definitely shows that the difference in visual acuity between habitua l violators (the vast majority of whom have average visual acu ity) and the fatal accident 

drivers is not due to major differences in 

visual acuity bu t rather to minor diffe rences.1

 This may lead to the conclusion tha t 

a person becom es aware of major deficiencies more readily than minor ones, and thus 

is more likely to endeavor to compensate fo r 

the major ones. 2

 It must be considered that 

fatigue and other factors may temp orarily 

enlarge a minor deficiency to major proportions. This may occur in hyperopia, astigmatism, high heterophoria or vertic al imbalance 

of th e extra-ocular muscles.

Low visual acuity is significantly more 

prevalent among drivers involved in inte rsection accidents (63 .2% ), while those involved in non-intersection accid ents (90 %), 

possess average visual acuity. It was noted 

in the California survey tha t habitual violators compared favorably in visual acuity 

with the intersection accident cases.3

 It was 

noted in this same survey tha t 90.9% of intersection accidents hap pen ed at the side of 

the deficient eye. It was concluded that defective visual acuity app arently is a potent 

factor in intersection accidents.

It was noted, too, tha t poo r visual acuity, 

especially in one eye, was significant in 

rear-end accidents and, again, in accidents 

where violators attempted improper passing 

and had allowed insufficient clearance in 

passing.3

 Tiffin, of Purdue University, reported tha t the perc entage of drivers in 

need of eye care varies with age (20-30 

years old: 15%; 50 years and over: 40%). 

A Better Vision Institute survey disclosed 

the following perce ntages of need for eye 

care for the ages indicated : at age 20, 23%; 

at age 30, 39%; at age 40, 48%; at age 50, 

71%; at age 60, 82%; and at age 70, 95%.

The “act of driving” is n ot merely the operation of a motor vehicle, or the carrying 

out of motor vehicle operation und er a given set of conditions. The term is all-inclusive, covering the driving of a variety of 

motor vehicles, ranging from a simple motor 

scooter o r go-cart to a 30-ton truck and tra iler. The “act of seeing” has many facets, too. 

It is more than visual acuity, even more than 

the sum total of the determination of visual 

acuity, lateral and vertical muscle balances, 

fusion, dep th perception, and color vision. 

We do not know all the relationships of the 

various visual skills to driving, even if we 

consider only daylight driving.

Motor vehicle bureaus should set up adequa te vision standards. These standards may 

be too lenient for many drivers and too 

harsh for others. At the same time, they 

should maintain high standards rather than 

turn to a complex series of standards to cover every type of driving.
106 NATIONAL ACCIDENT PREVENTION CENTER

It is incum bent upon motor vehicle officials to set up and maintain ade qua te stan dards which will stimulate improvem ent of 

visual efficiency rather than cause larg e scale 

rejection of applicants. Civil service commissions, insurance companies, trucking 

companies, large corporations req uire certain driver groups to demonstrate be tte r visual efficiency than that requ ired for a regular license in all states. Mana gement knows 

tha t a visually efficient driver is a safe driver. Yet, little or no scientific rese arch has 

been done to prove this point.

The eye practitioner, by train ing and experience, knows that certain symptoms, 

signs, and reactions are manifest with certain given ocular and visual anomalies. Hyperopia, myopia, and astigmatism are ocular 

anomalies, wherein the axial length of the 

eyeball or the curves of the various refrac ­

tive media vary from normal and prod uce 

an out-of-focus image of the retina. A functional vision anomaly may be considered 

occuring from the retin a to the percep tual 

center of the occipital area of the brai n, i.e. 

the sensory level of vision.

This pap er will attempt to review and interpre t the research and expert opinion 

available on the subject of motorists’ vision. 

Familiar to all is visual acuity.

Visual Acuity and Driving

Fou r states require a minimum visual 

acuity of 20/2 0 for chauffeur’s license. Thirty-three states require a 20/40 minim um visual acuity.3

 Visual acuity is a measurement 

which signifies the keenness with which the 

retinal images are perceived.4 Visual acuity 

is usually rated by the use of geometric 

forms, numb ers or letters which subtend a 5’ 

angle of an arc at 20 feet (Sn ellen) . Most 

researchers consistently mention that if it 

were up to them to set a drivers’ stan dard , 

it would be 20/20 visual acuity.

Hofste tter and Zerbe8 did a follow-up on 

the survey performed by Ho fste tter and 

Bryan6 on the prevalent and potential visual 

acuity of automobile drivers. They foun d a 

close similarity in the percentage of persons 

who could achieve 20/20 visual acuity or 

better if corrected. They concluded tha t 94%

of all drivers could ha ve 20/2 0 visual acuity, 

or more, in the better eye if corrected properly. Their findings indicate that 20% of the 

records examined showed drivers to have 

had substandard vision until corrected.

It is significant to consider that persons in 

older age brackets have a rapid diminution 

in keenness of vision. These individuals limit thei r driving or stop driving voluntarily in 

many cases. This has been proven in Pennsylvania where 3,035 drivers, of the 394,910 

re-examined so far, have voluntarily relinquished thei r licenses by not completing the 

required physical and vision examination required by Section 608G of the Motor Vehicle Code of Pennsylvania.28

Only 2% of those in the older age brac kets in Pennsylvania who were checked could 

not achieve 20/30 or be tte r visual acuity. It 

should be mandatory, therefore, that the 

best visual acuity possible be enforced as a 

driving prerequisite. This may prove a h ard ­

ship on some, but proper glasses will serve 

the driver for many uses other than driving 

a motor vehicle.

There has been much research done by 

the American Optical Company and by the 

Bausch and Lomb Optical Co. through Purdue University to evaluate industrial safety 

programs. It has been found tha t there is a 

general increase in efficiency, less lost time, 

less breakage, less waste, improvement in 

morale and, of course, fewer injuries in 

plants with industrial vision safety programs. 

We may transfer these results to the driver 

and similarly raise his driving efficiency. In 

a survey5’

6 by Hofstetter, et. al., on the best 

visual acuity, we note tha t only 2% could 

not achieve at least 20/30 visual acuity in 

the better eye. Only 0.6% could not achieve 

at least 20/4 0 visual acuity standard recommended by most groups throughout the 

country.

Effect of Illumination and Speed on V.A.

Considerable tho ught should be given to 

the issuance of limited licenses for persons 

who cannot meet the 20/30 visual acuity 

standard. While this license will limit the 

driver to daylight driving only, it will reduce 

complete rejections and may prove more ac-
NATIONAL ACCIDENT PREV ENTION CENTER 107

ceptable to the public and legislators. Richards 7

 finds tha t a driver with 20 /40 static 

daytime visual acuity has only 20 /80 visual 

acuity und er night illumination. Some years 

ago, Luckiesh and Moss m easured 150 people and found average, normal vision (2 0/ 

20) at 10 foot—lamberts and a decrease in 

the average visual acuity to 20/55 after 

ada ptation to 0.01 foot-lamberts. The person 

with the best vision at the lower level had 

only half of the acuity available to him at 

the higher level.

For a driv er to experience th e same acuity 

at the lower level of illumination, as at the 

higher level, symbols on road signs would 

need to be increased in size five-fold. Contras t would also have to be increased six to 

twen ty times to make the same size sign 

legible at the lower brightness. This assumes, of course, sufficient time to see. In 

othe r words, for a given contrast there is a 

minimal size tha t can be seen. Th e avera ge 

sign on our highways has lettering five 

inches high and is equivalent to 20/200 

Snellen-sized letters.

Seeing is limited by speed. Unless a minimum of light is focused on the retina for a 

sufficient time there is no vision, and when 

the image moves faster than the eye can 

compensate, vision is impossible. Fo r black 

and white seeing 1/30 second is said to be 

adequate, while 1/5 second is necessary for 

color seeing. Fast driving enhances perip heral blur ring so tha t progressively smaller 

fields in front of the driver remain clea r at 

greater distances.

Danielson3 reports that greater comfort is 

experienced when one drives at rap id speeds 

where only the central field is seen clearly 

and the eyes are shielded from the blurrin g 

in the periphery. The loss of clues from the 

blurring at the side may lead to over-confidence and even greater speed. Roper found 

tha t distances of seeing decrease by 20 feet 

for each increase of 10 mph. Vibration above 

205 cps causes vision to decrease. Th e loss 

of vision at high driving speed increases be ­

cause of the greater vibration of the vehicle. 

At high speeds the estimation of movement 

and judg men t of speed may be halved. The 

safe speed for a given driver is th at for

which the perceptual load is not too grea t 

for proper response. At night, this load is 

greater and speeds should be decreased proportionately. A driver with poor night vision 

may have to go so slowly as to be a hazard 

on the turnpikes or parkw ays where spee ding is permitted.

The visual mechanism is controlled by th e* 

nervous system. Vision efficiency depends 

upon the response to changes from moment 

to moment in the amo unt and distribution 

of light entering the eye. At nigh t the 

changes in illumination can occur faster than 

the eye can adjust to the changes. The resulting conflict in the seeing mechanism and 

the effort expended in tryin g to get a clear 

and sharp view, which cannot be obtained 

und er these conditions, are a source of strain, 

frustration and fatigu e in the driver. A sharp 

retinal image is perceived more quickly and 

is less disturbed by glare light. A properly 

place d qua rter diopter cylinder for the correction of astigmatism has been reported to 

improve nigh t acuity by 25% I7

High acuity is unnecessary for daytime 

driving when the pu pils are small. There are 

reports of accident-free driving with low 

acuity, even 20/400, with no great difficulty 

afte r the first five m inutes of adjustment. At 

nigh t this is no longer true; the weak .blurred 

images do not have enou gh contrast for seeing and the driv er may not see obstacles. 

Motorists with less tha n 20/20 daylight vision should drive more slowly at night than 

those with b etter vision, and the proportionate decrease in speed should be determined 

for a represen tativ e section of the driving 

public.

Aging Decreases Vision

Aging decreases vision along with the other changes of senescence. More light is necessary for seeing with smaller pupils, crystalline lens changes, etc. One study indicates 

tha t for equal seeing the light needs to be 

doub led for every 13 years of age.

Figure 1 summarizes other information 

showing how vision decreases with age. 

Acuity a nd contrast sensitivity decrease, and 

the decreases may result in lower levels of 

visual acuity than are legal for driving in
108 NATIONAL ACCIDENT PREVENTION CENTER

some states. This is another reason for a reconsideration of the importance of Snellen 

acuity as a criterion for a driving license.

Since the available illumination at night 

is scarcely adequate for the best eyes, many 

older people should drive less rapidly. Essential signs and signals should be much 

larger and brig hter than those req uir ed for 

the best young eyes. F ortunately, o lder peo ­

ple generally become more conservative and 

drive more carefully.

The professional responsibility of the optometrist and the ophthalmologist is more 

imp ortant with the older patient who needs 

spectacles. In addition, advice should also 

be given to certain older people concerning 

the inadvisability of driving at night. Opacities forming in the eye may redu ce vision to 

an unsafe level. Vision specialists have the 

problem of determining what is a safe level 

of visual acuity for driving and of advising 

traffic engineers and lawmakers so that highways can be made better and safer.

Accident-Proneness at Acuity Levels

Research at various institutes has shown 

us tha t a car traveling at 40 mph on a good 

road, with good tires and brakes, can stop 

safely at a distance of 143 feet. We can assume tha t a driver with 20/20 visual acuity 

can rea ct easily in this situation, for he can 

see clearly at 280 feet, and have sufficient 

time for safe stopping.

If the driv er has 20/40 visual acuity, his 

clear vision extends to only 113 feet. If he is 

traveling at 40 mph und er favorable conditions, he may be 30 feet beyond a sign or 

object be fore he can stop.26 Therefore, 20 /39 

visual acuity is a more desirable base than 

even the accepted 20/40 minimum.

With a 20/5 0 visual acuity minimum, the 

driver needs 90 feet to read a road sign. The 

implication of hazard is obvious.

Lauer’s and Silver’s studies both suggest 

a rapid transition to accident-proneness at 

acuity levels of above 20/40 visual acuity. 

A pilot survey of visual acuity by the National Home Demonstration Council in cooperation with the Women’s Auxiliary to the 

American Opto metric Association showed 

tha t 21.5% of 3,000 persons screened failed 

to achieve 20/40 visual acuity.26

Effect of Phorias

Little or no basic research has been accomplished on the relationship of a marked 

heterophoria to driving accident proneness. 

Again, we must rely on the empirical knowledge and experiences in daily practices.

A phoria is the measurement of the position the eyes tend to assume when fusion is 

absent. An exact phoria measurement is taken in an eye practitioner’s office with prisms. 

In screening instruments two dissimilar targets, which cannot be fused, are employed 

to take a gross measure. An individual has a 

measureable phoria if he is able to fuse the 

retinal images of both eyes into one. If he 

cannot fuse because of a high phoria, he has 

a “tropia” or strabismus. There are many 

borderline cases where fusion is present occasionally, bu t the phoria is too high to permit constant fusion (interm ittent tropia). 

This may result in a suppression or suspension of vision in one eye. Many times this is 

the cause of amblyopia.

Clues which stimulate the two eyes to produce single, binocular vision become fewer 

with deeper twilight and place more strain 

on the coordinating mechanism of the eyes. 

It is im portant to have the best possible correction for any phoria or muscular deficiencies of the motorist’s eyes.7

 Shapiro and 

Mastache8

 say that if there is a phoria of an 

appreciable degree, or if a tropia is present, 

any extended period of driving at night results in blurring of vision, diplopia, impairment of dep th perception, headaches, and 

resulting fatigue.

Refractive errors may be a cause of heterophoria. In fact, most tonic vergence
NATIONAL ACCIDENT PREV ENTION CENTER 109

anomalies probably owe their inception to 

refractive conditions and to the excessive 

use, or non-use of accommodation.9

 The 

clinical symptoms due to beterop horia derive largely from the strain of the constant 

effort to maintain fusion, tog ether with the 

confusion which arises owing to imperfe ct 

binocular fixation.10 Heterophoria is considered to be a laten t squint which is marked 

by reflex activity producing fusion. If fusion 

is lost or absent, the squint or strabismus 

will becom e permanent. There is no fundamen tal distinction between latent and manifest squint.10

Hig h Uncorrected Phorais Lead to Fatigue

The general subjective symptoms associated with “eyestrain” due to the continuous effort expended to maintain fusion in all 

visual activities (including drivin g) are a 

feeling of tiredness and discomfort in the 

eyes, varying from a dull ache to actual 

pain; headaches of various types; and rapid 

fatigue and blurring of vision sometimes 

lead ing to actual confusion or temporary 

dipl opia with giddiness and even nausea 

and digestive disturbances; torticollis (head 

tilting) which results from a vertical imbalance (hyper phoria). Most of these symptoms can be induced artificially by th e wearing of prisms by a normal person.9

-

10

Judgment of direction also suffers in heterophoria.10 The faculty of steropsis and the 

judgment of distances tend to be impaired. 

It is generally held that an exophore unde restimates distances and an esophore overestimates. 27 This could explain some of the 

rear-end accidents tha t are so common on 

the road.

