oversight

Motorcycle Safety: Increasing Federal Funding Flexibility and Identifying Research Priorities Would Help Support States' Safety Efforts

Published by the Government Accountability Office on 2012-11-14.

Below is a raw (and likely hideous) rendition of the original report. (PDF)

                United States Government Accountability Office

GAO             Report to Congressional Committees




November 2012
                MOTORCYCLE
                SAFETY

                Increasing Federal
                Funding Flexibility
                and Identifying
                Research Priorities
                Would Help Support
                States’ Safety Efforts




GAO-13-42
                                             November 2012

                                             MOTORCYCLE SAFETY
                                             Increasing Federal Funding Flexibility and
                                             Identifying Research Priorities Would Help Support
                                             States’ Safety Efforts
Highlights of GAO-13-42, a report to
Congressional Committees




Why GAO Did This Study                       What GAO Found
According to NHTSA, per vehicle mile         GAO estimated that the total direct measurable costs of motorcycle crashes—
traveled in 2010, motorcyclists were         costs that directly result from a crash and that can and have been measured—
about 30 times more likely to die in a       were approximately $16 billion in 2010. However, the full costs of motorcycle
traffic crash than passenger car             crashes are likely higher because some difficult-to-measure costs—such as
occupants. States have implemented           longer-term medical costs—are not included. Victims and their families, as well
various strategies to address the            as society—including employers, private insurers, healthcare providers,
factors contributing to motorcycle           government, and others—bear these costs. The National Highway Traffic Safety
crashes and fatalities, and NHTSA has        Administration (NHTSA) estimated that society bears about three-quarters of the
assisted these efforts through
                                             measurable costs of all motor vehicle crashes. Society’s share of the costs of
guidance, grants, and research. GAO
                                             motorcycle crashes may be similar or higher, in part because injuries from these
reviewed: (1) what is known about the
cost of motorcycle crashes; (2) the
                                             crashes are generally more severe than those from other motor vehicle crashes.
factors that contribute to motorcycle
crashes and fatalities, and strategies       Various factors contribute to motorcycle crashes and states pursue a range of
states are pursuing to address these         strategies to address them. These factors include alcohol impairment; speeding;
factors; and (3) the extent to which         lack of a license, training, or riding skills; and lack of motorist awareness of
NHTSA assists states in pursuing             motorcycles. Another factor, lack of helmet use, does not affect the likelihood of a
strategies that address these factors.       crash but increases the risk of a fatality when a crash occurs. State strategies
GAO reviewed studies, analyzed               include: licensing approaches, training programs, enforcement of alcohol
documents and data from NHTSA and            impairment and speed limit laws, efforts to improve motorcyclist safety
other sources, and interviewed officials     awareness and motorist awareness, and helmet-use laws. Laws requiring all
in the U.S. Department of                    motorcyclists to wear helmets are the only strategy proved to be effective in
Transportation (DOT) and 16 states as        reducing motorcyclist fatalities, but some opposition to such laws exists, and only
well as representatives of various           19 states currently have them. According to NHTSA, proven approaches used in
stakeholder organizations. GAO               some other highway safety efforts, such as combining strong enforcement with
selected states that were                    public education, may hold promise for improving motorcycle safety.
geographically diverse and that had
varying fatality rates, laws and policies,   NHTSA helps states develop and implement motorcycle safety strategies through
and ridership levels.                        various efforts. It has provided states with guidance, outreach, and training
                                             which according to state officials, has improved their ability to address
What GAO Recommends                          motorcycle safety. From fiscal years 2006 to 2012, NHTSA awarded $45.9
Congress should consider expanding           million in motorcyclist safety grants to states; Congress has allowed these funds
the strategies for which NHTSA’s             to be used for motorcyclist training and motorist awareness efforts only.
motorcyclist safety grants can be used       However, major studies on motorcycle safety issues have recommended a range
to give states more flexibility in how to    of additional strategies for reducing crashes and fatalities, some of which NHTSA
use these funds. In addition, GAO            has identified as a high priority for states to pursue. These strategies include
recommends that NHTSA identify               increasing helmet use and motorcyclist safety awareness, and educating police
research priorities for motorcycle           about motorcycle safety in order to strengthen enforcement. NHTSA and state
safety that address gaps in knowledge        officials noted that expanding the allowable uses for the grants would better
about the effectiveness of state             enable states to use such strategies. NHTSA has conducted research—totaling
strategies, particularly those strategies    $7.3 million in the last 5 fiscal years—to identify new and evaluate existing state
it has identified as high priority or        strategies. For example, one new study will identify factors and programs that
promising. DOT officials agreed to           may be related to higher rates of helmet use in states that do not require all
consider this recommendation and             motorcyclists to wear helmets. NHTSA does not have a current plan to guide its
provided technical comments, which           motorcycle safety research efforts but intends to develop one by spring 2013.
GAO incorporated as appropriate.
                                             Given its limited funding for research, such a plan provides an opportunity for
View GAO-13-42. For more information,        NHTSA to identify research priorities, based on gaps in knowledge about the
contact Susan Fleming at (202) 512-2834 or   effectiveness of motorcycle safety strategies and the types of strategies it has
flemings@gao.gov.
                                             identified as a high priority or promising for states to pursue.
                                                                                      United States Government Accountability Office
Contents


Letter                                                                                   1
              Background                                                                 5
              The Costs of Motorcycle Crashes to Society and Individuals Are
                Significant                                                              9
              States Are Addressing Some of the Factors That Contribute to
                Crashes and Fatalities through Various Strategies, but
                Effectiveness Is Unclear                                               16
              NHTSA Supports States’ Motorcycle Safety Programs, but Funding
                Flexibility and New Research Priorities Would Enhance Efforts          39
              Conclusions                                                              50
              Matter for Congressional Consideration                                   51
              Recommendations                                                          51
              Agency Comments                                                          51

Appendix I    Scope and Methodology
                                                                                       53



Appendix II   GAO Contact and Staff Acknowledgments                                    60



Tables
              Table 1: Types of Direct Measurable Motor Vehicle Costs
                       Estimated in 2002 NHTSA Study                                   11
              Table 2: Types of State Motorcycle Safety Strategies                     22
              Table 3: NHTSA Research and Development on Strategies to
                       Improve Motorcycle Safety, Fiscal Year 2012                     48


Figures
              Figure 1: Example of a Crash Involving an Automobile and
                       Motorcycle                                                        5
              Figure 2: Motorcyclist Fatality Rate per 100,000 Registered
                       Motorcycles, 1991 to 2010                                         7
              Figure 3: Distribution of Estimated Direct Measurable Costs of
                       Motorcycle Crashes, 2010                                        12
              Figure 4: Example of a Poster Used to Encourage Motorist
                       Awareness                                                       26
              Figure 5: Helmet Use Laws in the United States as of October 2012        28



              Page i                                            GAO-13-42 Motorcycle Safety
Figure 6: Examples of Non-Compliant and DOT-Compliant Helmets                             30




Abbreviations list

BAC               blood alcohol concentration
CDC               Centers for Disease Control and Prevention
FARS              Fatality Analysis Reporting System
FHWA              Federal Highway Administration
MAP-21            Moving Ahead for Progress in the 21st Century Act
NHTSA             National Highway Traffic Safety Administration
NTSB              National Transportation Safety Board
SAFETEA-LU        Safe, Accountable, Flexible, Efficient Transportation Act: A
                  Legacy for Users


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Page ii                                                       GAO-13-42 Motorcycle Safety
United States Government Accountability Office
Washington, DC 20548




                                   November 14, 2012

                                   The Honorable John Rockefeller
                                   Chairman
                                   Committee on Commerce, Science, and Transportation
                                   United States Senate

                                   The Honorable Patty Murray
                                   Chairman
                                   The Honorable Susan Collins
                                   Ranking Member
                                   Subcommittee on Transportation, Housing and Urban Development, and
                                   Related Agencies
                                   Committee on Appropriations
                                   United States Senate

                                   The Honorable Tom Latham
                                   Chairman
                                   The Honorable John W. Olver
                                   Ranking Member
                                   Subcommittee on Transportation, Housing and Urban Development, and
                                   Related Agencies
                                   Committee on Appropriations
                                   House of Representatives

                                   In 2010, an estimated 95,000 motorcycle crashes occurred in the U.S.
                                   and 4,423 of these crashes were fatal. 1 Motorcyclists are involved in fatal
                                   crashes at higher rates than drivers of other types of motor vehicles, both
                                   per registered vehicle and vehicle miles traveled. In 2010, while
                                   motorcycles accounted for only about 3 percent of all registered vehicles,
                                   they were involved in about 15 percent of all fatal vehicle crashes. Not
                                   only can motorcycle crashes result in injury to or death of the victims, but
                                   they can impose costs for medical treatment, property damage, and loss
                                   of productivity. Various factors, such as alcohol impairment, have been
                                   identified as contributing to the occurrence of such crashes, while others,


                                   1
                                    The vast majority of these fatal crashes involved two-wheeled motorcycles. In addition to
                                   two-wheeled motorcycles, the broad definition of “motorcycles” used here includes
                                   mopeds, three-wheel motorcycles, off-road motorcycles, and other motored-cycles (such
                                   as mini-bikes, motor scooters, and pocket motorcycles).




