Air bags can also cost lives

At this writing, federal regulators are poised to issue-final rules mandating nextgeneration air bags, to be phased into new cars and light trucks over the next several years.

The new standards will aim to make these devices less prone to kill small women, children and the elderly in survivable car crashes, without losing much protection for large, unbelted male drivers ir certain otherwise fatal crashes-hence the term, "smart" air bags.

Safety Questions Remain

How well this advanced technology works both in terms of safety and effectiveness will take years to determine, as it took years to gather enough real-world evidence to satisfy officials, just over three years ago, that something had to be done about air-bag safety in the first place.

Then, a public outcry from news stories of children killed by bags, buoyed by findings of the National Transportation Safety Board (NTSB) and the National Highway Traffic Safety Administration (NHTSA), strengthened a position long held by critics of the air-bag mandate: that forcing the technology on the general public, relatively untested, was a grave policy mistake.

Official reports also established that this "passive" technology was far less effective in reducing fatalities than originally, and widely, promised. For example, NHTSA found in 1996, in its most thorough review of effectiveness, that air bags were about onethird as effective in saving lives as it had estimated in announcing the 1977 rules, which mandated so-called passive restraints.

With safety-belt use up from the time of the original mandate (from around 10% in the 1970s to around 68% in 1996), the asserted need for passive-restraint mandates, intended to protect a public that largely went unbelted, was dramatically diminished-- particularly for anyone wearing belts. (All states but New Hampshire now require belt use, at least in the front seat.) The safety data showed that air bags offered only modest improvement for people who buckle their safety belts and significantly less protection than that provided by belts alone.

According to NHTSA, for instance, air bags reduced a belted driver's fatality risk by about 9%. Given roughly 42% effectiveness of belts, this suggested that of 100 drivers killed in a crash when they were not wearing belts, 42 would have survived if they all had been wearing belts, and another five would have survived with the addition of an air bag -a positive benefit, but one dwarfed by the advantage of seat belts alone. (Unbelted drivers' deaths were generally reduced by 14% by air bags alone.)

Public-Safety Blunder

Yet, hidden within these statistics was a troubling fact: The available research showed that about a quarter of the U.S. population got little or no protection from air bags-and may have been at an increased risk of harm. NHTSA's data revealed that children younger than 13 were substantially more likely to die in an air bag-equipped car than one without. And the data suggested that people older than 70, as well as short-- stature women, might also have been at increased risk.

Moreover, the big secret behind the posifive air-bag pronouncements was how little information was available about effectiveness for specific populations: It was not (and still is not) clear in the big numbers how many people reportedly saved by air bags were belted or unbelted, how many were female or elderly.

Official tallies put lives saved at about 1,700 through 1996 (about 5,000 through 1999). But they relied on data extrapolation without accounting for specific populations, let alone changes in behavior-such as driving more quickly-that also could reduce effectiveness of the devices. While this was enough to support the official statements of air bags' "public safety" value, it ultimately could prove hollow as more data come in.

In all, the air-bag mandate had been shown to be a certifiable blunder. It was unique among government health initiatives in its threat, and continued threat, to innocents. As one leading traffic safety researcher summed up the issue before an NTSB panel:

"I am the husband of a 4'11" wife who quite often points to the driver seat in our car and says to me, the safety expert, 'Why am I compelled to drive at increased risk of being killed and injured by a device that was installed in order to reduce the risk to a large male who is driving illegally without a safety belt? Such a person will never sit in that seat. It is my car. Yet I sit in it twice per day."'

In response to such concerns, NHTSA turned the whole notion of air bags as a passive safety device on its head. Suddenly, people no longer were expected to drive blissfully as they had before, protected "passively" whether they wore belts or not.

Under the revised instructions, they had to follow a series of steps to protect themselves from air bags, getting pedal extenders if necessary. Kids, whenever possible, were to be put in the back seats. If people thought the bags a risk to their or their loved ones' safety, they had to request permission from NHTSA to get the devices shut off (if they could find a shop to do it).