Corre ctive lenses an d/or orthoptic training (vision train ing) to encourage habits of 

binocularity can compensate for, improve or 

correct a heterophoria. Thus, if the motor 

vehicle inspector finds a heterophoria, the 

app lica nt for a license should b e refe rred in 

an effort to have this condition corrected. If 

the inspector or eye prac titio ner does not 

check or examine for this function, the driver of a car operates und er a false sense of 

security.

What does a high, uncorre cted heterophoria mean to the operator of a motor vehicle? The abov e mentioned subjective 

symptoms lead to fatigue and confusion. 

Fati gue brings on a daze d condition where 

diminished attention and speed of reaction 

(bo th sensory and motor) make the driv er 

prone to accidents.

In a screening of 3,000 drivers, 16.9% 

failed minimum requirements for lateral 

phorias and 13% failed for vertical phorias.26

Effect of Fusion

Binocular fusion may be defined as the 

process by which the visual portion of the 

cerebral sensory area combines the sensory 

impulses initiated by the two somewhat disparate retinal images of an object of regard 

into a single perception, so that only one 

tri-dimensional object is seen.9

Obviously, fusion is a binocular function. 

One must have two impulses or messages 

going into the occipital cortex of the brai n 

for a process of assimilation, integration and 

othe r reflex functions, with a resultant single 

picture to be perceived and interpreted. 

Fusion is absent whe n a driver possesses 

only one eye. It is also absent when a person 

suppresses or suspends vision in one eye.

The act of suspension of vision in one eye 

is quite common. It does not always occur, 

but may be found under conditions of stress. 

This is a protective mechanism of binocular 

situation und er stress. The suspension may 

be in the area of the m acula only, or it may 

be total. Suppression of vision in one eye 

can be found in tropias. Again, this is a pro ­

tective mechanism o f the b rain to stop diplopia.

Even when two eyes are app arently 

straight but, for some reason which may be 

muscular or neurological, the eyes cannot 

coordinate or the bra in cannot fuse the two 

images because of a gross dissimilarity, the 

impulse from one eye to the brain is cu t off. 

If this situation is perm itted to continue, 

nerve fibers from the macular area may atrophy, with a resulta nt amblyopia. Confusion 

and inefficiency in the visual process are due 

at times to a situation in which the basically 

dominant' eye is more optically deficient than 

the other, thus making the second eye arti97 767 0 — 6: •8
110 NATIONAL ACCIDENT PREVENTIO N CENT ER

ficially dominant. 9 This is often corre ctibl e 

with glasses.

Clinically, fusion is classified in thre e 

grades: Grade I. Simultan eous Perc eption 

(sup erim pos itio n); Grade II. Tr ue Fusion 

Wi th Some Stereopsis; Grade III . Tru e Fu ­

sion Wi th Stereopsis.10

It is prob able that very close to 100% of 

all drivers could achieve Grade II I fusion, 

with th e proper care of an eye prac titione r 

if even some fusion is present. Th e visual 

proces s develops in the infan t in the above 

successive levels. If the eye doctor finds an 

imp airm ent of fusion, he traces i t bac k to its 

deve lopm enta l level and insti tutes train ing 

from tha t point.

Now, what does the fusion faculty have 

to do with the safe operation of a motor 

vehicle on our highways? It can be safely 

said th at good fusion is the cum ulative result of an efficient visual process. If fusion 

is imp aired somewhere along th e visual 

path way , from the eyelids to th e occipital 

are a of the brain, something is wrong.

In the majority of people, fault y fusion can 

be improved. First and foremost, however, 

it mus t be found. Fusion ability can be discovere d only by the professional prac titione r 

who is examining for it. An imp aired fusion 

facu lty may be compared to a head ache , 

because its presence may indicate a malfunction.

Effect of Color Vision

Most author ities state tha t the abil ity of 

the eyes to interpre t color is d epe ndent upo n 

the possession of certa in color rece ptors in 

the retin a. In the absence of these color receptor s, the individual is color blin d.

Genetic ally, color sense has develop ed 

from black and whit e ( and the various 

shad es of gray in between ) to blu e and yellow perc eption and then to red and green 

perc eption. Ligh t as we see and use it is 

ma de up of the various visible wav e length s 

of the spectru m. The various wav e length s 

can be sepa rated and measu red. Th e eye is 

most sensitive to the D line of sodium , a 

shade of yellow.

Lack of color perce ption mus t be considered from two aspects: 1 ) color blindn ess,

where the retinal receptors are absent; and 

2 ) color ignoranc e, w her e the individual has 

not learn ed to int erp ret or discriminate color.

About 4% of the male and 0.4% of the 

female population are congenitally color 

blind. Color blind ness may be acquired 

through disease or injury to the retina. Partial color blindness can be caused by the 

excessive use of tobac co or alcohol.11

Many color blin d peop le leam the normal 

colors of objects thro ugh experience and un ­

der circumstances wit h which they are familiar. A color blin d or color deficient driver 

must know th at he is color b lind or deficient. 

The color deficient may be trained to distinguis h color. The color blind cannot be so 

trained. Color blin d patie nts who drive, 

know they are color blin d and compensate 

accordingly. We might add tha t a few take 

their clues from oth er drivers, especially 

when unce rtain abo ut the color of traffic 

signals.

. We believe moto r vehicle inspectors 

should contin ue to check for color vision 

simply to inform the driv er if color blin dness exists bu t not depri ve a license for this 

visual anomaly.

Stereopsis and De pth Perception

As note d above, stereopsis, the ability to 

see tridimensionally, is the highes t develop ­

ment of the bino cula r organism. Monocula r 

vision or substan dard vision in one or both 

eyes is actually a “d epth conception”, wh ereas, good binoc ular vision is truly “depth p er ­

ceptio n with stereoscopic vision”.12

A monoc ular indiv idual, or one seeing with 

subs tand ard vision, dep end s greatly on experience to dete rmine distan ce and size. 

These experiences are: 1) Psychological (a . 

aerial perspective; b. distribution of light 

and shade; c. the overl apping of contours; 

d. geometric perspective; e. interp retation of 

size .) 2 ) Physical—parallax.

These experience s const itute a learned 

process of spatial localization. A monocular 

person actually sees his space world flat. His 

learning, almost from birt h, to localize objects in space perm its him to find these ob ­

jects and to orie ntate to his space world.
NATIONAL ACCIDENT PREVENT ION CENTER 111

Parallax is an optical phe nom enon which 

makes a near body seem to move in a direc ­

tion oppo site to the motion of the eye, while 

a more remote objec t appe ars to move in t he 

same direction; the relati ve deg ree of motion bein g conditioned by the spa ce interv al 

betw een the two objects. Ther efor e, when 

one moves one’s head or eye slightly to the 

side, he is able to localize an obj ect in space 

by the app arent movem ent of oth er objects 

bot h closer to ( against mo tio n) and furt her 

away (w ith motion ) than the obj ect of regard. When we adjust the muscle s within 

and outs ide our eyes, we have a clue to 

dep th thro ugh kinesthetic (m us cl e) sense.

Now, let us consider stere oscop ic vision. 

This is achiev ed by the stim ulation of disparat e areas of the retina . In additi on to 

this, we must also consid er the sepa ratio n 

of th e two eyes whic h makes us see two 

images, one with each eye, bu t at a slightly 

diffe rent angle. Wert h, Stralto n, Jaensch, 

Lang lands, et. al. have foun d th at stereoscopic vision is a very fine an d accu rate 

func tion of the eyes.12

As not ed before, lack of stereo psis does 

not preclu de the absence of de pth per cep ­

tion as we know it. Many driver s, who are 

mono cular individu als und er condition s of 

stress and fatigue , are acci dent free. It would 

give gre at assistance to the dri ver to be 

warne d of an impaired judgm ent of distance. In discussions with patien ts fou nd to 

have faulty stereoscopic vision, we find they 

argu e when they are told to b e c areful w hile 

drivi ng and allow sufficient room for safety 

betw een thei r car and the car in fro nt of 

them. They say they have no difficulty. 

Again, it is experience and know ing limitations. No mat ter how vociferous the arg ument, thes e patients will generally allow 

more room betw een cars in the future .

Referra l But Not Refusal

In a stud y on dep th perc eption testing by 

motor vehic le inspectors, Ryan fou nd tha t 

stereopsis was b eing measu red. No m inimu m 

requ irem ents were in use, so the re we re no 

license refusals bu t rather referrals to optometrists or ophthalmologists for fur the r 

cons ultation.13

If depth perc eption is to be a salient factor in passing or rejecting an applicant for 

licensure, then de pth perc eption tests, such 

as the How ard-D olman test, must be employe d rat her tha n stereoscopic targe ts in 

screening instru ments.

De pth perc eption tests of some sort must 

be used by moto r vehicle inspectors. Th e 

record s show man y rear -end accidents. If 

the d river is war ned abou t fair or poor dep th 

perce ption, he coul d comp ensate by control 

of his speed and the inter val betw een cars. 

If dep th perceptio n is poorly learn ed or de ­

velope d, we believe the app licant should be 

rejec ted and re ferred to an optom etrist or an 

ophth almol ogist for vision training. Once it 

is learn ed, he may, upo n re-application , be 

awa rded a driv er’s license. In a screenin g 

program for depth perceptio n, 22.3% failed 

the How ard-D olma n test. 28

Effect of Visual Fields

The visual field is th at portion of space in 

which objects are visible at the same momen t during stead y fixation of the gaze in 

one direction. Th e eye moves constantly, 

and with every eye movement, the re is a 

change in the visual field. The effects of visual impressions last longer tha n an insta nt 

with a resu ltant larg er field in normal use 

of the eyes.

We are mainly inte rested in the lateral or 

temporal field of a d rive r.14 In a normal eye, 

one should be able to disce rn movement at 

90° or more to the side. No large scale 

studie s have be en conducted on the problem 

of wh at the minim um angu lar visual field 

should be for drivers .

Hockenbeamer 15 state s tha t the normal, 

statio nary “side vision” of 180° or more, is 

reduce d as follows whe n moving: 20 miles 

per hour, 104°; 3 0 mph , 96°; 40 mph, 7 0°; 60 

mph, 42° . This is du e to the blurring of stationar y objects close to the side of the car 

which are not allowe d enou gh time to create an impres sionable, clear stimulus on the 

per iphe ral retina .

Danie lson17 states th at the Harrington - 

Flock Method of screening for centra l visual 

field defects is more imp orta nt than per ipher al field defe ct dete ction because centr al
112 NATIONAL ACCIDENT PREVENTION CENTER

Fig. 2. Comparison of Figures 

For Stopping Distance (Kite)

vision may be absent and the d river may be 

una ware of this condition.

The visual field is limited normally by the 

anatomical structures that surround the eye. 

Thus, the deep-set eye will have a redu ced 

field. And several pathological conditions reduce the field. It is important for the individual to know that he has a reduce d field 

and there must be consultation t o screen out 

active pathology that would reduce the field 

below requirements. We would favor a 70° 

lateral field in one eye and 140° total lateral 

field as a standard. The num ber of persons 

who would be referred to an eye practitioner by this standard would be very small.

Th e conclusion of Kites and King18 is that 

while not enough research has be en done on 

visual fields in relation to the driv er, there 

is a relationship between speed and size of 

the visual field which the driver requ ires for

safe driving. If a driv er uses a “scanning” 

technique in driving, he can overcome a 

field defect, but this is rarely done by drivers.

A driver depends on a moving stimulus to 

attr act his fixation with foveal vision so that 

the significance of deta il may be assessed. 

If the area which receives this moving stimulus is blind, the driver misses it and is p otentially in danger. In a peripheral field 

check where 70° and 140° were the minimums, 10% failed to qualify.26

Eye Fatigue Causes Haz ard

Visual fatigue is closely related to psycho 

logic fatigue. When drivers are presented 

with a situation in wh ich the eyes do not see 

well, as easily and comfortably as they 

should, they react to this situation by trying 

to improve seeing by making better adjust-
NATIONAL ACCIDENT PREVENTION CENTER 113

ments. The best adjus tmen t is not always 

easy to find. There may be a conflict of reflexes with a consequent rapid shifting to 

overcome the difficulties.

If it is true that “eyestrain” is due to extra 

demands on the neuro-muscular adjustment 

mechanism, then it should follow tha t “eyestrain” increases when conditions for the use 

of the eyes are made worse. The eyes should, 

by more efficient adjustments, compensate 

to a measureable degree for these conditions. The result should be nearly equal 

work done but greatly increase d fatigue. 

This was proven by Luckiesh and Moss.19

Under conditions of fatigue, reactions become more superficial. In a fatigued state 

experimenters have noticed momentary 

lapses scattered through the performance of 

uniform tasks.20 Driving of a motor vehicle 

is considered a uniform task in which boredom and fatigue reduce overall efficiency.

Physical fatig ue and ocular fatigue naturally would occur at the same time. At 

night und er normal conditions with the approaching glare of oncoming headlights, 

there is a constant fluctuation in the size of

the pupil to decrease or increase the amount 

of light entering the eye. The searching 

movement to compensate for varying light 

intensities and the adjustments of the pupil, 

increase fatigue.21 If, in addition to this, an 

eye is already making compensations for a 

refractive error, muscular imbalance, or poor 

coordination, a definitely hazardous situation for the driver is the result.27

Research on Night Visibility

More research is being done presently, 

and has been don e in the recent past, on 

nigh t visibility than all other phases of motorists’ vision pu t together. Outstanding is 

the work of Oscar Richards of the Biological 

Laboratories of American Optical Company 

and of Merrill Allen and Henry Hofstetter 

of the Indi ana University Division of Op ­

tometry und er a gra nt from the American 

Optometric Foundation. Allen and his colleagues are atte mpting to determine what 

visual functions are involved in night visibility while driving and to then devise an 

instrument to measure these functions.

More motor vehicle deaths and accidents

Fig. 3. Effect of Speed on 

Visual Field (Hockenbeamer, 

1952)
114 NATIONAL ACCIDENT PREV ENTION CENTER

occur at night. At dusk seeing becom es difficult. The sky is still qui te br ight while objects on the road seem to merge with their 

shadow s and fade in the da rknes s. The o verhead brightn ess veils the field of view with 

glar e tha t prevent s the retina from adap ting 

eno ugh to use efficiently the small amoun t 

of ligh t reflected from the ro adw ay. Parking, 

or low beam, lights aid in plac ing vehicles; 

high beams add to veiling gla re and should 

not be used.

Clues to stimulate the two eyes into fused 

bino cula r vision becom e fewer with deeper 

twil ight and more strain is placed on the 

mus cular coordinating mechanism of the 

eyes. The glare and smalle r numb er of visual clues hand icap judgmen t of dep th, position and speed of vehicles. At twilight, objects seem to be furt her away tha n their 

actu al distance.2 2 These cond itions prevail 

with normal, average and abnorm al eyes.