                                   Page 1                                                        GAO-13-42 Motorcycle Safety
particularly the lack of helmet use, affect the likelihood of a fatality when a
crash occurs. States have responsibility for developing and implementing
strategies—such as training programs for motorcyclists and laws
requiring helmet use—to address motorcycle safety. The National
Highway Traffic Safety Administration (NHTSA) is the federal agency that
assists states in pursuing strategies to address the factors contributing to
motorcycle crashes and fatalities through various activities, including
providing guidance, outreach, and training, administering grants, and
sponsoring research.

We conducted this work for the Senate and House Committees on
Appropriations. 2 The Chairman of the Senate Committee on Commerce,
Science, and Transportation also requested that we conduct such a
study. In this report, we:

1. determine what is known about the costs of motorcycle crashes;
2. identify factors that contribute to motorcycle crashes and to fatalities
   when crashes occur, and strategies states are pursuing to address
   these factors; and
3. examine the extent to which NHTSA assists states in pursuing
   strategies that address these factors.

To determine what is known about the costs of motorcycle crashes, we
reviewed studies on these costs, including the amount and types of costs
that crashes impose and who pays those costs. Because existing cost
estimates either only covered specific types of costs or pertained to all
vehicle types, we developed an estimate of the total direct measurable
costs 3 of motorcycle crashes in 2010. We used data developed in a 2002
NHTSA study, which provided estimates of direct measurable costs of all
motor vehicle crashes in 2000 for various categories of costs, such as
medical costs and costs associated with loss of market productivity (lost




                                                                               th
2
 A direction to perform this work is contained in S. Rept. No. 112-83, p. 66, 211 Cong.
(2011), the conference report that accompanied the Consolidated and Further Continuing
                                                                th
Appropriations Act, 2012. H.R. Rept No. 112-284, p. 286, 211 Cong., (2011) directed
that our report be filed with both the Senate and House Committees on Appropriations.
3
 Direct measurable costs are those costs directly resulting from a crash that can and have
been measured.




Page 2                                                       GAO-13-42 Motorcycle Safety
wages). 4 To arrive at our estimate of costs specifically for motorcycle
crashes in 2010, we used inflation indices to convert NHTSA’s cost
estimates to 2010 dollars and 2010 motorcycle crash data to extricate
costs attributable solely to motorcycle crashes. To identify the factors that
contribute to motorcycle crashes and fatalities and strategies that states
are pursuing to address these factors, we conducted interviews with
officials from NHTSA, the Federal Highway Administration (FHWA), the
Centers for Disease Control and Prevention (CDC), the National
Transportation Safety Board (NTSB), and stakeholder organizations
involved in motorcycle safety, including the American Association of
Motor Vehicle Administrators, the Governors Highway Safety Association,
the National Association of State Motorcycle Safety Administrators, the
Motorcycle Safety Foundation, and the American Motorcyclist
Association. We also conducted interviews with and reviewed
documentation from state officials responsible for motorcycle safety in 16
states. We selected these 16 states to include a range of fatality rates,
varying types of motorcycle safety laws and policies, varying levels of
motorcycle ridership, and geographic diversity. 5 We analyzed data from
NHTSA’s Fatality Analysis Reporting System (FARS) for calendar years
1991 to 2010 to identify characteristics of fatal crashes. In addition, we
conducted a literature review to obtain information about the factors that
contribute to motorcycle crashes and fatalities and determine the extent
of knowledge about the effectiveness of motorcycle safety strategies used
by states. We included in our review studies that we identified based on
certain selection criteria, including those authored or provided to us by




L. Blincoe et al, The Economic Impact of Motor Vehicle Crashes, 2000 (Washington,
4

D.C.: National Highway Traffic Safety Administration, 2002).
5
 These 16 states are Arizona, California, Colorado, Florida, Idaho, Iowa, Maryland,
Mississippi, Missouri, New Hampshire, New Jersey, New York, Texas, Utah, Washington,
and Wisconsin. For five of these states—Florida, Iowa, Maryland, Texas, and
Wisconsin—we interviewed additional agencies and organizations responsible for
motorcycle safety, including the applicable NHTSA region, state agencies responsible for
motorcycle licensing and training; state and local law enforcement agencies; and
motorcycle advocacy groups. We did not include states’ motorcycle safety efforts related
to road infrastructure or emergency response in our review.




Page 3                                                      GAO-13-42 Motorcycle Safety
federal and state agencies and organizations we interviewed and other
studies published in the last 10 years. 6

To examine the extent to which NHTSA assists states in pursuing
strategies that address factors contributing to motorcycle crashes and
fatalities, we reviewed the Safe, Accountable, Flexible, Efficient
Transportation Equity Act: A Legacy for Users (SAFETEA-LU), 7 the
Moving Ahead for Progress in the 21st Century Act (MAP-21), 8 relevant
portions of the United States Code, and federal regulations to determine
NHTSA’s responsibilities and authority related to motorcycle safety. We
reviewed documentation and interviewed officials in NHTSA headquarters
and regional offices to determine what NHTSA has done to identify and
promote motorcycle safety strategies for use by states, including
guidance, outreach, and training; providing grants; and conducting
research. We obtained views of state officials we interviewed on NHTSA’s
efforts and determined the extent to which these efforts address research
gaps we identified as well as high priority motorcycle safety strategies
identified by NHTSA, the Motorcycle Safety Foundation, NTSB, CDC, and
the Transportation Research Board.

We conducted this performance audit from October 2011 to November
2012 in accordance with generally accepted government auditing
standards. Those standards require that we plan and perform the audit to
obtain sufficient and appropriate evidence to provide a reasonable basis
for our findings and conclusions based on our audit objectives. We
believe that the evidence obtained provides a reasonable basis for our
findings and conclusions based on our audit objectives. Further details on
our scope and methodology can be found in appendix I.




6
 To assess the effectiveness of motorcycle helmet laws, we included older studies
because many changes in helmet laws occurred and were evaluated more than 10 years
ago. In some cases, we also included studies published more than 10 years ago when
there was limited or no research about that strategy in the last 10 years. In such cases, we
considered the extent to which factors may have changed over time that could affect the
relevance of their findings.
Pub. L. No. 109-59, 119 Stat. 1144 (2005).
7



Pub. L. No. 112-141, 126 Stat 405 (2012).
8




Page 4                                                        GAO-13-42 Motorcycle Safety
             Motorcycle crashes are more likely to be fatal than other types of vehicle
Background   crashes. Of the estimated 5.4 million motor-vehicle crashes that occurred
             in the U.S. in 2010, less than 1 percent resulted in at least one fatality,
             while almost 5 percent of the 95,000 motorcycle crashes in 2010 resulted
             in at least one fatality. When a crash occurs, motorcycle riders are much
             more vulnerable than passengers of other vehicles. Unlike a motorcyclist,
             a passenger vehicle occupant is protected by the car’s metal frame and
             generally by a seat belt (as required by law), and usually airbags for the
             front seats. 9 As a result, according to NHTSA, motorcyclists were about
             30 times more likely to die in a traffic crash than passenger car occupants
             per vehicle mile traveled in 2010. 10

             Figure 1: Example of a Crash Involving an Automobile and Motorcycle




             9
              As we discuss in more detail later in this report, helmets and other protective gear do
             offer some protection.
              U. S. Department of Transportation, National Highway Traffic Safety Administration.
             10

             Traffic Safety Facts: 2010 Data, Motorcycles. DOT HS 811 639 (Washington, D.C.: 2012).




