Lap belts have been required in front seats of automobiles manufactured for sale in the united states since 1964, and lap and shoulder belts have been placed on almost all new cars sold in the united states since 1969. However, availability and use did not match. Several states have enacted mandatory belt use laws (muls) in the past 5years. Maryland enacted a mul in 1986, and an evaluation of its effectiveness in terms of belt use and injury reduction is described. Specifically, 55 observational field studies were conducted at 44 sites in 1987, 32 studies at 26 sites in 1988 (12 of which were the same locations as in 1987), and 16 studies at 16 previous sites in 1989. These studies showed trends as well as usage for different types of highways, times of day, and rural versus urban locations. An analysis of traffic accident victims admitted to maryland's 11 trauma centers showed a huge increase in serious injury and mortality for unbelted versus belted victims. This paper appears in transportation research record no. 1325, Highway safety: older drivers, seat belts, alcohol, motorcycles, and pedestrians 1991
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