At night, there are many factors which 

may lead to frustration and confusion for 

the driver. They would be qu ite obvious 

during daylight driving bec aus e the field of 

view is not then limited by th e range of the 

headlights and stree t lights, which at times, 

give improper clues. Ext end ed driving at 

nig ht tends to make a driv er sta re fixedly 

and thus can lead to fatig ue and fascination . 

This can grossly impede a norm al response. 

Under these conditions, response to a haz ­

ardo us stimulus is slowed to a dangerous 

degr ee. The drive r must “snap out” of this 

leth argi c or hypno tic stat e to rea ct quickly 

eno ugh to avoid an acci dent .17

The rate of dark ada ptation of the retin a 

is dep end ent upon its level of dar k adaptation at the beginn ing of the ada pta tion as 

well as the illumination concerne d and the 

physiological state of the organism. Daytim e 

exposur es to intense sunlight slows the rate 

of dark adap tation . This is espec ially significan t in summer for vacationers retu rning 

after long hours of exposure to daylight 

glare from the ocean or swimm ing pools and 

th e sand.

Dark adap tatio n is rep orted to be slower 

at age ranges of 20 -29 and 50-5 9, than at 30- 

50 a nd over 60 .23 Careful considerat ion must 

be given to the issuance of limited licenses

to drive duri ng day ligh t hours only beca use 

of the myria d of problem s involved in nigh t 

driving even under optimum conditions. 

Summary

Very meag er bon a fide research has been 

done on the visual requiremen ts for an operat or of a mot or vehicle. This sensory func ­

tion is so inte rrel ated with other senses and 

neural reflexes th at it becomes a “complex 

complex” whic h is, often times, immeas ureable in its total ity.

We must rely upon our empiric al and 

prac tical know ledge, plus a clinical sense, to 

derive minimu m standards for licensure. To 

this, there shou ld be add ed the vast experience of motor vehicl e inspectors who screen 

many thous ands of eyes and are able to de ­

velop an insight into the function of vision 

as it relates to drivin g.

It has been shown tha t it is necessary for 

many functio ns of vision, other than visual 

acuity, to be measured and evalu ated by 

the professional eye pract ition er to insure 

tha t a motori st is visually efficient for driv ­

ing. The end resu lt of visual inefficiency is 

fatig ue and confusio n which lead to lowere d 

perform ance.

It has been dem onstrated in scientific surveys t ha t over 90% of all persons can be correct ed to 20 /2 0 visual acuity. This is the 

stan dard recom mended by all researchers 

and experts in the field. The experience in 

Pennsylvania* , in perio dic vision rechecks 

and physicals, is heart ening .

It is furthe r noted tha t with an increa sed 

minimum requ irem ent in visual acuity and 

othe r visual functions, only a small fraction 

of licensed drive rs will be rejecte d. Many 

who might be reje cted und er higher stan dards have alre ady voluntarily stopped driv ­

ing or limit the ir drivi ng to daytim e only. 

Upg radin g of vision standard s for motorists 

has as its basic purpos e enhancement of the

•Da ta published by the Bureau of Highway Safety, 

Commonwealth of Pennsylvania, in its motor vehicle driver re-testing program reveal that of 875,- 

396 re-examinations, there were 9,491 persons rejected for all causes. Of the 9,491 persons rejected, 284 were rejected because of 20/7 0 vision or 

less in the better eye. This represents 3% of the 

failures and .03% of the total number examined.
NATIONAL ACCIDENT PREVENTION CEN TER 115

performance of the driver and does not seek 

to “lift” licenses.

A Gallu p Poll report, pub lish ed Decembe r 20, 1961, demonstrated that the public 

is read y to acce pt additional regulations 

which, authorities believe, could d o much to 

reduce the tremendous number of casualties 

on our nation’s highways. ■ ■ ■

77 Broadway

Paterson, New Jersey

RE FERE NC ES

1. FL ET CHER , ED WIN D. “M otorist Vision 

Pap er”, O.E.P. Vol. 6 & 7, 1953.

2. MASON, PAU L. “Driver’s Te sts ”. Lecture 

to Society of Autom otive Engin eer s 1937.

3. Survey of State Vision Req uire ments and

Policies for Vehicle Driver Licensing. AO A,

1960.

4. AT KINSON , T. G. Oculo-R efractive Cyclop edia and Dictionary 2nd Ed. Professional Press Chicago, 1934.

5. HOFS TE TT ER , H. W. and Z ER BE , L. B. 

“Prevalence of 20 /2 0 with be st previous 

and no lens correction” . J AO A, J uly , 1958.

6. HOFS TE TT ER , H. W. and BRY AN, W. 

E. “A statistical summ ary and evaluation 

of the vision of autom obile drivers”. J AO A,

March, 1958.

7. RICH AR DS, OSC AR. “N ight-driving, seeing problems”. Am. J. Opt. Monograph 

#241. 1957.

8. SHA PIR O, H. J. and MAS TA CH E, L. J. 

“Safegua rding patients on the highw ay” 

Opt. J. 6- Rev. Optom., Feb., 1950.

9. TA IT, E. F. Textbook of Refration . W. B. 

Sau nders Co., Philad elphia, 1951.

10. DU KE EL DER , W. S. Textbook of Ophthalmology: Vol. IV C. V. Mosby, St. 

Lou is, Mo., 1949.

11. BE RE NS, C. The Eye and Its Dise ases .

2nd Ed . W. B. Saunders Co., Philadelphia, 1949.

12. DU KE EL DER , W. S. Textb ook of Oph ­

thalmology: Vol. 1 C. V. Mosby, St. Louis, 

Mo., 1946.

13. RYAN , V. “A survey on depth perception 

testing of motorists” . JAO A, June , 1957.

14. TRAQUAIR, H. M. Clinical Perimetry. C. 

V. Mosby, St. Louis, Mo., 1946.

15. HO CK EN BE AM ER . “Side vision versu s 

speed”, 1957.

16. KI TE , C. R. “R oad Research La b Report,

1961.

17. DA NI EL SO N, R. W. “Th e relationsh ip of

field of vision to safety in drivin g”. Am. J.

Ophth., Nov., 1957 .

18. KI TE , C. R., and KING , J. N. "A survey 

on the factors limiting the visual field of 

motor vehicle drivers to minimum visual 

field and visib ility stan dards” . Brit J. Phys.

Optics, April, 1961.

19. LU CK IE SH , M. and MOSS. “Th e Science 

of Seeing”, 1957 .

20. WO ODWO RTH, R. S. Experimental Psychology. H. Holt Co., 1946.

21. HO PKINSON, R. G. “Glare discomfort 

and pupil diam eter”. J. Opt. Soc. Am.,

Aug ., 1956.

22. SA CH EN W EG ER , R. “Stereoscopic acu ity in twilight” Optician, 131: 475- 481. 

1956.

23. McFar la nd, r. a. and fi sh er , m. b., 

“Alterations in dark adap tatio n as a fun ction of age” . J. Gerontology, Oct., 1956.

24. HA BER, H. Tra ffic Engineering, Univ. of 

Cal. Press, 1955.

25. KE LL Y, F. C. Report of Dep t. of Health, 

Sta te of Penna., 1961.

26. BRYAN, W. E. “Current Safe ty Topics” . 

National Saf ety Council Vol. 7, 1957.

27. “Vision in Aviation Medicine”, WADC 

Technical Rep ort 58-399.

28. Philadelphia Inquirer June 10, 1962, Pa ge

• • •

Anti-Laser Protective Safety Eyewear

Anti-laser safety eyew ear is designed to 

protect the eyesight of researchers experimenting with lasers. The product is a combination of abso rbing plastic and a dichroic 

mirror. It is said to have 97-db atten uatio n 

at a wavelength of 6943 A, and yet transmit 

enough visible light to allow the wearer 

more vision than a normal pair of sunglasses.

The laser filter plates give a wide unobstructed visual field, and the holder fits 

easily over regular glasses. Plates can be removed and replaced quickly through a side 

slot. Air circulation is provided by six-plastic-lated vents on the top, bottom , and sides 

of the holder. An air space between the two 

plates combined with the low therm al conductivity of the plas tic prevents fogging.

A clear cover plate protects the laminated 

laser filter. Bausch & Lomb Inc., Rochester 

2, N.Y. is the man ufac turer. ■ ■ ■
116 NATIONAL ACCIDENT PREVENTION CENTER

Certain visual aspects of the average modern 

American automobile*

MER RILL J. ALLEN, O.D. PH .D .* ‘

STUDY OF CARS of four major American manufacturers was underta ken to 

learn the position of drivers’ eyes in the vehicles and the location and size of visual obstructions present. The method is based on 

an analysis of photographs taken un der typ ical highway conditions.

Dete rmining Driver Position

A Polaroid Land Camera was mou nted 

beside the highway and was used to photograph traffic entering a 40 mile pe r hou r 

zone on Highway 37 on the outsk irts of 

Bloomington, Indiana.

Profile photographs like Figure 1 w ere taken of 20 automobiles of four makes of the 

1960, 1961, and 1962 models. On another 

occasion, regular highway traffic was sampled by photographing unsuspec ting drivers 

in their automobiles from the research vehicle 

which overtook them from behind. Figure 

2 is an example of the photo graphs obtained. 

Twenty-one automobiles repr esenting the 

same four makes from 1960-62 were pho tographe d in this way.

The photographs were analyzed with the 

aid of basic measurements obtain ed from 

local automobile dealers. Figure 3 shows a 

schem atic automobile and the average values 

obtained from the 41 photographs.

From these data one may conclude that

• Report of a study conducted under the American 

Optometric Foundation Motorists Night Vision 

Research Grant to Indiana University.

••Professor of Optometry, Indiana University

the average driver sits in the average automobile with his eyes 9% inches above the 

horizontal plane passing through the top of 

the dash panel. His position places the po int 

tha t is midway betw een his eyes ten inches 

away from the left window and at a distance 

of 36”.behind the vertical frontal plane pas ­

sing through the most anterior point of the 

windshield.

Interference by Corner Posts

With th e average values of the driver position at han d a study was undertaken to determine the amount a nd kind of interference 

offered by com er posts and mirrors in the 

average automobile.

A camera support was built so tha t the 

camera could be correctly located in the

Fig. 1. Profile photographs were taken of 20 automobiles of four makes of the 1960, 1961 and 1962 

models.
NATIONAL ACCIDENT PREVENTION CENTER 117

Fig. 2. Unsuspecting drivers in their automobiles 

were photographed from the research vehicle which 

overtook them.

average driv er’s eye position and multiple 

exposures were made as illustrated in figures 

4, 5, 6, and 7. Twenty-two automobiles (six 

from the Ford Motor Co.; eight, General 

Motors; four, Chrysler Motors; and four, 

American Motors) were studied in this way. 

Included were compacts, stan dard and de ­

luxe models. Table 1 summarizes the results 

obtained from measurements made on the 

photographs.

The results in Table I indicate a great 

similarity in the average angular size of corner posts and rear view mirrors amon g the 

four companies sampled. Of interest is the 

fact th at American Motors produ cts have the 

least obstruction (per cent of 180°) of all 

cars and show the smallest variability of 

measurements from model to model.

Another result, confirming the authors 

subjective impression, is tha t Chevrolet’s left 

corner post is least displaced (17.3°) from 

the straight ahea d position and constitutes 

a grea ter accident haz ard than, for example, 

the American Motor car produc t where the 

corner post is 24.2° to the left of straig ht 

ahead. It would be q uit e easy while turning 

left to run down a pedestrian or to be in 

collision with another car tha t was approaching on a collision course from the left and 

for the driv er not to see the hazard until too 

late due to the left corner post obstruction. 

The right corner post seems reasonable in 

size though not entirely free from hazard, 

particularly at high speeds with rapid approach of vehicles on collision courses.

In England1

 the Society for Motoring 

Manufacturers and Tra ders established that 

the comer post should not be nearer than 

25° from the straight ahead position, and at 

25° the maximum permissible obscuration is 

4° (approximately) and this is increased by 

1° for each 5° increase in the angular distance from straight ahead. No American 

automobile meets the S.M.M.T. values for 

the left front comer post.

At this point it is important to state that 

the values in Table 1 are based on a single 

eye, and measurements were taken at the 

average eye level intercep t with the obstruction being measured. For example, the left 

corner post in figure 5 was measured on the 

level abou t 4/1 0 of the distance from the 

top to the bottom of this photo graph. Since

Fig. 3. Schematic automobile developed from the photographs taken of automobile profiles and driver po­ sition with the aid of basic measurements from local automobile dealers.
118 NATIONAL ACCIDENT PREV ENTION CENTER

FIO. 5 CHEVROLET '6 2

FIG 6 RAMBLER *«2

FIG. 7 PLYMOUTH ’02

Figs. 4, 5, 6, 7. A camera support was built so that the camera could be correctly located in the average

driver’s eye position and multiple exposures were made. Twenty-two automobiles were studied this way.

FORD GENERAL

MOTORS CHRYSLER AMERICAN ALL BRANDS

SIZE POSITION SIZE POSITION SIZE POSITION SIZE POSITION SIZE POSITION

Lef t Cor ne r Po et 10 .4°+ 3.7« 19 .1°± 6. 9° 7. 8°il.7<> 17.3° +7 .5® U .4 ° jA1.2 ° 20° +4 .8° 6. 9°+ 2.1 ° 24.2 C^ 2 .4 ° 9. 0c +2 .70 19 .5°± 6.4°

In si d e M irro r 16. 4° ±2. 5° 53 .2 °± 10 .2c 15.2°± 2.0® 4e .G °± 7. 7° 16 .1 °* 1. 9° 40J+ 2.2 0 14 .6 °+ 1. 9° 3 3 .9 °+ l. l° 16 .5 °± 1. 9° 45.5 °±9.8°

Right Cor ne r Po et 5 .6 °i2 .0 o 77 .1°* 4.6 ‘ 4.8 °± 1. 4° 77.3°±7.1<> 4.8 °± 0. 1° 79_l°+7.2° 4.2 °* 0.6 ° 64.4 °± 2. 2° 4. 9° ±1. 3° 7S.2°±7.6 °

Area of

In eld e M irro r 25.1 In . 2 i 6. 7 22 .9 I n . 8

 * 6. 1 25. 4 In 2

 + 7.4 21 .6 In 2

 i 1.7 23 .7 i n . 2

±

 6. 7

T ute l O bst ru cti on 

By C om er P ost s ' 

At Eye Lev el

«-9l ± l.«l 9 .6 1 + 0. 91 7 . 9 t ± 0 .4 J 8 .9 t i 1. 31

Table 1. Summary of data obtained from measurements on the photographs in Figs. 4, 5, 6 and 7.
NATIONAL ACCIDENT PREV ENTION CENTER 119

no significant vision was felt possible thro ugh 

the left ventilator glass at this level in this 

car, the tota l angu lar obstruction includes 

the main curved body post and the vertical 

window guide.

None of the rear view mirrors posed a 

problem at average eye level as noted in the 

photographs. However, one cannot help bu t 

observe that tall drivers in many automobiles with mirrors attac hed above the w ind ­

shield are completely obstructed from a view 

to the righ t by the mirror (Figure 2). Similarly short drivers find their vision is blocked 

by a dash mou nted mirror.