             Page 5                                                         GAO-13-42 Motorcycle Safety
Over the last two decades, the number of fatalities of passenger vehicle
occupants as a result of crashes has decreased, while the number of
motorcyclist fatalities has increased. From 1991 to 2010, fatalities of
passenger vehicle 11 occupants dropped from 30,776 to 22,187, while
motorcyclist fatalities rose from 2,806 to 4,502—a 60 percent increase. 12
Much of the increase in motorcyclist fatalities is related to an increase in
motorcyclists on the road. From 1991 to 2010, motorcycle registrations in
the U.S. increased from about 4.2 million in 1991 to 8.2 million in 2010—a
97 percent increase. When looking at the number of fatalities per
registered vehicle for motorcycles, fatality rates have declined over the
last few years (see fig. 2).




 Fatalities include only traffic fatalities. Passenger vehicle fatalities include drivers and
11

passengers of passenger vehicles. We have defined passenger vehicles as passenger
cars and light trucks and vans. Motorcyclist fatalities include drivers and passengers of
motorcycles.
12
  The number of motorcyclist fatalities peaked at 5,312 in 2008, then decreased to 4,469
in 2009 and rose slightly to 4,502 in 2010. Based on preliminary data for 2011, the
number of motorcyclist fatalities is expected to remain about the same as in 2010.




Page 6                                                           GAO-13-42 Motorcycle Safety
Figure 2: Motorcyclist Fatality Rate per 100,000 Registered Motorcycles, 1991 to 2010




                                         Because motorcycle enthusiasts are a diverse group of people,
                                         motorcycle crashes and fatalities affect a wide demographic. Men still
                                         make up an overwhelming proportion of riders, but ridership among
                                         women is increasing. With regard to age, motorcyclist fatalities are not
                                         concentrated among younger riders. As older riders who rode in their
                                         youth increasingly return to motorcycling, fatalities among older
                                         motorcyclists have increased. From 2001 to 2010, riders 35 and older
                                         constituted more than half of all motorcyclist fatalities. That proportion has
                                         steadily increased from just over 50 percent in 2001 to 66 percent in
                                         2010. In fact, the largest number of fatalities in 2010 was in the 45-54 age
                                         group.

                                         NHTSA, states, and, to some extent, local governments, have a role in
                                         improving motorcycle safety. NHTSA aims to reduce deaths, injuries, and
                                         economic losses resulting from motor vehicle crashes, including
                                         motorcycle crashes, through the efforts of its headquarters and 10
                                         regional offices. NHTSA does so primarily through grants to state
                                         governments meant to support state and local safety programs. As part of
                                         that effort, NHTSA headquarters conducts research on motorcyclist
                                         behavior and safety strategies and provides guidance, outreach, and
                                         training to states. NHTSA headquarters is also responsible for evaluating
                                         those programs, collecting data, and promulgating regulations. NHTSA’s



                                         Page 7                                               GAO-13-42 Motorcycle Safety
regional offices monitor states’ spending and provide assistance to states’
motorcycle safety programs.

Each state must have a highway safety program that is approved by the
Secretary of Transportation and in accord with uniform guidelines issued
by the Secretary. 13 Under these guidelines, states are expected to
develop a centralized motorcycle safety program, among other things,
and to implement projects to reach the goals and objectives that reflect
their states’ demographics and needs. States’ motorcycle safety
programs should include:

•     a motorcycle licensing system that provides among other
      components, educational information and penalties for violations of
      licensing requirements;
•     a state motorcycle rider education program;
•     safety communication campaigns; and
•     data on the frequency and types of motorcycle crashes in their state.

Also, each state should ensure that programs addressing impaired driving
include an impaired-motorcyclist component.

Congress has also taken steps to support states’ efforts. In 2005,
SAFETEA-LU established a $25 million motorcyclist safety-grant program
to encourage states to adopt and implement programs to reduce the
number of crashes involving motorcyclists. States received the first year
of these grants at the end of fiscal year 2006. 14 To be eligible to receive
this grant, a state had to meet certain criteria, including implementing a
statewide training program for motorcycle riders and an awareness
program for motorists. 15 Funds granted under the program could be used
for motorcyclist training and motorist awareness programs, such as
improving training curriculums, delivering training, recruiting or retaining
motorcyclist safety instructors, and establishing and conducting public
awareness and outreach programs. States were not required to provide



13
    23 U.S.C. § 402(a), as amended by MAP-21, § 31102, 126 Stat., 734-739.
14
    SAFETEA-LU, § 2010, 119 Stat., 1535, repealed by MAP-21, § 31109(g).

 All states have been eligible to receive these grants each year, except for Alabama and
15

Mississippi (only eligible in 2009), South Carolina (ineligible in 2006, did not apply in 2007
and 2008, eligible and received grants in 2009 and 2010), and the District of Columbia
(has never applied).




Page 8                                                          GAO-13-42 Motorcycle Safety
                     matching funds. Additionally, states could use the State and Community
                     Highway Safety Grant Program for motorcycle safety efforts, if those
                     efforts are included in their state highway safety plan. This grant program
                     provides highway safety program funds for states through a formula
                     based on each state’s population and public road miles. 16

                     In July 2012, the President signed MAP-21 into law, amending section
                     405 of title 23, United States Code, to establish National Priority Safety
                     Program grants, including motorcycle safety grants formerly authorized by
                     SAFETEA-LU section 2010. 17 MAP-21 authorized continuing funding for
                     these grants, 18 at about half the SAFETEA-LU funding level, through the
                     end of fiscal year 2014. States may continue to use their State and
                     Community Highway Safety Grant funding for motorcycle safety efforts.

                     Studies indicate that the costs of motorcycle crashes are significant, but
The Costs of         have only estimated specific types of these costs. We conducted our own
Motorcycle Crashes   analysis, using data from a 2002 NHTSA study on the costs of all motor
                     vehicle crashes as well as some additional data, and estimate that the
to Society and       direct measurable costs of motorcycle crashes—those costs that directly
Individuals Are      result from a crash and that can and have been measured—were
Significant          approximately $16 billion in 2010. However, accurately determining the
                     full costs is difficult because some—such as long-term medical costs and
                     intangible costs related to emotional pain and suffering—are difficult to
                     measure. Thus, the full costs of motorcycle crashes are likely higher than
                     our estimate. Victims and their families as well as society—including
                     employers, private insurers, healthcare providers, government, and
                     others—bear these costs. NHTSA estimated that society bears about
                     three-quarters of the measurable costs of all motor vehicle crashes.
                     Society’s share of the costs of motorcycle crashes may be similar or
                     higher, in part because injuries from these crashes are more severe.




                      See 23 U.S.C. § 402, discussed above.
                     16



                      MAP-21, § 31105, 126 Stat., 741-755, codified as positive law at 23 U.S.C.
                     17

                     § 405(a)(1)(E). The terms and requirements for motorcyclist safety grants under 23 U.S.C.
                     § 405 are substantially similar to those under SAFETEA-LU § 2010. NHTSA classified
                     motorcycle safety as a National Priority Program Area under 23 C.F.R. § 1205.3 for
                     purposes of administering the highway safety grant program under 23 U.S.C. § 402(c),
                     and reflecting the role of § 402 as a second source of funding for motorcycle safety
                     programs. See, also, 23 C.F.R. § 1205.4.
                      MAP-21, § 31101(a)(3), 126, Stat. 732-733.
                     18




                     Page 9                                                      GAO-13-42 Motorcycle Safety
Overall Costs Are            Studies we identified on the costs of motorcycle crashes indicate that the
Substantial, but Some Cost   costs are significant, but the studies estimated only specific types of direct
Elements Are Difficult to    measurable costs. Direct measurable costs are those costs directly
                             resulting from a crash that can and have been measured. One study,
Measure                      conducted by CDC and Pacific Institute for Research and Evaluation,
                             estimated three categories of costs associated with motorcycle crashes:
                             medical costs, costs associated with the loss in market productivity (lost
                             wages), and costs associated with the loss in household productivity
                             (costs of hiring someone to perform household tasks). The study
                             estimated that the total for these cost categories for all motorcycle
                             crashes nationwide in 2005 was $12 billion. 19 A number of the studies we
                             identified estimated only the motorcycle crash victims’ medical costs. One
                             such study estimated that the total hospital charges for the initial
                             treatment of motorcyclists injured in traffic crashes in Florida in 2010 was
                             $348 million.