Thicker Doors or Extende d Arm Rests

One imp ortant conclusion from this study 

is tha t the average driver tends to sit very 

near to the left door, undoubtedly to use the 

conventional arm rest or to pu t his arm on 

the window ledge, and pe rhaps to steer more 

easily with his righ t hand.

This position appears to offer a haz ard in 

three ways. First, it is ap pare nt tha t the c orner post obstructio n of the field of view is

sufficient to be dangerous and sitting to the 

left increases the danger from such obstruction. Second, the windshield distortions are 

increasingly serious as one moves his head 

laterally nearer the comer post. Finally, the 

driver is more subject to injury in sideswipe 

accidents if he is to the extreme left of the 

front seat.

A simple solution to this problem suggests 

itself. Manufacturers should provide a thicker door or an extended arm rest or both, 

so that th e driver will be able to be comfortable and occupy a more central position in 

the cab which affords g reater side vision and 

less windshield distortion. ■ ■ ■

Division of Optometry

Indiana University

Bloomington, Indiana

REF ERENCES

1. KITE, C. R. and KING, J. N. “A survey 

of the factors limiting the visual fields of 

motor vehicle drivers in relation to minimal visual field and visibility standards” 

Brit. J. Physio. Optics, New Series 18:2 

April, 1961, pg. 98.

VISION AND LIGHTING: a German study

Lumeritas, in Lig ht and Lighting, S eptember, 1962, gives details of a new Germ an 

study by a Dr. Bodmann of preferred illum ination levels for a critical visual task that is 

similar in nature to reading.

The visual task set for subjects consisted 

of searching for very small numerals scattered over a sheet of paper, each w ith a ho le 

beside it exposing a metal sheet under the 

pape r. As the subject found the number he 

was instructed to seek, he touched the metal 

through the hole with a meta l pencil, thu s 

completing an electrical circuit. The time 

taken to complete the search provided an 

objective measure of visual performance. 

This test was carr ied out at a succession of 

diffe rent illum ination levels up to 1,000 

Im./sq. ft., and at each level th e subject w as 

asked for his impression of the lighting pro ­

vided—whether it was “good”, too dark, or 

too bright.

Subjects were divided into two age-groups

—the under- and the over-50s. Performance 

standards for th e tw o groups rem ained much 

the same when visual task conditions gave 

good contrast (e.g., searching for black numerals scattered on w hite p ap er ); but where 

contrast was poor (black numerals on dark 

grey pa pe r), the younger subjects performed 

significantly better.

Individual subjects varied a good deal as 

to the level of illumination they found best; 

bu t the average tended to be around 150-209 

lm./sq. ft. This is roughly the same level as 

tha t chosen by office worker subjects who 

took p art in a British Lighting Council study 

not long ago.

Very high levels of illumination were unpopu lar not only, it was felt, because of discomfort from the light itself, bu t because of 

the heat radiated by the ligh t sources used 

to produce very high-level illumination.

■ ■ ■

—The Optician
120 NATIONAL ACCIDENT PREVENTION CENTER

DAYTIME AUTOMOBILE WINDSHIELD

and

DASH PANEL CHARACTERISTICS

M e r r ill J. A lle n , O .D . Ph. D.

D ir e c to r, A .O .F . M o to ris t V is io n R esearc h

D iv is io n o f O p to m e tr y

In d ia n a U n iv e rs it y

B lo o m in g to n , In d ia n a

As Published in The American Journal of Optometry and Archives of

The American Academy of Optometry, February, 1963.

T ha t som e au tomob ile m an uf ac tu re rs ha ve 50 years of ex pe rien ce 

is no t im med iately ob viou s wh en th e pre se nt day pr od uc tio n is ch ec ke d 

for vis io n en gi ne er in g. From th e re su lt s of th is and an earl ie r stu dy 

( i ) it al m ost ap pe ar s th at au to m ob ile m an uf ac tu re rs bel ie ve th at vi si on 

has no th in g to do with dr iving. Not a si ngle au tomob ile man uf ac tu re d in 

Am eri ca an d ne ithe r of the two Eu rope an pr od uc ts te st ed co ul d provide 

a su it able vis ual environm ent for da ytim e dr iving. T hes e ar e th at the 

dr iver be ab le 1) to se e through th e w in ds hi el d with ou t redu ct io n in 

co ntr ast no r se ri ous redu ctio n in br ig htn es s; 2) to re ad th e in stru m en t 

pa ne l with a minimum of tim e aw ay from the high way , an d 3) th at the 

au tomob ile be fre e of so urc es of gla re in th e fiel d of vie w.

The re su lt s of th is stud y in dic ate th at an ot he r look at ac ci den t 

s ta ti s ti c s is in order. F ai lu re to se e is no t only poss ib le bu t prob ab le! 

Th e blam e for th e th ou sa nd s of li v es lo st ea ch ye ar li es in pa rt at le ast 

with th e au tomob ile m an uf ac tu re rs , for no t a si ng le v is u al ha nd ic ap 

en gi ne er ed into modem au to m ob iles nee ds to be th er e. T her e are some 

good vis ual asp ects to ea ch m an uf ac tu re r’s pr od uc ts, bu t th e fa ult s in 

ea ch are so se ri ous as to ma ke it se em th at th e good poin ts must ha ve 

be en accid enta l. In de ed , th e go od fe atu re s on e yea r ar e of ten re pl ac ed 

in th e ne xt y ear’ s pr od uctio n by gl ar in gl y poor on es .

T his stud y wa s co nd uc te d durin g th e sum mer of 1962 on au to ­

mob ile s of all m an uf ac tu re rs for th e yea rs I9 60 , 61 and 62 .** Fifty -s ix 

au to m ob iles we re ph otog raph ed an d m ea su re d f or w in ds hi el d tran sm is si on, 

amoun t of di rt on the w in ds hi el d, in st ru m en t pa ne l lumin an ce le vel s and 

the v ert ic al siz e of sp ee dom et er an d od om eter n um er al s. A Pola ro id La nd 

Ca mera w as ad ap te d to ph otog raph th e in stru m en t pa ne l from a dis ta nce 

of 1 m et er, and a Sp ec tra B ri ghtn ess Spot Me ter an d a G en er al E le ct ri c 

fo ot -c an dl e meter were us ed for li ght m ea su re m en ts.

* Professor of Optometry

** Special recognition is due Dr. James Wilhite, Jr., of Bedford, Indiana, who

gathered the data for this report.
NATIONAL ACCIDENT PREV ENTION CENTER 121

Tab le I li s ts th e au to m ob ile s st udie d with th e po si tion of th e sun 

be ing in fe rred from th e tim e of day an d th e dir ec tion of the au to mob ile . 

Fo r re fe re nce , at 12 :30 th e sun wa s st ra ig ht so ut h and was 70° ab ov e 

th e ho rizo n.

Tab le II sh ow s th e re su lt s of m ea su re m en ts in te nd ed to esta bli sh 

an av er ag e sc en e re fl ecta nce va lu e. V ar io us ea rth su rf ace s we re 

m ea su re d usi ng th e G .E . m eter an d ne ut ra l de nsi ty wratte n fi lt ers . Th e 

mete r was he ld hori zo nta lly at w ai st he ig ht an d aimed at th e ho riz on 

ov er th e road or fi el d. A 10- inc h bl ac k sh ie ld was pla ce d ab ov e the 

m et er to cu t ou t th e sk y ligh t. Rea di ng s ob ta in ed we re m ul tip lie d by two 

as a rou gh co rrec tion for th e lo ss of 1/2 of th e m ete r’s normal re ce ptive 

fiel d ca use d by th e bl ac k sh ie ld he ld ov er th e m et er . To ob ta in th e 

am bien t (su n pl us sk y) luminan ce th e m et er w as aim ed at th e ze ni th 

an d th e op er at or care fu ll y av oi de d obst ru ct in g any of th e sk y light. 

The av er ag e fig ure of 11.7% re fl ec ta nce obt ai ned is , th er ef or e, part icu la rly si gnif ic an t for view in g ho ri zo nt al ly alon g a hig hw ay an d is th e 

in te gr at io n of hig h li g h ts an d sh ad ow s a s en co unte re d du rin g th e m eas ure ­

m en ts. Th e re fl ecta nce of 11.7% will be use d with th e m ea su re d am bien t 

ill um in an ce to ob ta in a va lu e for co mparin g with th e stra y ligh t from th e 

w in ds hi el d, whic h re su lt s from di rt on th e outs id e and in si de of th e 

w in ds hi el d and from li ght re fl ec te d from the w in ds hi el d su rf ace s, 

se e Fig ur e 1 on pa ge 10.

In Tab le III, th e ca r numb ere d in th e fi rs t colum n, is co m pl et ely 

des cr ib ed in Tab le I. The sky ill um in an ce in column 2 is th e am ount

Fig ure 2, Car No . 5. S is th e standard re flecto r. Th e ft . L . lufriinan ce le v els

at th e numb ers shown are: 1) 12; 2) 17; 3) 11; 4) 22; 5) 22;

6) 40; 7) 95 0; 8)7 500; 9) 27 00 . Note refl ecti o n s in win dshie ld .

Th e "ven eti a n b li n d " at th e righ t is a g ril l on th e top of th e

dash re flecte d in th e w in dshie ld .N ote gla re from turn sign al le ver .
122 NATIONAL ACCIDENT PREVENTION CENTER

of light in foot-candles on a horizon tal surface. The average scene 

value in column 3 is obta ined by multiplying the sky luminance value 

by 11.7% obtaine d from Table II. The illumination on the dash, column 

4, was obtained with the Spectra Brig htne ss Spot Meter by measuring 

the ligh t ref lec ted from a small white reference plaque attach ed in the 

cen ter of the speedometer on each instrument panel, and a suitab le 

correction was made for the coe fficie nt of reflection of the plaque. 

Columns 5, 6 and 7 show the Maximum, Minimum and Average Luminan ces of the Instruments and the ir immediate surround ings. These 

value s are direct mea sures with the Spectra Brightnes s Spot Meter. 

Column 8, the Maximum Glare in the Fie ld of View, was obta ined with 

the Spectra Brig htne ss Spot Meter aimed toward the glare source as the 

driver would see it. Column 9 giv es the Eye to Panel Distance in centimeters with the seat position as found when the car was being measured. 

Columns 10 and. 11 give the angular siz e of the ver tical dimension of 

the speedometer and odometer numbers.

Column 12 gives the transm ission of the clean windshield as 

measured by the Spectra Brightne ss Spot Meter. A white diffusing 

refe rence plaque was placed ver tically on the car hood. The windshield was clea ned both on the inside and the ou tside, and black 

velveteen cloth was placed ove r the dash pane l to elim inate windshield 

back surface ref lec tions. The light reading through the cleane d windshield was then divided by the ligh t reading taken outside the windshield, of the same plaque in the same pos ition, to obtain the per cent 

of trans mission.

Column 13 gives the va lues of ligh t reflected toward the driver 

by the windshield from the top of the dash panel. This is a derived 

value and is the diffe rence in windshield “ tra nsmi ssi on ” with and 

without black velv eteen over the top of the dash . Column 15 gives 

the val ues of light sca tte red from dirt on the outsid e of the windshield. 

These were obtained as the difference between the win dshield “ transmission” before and afte r cleaning on the out sid e. Column 17 gives 

the value s of light scatt ered by dirt on the inside of the windshield. 

These value s are the diffe rence between the windshield “ transm ission ” 

before and after cleaning on the inside. Columns 14, 16 and 18 are per 

cent value s derived by comparing columns 13, 15 and 17 with the 

average sce ne luminances in column 3.

At the bottom of Tab le III is the average of the data of all auto ­

mob iles tes ted . The average das h luminance of 72 ft. L. compared to 

the ave rage scene luminance of 683 ft. L. viewed through the average 

windshield transmitting 86.4%. The luminance differen ce is about 8 to 1 

which is comparable to the special aircraft dash luminance problem 

(5 to 1) studied by t he au th or ^! usin g a reaction time measure of ability 

to recogn ize a test lette r on the dash panel. Such brightne ss differen ces 

prohibit “ ins tan taneou s glan ce’’ perception and may require fixation for 

a second or more to see well enough to identify the task. Subsequent 

return of the attention to the road must result in temporary dazzling 

due to the heightened sens iti vity of the eye needed to see the dash 

pane l. The ser iou sne ss of the problem is substan tiated by the fac t 

that on the average dash the average speedometer dial luminance is
NATIONAL ACCIDENT PREV ENTION CENTER 123

46 ft. L. (not shown in the tab les), which giv es an outside sce ne to 

dial luminance rati o of about 12 to 1. Several autom obiles had ratio s 

above 30 to 1. According to Duke Eld er! 4

) ” . . . the vis ual acuity 

improves slowly as the surrounding illum ination is raised to ju st below 

the level of tha t of the test object: when it is rai sed beyond this poin t, 

there is a rapid fall in performance (Ly thgoe).” The cri tical instrument 

panel detai ls are the darkest are as on the dash in almost every ca se 

stud ied. The following is from the IES Handbook(5 h ‘‘Current good 

lighting pra ctice ha s estab lished that best re su lts are obtained when 

brightness variatio n of adj ace nt are as, particu larl y within the working 

field , does not exc eed 3 to 1, the work ‘‘(speed ometer)” being brighter.” 

(Not shown by this study, but very easily observed in certain automobiles, is the camouflaged nature of the speedometer pointer which is 

more difficult to see in the daytime than are the numbers on the dial). 

It is clear that brightne ss ratios are not ideal, in addition they are 

reverse d from what is recommended. The average glare in the fiel d 

of view of 20,047 ft. L. is explaine d by chromium horn ring s and trim 

and by chrome pla ted windshield wiper arms, etc . So long as the se are 

permitted near the dri ver’s line of sight, certain sun pos itio ns are going 

to produce annoying and even inc apa cita ting gla re reflections.

The average dista nc e of 72 cm. of the driv er’s eyes to the dash 

panel calcu lat es to be 1.4 diop ters which is the stimulus to accommodation provided by the numbers on the various dia ls. For presbyopes 

with bifoca ls, the dials are likely to be blurred with eith er portion of 

the gl as se s. For a presbyope with trifoc als , this distan ce is within the range at which he should see cle arly. For the younger emmetrope, accommodation time, in addition to adaptation time, is a factor 

in clea ring the speedometer numerals. According to Borish ( 3 ) a 1.5D. 

blurred image will reduce Snellen visual acuity to 20/80(w hen a targ et of 

100% con trast is used, the surround luminance is nearly ideal and 

the pat ient is perm itted time to adapt). The ave rage speedometer number 

size is equivalent to about 20/300 ,but at the low lev els of dash panel 

illuminatio n in the daytime, the probability of being out of focus, and with 

the adverse effect s of the ever presen t chromium glare sou rces, even 

the se large speedometer numbers are too small for quick viewing. The 

odometer which has 20/80 siz ed numbers surely will require a much 

longer time to read than does the speedometer in most of the car s tested .

The average windshield transmission of 86.4% seems adequate 

in view of a 70% minimum industry standard. On the other hand, if we 

add to the unnec ess ary 15.5% average reflec tan ce from the back of the 

windshield toward the eye s, the 3.5% and 1.3% average values of ligh t 

scattere d by the dirt on the windshield, we obtain 20.3% us el es s ligh t 

sca ttered toward the driver ’s eye s. The average sce ne luminance of 

683 ft. L. becomes 590 ft. L. when viewed through the 86.4% tra ns ­

mission windshield. The us eles s ligh t (20.3% of 683) is 138 ft. L. This 

means that objec ts of 100% con trast can never be seen by the driver of 

the average automobile at more than about 81% contrast during the day

590 4- 138 0.81.
124 NATIONAL ACCIDENT PREVENTION CENTER

Special conditions such as dark objec ts on asp halt pavement or automobiles with excessi ve win dshield ref lec tan ces, e.g ., cars No. 5, 35, 

43, 45 and 55 (and no doubt others at certain sun position s) will produce very low c ontrasts.

While dirt on the win dsh ield is , on the average, unimportant, 

certain notable exc eptions were found (se e cars 35, 39 and 56). It is 

known that tobacco smoke is hygroscopic , and smoke res idu es on the 

insid e of the windshield will probably cause gre ate r light sca tter ing, at 

high atmospheric hum idities, than noted here.

The figures 2 through 6 show various manufacturers* concepts 

of a modern space age automobile’s control panel! It is apparent that 

standa rdization of basic con trols, instruments and loc ations would be 

helpful and would remove th is most critical visual area from the hands 

of the car styl ist and permit life saving basic improvements. The 

numbers in each photo indicate are as corresponding to the luminances 

given in the figure legend s. Fourteen to 20 measurements were made on 

each automobile dash pan el and the site s chosen were marked on a 

transp are nt overlay of a photograph of the dash panel. The camera 

dis tan ce was about 1 meter from the speedometer in each case. The 

objec t marked S is a stan dard reflector used with the Spectra Brightness 

Spot Meter to determine the illum inance falling on the instrument panel.

The photographs and brightness read ings paint a cle ar picture. 

Fig ures 2 and 3 show car s number 5 and 34. While car No. 5 has nearly 

the low est (12 ft. L.) instrument panel brig htness of all tes ted , car 

No. 34 ha s nearly the highest . The author has driven a veh icle similar

Fig ure 3, Ca r No. 34. S is th e stan da rd re flecto r. Th e ft . L . luminan ce

le vels are: 1) 125; 2) 135 ; 3) 23 0; 4) 1700. N ote th e need to

searc h “ in the dark *' be low area 4) for control le vers and knobs.
NATIONAL ACCIDENT PREV ENTION CENTER 125

to No . 5 on a trip an d th e fr us tr at in gl y long tim e re quir ed to ad ap t to th e 

dark sp ee do m et er ar ea w as sti ll fu rth er ex te nd ed by th e nee d to se ar ch 

for th e m eter ne ed le whic h w as ev en le s s vis ib le . Car No. 34 is muc h 

b ett er in th is re sp ect, sin ce th e sp ee do m et er di al is at 125 ft. L ., ho wev er di e ex te nsi ve da sh are a im med iately be low is 170 0 ft. L ., a lu m inan ce ra tio of ov er 13 to 1 ! Si nc e ta sk an d su rrou nd lu m in an ce ra ti os 

3 to 1 or le ss ar e consi der ed des ir able an d si nce 10 to 1 is co ns id er ed 

as th e up pe r lim it, i t is ap pare nt th at se ri ous se ei ng pr ob lem s are pre se nt 

in th e se two ca rs .

Fig ure 4, Car No. 15. S is th e standa rd re flecto r. The ft . L . luminan ce

le vels are: 1) 100; 2) 90 ; 3) 410; 4) 16 00 . At 3 th e gla ss re -

flection has blo ck ed ou t the sp eedo meter nu mbe rs. The num bers

are of a p a rt ic ula rl y lo w co ntra st on th is mod el.

F ig ure s 4, 5 and 6 show som e of th e var ia ti ons in pan el de si gn 

ch a ra cte ri sti c of th e in dust ry . Note th e ex tre me ra ng e of gl ar e in te ns it ie s in fig ur e 5 and th e bri gh te r, more uniform ap pea ra nce of th e da sh 

in figu re 6. Ev en in th e figu re 6 th e surro un d (3) is br ig ht er tha n th e dia l 

th em se lv es !

(I nfo rm ation c o n ti n u e d on p a g e 8)

97767 O— 63------0
126 NA TION AL AC CIDE NT PRE VE NT IO N CE NT ER

Figure 5; Car No. 41. S is the standard reflector. The ft. L. luminance

levels are: 1) 35; 2) 120; 3) 52; 4) 1000; 5) 26,000; 6) 2,500;

7) 380,000. Note the veiling glare at 2 and the poor contrast of

labels on control knobs at lower left.

Figure 6, Car No. 40. S is the standard reflector. The ft. L. luminance

levels are: 1) 100; 2) 150; 3) 175; 4) 7,200; 5) 38.
NATIONAL ACCIDENT PREVENTION CENTER 127

The photographs in figures 7 and 8 offer dramatic evidence of

the windshield refle ctan ces shown in Table III in the columns lab eled

dash reflection . Figure 7 sho ws a man standing on a tree -cov ered street.

The photograph was taken with black velve tee n lying on the dash top.

Fig ure .8 show s the same scen e without the velve teen ligh t absorber.

As a pedestrian in broad daylight, he wouldn’t su sp ec t that he was

in vi sibl e to the driver.

Figure 7. With Black Cloth on Top of Dash.

Figure 8. Without Black Cloth on Top of Dash.
128 NATIONAL ACCIDENT PREVENTION CENTER

Recommendations:

To achieve optimum visual performance at dis tan ce the automobile 

driver must be provided a daytime highway scene with the controlla ble 

item s in the field of view adjuste d to hold brightness leve ls equal to or 

lower than the average sce ne brightness but not lower than 1/10. Since 

the average scene was measured in this study to be 11.7% of the outside 

natural illumination, all ob jects rece ivin g direct sunlight, e.g ., the hood, 

the steering wheel, wiper blad es, etc ., should ref lec t not more than 10%. 

Com er posts and automotive interiors not receiving direc t illumination 

should be of high reflecta nce val ues to keep away from exc ess ive ly 

dark objec ts anywhere in the field of view. The surfa ces reflecting in 

the windshield, however, must be as black and dull as pos sib le to

control veiling glare.

So that the driver may ach ieve optimum visual performance in 

reading the instruments of the dash pane l, the instrum ents should 

be equal to or brighter than the immediate surrounding panel by an 

amount of up to 3 to 1 but not brigh ter than 10 to 1. Furthermore, to 

make it possible to adapt quickly from far seeing to dash panel seeing, 

illum ination on the dash panel must be improved. A value to strive for 

is not le ss than 1/3 of the average outdoor sce ne brightne ss.

Summary and Conclusions:

A. This study on w inds hield and instrument pane l ch arac teris tic s has 

shown:

1. All of the fi ft y-s ix 1959-62 automob iles tes ted had 

ser iou s fau lts so far as the visibility of the highway and the instrument pane l in the daytime is concerned.

2. The amount of ligh t reflected from the top of the dash 

onto the windshield and into the eyes of the driver ave rages over 15% 

of the average scene luminance.

3. The amount of light sca ttering dirt on automobile windsh ields is small, and var iable as one would e xpe ct, averaging only 4.8%.

4. Glare sourc es of exceedingly high intens iti es were 

noted and all cars tested had chromium trim of various types in the 

field of the view of the driver.

5. Dash panel instrument illum ination was generally much 

too low in the daytime to permit the meters to be seen at a glan ce. This 

is in addition to the problem in 4 above which further interferes with 

quick seeing.

B. Every vision engineerin g defect noted in this study can be remedied 

by the automobile man ufacturers by pra ctical and economical changes. 

Specific recommendations are made in the text.
NATIONAL ACCIDENT PREV ENTION CENTER 129

— R E F E R E N C E S - -

1) Alle n, Merrill J. , Certain Visual Aspec ts of the Modern Automobile, 

Jou rna l of the American Optom etric Ass ociatio n, December 1962.

2) Alle n, Merrill J., A Study of Visu al Performance Using Opthalmic 

Fi lter s. ASD Tec hnical Report 61-576, pp. 21-26, October 1961, United 

States Air Force, Wrig ht-Patterson Air Force Base, Ohio.

3) Borish, Irvin M., Clini cal Refraction, Chicago, The Pro fessional 

Pre ss , 1949, Pg. 110.

4) Duke Elder, Sir W. Stew art, Textbook of Ophthalmology, Mosby Co., 

Vol. IV, 1950, Pg. 4492

5) I.E .S. Handbook, 3rd Editio n, Illuminating Enginee ring Society, I860 

Broadway, New York, New York, 1959. Sect. 12, Pg. 6; also see Sect. 2, 

Sect. 14, Pg. 3, Sect. 15, Pg. 3.

97767 O— 10
130 NA TION AL AC CI DEN T PR EVENTIO N C EN TER

TABLE I. Spec ific Automobiles Stu die d.

Car Make Tear Model Vindshi eld Co lor of Dash D ir.-C ar Time Sky

1 Ch ew 1962 II-hOO Nova Clear Royal Blue W 12:3 5 Clear

? Chevy I960 Biscay ne Sedan Clear Royal Blue S W 11:12 Clear

? Chevy 1961 Bel Ai r Clear Royal Blue S W 12:1 $ Clear

h Chevy 1962 h-Doo r Sedan Clear Med .-Drk.Grey S E 2:1$ Clear

5 Chevy 1962 Impala Hardtop Gr ad ient Maroon s w 3:?5 Clear

6 Ch.=>VY 1962 Impala Hardtoo Clear Med.-Drk. O.Gm N $:0C Lt. Haze

7 Chew 1961 h-Door Sedan Clear For es t Green N h :l $ Clear

8 Chew 1962 In-oala Hardtop Gradien t Med .-Lt,Bro nze N 1:3 0 Clear

? Ch ew 1962 Corva ir 700 Clear Drk.Beige N-NW h:0$ Cl ear

10 Chevy 1962 Cor va ir 700 Clear Drk.Beige W h:35 Cloudy

11 Chew I960 Cor va ir Clear Blac k s w 10: hO Clear

1? Chew 1961 Corva ir Monza 900 Cl ear Beige E h:25 Cl ear

13 Ford 1962 Sp or ts Coupe Clear Fi re Eng. Red s 9:2 0 Clear

Hl Ford 1962 Ga lax ie Sedan Cle ar Blu e-Green E 2: hO Cl ear

1$ Ford 1961 Galax ie Ha rdtop Clear Black s w 12:$0 Clear

16 Ford 1961 Falco n 2-Door C le ar Blac k N 2:1$ Clear

17 Ford 1962 Falcon 2-Door Clear Black H 3:2 0 Clear

18 Ford 1961 Fa lco n Sta . Wagon Clear Med. Blue N 9:$ 0 Cl ear

1? Ford I960 Sun line r Co nv ert. Clear Black S 11:30 Cl ear

20 Ford 1960 Co nv ert . Too Down Clear Fi re Eng. Red N 1:35 Clear

21 Ford 1960 Fai rl an e $00 Clear For es t Green N 5:15 Cloudy

22 Po nt. 1962 S ta r Ch ief Sedan Gr ad ient T-Brwnj 3 -Tan E 2:2$ Clear

23 Po nt. 1962 Grand Pr ix Hd tp. Gr ad ient T-Maroon;B-.Red E 12:20 Lt. Haze

21, Po nt. 1960 S ta r Ch ief Sedan Gr ad ient Pea Green E 2:55 Pt.Cldy.

25 Po nt. 1961 Bo nn ev ille Convert Gra di en t T-Ry],B1;B-B1. S W 10:00 Clear

?6 a ont. 1961 Temoest Sedan Gradien t Drk. Royal BI, S h:hO Clear

?7 Po nt. 1961 Temoest Sedan Gra dien t T-Wine; B-Red E $:00 Clear

?8 Cld s. 1961 2-Door Hardtop Gradien t T-3rwn; Tan P. N 10:1*5 Clear

29 Olds. 1961 88 2-Door Hardto p Gradient T-3rv n; Brz. P. S W 1:35 Clear

30 Ol’ds. 1962 Suoer 88 Sedan Gr ad ient T-RyLBl} BL. P. N 9:00 Clear

31 Ol ds. 1962 88 h-Do or Sedan Gr ad ient T-Maroon; Red P. W 3:30 LU Haze

3? Cld s. 1962 S ta rfir e Hardtop Gra dien t T-Haroon;Red P. N 10:1*5 Clear

33 Buick 1962 h-Do or Sta . Wagon Gr ad ient T-Ryl.El; BL P. E 11:55 Clear

3h Buick 1961 In v ic ta Hardtop Gr ad ient T-Brwn, Bg. P. E 2:00 Lt. Haze

35 Cad. 1962 h-Door Hardtop Gr ad ient Blac k W h:2 0 Clear

36 Dodge 1962 Lancer Hardto p Clear Fore st Green E 12:32 Clear

37 Dodge 1962 Lancer Sedan Clear Medium Blue W-SW 2:10 Clear

38 Dodge 1962 Dart hhO S ta. Wagon Clear Rose Beige s 3:00 Clear

39 Dodge 1962 Da rt hhO Sta . Wagon Clear Rose Beige s 12:1$ Cloudy

ho Plm th. 1961 V al ia nt Sedan Clear Medium Blue s l*:00 Clear

hl Rmblr. 1962 American Sedan Clear Medium Green W-SW 3:1 0 Clear

h? Rmblr. 1962 American C le ar Grey s ll :$ 0 Clear

h3 Rmblr. 1962 C la ss ic S ta . Wagon Clear Medium Blue s 1:35 Clear

hl, Rmblr. 1962 Cla ss ic Sedan Solex Medium Blue E 11:30 Clear

1,5 Rmblr. 1962 C la ss ic S ta . Wagon Cle ar Grey E 10: $0 Clear

1*6 Stb kr. 1962 Lark Sedan Clear T-Drk.BG*,BG. P. E 11:2$ Cloudy

1*7 Stb kr. 1962 Lark Sedan Cle ar Royal Blue 5 12:20 Clear

h8 Stb kr. 1962 Lark Tayto na Hdtp. Clear T-Red;Brwn. P. s 3:15 Cl ear

h9 Chrys. 1962 Newoort Hardtop Gra di en t Charcoal s h:2$ Cloudy

50 Chrys. I960 Newoort Hardtop Gr ad ient Charcoal s h:00 Clear

51 Ch rys. I960 ImDe rial HardtoD Gr ad ient Dark Brown N-NE 2:50 Clear

52 R nlt. 1961 Dmphine Sedan Cl ear Cream N E 1:3 0 Clear

53 VW 1962 2-Door Sedan Clear Grey N ll :$ 0 Clear

5h Here. 1962 Comet Sedan Clear Fir e Eng. Red W-NW 1:3 0 Cloudy

55 Merc. 1961 Monterey Sedan Gr ad ient Med .-Drk. Beig« N E 12:00 Cloudy

56 Merc. 1962 h-Do or S ta . Wagon Gra di en t Med.-IVk. Brow N W ETlO Lt. Haze

Abb re vi ations : Dir.» D ir ecti on; T .- Top, B.« Bettom; P.“ Pan el .
NATIONAL ACCIDENT PREV ENTION CENTER 131

TABLE II« Average Scene % Reflec tance

Illuminance 

From Sky

Illu minan ce 

From Earth

% Earth 

Ref lectance

Earth

Surface

6900 1080 15.65 Concrete Road

7000 880 12.57 Di rt

7100 500 7.Oh Green Field

7200 900 12.50 Blacktop

7200 1380 19.17 Gravel Parking

7300 lOhO 1U.25 Concrete

7U00 950 12.8k Dirt

7700 380 k.93 Green Field

7800 1280 16.U1 Gravel Road

8000 570 7.12 Blacktop

8150 830 10.18 Ci ty Stree t

7850 680 8.66 City Str ee t

7U66 872 11.7% Av. Scene
132 NATIONAL ACCIDENT PREVENTION CENTER

TABU m . UDHT CHARACTERISTICS OF INSTRUMENT PANELS AMD WINDSHIELDS

Car Sky

IllUM -

in an oe

F t.