                             Lacking a comprehensive study of the costs of motorcycle crashes, we
                             conducted our own analysis and estimate that the direct measurable
                             costs of motorcycle crashes in 2010 were about $16 billion. To develop
                             our estimate, which is a rough approximation of these costs, we began
                             with a 2002 NHTSA study that provided a comprehensive examination of
                             the direct measurable costs of all types of motor vehicle crashes in 2000,
                             estimating nine categories of costs (see table 1). 20 We used data
                             developed in the 2002 NHTSA study, which provided estimates for each
                             of these cost categories across various levels of injury severity. We
                             updated these cost estimates to 2010 values by adjusting for inflation. We
                             then applied the updated motor vehicle crash cost estimates to NHTSA’s
                             2010 data on motorcycle crash incidence, which included a breakdown of
                             crashes by severity classifications. This provided our aggregate estimate




                             19
                               Naumann RB, Dellinger AM, Zaloshnja E, Lawrence BA, and Miller TR, “Incidence and
                             total lifetime costs of motor vehicle-related fatal and nonfatal injury by road user type,
                             United States, 2005,” Traffic Injury Prevention, vol. 11, no.4 (2010).
                             20
                               L. Blincoe et al, The Economic Impact of Motor Vehicle Crashes (Washington, D.C.:
                             NHTSA, 2002). NHTSA estimated the costs of all motor vehicle crashes—not just those
                             involving motorcycles—to be $230 billion in 2000 (or $280 billion in 2010 dollars).




                             Page 10                                                        GAO-13-42 Motorcycle Safety
                                         of the cost of motorcycle crashes in 2010. 21 (See app. I for further
                                         description of our methodology.) NHTSA is in the process of updating its
                                         motor vehicle crash cost estimates and, as part of that effort, plans to
                                         separately calculate the direct measurable costs associated with
                                         motorcycle crashes. 22

Table 1: Types of Direct Measurable Motor Vehicle Costs Estimated in 2002 NHTSA Study

Type of cost                     Description
Medical                          Costs of all medical treatments, including those during ambulance transport. It includes costs of
                                 emergency room, inpatient costs, follow-up visits, physical therapy, rehabilitation, prescriptions,
                                 prosthetic devices, and home modification.
Emergency services               Costs of police and fire department response services.
Loss in market productivity      Total lost wages of the victim.
Loss in household productivity   Costs associated with lost productive household activity, valued at the market price for hiring
                                 another person to accomplish the same tasks.
Insurance administration         Administrative costs of processing insurance claims and defense attorney costs.
Workplace                        Costs of workplace disruption that are due to the loss or absence of an employee.
Legal                            Legal fees and court costs of civil litigation resulting from crashes.
Travel delay                     Value of travel time delay for all road users as a result of a crash.
Property damage                  Value of vehicles, cargo, roadways and other items damaged in a crash.
                                         Source: NHTSA, Economic Impact Report, 2002.



                                         Our estimated $16 billion in direct measurable costs of motorcycle
                                         crashes can be broken down according to the nine different types of costs
                                         identified by the NHTSA study. As shown in figure 3, loss in market
                                         productivity was the largest cost element, constituting 44 percent of the
                                         estimated total direct measurable costs. This category is followed by


                                         21
                                           Various factors account for differences between our cost estimate of $16 billion and the
                                         previous estimate produced by CDC and the Pacific Institute for Research and Evaluation
                                         of $12 billion. Our estimate covers the nine types of direct measurable costs developed in
                                         the 2002 NHTSA study, whereas CDC and the Pacific Institute for Research and
                                         Evaluation estimate covers only three types of costs, as noted above. Given that medical
                                         and productivity costs constitute almost 80 percent of all costs (see fig. 1), our estimate is
                                         very similar to theirs as 80 percent of $16 billion is about $12 billion. Furthermore, CDC’s
                                         estimate accounted for unreported crashes whereas ours did not, and its estimate was in
                                         2005 dollars and ours is in 2010 dollars. Accounting for all of these differences, the two
                                         estimates are somewhat consistent.
                                          NHTSA’s current effort to update its crash cost estimates will provide a more accurate
                                         22

                                         estimate of motorcycle crash costs and will consider various environmental costs, such as
                                         congestion costs. NHTSA plans to issue its report in spring 2013.




                                         Page 11                                                          GAO-13-42 Motorcycle Safety
medical costs (18 percent), household productivity costs (14 percent),
legal costs (9 percent), and insurance administration costs (7 percent).
The remaining 8 percent is divided among workplace costs, travel delay
costs, and costs resulting from property damage.

Figure 3: Distribution of Estimated Direct Measurable Costs of Motorcycle Crashes,
2010




In addition to our overall estimate that the direct measurable costs of
motorcycle crashes were about $16 billion in 2010, we found that crash
costs varied dramatically based on injury severity. In 2010, 82,000
motorcyclists were injured in motorcycle crashes, and these injuries
ranged from minor to very severe; the direct measurable costs for non-
fatal crashes ranged from $2,500 for the most minor injury to about $1.4




Page 12                                                 GAO-13-42 Motorcycle Safety
                            million for the most severe injury, on average. 23 As noted previously, in
                            2010, 4,502 motorcyclists died in motorcycle crashes. The average cost
                            for a fatal crash was estimated to be about $1.2 million. That a fatality can
                            cost less than the most severe injury is partly because severe injuries can
                            result in total incapacitation. Some victims, such as those with severe
                            brain injuries, cannot be productive and require ongoing care and medical
                            expenses.

                            Although prior studies and our analysis suggest that the costs of
                            motorcycle crashes are significant, it is difficult to determine the full costs
                            with accuracy because some types of costs are difficult to measure. For
                            example, the treatment for serious injury can be long and costly, but
                            follow-up analyses are conducted only for a few years to calculate long-
                            term medical costs. Also, other costs of long-term injury consequences
                            such as change in employment and living status cannot be fully
                            measured. Moreover, intangible costs—such as emotional pain and
                            suffering of the victim and family members resulting from a changed
                            quality of life of the victim—are also significant but are difficult to measure
                            in financial terms. Thus, the full costs of motorcycle crashes are likely
                            higher than our estimate because we could not account for such difficult
                            to measure costs. Also, we did not account for the costs of unreported
                            crashes.


Individuals as well as      Victims and their families bear many of the direct measurable costs of
Society Bear the Costs of   motorcycle crashes. They may pay medical expenses that are not
Motorcycle Crashes          covered by insurance, suffer the loss of income of the victim and lost
                            productivity at home, incur the costs of family members caring for the
                            victim, and suffer losses for property damage not covered by insurance.
                            Because motorcycle accidents are often severe, victims might not return
                            to work for some time or not at all. According to a 2006 NHTSA study
                            based on a survey of motorcycle crash victims who entered inpatient




                            23
                              This represents lifetime costs associated with a crash. However, this might be an
                            underestimate for very serious injuries as calculations of long-term medical costs rely on
                            follow-up analyses of these costs for only 2 to 3 years post-injury.




                            Page 13                                                        GAO-13-42 Motorcycle Safety
rehabilitation, of those employed at the time of the crash, 51 percent were
no longer employed at the time of discharge. 24

In addition to victims and their families, other members of society—
employers, private insurers, healthcare providers, government, and
others—bear a significant amount of the direct measurable costs of
motorcycle crashes. Both state and federal governments pay some of
these costs through Medicaid and other assistance programs. Private
insurers often bear significant costs for covered treatment—which are
largely paid through their customer base. Healthcare providers—such as
hospitals—may bear some unpaid charges. The victims’ co-workers and
employers may need to temporarily work overtime or hire and train new
employees to cover the work of lost employees and other administrative
costs of personnel changes. Even road users can be affected if travel
delays result during the emergency response to and cleanup of the crash.

NHTSA’s 2002 study, based on data on all motor vehicle crashes in 2000,
estimated that three-quarters of the direct measurable costs appear to be
borne by society. Although NHTSA’s analysis of the societal burden
associated with crashes was based on all types of motor vehicle crashes,
there is some evidence that society’s share of costs for motorcycle
crashes may be similar or even higher, for example:

•      Motorcyclists have a greater likelihood of a more severe injury in a
       crash compared to other motorists. Based on a 2008 NHTSA study,
       about 43 percent of motorcyclist crash victims suffered moderate to
       critical injuries when involved in a crash. 25 In contrast, based on
       NHTSA’s 2002 study, less than 8 percent of all motorists suffered
       from such injuries in a crash. 26 As previously noted, direct measurable
       costs increase substantially with the degree of accident severity.



24
  Ted Miller et al, Rehabilitation Costs and Long-Term Consequences of Motor Vehicle
Injury (Washington, D.C.: NHTSA, 2006). A total of 237 motorcycle crash victims were
surveyed. Length of stay in inpatient rehabilitation ranged from 10 to 71 days.
25
  Lawrence J. Cook et al, Motorcycle Helmet Use and Head and Facial Injuries, Crash
Outcomes in CODES-Linked Data, DOT HS 811 2008 (Washington, D.C.: National
Highway Traffic Safety Administration, 2008). Moderate to critical injuries are injuries that
fall in the maximum abbreviated injury scale categories 2 to 5, and these proportions were
calculated from a NHTSA 2008 study, which evaluated combined data from 18 states on
89,086 motorcycle crashes and 104,472 motorcyclists between 2003 and 2005.
26
    Data on all motorists is for the year 2000.




Page 14                                                        GAO-13-42 Motorcycle Safety
     Furthermore, according to a 2008 report by the Pacific Institute for
     Research and Evaluation, for each category of injury severity,
     government cost per crash is higher on average for motorcycle crash
     victims than for all motor vehicle crash victims. 27
•    Motorcyclists may insure against fewer risks than their motor vehicle
     driver counterparts. According to a 2003 report by the Pacific Institute
     for Research and Evaluation conducted for NHTSA, legal and lender
     insurance requirements force most motorists to insure against a broad
     range of risks, but the requirements for motorcycle insurance
     coverage are usually less stringent. 28 In particular, the study found
     that, for the insurance companies included in the study, only 15
     percent of motorcycle insurance policies in 1999 included personal
     injury protection or coverage of the motorcyclist’s own medical
     expenses, while 98 percent of the insurance policies for other vehicles
     included these types of coverage. Our review did not identify any
     more recent studies on this topic. However, we did identify estimates,
     provided by Florida state officials that, in 2010, 51 percent of the costs
     of motorcyclist hospitalizations and emergency department visits in
     their state were not covered by commercial insurance. Also, we
     identified a 1999 study of uninsured vehicles in California that found
     that 66 percent of motorcycles were uninsured compared with only 19
     percent for automobiles. 29 To the extent that motorcyclists have less
     insurance coverage than other motor vehicle drivers, a greater
     proportion of medical costs associated with motorcycle crashes may
     need to be paid from public funds.

With respect to difficult-to-quantify costs, determining the share paid by
victims and their families versus society is difficult. NHTSA’s estimates of


27
  Ted Miller et al, Cost of Crashes to Government, United States, 2008. (Washington,
D.C.: Pacific Institute for Research and Evaluation, 2008). For different severity of
injuries, total government cost on average ranged from $5,200 to $30,000 for motorcycle
crashes and from $3,500 to $21,000 for all motor vehicle crashes. For fatalities, the cost
was the same for motorcycles and all motor vehicles. For the no-injury category, the cost
was higher for all motor vehicles than for motorcycles.
 The study analyzed data collected from insurance companies that specialize in
28

motorcycle insurance and the nation’s five largest motor vehicle insurers. See Ted R.
Miller and Bruce A. Lawrence., Motor Vehicle Insurance in the United States: A 1998-
1999 Snapshot with Emphasis on Motorcycle Coverage, Final Report to the National
Highway Traffic Safety Administration (Washington, D.C.: National Highway Traffic Safety
Administration, 2003).
 Robert O. Bernstein, California Uninsured Vehicles as of June 1, 1997, Policy Research
29

Bureau, California Department of Insurance (1999).




Page 15                                                       GAO-13-42 Motorcycle Safety
                         the shares of all motor vehicles crash costs borne by individuals and
                         society only covered direct measurable costs, and society’s share of the
                         difficult-to-quantify costs of motorcycle crashes is unclear. For example,
                         while victims and their family are likely to bear most, if not all, of the
                         intangible or nonfinancial costs in terms of emotional pain and suffering
                         resulting from loss in quality of life of the victim or from psychic
                         repercussions of victim’s injury, society may pay a significant portion of
                         the victims’ long-term rehabilitation costs. A 2006 NHTSA study found
                         that inpatient rehabilitation costs for motorcycle injuries averaged $13,200
                         per patient for the year 2002 ($16,000 in 2010 dollars) and that almost 20
                         percent of this was paid by public funds. 30 A 1988 study pointed out that
                         since many insurance policies typically do not cover long-term
                         rehabilitation or nursing home needs, most of these additional charges
                         are paid for by public funds, such as through Medicaid. 31


                         Various factors—including alcohol impairment; speeding; lack of a
States Are Addressing    license, training, or riding skills; and lack of motorist awareness of
Some of the Factors      motorcycles on the road—contribute to motorcycle crashes; another
                         factor, lack of helmet use, contributes to the likelihood of a fatality when a
That Contribute to       crash occurs. States pursue a range of strategies to address these
Crashes and Fatalities   factors, including licensing approaches, training programs, law
through Various          enforcement, efforts to improve motorcyclist safety awareness and
                         motorist awareness, and helmet-use laws. Laws requiring all
Strategies, but          motorcyclists to wear helmets are the only strategy proven to be effective
Effectiveness Is         in reducing fatalities, but only 19 states have such laws. The
                         effectiveness of the other strategies in reducing motorcycle crashes and
Unclear                  fatalities is unclear because research has been limited and results of
                         studies have been mixed or uncertain. However, according to NHTSA
                         officials, approaches that have been proven to be effective in some other
                         highway safety efforts—such as combining strong enforcement with
                         public education to reduce driver alcohol impairment generally—may hold
                         promise for improving motorcycle safety.




                         30
                           Ted Miller et al, Rehabilitation Costs and Long-Term Consequences of Motor Vehicle
                         Injury.(Washington, D.C.: NHTSA, 2006).
                          Frederick P. Rivara et al, “The Public Cost of Motorcycle Trauma,” Journal of the
                         31

                         American Medical Association, voI. 260. no..2 (1988).




                         Page 16                                                      GAO-13-42 Motorcycle Safety
Various Factors Contribute
to Motorcycle Crashes and
Fatalities
Factors Contributing to a Crash   Various factors contribute to the likelihood that a motorcyclist will crash.
                                  Often, a combination of factors can work together to increase the
                                  likelihood. 32 While the extent of evidence concerning each factor’s
                                  importance varies, the four factors identified most frequently by the
                                  federal officials, selected state officials, and stakeholder organizations
                                  that we spoke to were alcohol impairment; speeding; lack of a motorcycle
                                  license, training, or skills; and lack of motorist awareness of
                                  motorcyclists. 33

                                  Alcohol impairment is associated with a large portion of fatal motorcycle
                                  crashes. In 2010, 28 percent of motorcycle drivers involved in fatal
                                  crashes had a blood alcohol concentration (BAC) of 0.08 grams per
                                  deciliter—the legal limit in all states for operating a vehicle—or higher.
                                  This is compared to 23 percent of drivers of passenger vehicles. 34 A BAC
                                  level at or above this limit impairs the judgment of motorcyclists, making



                                  32
                                    While these factors affect the likelihood that an individual will experience a crash,
                                  exposure—the time and miles motorcycles are driven on the road and the number of
                                  motorcycles on the road—affects the overall number of crashes and fatalities in each
                                  state. Weather and the length of the riding season, which vary from state to state,
                                  influence the amount of time motorcyclists spend riding.
                                  33
                                    These factors were also identified in the following reports on motorcycle safety issues
                                  and strategies: National Highway Traffic Safety Administration, Countermeasures That
                                  Work: A Highway Safety Countermeasure Guide for State Highway Safety Offices. Sixth
                                  Edition. DOT HS 811 444. (Washington, D.C.: NHTSA, 2011); Motorcycle Safety
                                  Foundation and National Highway Traffic Safety Administration, National Agenda for
                                  Motorcycle Safety (Washington, DC.: NHTSA, 2000); Transportation Research
                                  Board/National Cooperative Highway Research Program, NCHRP Report 500: Guidance
                                  for Implementation of the AASHTO Strategic Highway Safety Plan, Volume 22: A Guide
                                  for Addressing Collisions Involving Motorcycles. (Washington, D.C.: Transportation
                                  Research Board, 2008); Governors Highway Safety Association, by State: 2011
                                  Preliminary Data. (Washington, D.C.: Governors Highway Safety Association, 2012).
                                  Some of these reports identify additional factors. In particular, the National Agenda for
                                  Motorcycle Safety identified a range of human, social, vehicle, and environmental factors
                                  affecting the likelihood of crashes and the severity of crash outcomes.
                                   Estimates of the percentage of drivers with BAC levels greater than 0.08 grams per
                                  34

                                  deciliter with their 95 percent confidence intervals (CI) are for motorcycle drivers 27.8
                                  percent (95 percent CI of 26.1 percent to 29.4 percent) and for drivers of passenger
                                  vehicles, 22.8 percent (95 percent CI of 22.3 percent to 23.4 percent). See appendix I for
                                  more information about these estimates.