Can dl es

Av. Soene

F t. Dra ­

bs r ts

(Sk y x

U .T t)

I llim l natio n on

Dash

F t.

Can dles

141—4 WRW

Instr um en

Pan el , Ft

La ah er ta

o f

t

Max.

Olare

In View

F t. Lamb

■ye to

Pa nel

(«».)

Se at

as I s

e te r

Ver tloa ;

Mo. Slz<

K erti oal

No. S is e

Tr an sm is si on

Dash R efl ­

e c tio n

Out side

D ir t

In sid e

D ir t

Max. Min. Av. F t.L . t F t. L . n F t. L . t

1 6640 770 258 130 21 65 90 ,0 00 72 48' 19* sa.si 91 11 .7 15 1.9 5 0 .6

2 653 0 764 143 490 12 86 60 ,0 00 67 1°27* 23* 9 0 .3t 36 4. 7 0 0 4 0 .5

- ■ 765 0 896 157 65 13 36 950 72 1° 14 ' 19* 91.8 1 46 5.1 10 1.1 1 0 .1

4 772 0 903 115 70 24 40 360 84 1 °4 ‘ 16* 7 9 .M 53 5.9 17 1. 9 0 0

5 6410 634 46 40 11 21 7,5 00 77 1®9' 18* aa.rit 87 3 3 8 .C 80 12 .( 0 0

6 375 0 449 50 28 12 18 63 77 1°9* 18' 85 t 67 14 .9 10 2 .2 15 3 .3

7 5570 652 186 100 18 45 140 69 1°17* 20* 871 53 8. 1 50 7 .7 3 0 .5

6 6670 1,0 15 118 66 22 39 1, 500 81 1° 6' 17* 76.3 1 117 11 .5 0 0 10 1 .0

9 567 0 663 214 150 13 75 400 63 l ’ a o 1 25* 87.2 1 80 12 .1 30 4 .5 15 2 .3

10 1290 151 79 140 8 39 140 63 l° 2 0 ' 25* 901 25 16. 5 15 9.9 2 1 .3

11 611 0 715 172 420 16 129 420 64 1° 22 ' 24* 90.8 1 14 2 .0 28 3. 9 30 4 .2

12 5250 614 179 225 21 74 225 67 1° 17 ' 23* 85.7 1 34 5.5 0 0 50 8 .1

13 386 0 452 214 205 18 88 700 72 l

u 0' 21* 881 57 12.6 15 3 .3 0 0

14 7280 852 200 170 25 100 1, 800 72 1° 16 ' 19* 92.2 1 58 6 .8 45 5.3 7

18 7500 877 257 410 30 108 1, 60 0 65 1°27 ■ 21* 92.2 1 30 3 .4 25 2 .9 2 0 .2

16 7280 852 272 670 9 189 670 71 1°34* 22 ' 85.5 1 22 2 .6 5 2x6 17 2 .0

17 5570 652 178 92 8 46 1, 10 0 65 1°43* 24' 861 171 26.2 5 0.7 0 0

16 5780 676 164 165 11 50 220 72 1°3 3’ 21* 90.6 1 65 9 .6 10 1.5 8 1 .2

19 7280 852 143 170 10 56 2,8 00 70 1°43* 22* 88.6 1 79 9 .3 5 0 .6 5 0 .6

20 7260 852 1,6 4Q 240 100 205 >00,000 77 1°3 4’ 20' 86.2 1 89 10.4 25 2 .9 0 0

21 105 0 123 121 115 12 45 170 70 1°4 3‘ 22 ' 87.9 1 2 5.5 20.9 5 4 .1 4 3 .3

22 6420 752 140 98 20 40 14 ,0 00 76 1° 12 ' 18* 58. 51 28 3.7 15 2 .0 3 0 .4

23 483 0 565 143 97 22 46 110 72 l

u 16* 19* 83.8 1 35 6 .2 0 0 3 0 .5

24 6320 739 137 120 23 56 310 74 1° 21 ' 19* 72.2 1 24 3 .3 1 0 .1 0 0

25 547 0 640 157 63 13 37 4,3 50 72 1°14* 19* 77.7 1 18 2 .8 56 8.8 4 0 .6

26 546 0 639 172 350 12 63 350 67 1°2 2’ 20* 79.7 1 20 3.1 5 0 .8 0 0

27 375 0 416 73 37 9 17 105 67 1° 22 ' 20 ' 75.2 1 4 1. 0 0 0 2 0 .5

28 642 0 751 128 95 19 42 200 75 1° 85 ' 21* 72.3 1 27 3. 6 5 0.7 0 0

29 604 0 940 208 110 26 53 1, 40 0 71 1°59* 22* 88.2 1 99 10 .5 55 5. 9 0 0

30 5350 628 124 62 11 .! 26 62 71 1° 47 ' 19* 67.3 1 15.5 2 .5 11 1. 8 2 0 .3

31 5670 662 131 63 12 32 250 71 1°47* 19* 87 . <1 124 18 .8 65 9 .8 8 1.2

32 74 90 876 117 130 12 44 130 72 1° 46 ' 19* 6 5 l 16 1.8 9 1.0 8 0 .9

33 932 0 1,0 90 172 150 17 48 380 76 1024* 19* 791 90 8 .3 8 0.5 0 0

34 7170 639 214 L,70< 80 405 1,7 00 86 1° 24 ' 16' 78.4 1 26 3.1 15 1.8 0 0

35 482 0 564 136 110 8 40 315 77 1°25 • 18' 88.2 1 305 54 .1 150 26. 6 15 2 .7

36 7550 663 200 125 20 60 350 71 103* 22’ 92.2 1 48 5. 4 17 1. 9 8 0 .9

37 7500 877 214 140 17 50 10 ,0 00 70 “ I V 22* 9 4 .7 1 68 7.8 18 2. 1 6 0

. 58 5350 626 258 220 15 87 800 62 1° 12’ 22* 91< 60 9 .6 18 2.9 9 1.4

39 116 0 138 114 130 9 40 230 67 1©7 • 20* 94 .7 1 33 23.9 14 10 .1 7 5 .1

40 5780 676 286 175 SB L14 7,2 00 74 1°8* 21* sal 90 1 3.3 5 0 .7 5 0 .7

41 6580 770 204 200 36 76 180 ,00 0 75 21' 951 134 17.4 13 1.7 19 2 .5

42 7700 902 300 270 41 80 810 70 1°9* 22' 9 4 . T i 153 17.0 25 2 .8 30 3 .3

43 7260 612 193 120 32 65 120 74 21' 92.8 1 538 6 3.2 5 0 .6 20 2 .4

44 7820 914 286 145 40 94 145 75 1° 18 ' 21 ' 82.9 1 238 26.5 20 2 .2 0 0

45 7020 822 250 130 46 73 570 70 1° 24 ' 22* 9 3 .2 1 651 7 9 .3 0 0 6 5 7 T

46 171 0 200 124 82 3 42 290 79 22' 19* 92.3JL 5 .5 2.7 6 3 .0 4 2 .0

47 635 0 977 900 135 P6 98 830 76 23' 20' SS.ffjt 116 11. 9 5 0 .5 0 0

48 664 0 777 243 104 34 67 260 74 28' 21' 92.2 1 71 9 .2 8 1.0 16 2 .1

49 621 73 74 205 4 33 205 79 l

w5' 17* 7 5 .8< 7 9 .6 3 4 .1 1 1 .4

50 642 0 753 214 350 19 L01 305 79 1° 5' 17' 77 .8 1 9 1 .2 14 1.9 19 2 .5

51 7650 895 143 810 10 47 3,4 00 84 l° 3 0 ' 18* 79 .0 1 52 5.6 70 7 .8 0 0

52 7500 878 164 620 49 L88 1,6 60 63 55' 29* as.ot 179 2 0.4 5 0 .6 10 1 .1

53 803 0 939 357 210 21 99 20,0 00 66 44* 21* 8 9 .o t 47 5.0 s TT T —s- 5T1T

54 1500 176 136 160 6 41 160 71 T T — ' l i ' " 81.9 1 46 s r r — 7— T 7T ■~TS— U -

55 150 0 182 129 95 25 47 280 70------- i

0U ' ' ~i 5— ~7 5— S9 .5 10 5.5 8 . 1

56 3220 377 250 130 29 57 560 76 l ’ i s - ' 16* 76.3 1 52 13.8 55 14.6 3 0 .8

Av. 564 0 663 20 4 205 22 78 20 ,0 47 78 1 * W 20* M . a 15.5 S.8 - l . s t
NATIONAL ACCIDENT PREVENTION CENTER 133

Statement of Robert L. Davis, Vice President, Davis Aircraft Products, 

I nc., Northport, Long Island, N.Y.

Mr. Chairman, I am Robert L. Davis, vice preside nt, Davis Aircraft Products, 

Inc., Northpor t, Long Island, N.Y. I am a member of th e legislative committee 

of the American Seat Belt Council which comprises numerous man ufacturers in 

the sea t belt industry. I appear here today as a representative of the Davis 

Aircraft Products Corp., the American Seat Belt Council and as a private citizen 

in su pport of the principals of th e bill being considered today, H.R . 133, to amend 

title 3 of the Public Hea lth Service Act to establish a National Accident Preven tion Center.

Fir st, I should like to tell you a little bit about th e American Seat Belt Council. 

This council was estab lished to insure th at seat belts th at are manufactured 

would meet adequate safety sta ndard s. All members of the American Seat Belt 

Council must comply with the standard s adopted by the council and all seat 

belts sold must carry the sta mp of approval of the council. This stamp of 

app roval guarantees th at the belts have been tested to current SAE standard s.

As you can see, the various industries th at are members of the council are 

vita lly concerned with safety an d I believe th at the e stablishm ent of an accident 

prevention center such as the one proposed in H.R. 133 would be one of the 

greatest steps ever tak en to systema tically attack the epidemic problem of 

accid ents. As I und erstand it, the purpose of such a cente r would be to correlate 

all available knowledge relatin g to cause and prevention of accidents.

I furth er understand th at the legislation would provide a special autho rity to 

create a un it comparable to the Communicable Disease Center, the Sanitary 

Engineering Center, and the Arctic H ealth Research Center. It would encompass 

research into medical (and psychological) and environm enta l (engineering) causes 

and preven tive measures, pilot s tudies, demonstrations, technical aid, and project 

gra nt activities. In addition, machinery would be set into motion to enumerate 

types of causes such as vehicular, home, occupational (with the exception of certain phases), and farm accidents.

We, of the American Seat Belt Council, believe th at such a cen ter as the proposed National Accident Prevention Center is vita l and is an aug mentation and 

not a duplic ation of the activities currently being carried on b y the various departments of the Government, the Nation al Safety Council, and organizations such as 

the American Automobile Association and others. These organizations currently are performing meritorious service. However, the council feels th at the 

correlation of the inform ation prov ided by these various organizatio ns, associations, and governmental agencies, is essential if we are to obtain all information 

possible with regard to accidents and in order to preven t these accidents. It 

would provide a central source of information such as the Congress has in the 

Library of Congress and its Legislative Reference Center and such as th e Institut e 

of Health has in its Medical Library . It seems to me th at the centralization of 

information will provide a most necessary adjun ct to the safe ty program, and 

again I say th at I, as a n individual, and as a represe ntative of the Davis Aircraft 

Corp., and as a member of the American Seat Belt Council Legislative Committee, 

hea rtily endorse the principles of thi s legislation and the continuing efforts of thia 

comm ittee.

Statement by David M. Marsh, Manager, Association of Casualty and

Surety Companies

The Association of Casualty and Sure ty Companies is a volun tary nonprofit 

organization with a membership of 131 capital stock insurance companies. We 

take pleasure in subm ittin g the following recommendations regarding H.R. 133.

In the view of this association, base d upon many years of experience in supp ort 

of measures directed toward the p reve ntion of highway traffic accidents, Congress 

should enact this measure following its amendment by your committee to more 

accu rately define its purpose and to limit its scope to the encou ragement and implem entation, by all possible means, of research projects designed to enable responsible official agencies, at all levels of government, to effect those measures necessary 

to the control of the highway traffic accid ent problem.

While fully in accord with the Federal Government adopting every reasonable 

means to encourage States and cities (in both their official a nd nonofficial capacities) to attack the problem of highway traffic accident preventio n, we strongly 

urge th at Congress refrain from the enactm ent of an y measure which, in its application, would in any way encro ach upon the responsibility of Sta te and city
134 NATIONAL ACCIDENT PREVENTION CEN TER

government for the regulation and supervision of the movement of all manner of

traffic on public streets and highways. Further, we urge that any such bill en­ acted by Congress should clearly avoid giving the Federal Government any author­ ity to control public and private traffic action programs other than that which presently exists and further, such a bill should not operate either to discourage or

in any manner curtail the programs and activities of State and local private agencies now doing so much tha t is good in the cause of highway safety. We appreciate the interest of this subcommittee and of the Committee on Interstate and Foreign Commerce in the important field of traffic safety.

Sta t e m e n t o f t h e A m er ic a n P u b lic H ea lth A sso cia tio n by E dwar d P r e ss, 

M .D ., M .P .H ., C h a ir m a n , Ac c id en t P r e v en tio n C om m it tee

I have appeared before this subcommittee on February 8, 1962, for a similar statement. The statement was submitted and the discussion at the time, has been printed in the records of the subcommittee hearing and I shall not takeyour 

time to detail its contents again. In summary, I explained that I testified as spokesman for the American Public Health Association and its branches and affiliates in 48 States in this country. I referred to 10 separate resoltuions on the subject of accident prevention passed during the annual general conclaves of the American Public Health Association in the past 11 years. This association is not limited to physicians in public health only but includes a wide variety of persons such as nurses, nutritionists, engineers, 

administrators, inspectors, etc. One of these resolutions, passed 7 years ago, resolved "th at consideration be given to the advisability of establishing within the Federal Government a National Accident Prevention Center to coordinate the activities of various accident pre­ vention agencies in order to improve the safety of the people of the United States through conducting research, investigations, experiments, and demonstrations 

relating to the cause of and means of preventing accidents.” I also gave examples of how such a center might have expedited research in the prevention and treatment of periodic increases in accidents as well as regularly recurring accidents tha t could in a way be considered "epidemics” and "endemics” of accidents. Examples were cited in the fields of lead poisoning and of injuries from wringer-type, home washing machines. The relatively scant amount of research funds devoted to accidents and the need for greater coordination of safety 

activitie s were also mentioned. Rather than review in any more detail the material already presented, I would like to take this op portunity to comment on one of the points raised in last year ’s hearings. It had to do with an opinion tha t the prevention of accidents was an engineering science rather than a medical act ivity and tha t the emphasis put on the medical and psychological aspects of accident prevention (through placing the Center in the Public Health Service) would result in a disruption of the safety movement. There were also opinions that the proposed research or activities might conflict with or duplicate existing activities under other auspices. In relation to this latter point, it would not be difficult to include amendments in the bill that would result in obtaining advice, consultation, and/or consent by representatives of other agencies involved when and if potential conflicting or duplicating activities might be undertaken. However, most administrators 

would consider this part of the standard operating procedure. I would like to cite an example of a specific type of accident that I believe would serve to illustrate how one of the problems in this area could more expe­ ditiously be attacked with the aid of an Accident Prevention Research Center 

or laboratory. I happen to be chairman of a Committee on Hazards to Children of the American Standards Association which incidentally is basically an engineering group. One of the projects on which this committee is working is the exploration of flame resistant standards for children’s clothing. Some of you will remember the outbreak or “epidemic” of injuries and fatalities resulting from the introduction 

of children’s cowboy chaps with long rayon pile fibers and the "torch” sweaters made out of similar fabrics. The culprit in this instance was not so much in­ creased carelessness or increased exposure to fire but a considerably increased flammability of the fabric. As an indirect result and after a latent "incubation” period of 9 years from the cowboy chaps incident and 3 years from the more 

spectacular human “torch ” sweaters, a Federal Flammability Fabrics Act was
NATIONAL ACCIDENT PREVENTION CENTER 135

pu t into effect. This helped by prohibiting excessively flammable fabrics from being sold in the United States. Although this measure largely controlled burns from very highly flammable clothing, it had relatively little effect on the con­ tinuing week-by-week “endemic” burns from other types of clothing catch ing on fire. How could a National Accident Prevention Research Laboratory help 

this? In my opinion, there are seve ral ways:

I. SHA RPE R DELIN EATIO N OF THE PROBLEM

In spite of the hard work by the National Fire Protective Association, the U.S. Department of Agriculture, the Fed eral Trade Commission, and members of the chemical and cotto n industry, the progress was relatively slow in delineating the details of the problem. Specific well-documented information on all the majo r circum stances involved in the casualties was and is scant. Even now, 18 years after t he cowboy chaps incidents and 12 years after the “torc h” sweaters, we still do not know how many people in this country die or are injured from clothing fires. I contacted officials of the National Fire Protectiv e Association, the U.S. Public Health Service, the National Safety Council, the National Board of Fire Under­ writers and others. Not one of them could give me specific figures, even on 

fatalities. Newspaper accounts similar to those in exhibit A attache d were clear indications th at a substantial problem existed. Finally, I made a pe rsonal visit to the Cook County (Chicago) coroner’s office and with the aid of personal phone calls to the coroner in Cleveland, Ohio, and Miami, Fla., some specific facts were elicited. For example, during 1962, a total of 27 persons lost their lives because their cloth­ ing cau ght fire in Cook County, 21 of these in the city of Chicago and 6 in the sub urban areas of the county. In Cuyahoga County, which includes the city of Cleveland and has a population of 1,750,000 persons, there were 23 deaths in 1962, stem ming from the ignition of clothing. In Dade County, Fla., because of the mild tem perature only a minim um of space heating is required. In 1960 there 

were five d eaths there. In 1960, according to the Nation al Vital Statistics Division of the Public Health Service, the re were a tota l of 7,645 dea ths as a result of fire and explosion. This includes several other types of deaths besides those due to clothing. A statistical 

study by the Metropolitan Life Insurance Co.1

 estimates th at 13 p ercent of death s 

from burns among their policyholders were due to the ignition of clothing. If we were to ex trap olate this figure of 13 percent to the national to tal of 7,645, it would amount to 994. This excludes an additional 13 percent where burns ensued in 

connection with smoking in bed or in an upholstered chair.

2. FLAMMABLE FABRICS STANDARDS

As a result of the Flamm able Fabrics Act, which became effective on June 30, 

1954, the Secretary of Commerce prom ulgated a safety standard (Flammability of Clothing Textiles, Commercial Standard 191-53) and developed rules and 

regulations in this area. This cur ren t stan dar d for plain surface textile fabrics, for example, is calibrated to allow fabric to be sold unless it is so dangerous th at it ignites in 1 second. Even then, if it does not burn rapidly enough for the flame to travel 5 inches in 

3M seconds with the cloth at a 45° angle, it is considered safe for wearing apparel. 

In a study of about 100 burned cases th at were severe enough to require hospital treatm ent, underta ken by the National Fire Protection Association and the American Academy of Pediatrics, it was found th at 109 of 120 different clothing samples tested took more tha n 1 second to ignite. In none of the fabrics in­ volved did the flame trav el the 5 inches at a 45° angle in 3*6 seconds or less. They all took longer than this. Thus, although the Federal Flammable Fabrics Act is a definitely helpful step forward, I feel tha t if a National Center for Acci­ den t Prev ention Research was in operation, this step would have been made more effective, would have been taken sooner, and additional steps would probably 

have been taken.

3. RESEARCH ON FLAME RETARDA NTS

A considerable amount of research has been done on flame ret ard ants. In 

summ ary, it was found th at chemical compounds containing phosphorus and nitrogen gave excellent flame r esista nt qualities to textiles. A compound called TH PC (tetrakishyd roxymethylphosp honium chloride) is mixed with ano ther one called APO, whose chemical name is tris (1-aziridinyl) phosphine oxide. By

i Statistical Bulletin, October I960, M etropo lita n Life Insura nce Co.
136 NATIONAL ACCIDENT PREVENTION CENTER

mixing TH PC and APO in a 1-to-l mole ratio, wetting the fabric, squeezing out 

the excess solution, drying, during and washing, a good flame retard ant fabric 

results. Samples of such fabrics have been laundered over 100 times in home 

laundry washing machines and have been subjected to 60 or more commercial 

launderings including chlorine bleaching without losing flame retardancy. They 

have also retained crease resistance, rot resistance, mildew resistance, and glow 

resistance.

You may be interested in seeing and feeling some of these fabrics so treated 

and noting the difference in flam mability. (Sample fabrics circulate d and difference dem onstrated.) Unfortunately, this tre atm ent also adds to the cost of the 

fabric and depending on the volume manufactu red, this addition al cost amounts 

to from 4 to 13 or more cents per yard for the fabric treated. As far as most of 

the cotton indu stry is concerned, the y feel the public is not willing to pay the 

add itio nal cost unless it gets down to a range of 3^ cents per yard. Thus, at the 

presen t time, for general cloth ing purposes, relatively little of the commonly 

marketed mate rial has been tre ate d with flame r etarda nts.

I feel th at with the aid and assistance of a Natio nal Accid ent Preventio n Research Laboratory, progress in this area could be greatly expedited, not only in 

the field of more research bu t also in the areas of educ ation and application of 

research.

In summary, I believe th at in just this single area of accide nt prevention th at 

pertain s to one type of burn th at kills abo ut 1,000 persons annually—the type 

associated with the ignition of clothing—scores or hundreds of lives could be 

saved years earlier with such a center or laboratory than with out. Similar 

benefits, in my opinion, would result in many other areas of accid ent prevention.

St a t e m e n t by J. Au st in L a t im e r, C o u n sel fo r A u to m o tiv e S e r v ic e I ndust ry

Asso cia tio n

Mr. Chairman, gentlemen of the committee, tha nk you for the opportu nity to 

sub mit this statem ent on behalf of th e Automotive Service Ind ustry Association, 

located at 168 N orth Michigan Avenue, Chicago, Ill. ASIA, as it is known, is a 

nonprofit trade association serving manufacturers, wholesalers, warehouse distributor s, and rebuilders of automotiv e parts, equipment, tools, supplies, 

accessories, chemicals, and refinishing materials, with membership affiliations of 

over 10,000 firms, representing nearly a half million people, employed in the 

autom otive afterma rket.

Obviously, as an association in the automotive service field, we have both an 

individua l’s intere st and stake in highway safety , as well as a professional concern. 

Our thousands of firms a nd mem bers a nd their families make up a grea t segment 

of the motoring public. Our associa tion’s safety slogan has long been “Highway 

Safety Is Our Business.”

It is our segment of the autom otive business which, since the early days of th e 

auto industry, has con trib uted so much to highway safety by making available 

through the years produc ts which have become standard equipment on toda y’s 

motor vehicles—item s such as the windshield, the headlight, tail light, direction 

signals, horns, windshield wipers, and so on. Like Marconi and his radio, certain 

circles scoffed at some of these items and action was deferred for years before 

the y were accepted.

We have a long history of interest in legislation pertinent to the motor vehicle 

and its appurtenances. Th at explains our inte rest in appearing at this hearing 

on H.R . 133, because it may well affect the research necessary, the coordination 

desirable and the stimulation long overdue to cut the needless slaughter on our 

highw ays.

As you know there are many groups active in safety work, with a long line of 

“c red its” to whom they con trib ute or with whom they cooperate, as well as 

stu die s the y have made of the many facets of automotive safety. We are not 

devoting ourselves to driver education, altho ugh we favor it; we are not working 

actively for improvements in the vehicle registration methods nor highway engineering, although we admit changes may be desirable. We are not developing 

cou nter agen ts for the drun ken driver problem, much as we oppose it and many 

oth er accident problems. We are devoting ourselves to a concentrated effort to 

foster Sta te regulated periodic motor vehicle inspection, because motor vehicle 

main tena nce a nd the inherent safety values therein, is som ething we know abo ut.
NATIONAL ACCIDENT PREVENTION CENTER 137

Slightly over 37 million motor vehicles 3 to 9 years old were on our highways 

at the end of 1960, compared with 29.7 million 5 years earlier. Today ’s automobiles are soundly engineered and sturdily built, bu t as with any machine, 

wear and constant use inev itably take their toll in safety and efficiency.

The mechanically unsafe car has always been a contributin g cause to highway 

accidents and it will grow in th at role as the vehicle registration increases through 

the years ahead. Among the 18 States and the Dis trict of Columbia which 

alre ady have periodic moto r vehicle inspection, studies have revealed as high as 

55 percent of the vehicles inspec ted are unsafe because one or more parts affecting 

safe driving conditions required immediate atte ntion.

The U. S. Commerce De partm ent’s Bureau of Public Roads suggests th at 

vehicle condition plays a more imp ort ant p art in accidents tha n has been believed. 

We know th at in the reporting procedure of traffic accidents, unsafe vehicle conditions have not been given proper recognition »s a con trib uto ry cause of traffic 

accidents. There are a num ber of reasons for this, including—

1. Vehicles are often damaged beyond the point of determining their true 

condition at th e time of accide nt;

2. Accident investigations ten d to concentrate on the driver and driving 

conditions;

3. Many investigators are not trained to recognize evidence of unsafe 

vehicle conditions;

4. Accident reporting procedures in different States are not uniform;

5. Drivers are reluctan t to adm it maintenance neglect, fearing assertion 

of contributory negligence in civil law suits;

6. Vehicles are often defective because of the lack of proper inspection.

The expansion and improveme nt of our highway system is increasing; the number of motor vehicles on the highw ays is increasing, more and more people are 

driving more frequently and longer distances. The problem of highway safety 

is growing and destined to grow for years.

There will be additional burdens placed on the many fine organizations in the 

field of safety. The time, effort, and moneys the y will need to continue and to 

expa nd their efforts will become more and more burdensome.

For th at reason the establishment of a central clearing house under Federal 

Governm ent auspices, to coordin ate all the manifold aspects of probing the 

causes of highway accidents and the ir prevention, could be beneficial.

It would be easy to say to this comm ittee th at any actio n tak en by an group, 

be it priv ate, municipal, State, or Federal Government, designed to prev ent 

traffic accidents and thereby save lives, prevent injuries to persons and to prop erty 

would thu s save the taxpay er a staggering burden, and so is to be commended. 

However, we urge strongly upon this committee th at the members consider the 

possibility of duplication by the proposed National Accident Prev entio n Center 

of ac tivities already being performed and responsibilities assumed by such organizations. We heartily oppose unnecessary duplication, and waste of taxpayers’ 

moneys.

In the field of proper periodic motor vehicle inspection legislation the research 

studies to implement it, there is m uch room for help with little danger on overlap 

of responsibility or activity.

Many Federal agencies an d offices have already become aware of the problem of 

inspection and have endorsed the principles of periodic moto r vehicle inspection. 

Among them are Secretary A. Ribicoff (HEW ), and President Kennedy ’s own 

Safety Committe e, headed by William Randolph Hea rst, Jr.

Knowing th at this committee’s p urpose is to c onstruct legislation in the public 

interest, and knowing th at since 1900 we have killed well over 1,300,000 people 

on our highways, injured countless millions, and th at unless something is done 

abo ut it 700,000 of our friends, neighbors, relatives and business associates, will 

meet death on the highways by 1975, we respectfully urge the committee to 

consider the effect of any legislation in the safety field on the needs of th e nation 

for periodic motor vehicle inspection. It is a herculean task and we do not wish 

to demean any of the fine priv ate, and State, or Federal organizations which have 

worked long and hard in this field. We do know t ha t the goal of effective periodic 

motor vehicle inspection is y et a long way off and th at it is, strictly speaking, vita l 

for many Americans living and as yet unborn.
138 NATIONAL ACCIDENT PREVENTION CENTER

Statement by Col. Gaylord B. Kidwell, U.S. Army (Retired)

Mr. Chairman and committee members, may I express my appreciation for 

your gracious invitation to appear before your committee. Perhaps a brief 

summary of my experience over a 9-year pursuit to improve safety techniques 

to prevent accidental entrapment and suffocation of children in idle refrigerators 

and freezers might be helpful in your deliberations of H.R. 133. Incidentally, 

my services have been rendered on a purely voluntary basis in the capacity of a 

private citizen and without benefit of remuneration of any kind.