                                  Page 17                                                        GAO-13-42 Motorcycle Safety
them more likely to engage in risky behaviors such as speeding. Some
studies have also found that motorcyclists who are intoxicated are less
likely to wear helmets. 35 In addition to judgment, alcohol also affects the
riding skills of the motorcyclist. A NHTSA study assessing the effects of
alcohol on rider performance showed that motorcyclist riding performance
was significantly impaired at a BAC level of 0.08, and somewhat impaired
at a lower BAC level of 0.05. 36 Drug impairment was also cited by some
state officials as a factor contributing to crashes. 37

Speeding is a major factor contributing to motorcycle crashes, according
to federal and state officials and stakeholder groups we interviewed.
NHTSA has estimated that more than a third of motorcyclist fatalities
involve speeding. However, quantifying the contribution of speeding to
crashes and fatalities is a challenge, because information about the
speed of the motorcycle at the time of the crash often is unreliable.
Officials in two states told us that certain sections of highways are popular
sites for speeding by motorcyclists. According to the Insurance Institute
for Highway Safety, riders of the increasingly popular “supersport”
motorcycles, which can reach higher speeds than other motorcycles, 38
tend to be younger than 30 and are more likely to be involved in crashes
where speed was a factor.

Lack of a motorcycle license, training, or skills were cited by federal
and state officials and stakeholders as significant factors associated with
crashes and fatalities. Licensing programs measure the readiness of
motorcyclists to drive safely and can encourage or require that beginning



 Carley Sauter et al, “Increased Risk of Death or Disability in Unhelmeted Wisconsin
35

Motorcyclists,” Wisconsin Medical Journal, Vol. 104 , No. 2 (2005), pp. 39-44. Timothy
Pickrell and Marc Starnes, An Analysis of Motorcycle Helmet Use in Fatal Crashes,
National Highway Traffic Safety Administration (Washington, D.C. 2008). Thomas S. Dee,
“Motorcycle helmets and traffic safety,” Journal of Health Economics, vol. 28 (2009), pp.
398-412.
 Creaser, J. I. et al. Effects of Alcohol on Motorcycle Riding Skills. (Washington, D.C.,
36

NHTSA, 2007).
 A 2007 survey of alcohol and drug use by drivers found about twice the prevalence of
37

drug use by motorcyclists as passenger vehicle drivers. See John H. Lacey et al, A 2007
National Roadside Survey of Alcohol and Drug Use by Drivers, Drug Results (Washington,
D.C.: National Highway Traffic Safety Administration, 2009).
 Supersport motorcycles are built on a racing bike frame and can reach speeds of nearly
38

190 miles per hour.




Page 18                                                        GAO-13-42 Motorcycle Safety
riders take training prior to receiving a license. Twenty-two percent of
motorcycle riders involved in fatal crashes in 2010 were driving their
vehicles without a valid motorcycle license, compared to 12 percent for
passenger vehicles. Agency officials in eight of the states we covered in
our review reported that some crashes occur as a result of riders
departing from their lane, making improper turns, or following the vehicle
in front too closely. Such riding behaviors may be because of lack of skill
or experience. In addition, agency officials in 10 states reported that older
motorcyclists returning to motorcycling after years of not riding have
contributed to crashes in their state. Some of these officials explained that
many of these older motorcyclists have maintained their motorcycle
licenses for a number of years because they are automatically renewed,
their riding skills have decreased, and they are not required to
demonstrate their skills when returning to riding. This is a possible
explanation for the previously mentioned statistics on fatalities among
older “returning” riders.

Lack of motorist awareness of motorcyclists is a major factor
contributing to crashes, according to many of the federal and state
officials and stakeholders we interviewed. In 2010, 54 percent of all
motorcyclist fatalities were the result of multi-vehicle crashes. A main
problem cited by some of those who noted this factor is that drivers make
a left turn without noticing an oncoming motorcyclist coming from the
opposite direction. Distracted driving can contribute to this problem.
According to NHTSA officials, there are no studies to support the extent
to which motorists are at fault in two-vehicle crashes with motorcycles
because, in part, fault is very challenging to definitively determine.
Related to this issue, motorcyclists who do not wear bright colors can be
less conspicuous to drivers.

Some additional, less frequently cited factors can also contribute to the
likelihood of a motorcycle crash. According to NHTSA officials, judgment
is an overriding factor that affects the likelihood of crash involvement.
Lack of good judgment about actions related to safety can lead to driving
a motorcycle while under the influence of alcohol, speeding, or
aggressive driving. In addition, the design and function of the motorcycle
can affect the likelihood of a crash. According to the Insurance Institute
for Highway Safety, anti-lock braking systems on motorcycles reduce the
likelihood of a crash. Some have also cited road conditions as a main
factor that can lead to a crash. Problems include uneven road surfaces
and rural roads with narrow or no shoulders. According to FHWA officials,
while roadway conditions do contribute to crashes, it is currently unknown



Page 19                                             GAO-13-42 Motorcycle Safety
                                 how frequently this occurs. 39 Other factors cited include encounters with
                                 wildlife (especially deer) and weather conditions.

Factors Affecting the Severity   Other factors that we identified do not affect the likelihood of a crash
of Crash Outcomes                occurring but can affect the severity of injuries when a crash does occur.

                                 Lack of helmet use, most notably, is an important factor contributing to
                                 an increased risk of fatality or serious brain injury when a motorcycle
                                 crash occurs. Several studies have estimated that helmet use reduces
                                 motorcyclist fatality risk, with reductions ranging from 34 to 39 percent. 40
                                 Further, according to NHTSA, the latest studies have found that helmets
                                 reduce the incidence of motorcycle rider brain injuries by 41 to 69
                                 percent. 41 Head injuries account for a significant percentage of
                                 motorcyclist injuries resulting in fatality. NHTSA has estimated that
                                 helmets saved the lives of 1,550 motorcyclists in 2010. 42 DOT has
                                 established standards for motorcycle helmets to ensure a certain degree
                                 of protection in a crash. 43 Use of helmets that are not compliant with
                                 these standards can pose a risk to riders, as wearing non-compliant
                                 helmets is associated with a higher likelihood of receiving a head injury
                                 when a crash occurs.




                                  For further information on this issue and approaches used by state governments to deal
                                 39

                                 with it, see Richard Schaffer et al, Scan 09-04, Leading Practices for Motorcyclist Safety
                                 (NCHRP Project 20 68A) (Washington, D.C.: National Cooperative Highway Research
                                 Program, 2011).
                                  Williams Deutermann, Motorcycle Helmet Effectiveness Revisited, National Highway
                                 40

                                 Traffic Safety Administration (Washington, D.C.: 2004). Thomas S. Dee, “Motorcycle
                                 helmets and traffic safety” Journal of Health Economics, vol. 28 (2009), pp. 398-412.
                                 Daniel C. Norvell and Peter Cummings, “Association of Helmet Use with Death in
                                 Motorcycle Crashes: A Matched-Pair Cohort Study,” American Journal of Epidemiology,
                                 Vol. 156 (2002), No. 5, pp. 483-48.
                                  NHTSA, Countermeasures That Work, 2011.
                                 41



                                  CDC has reported that, in 2010, approximately $3 billion in costs were saved as a result
                                 42

                                 of helmet use in the U.S. and another $1.4 billion could have been saved if all
                                 motorcyclists had worn helmets. See Centers for Disease Control and Prevention,
                                 “Helmet Use Among Motorcyclists Who Died in Crashes and Economic Cost Savings
                                 Associated With State Motorcycle Helmet Laws—United States, 2008-2010,” Morbidity
                                 and Mortality Weekly Report, Vol. 61 No. 23 (2012), pp. 425-430.
                                  Approved helmets must meet the DOT’s Federal Motor Vehicle Safety Standard 218
                                 43

                                 which requires that helmets provide minimum levels of performance to protect the head
                                 and brain in the event of a crash.