I take this time of the committee to point up a particular problem in safety 

tha t, had a center, such as is proposed by H.R. 133, been in existence at the time 

legislation was enacted regarding refrigerators, many years of time required to 

obtain the results desired by the legislation would have been saved, to say nothing 

of the effort and cost incident thereto.

This deduction is not intended as a reflection on any agency of the Government 

responsible for safety. In the years I have devoted to the problem, every agency 

I have contacted has been most cooperative. However, the scope of their activity 

in the particular field in which I was deeply interested (and I am sure the Congress 

was, or this legislation would not have been enacted into law) was limited. The 

establishment of a centralized depository or clearinghouse for information and 

data as proposed by H.R. 133 I believe is not only vital but will serve a useful 

and beneficial purpose.

Shortly after my retirement from active military service in 1953, the problem 

of these tragic childhood accidents was high in the public mind. Several remedial 

legislative bills had been introduced in both Houses of the Congress, and at least 

two hearings had been held with another one in prospect. Shortly thereafter 

Public Law 930, which was sponsored by the Honorable Kenneth A. Roberts, 

of Alabama, was enacted in 1956. This law, as you know, required tha t subsequently all new household refrigerators shipped in interstate commerce had to 

be equipped with doors th at could easily be opened from the inside.

Regardless of the safety benefits that were hoped for through this new law 

there still remained a national inventory of some 60 to 80 million old units with 

conventional locking devices to be coped with. It is to this aspect of the problem 

that I have mainly directed my efforts.

Hope for the protection of children from accidental entra pment in these boxes 

has rested mainly in safety educational programing and the enactment of State 

and local laws and controls. Educational programing consisted of an intense 

concentration on “abandoned or discarded” refrigerators and freezers. This 

emphasis may very well have unintentionally invited neglect of precaution being 

taken with boxes temporarily out of service, but intended for an early return to 

use. Examples of such temporary idleness are those in vacant apartm ents and 

houses, on back porches of homes and summer cottages, or merely stored in a 

basement or garage awaiting transfer to another location. There are numerous 

newspaper accounts of children being killed under these circumstances.

The safety precautions advocated, until recently, seemed hardly suitable on 

boxes intended to be used again. They were cumbersome to apply and somewhat 

damaging to the units themselves. These actions included the complete removal 

of doors, hasps, gaskets, and even boring holes in the cabinet with an electric drill. 

True, any of these actions would be effective on a box th at had been discarded 

and was headed for the junkyard. However, none were practicable for application 

by an owner or housewife who wished to render a temporarily idle box harmless.

The direction of search for improvement seemed to lie in devising a number 

of simple things that a homeowner or housewife might do that required a minimum 

of mechanical skill. In pursuing this search it was my pleasure to consult with 

many Federal and State officials who had interest and responsibility in this and 

other safety matters. On two occasions consideration was given to safety devices 

conceived by me and offered for the free use of the Government and the general 

public. In both instances the matter of testing and evaluating these devices 

presented the same problem. The department tha t had the authority to consider 

a device and to advocate its use, lacked the capability of independent research and 

testing.

In the early months of this effort the results of the behavior tests with live 

children under simulated refrigerator entrapment, conducted by the National 

Bureau of Standards, were made public. Surprisingly, this report showed th at 

many smaller children made no effort to escape their capture, but merely sat 

quietly as if awaiting assistance. My little grandaughter, then 3 years old, was 

one of these children selected for use in the test.
NATIONAL ACCIDENT PREV ENTION CENTER 139

The unexpected and disappointing degree of safety benefits inherent in push- open doors presented another problem. It became apparent tha t precautions must be taken with regard to new design refrigerators, as well as for the old ones. Such responsibility had not been anticipated by many manufacturers. Some national advertising and pronouncements by educators and editors, indicated assumption tha t push-open doors were foolproof and entirely safe. Relief from this dilemma, with all its ramifications, did not appear to come within the scope of any single Federal agency. Therefore, with the generous assistance of my Congressman, the Honorable Joel T. Broyhill, of Virginia, facts were presented to separate departments and agencies having means to institute corrective actions, 

which in due course were forthcoming. In th e summer of 1961, I learned that the Federal Safety Council in the Depart­ ment of Labor had a function to develop and advocate safety guides for use throughout the Government. I approached the Chairman of this Council offering a “toggle and plate” device to free use by the Government and general public, as one means of preventing child entrapment. In this contact I was introduced and sponsored by Congressman Roberts, the esteemed chairman of this committee. As we proceeded with conferences with the Standards Committee of the Council I was invited to continue my collaboration and assist in writing a new safety guide. The end product is the recent publication of the Council’s “Safety Guide for the Prevention of Refrigerator Entrapm ent.” which follows this statement. This guide recognizes the entrapment hazard to exist in all idle boxes con­ ceivably exposed to entrance by playing children. It suggests several novel and simple safety techniques that might be applied, among which is the toggle and plate device. Since publication this guide has been sent to all State health officers by the U.S. Public Health Service, and the substance contained therein was promptly adopted and advocated by the National Safety Council, a nongovernmental organization. It may appear somewhat astounding that safety assistance of rather simple characteristics, as were finally realized in the publication and acceptance of the Council’s “Safety Guide,” took so many years to accomplish. I venture to suggest that much delay in achieving this goal came abou t through the absence of centralized safety management, and a lack of independent research and testing capabilities within the framework safety organizations. Elimination of delays and excessive time consumption in realizing the prevention of accidents in other areas, may very well be realized by the establishment of a National Accident 

Prevention Center.

Thank you.

(The “Safety Guide” referred to in the above statement follows:)

S a fe ty G u id e fo r P r e v e n t io n o f R e f r ig e r a t o r E n tr a pm en t

1. The Standards Division of the Federal Safety Council has recently com­ pleted a comprehensive study and review of the safety problem of accidental entrapment and suffocation of children in refrigerators and deep freezers which 

are not in use. 2. In the pursuit of this study, the Standards Division gave consideration to the implications in Public Law 930, 84th Congress, approved August 2, 1956, to the implications in various State laws dealing with the specific problem, to safety measures advocated in national safety programing, and to measures 

currently in effect in some executive departments.

3. Other related matters considered in the stu dy were: (а) The results of the child behavior studies of 1957 and 1961. These studies, “Behavior of Young Children Under Conditions Simulating Entrapment in Refrigerators,” April 16, 1957, and “The Effects of a Luminous Door Marker on Escape From Refrigerators,” August 25, 1961, were prepared by the Children’s Bureau of the Department of Health, Education, and Welfare, and the National Bureau of Standards, U.S. Department of Commerce, with the cooperation of the 

National Electrical Manufacturers Association. (б) A press release and coverage by Dr. Leroy E. Burney, Surgeon General, Public Health Service, May 8, 1959, warning th at precautionary actions should be taken with all refrigerators, including the newer types equipped with safety 

door releases. (c) The position taken by the Federal Trade Commission relative to advertising 

claims of safety benefits in the new safety doors.
140 NATIONAL ACCIDENT PREVENTION CENTER

4. As a produc t of this stud y and review, the Council finds:

(а) Tha t positive prec autionary measures should be taken with all units 

temporarily or perm anently tak en ou t of service in their refrigerative function. 

This is reviewed as particularly significant to agencies having custodial responsibility for vacan t housing.

(б) Th at in view of the limited safety benefits disclosed in the child behavior 

tests, positive prec autionary measures should be taken with the new push-open 

door typ e refrigerators.

5. The Council therefore recommends that one of the following sa fety measures 

be taken where a u nit is to be taken ou t of service:

(а) Completely remove doors: This precautio n is seen as positive in eliminating 

the haz ard of accid ental entrapm ent and suffocation, and should be taken in all 

cases where the unit is discarded and not to be used again in its refrigerative 

function.

(б) Secure with metal stra pping: This should be applied with hand-operated 

baling equ ipm ent to insure a tamperproof seal. Use of “wire or sto ut rope” 

is not recommended.

(c) Toggle and plate device: This device has been dem onstrated to be adeq uate 

protection on units; the locking design will allow easy installation. Its use has 

the ad vanta ge of simplicity and will allow the door to swing freely witho ut locking 

accid entally. It also perm its inspection of the interior. This is viewed as helpful in cases of vacant housing which is subject to inspection from time to time by 

prospective tenants, or main tenance personnel. (Attached is a diag ram demonstrating the installation and use of the toggle and plate device.)

(d) Lock with padlock: In rare cases where handles are so constru cted as to 

receive a padlock, this action would be adequate.

(e) Metal or wood blocking: In those cases where the removal of latch, magnetic plate, or other locking featu re, will leave screw holes exposed, the following 

action is recommended: attach a metal or wooden block utilizing the exposed 

screw holes. The block to be of sufficient thickness so as to pre vent the door 

gasket from coming in con tact with the face of the cabinet and closing off air 

to the inside. In some instances, longer screws may have to be employed or the 

block countersunk to accom modate the added thickness.

6. The Council feels tha t these are the only foolproof precau tion ary measures 

th at are available to date.

If anyone has an idea, or a device, th at will provide for complete child protection aga inst refrig erator e ntrapm ent, sub mit it to the Federal Safety Council, 

U.S. De partm ent of Labor, Wash ington, D.C.

7. Priva te citizens, manufacturers, dealers. Federal and Sta te agencies owning 

refrigerators and deep freezers should check State, municipal, and local laws 

and regulations concerning the aba ndo nment, storage, or “jun kin g” of refrigerator 

units.
NATIONAL ACCIDENT PREV ENTION CENTER 141
142 NATIONAL ACCIDENT PREVENTION CENTER

[telegram]

Washington, D.C., April 22, 1963.

Hon. Kenneth A. R oberts,

Chairman, Subcommittee on Health and Safety, Committee on Interstate and Foreign

Commerce, House of Representatives, Washington, D.C.

The American Mutual Insurance Alliance, a trade association with a membership of approximately 120 m utual fire an d casualty companies, whose home office 

is number 20 No rth Wacker Drive, Chicago, Ill., respectfully calls to your attention t hat due to the loose structure contained in the bill, H.R . 133, we believe it 

is subject to misinterpre tation and th at Sta te and private agency activities will 

be duplicated by the Federal Governm ent. We urge the comm ittee to consider 

seriously the detrimental effect of any encroach ment upon local government 

and priv ate ind ustry by the esta blishment of a Federal sup erstructure in the 

area of accident prevention. We request th at this telegram be made a pa rt of 

the record as expressing our views in opposition to H.R. 133.

Wallace M. Smith,

Manager, Midatlantic Office, American Mutual Insurance Alliance.

National Association of Motor Bus Owners,

Washington, D.C., April 8, 1968.

Hon. Kenneth A. Roberts,

House of Representatives,

Washington, D.C.

Dear Congressman Roberts: We are writin g you in regard to your bill, 

H.R . 133, which proposes the esta blishment of a National Accident Prev entio n 

Center.

This association, which serves as spokesman for the intercity motorb us industry, 

is vitally inte rested in highway and employee safety. Our member carriers 

main tain extensive safety programs the effectiveness of which is ap parent from 

the fact th at the safety record of the interc ity motorbus industry has shown 

steady improvement and is better than, or equal to, th at of any oth er form of 

transp ortation. Directly and through our association, the indu stry sup ports and 

works closely with other organizations in the safety field such as the Automotive 

Safety Fou ndation, The Presiden t’s Com mittee for Highway Safety and the 

National Safe ty Council.

The ability of the Public Health Service to make major con tributions to safety 

through research is widely recognized and, in our view, is an app rop riate activity 

of the Federal Government.

We are, however, disturbed by the bre adth of the proposals set for th in H.R. 

133, par ticu larly with reference to the ir potential imp act on the National Safety 

Council with which we are closely affiliated. A program on a relatively modest 

scale such as th at proposed in subsectio ns (1) through (4) of section 382 of the 

bill is, we believe, an appropriate Federal project. Most of the rem aind er of the 

proposals we believe are not app ropriate because they would be ce rtain to infringe 

on the activities of the many private organizations which are con tributin g so 

greatly to safety through public education and otherwise.

It is our firm conviction that, except as to research contributions and enforcement where clearly in the public intere st, safety activities should be carried on 

under private auspices and by governmen t at the State and local levels and not 

by means of a sub stantial expansion of the Federal Government.

This is particularly important with respect to the highly probable impact 

of these broad proposals on the activities of the National Safety Council. The 

council, now in its 50th year, performs with outstanding success many of the 

same functions encompassed in H.R. 133, pursua nt to its charter, granted by 

the Congress und er Public Law 83-259.

The Nation al Safety Council operates in every phase of the safe ty field. It 

receives the benefit of financial support as well as the serious personal efforts 

of represe ntatives of every segment of the public, indu stry, and government 

including several Federal agencies. In addition to the impact of H.R . 133 on 

the actual operation s of th e council, the proposal in section 383(b) poses a thr ea t 

to the financial support which is essential to those operations.

We respe ctfully urge, therefore, th at any measure which may be enacted in 

this field be sufficiently restricted to prevent encroachment upon the activities
NATIONAL ACCIDENT PREV ENTION CEN TER 143

or sup port of the National Safety Council, its affiliated State and local safety councils, and the numerous oth er outstan ding private safety and related organizations. We shall very much app reciate it if this communication is incorporated in the 

record of the hearings on H.R . 133.

Cordially yours, James D. Mann, Secretary-Manager.

St. Petersburg, F la., April 1, 1963.

Hon. Paul G. Rogers,

Member of Congress,

House of Representatives, Washington, D.C.

Dear Sir : Having been a founder member of the American Association for 

Automotive Medicine and the pa st p resident of the association, I have more tha n the usual knowledge of a utom obile safety and the problem s conne cted to it. You are curren tly on the committee considering bill H.R . 133, known as the Roberts bill, to prov ide a national insti tute for the studying of all aspects of automobile 

safety and licensing procedures. I would first of all like to strong ly urge th at you sup por t th is bill and its passage and secondly th at you give serious consideration to pu tting it in St. Petersburg. I was instrumental in getting the public health departm ent to star t a research prog ram in St. Petersburg, this year, for the study of accidents in older people. This, of course, is not only pertaining to automobiles b ut also a ccidents in general. Dr. Lawton, who is currently heading it, has a large am ount of knowledge on th e entire sub ject of automobile saf ety and would prob ably head the new division, if the bill is passed. I think th at the facilities here, with the possibility of pur­ chasing the American Legion Hospital would provide him ple nty of room. They are alre ady getting a considerable amount of expensive and elaborate equipment for te stin g and th is could be easily amplified. In addition, we ha ve near at hand, Sebring with its annual race which provides an opp ortunity of studying large numbers of cars at speed. We are quite close to Daytona, with all of its testing possibilities for autom obiles in any phase as well as its numerous races. I must point out th at the c urrent use of seat belts originated from racing. Please let me know if there are any questions th at I could answer for you or 

if there are any further though ts th at I might help you with.

Yours very truly,

Paul F. Wallace, M.D.

(Whereupon, at 11:30 a.m., the hearing, in the above-entitled 

matter, was recessed, subject to call.)

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