                                 Page 20                                                       GAO-13-42 Motorcycle Safety
                          Other factors can also affect the outcome of crashes. According to
                          NHTSA officials, protective clothing can help prevent “road rash” 44 as a
                          result of a crash, which, in extreme cases, can result in death. They
                          noted, however, that little research has been performed on the effects of
                          such clothing on injuries and fatalities. An important factor in victims’
                          survival after a crash is the availability of emergency services. CDC, a
                          state agency, and an association cited crashes on rural roads as being
                          especially treacherous, given the longer time required to get the victims to
                          medical care.

                          Except for alcohol impairment and helmet use, the relative importance of
                          these various factors contributing to crashes and fatalities is not well
                          understood. Challenges to determining the contribution of these factors to
                          crashes and fatalities include unavailable or unreliable information about
                          key factors such as the speed of the vehicle, driver behavior, road
                          conditions, and various precipitating factors. Also, factors can be
                          interrelated, making it difficult to determine causal relationships and
                          relative contributions to risk. Several studies currently under way are
                          expected to provide much better information on the causes of motorcycle
                          crashes. 45


States Have Implemented   States use a range of strategies to address the factors that contribute to
Various Strategies to     motorcycle crashes and fatalities. The importance of these factors varies
Address These Factors     among states, and accordingly, states pursue varying strategies—
                          including some innovative ones—to address the factors that are of
                          greatest importance to them. Furthermore, states vary in terms of fatality
                          rates, ridership, and the length of the riding season, and therefore some
                          may choose to carry out more extensive motorcycle safety efforts than
                          others. However, at a minimum, all states that we included in our review
                          had some type of motorcycle licensing and training program in place and


                           Road rash injuries, or road burn injuries, are painful scrapes and bruises that occur when
                          44

                          motorcyclists are thrown or dragged by their motorcycles.
                          45
                            These include a crash causation study sponsored by FHWA, NHTSA, and the American
                          Motorcyclist Association and two naturalistic studies of motorcyclists, one sponsored by
                          NHTSA and one sponsored by the Motorcycle Safety Foundation. The crash causation
                          study will investigate at least 280 crashes to determine causes and rider characteristics.
                          The naturalistic studies will track a total of 260 motorcyclists, using equipment attached to
                          their motorcycles that will acquire a broad range of data on routine riding behavior, as well
                          as crashes and near-crash events. According to NHTSA officials, the results of these
                          studies will become available in several years.




                          Page 21                                                        GAO-13-42 Motorcycle Safety
                            included motorcyclists in their overall efforts to enforce alcohol
                            impairment and speed limit laws. Some strategies aim to prevent crashes
                            and other strategies aim to reduce the severity of crashes when they
                            occur (see table 2).

                            Table 2: Types of State Motorcycle Safety Strategies

                                                                            Strategies to reduce the severity of crash
                             Strategies to prevent crashes                  outcomes
                             •    Licensing                                 •   Helmet laws
                             •    Training                                  •   Enforcing use of DOT-compliant
                             •    Enforcing alcohol impairment and              helmets
                                  speed limit laws                          •   Promoting voluntary helmet use
                             •    Efforts to increase motorcyclist safety
                                  awareness
                             •    Efforts to increase motorist
                                  awareness of motorcyclists
                            Source: GAO.



Strategies for preventing   Licensing. According to NHTSA, all states require motorcyclists to obtain
crashes                     a motorcycle license in order to ride. 46 Licensing programs aim to ensure
                            that motorcyclists have the minimum knowledge and skills needed to
                            operate a motorcycle safely. All of the 16 states that we covered in our
                            review required a written test and demonstration of riding skills to obtain a
                            license. Some states imposed additional requirements, particularly
                            training requirements, for younger riders. Ten of the 16 states that we
                            covered in our review require riders under a certain age to successfully
                            complete a basic rider course before obtaining a motorcycle license. Two
                            states that we covered—Texas and Florida—require all riders to
                            successfully complete a basic rider course to be eligible for a motorcycle
                            license. 47

                            Utah has an innovative approach to motorcycle licensing with a tiered-
                            licensing system that was implemented in 2008. Utah provides four types
                            of motorcycle licenses based on the size—or more specifically, the
                            engine size—of the motorcycle motorcyclists test on. To obtain a license
                            to operate a motorcycle with a certain engine size, and thus more or less


                             NHTSA, Countermeasures That Work, 2011.
                            46



                             Information on licensing requirements for the 16 states in our review is based on
                            47

                            documentation on these states’ programs and interviews with state officials.




                            Page 22                                                        GAO-13-42 Motorcycle Safety
power, motorcyclists must demonstrate their ability to ride that size of
motorcycle during the licensing test. 48 The idea behind the program was
to encourage new riders to learn to ride on smaller, lighter bikes before
moving on to large, powerful motorcycles. Also, Utah officials told us that
this strategy helps address the problem of riders testing on a motorcycle
that was smaller than the one they intended to ride.

Some states that we included in our review have taken steps to increase
the number of licensed riders. For example, 4 of the 16 states that we
covered in our review—California, Maryland, Wisconsin, and
Washington—have used databases to identify individuals with a
registered motorcycle but no motorcycle license. Letters are then sent to
these individuals describing the potential consequences of not obtaining a
license. The officials that we interviewed said that these programs were
somewhat successful in increasing the number of individuals with a
motorcycle license.

Training. Motorcycle-training programs aim to provide motorcyclists with
the knowledge and skills necessary to safely operate a motorcycle. Most
states use the training curriculum developed by the Motorcycle Safety
Foundation. 49 All of the states that we included in our review offer basic
rider courses for new riders and advanced courses to encourage
experienced riders to refresh their skills and learn advanced-riding
techniques. Some states operate training programs while others rely on
private contractors.

Some state officials that we interviewed described their training programs
as being innovative. For example, New Hampshire offers a training
course specifically for returning riders, which, as noted previously, can be
a contributing factor in crashes and fatalities. According to state officials
in New Hampshire, returning riders are a challenge because many have
retained their motorcycle license during the period when they were not
riding and they are not required to take additional training or testing
before they begin riding again.


48
  By engine size, we mean the engine capacity in cubic centimeters. Licenses are granted
for motorcycles with an engine size of 90 cc or less, 249 cc or less, and 649 cc or less.
Riders who pass the test on a motorcycle that is 650 cc or larger are not restricted.
49
  The Motorcycle Safety Foundation is an internationally recognized not-for-profit
foundation, supported by motorcycle manufacturers, that provides leadership to the
motorcycle safety community through its expertise, tools, and partnerships.




Page 23                                                      GAO-13-42 Motorcycle Safety
In addition to developing training courses, states have used various
strategies to encourage riders to take training. According to a Governors
Highway Safety Association survey of state motorcycle programs
conducted in 2007, at least 33 states offer a waiver for the riding-skills
portion of the licensing test for individuals who complete a basic skills
course. Some states have tried other strategies. For example, Wisconsin
has purchased a mobile-training facility called the Transportable High-
End Rider Education Facility that travels around the state to encourage
motorcycle riders to take formal training, among other things. Likewise,
Texas has purchased two trailers that are used to deliver training to riders
in rural areas who do not have access to local training facilities. Officials
in Wisconsin and Texas told us that they have received favorable
reactions from motorcyclists when they take the trailers to motorcycle
rallies and other events.

Enforcing alcohol impairment and speed limit laws. Enforcement
strategies are designed to 1) identify motorcyclists who are not adhering
to the states’ laws and 2) increase law enforcement officers’ awareness of
laws and issues that affect motorcycle safety. All of the states that we
included in our review include motorcycles in their overall alcohol-
impairment and speed-limit enforcement efforts. For example, Maryland
and Missouri have used helicopters for surveillance in areas that are
known to be popular for speeding. Iowa and Florida target law
enforcement efforts in areas identified as having a large number of
crashes. However, less than half of the states included in our review
mentioned specific enforcement strategies aimed at motorcyclists who
are driving while impaired or speeding. Some states have developed
materials to educate law enforcement officers on motorcycle specific
issues, such as identifying impaired riders. States used a number of
methods to educate law enforcement officers about issues related to
motorcycle riding, including training courses, pamphlets, and reference
guides listing motorcycle violations.

However, according to some state and law enforcement officials,
enforcement efforts are limited because of state laws, limited resources,
and complaints by motorcycle groups. Some states have “no chase” laws
that prohibit officers from chasing speeding motorcycles to avoid
accidents with other motorists. According to one NHTSA regional official,
some states, such as Texas, do not allow sobriety checkpoints, so




Page 24                                             GAO-13-42 Motorcycle Safety
detecting and stopping alcohol-impaired motorcyclists can be difficult. 50
Additionally, some state and law enforcement officials that we interviewed
told us that states lack funding to train law enforcement officers on
motorcycle-specific issues. As a result, officers may be hesitant to
enforce laws related to motorcycles, because they may not be familiar
with all of the specific requirements and may lack some of the training
that would help them determine if a rider is complying with laws.
Furthermore, some NHTSA regional, state, and law enforcement officials
whom we interviewed said that states are often reluctant to focus
enforcement on motorcyclists because of complaints by motorcycle
groups that they are being unfairly targeted.

Efforts to increase motorcyclist safety awareness. These strategies
aim to encourage motorcyclists to ride safely and take actions, such as
wearing brightly colored clothing, to increase their visibility to other motor
vehicle drivers. The strategies address a number of factors that contribute
to motorcycle crashes and fatalities, including alcohol impairment,
speeding, lack of rider conspicuity, and lack of licensing, training, and
skills. Nearly all of the state officials that we interviewed described making
such efforts, including using billboards, electronic messaging, and printed
materials, or using contact among state motorcycle safety officials, law
enforcement, and motorcyclists to encourage safety awareness among
motorcyclists. 51 Several state and law enforcement officials whom we
interviewed emphasized that this contact can be particularly valuable in
developing relationships with motorcyclists during rallies and other
events, so that motorcyclists will be more receptive to safety messages.
One state official, however, noted that some members of the motorcycling
community are high risk takers and more resistant to safety messages.

During our interviews, some state officials identified some of their
approaches as being innovative. For example, Florida produced a peer-
to-peer video to convince motorcyclists to ride safely based on research
that riders are more receptive to messages from their peers than from
police or others. In addition, starting in 2008, Colorado kicked off its Live


50
  At a sobriety checkpoint, law enforcement officers stop vehicles at a predetermined
location to check whether the driver is impaired. According to the Governors Highway
Safety Association, in 12 states sobriety checkpoints are not conducted because they are
prohibited by law or the state lacks authority to conduct them.
 Promotion of helmet use is also intended to increase motorcyclist safety awareness. We
51

will discuss this strategy below.




Page 25                                                     GAO-13-42 Motorcycle Safety
to Ride campaign. The campaign is a comprehensive safety program
aimed at motorcyclists. Each year the campaign focuses on a different
theme, such as the importance of training or riding unimpaired.

Efforts to increase motorist awareness of motorcyclists. Motorist
awareness strategies educate and remind drivers of other motor vehicles
to be aware of motorcycles on the road and to drive safely near
motorcycles. Nearly all of the states that we included in our review
reported having a strategy to increase motorists’ awareness of
motorcycles. Some states use informational campaigns that deliver
messages, such as media messages and promotional materials (See fig.
4). These may be provided by NHTSA through its Share the Road
campaign that reminds drivers to look out for motorcycles. All of the
states in our review observe May as motorcycle safety month during
which they use media to broadcast public awareness messages to remind
drivers of other motor vehicles to look out for motorcyclists.

Figure 4: Example of a Poster Used to Encourage Motorist Awareness




Page 26                                               GAO-13-42 Motorcycle Safety
                              Some state officials identified some of their approaches as being
                              innovative. For example, California and Texas use electronic billboards to
                              display motorist awareness messages. Other states, such as Arizona and
                              Wisconsin, partner with motorcyclist groups to teach students about
                              motorcyclist awareness during driver education courses. In addition, while
                              it is not mandatory to discuss motorcyclist awareness in drivers’
                              education classes, California has updated its drivers’ education handbook
                              to include a discussion about motorcycles.

Strategies for reducing the   Helmet laws. States have one of two types of helmet laws: universal
severity of crashes           helmet laws (helmets required for all riders) or partial helmet laws
                              (helmets required for certain riders, most often age 17 and under).
                              Currently, according to the Insurance Institute for Highway Safety, 19
                              states have universal helmet laws and 28 states have partial helmet laws
                              (see fig. 5). For example, California and New York have universal helmet
                              laws requiring all riders to wear helmets while Arizona and Wisconsin
                              have partial helmet laws that only require riders age 17 and under to wear
                              helmets. Two states, Florida and Michigan, with partial helmet laws allow
                              motorcyclists over the age of 21 to ride without a helmet if they have a
                              certain level of medical insurance coverage. 52 Three states—Illinois,
                              Iowa, and New Hampshire— have no laws requiring helmet use by riders.




                              52
                                In Florida, motorcyclists over the age of 21 can choose not to wear a helmet if they carry
                              $10,000 in medical insurance coverage. Riders in Michigan who are over the age of 21
                              and have less than 2 years of experience or have passed a motorcycle safety course are
                              not required to wear a helmet as long as they also have at least $20,000 in medical
                              insurance coverage per person including any rider.




                              Page 27                                                        GAO-13-42 Motorcycle Safety
Figure 5: Helmet Use Laws in the United States as of October 2012




                                         In part due to controversy surrounding motorcycle helmet laws, states
                                         have a history of enacting and repealing them over the years. 53 According
                                         to the Insurance Institute for Highway Safety, no state has enacted a
                                         universal helmet law since Louisiana did in 2004. NHTSA and state


                                         53
                                           From 1992 to 1995, as part of an incentive package for states to pass laws requiring all
                                         riders to wear helmets, the Intermodal Surface Transportation Efficiency Act of 1991, Pub.
                                         L. No. 102-240, § 1031, 105 Stat. 1914, 1970, added 23 U.S.C. § 153 to require states to
                                         pass such laws or lose funds for highway construction. The helmet law requirement was
                                         repealed in 1995 (Pub. L. No. 104-59, § 205(e), 109 Stat. 568, 577) which was followed by
                                         repeal of helmet laws in a number of states.




                                         Page 28                                                      GAO-13-42 Motorcycle Safety
officials whom we interviewed said that it was unlikely that any state with
a partial helmet-use law or no helmet law would consider strengthening
requirements for helmet use. In 2011, according to a recent report by the
CDC, bills were introduced to change or repeal helmet laws in 10 of the
20 states that had universal helmet laws at the time, 54 and in 2012,
Michigan changed its universal helmet law to a partial helmet law. Many
government entities and safety organizations—like NHTSA, CDC, and the
Motorcycle Safety Foundation—promote helmet use, citing its benefits.
The CDC also cites the social and economic costs of motorcycle crashes
and fatalities. However, some motorcycle groups, like the American
Motorcycle Association, advocate helmet use but oppose mandating it.
Some motorcycle groups maintain that these mandates violate
motorcyclists’ personal liberties and their right to assume the risk
associated with riding without a helmet. They also point out that helmet
laws do nothing to prevent crashes and that resources are therefore
better spent on crash prevention efforts such as training and motorist
awareness.

Enforcing use of DOT-compliant helmets. States with universal helmet
laws face challenges in getting riders to wear DOT-compliant helmets.
According to NHTSA’s National Occupant Protection Use Survey
conducted in 2011, 12 percent of riders in states with universal helmet
laws used non-compliant helmets. 55 In states with universal helmet laws,
some states have used innovative strategies to address this issue. For
example, officials in California told us that they have developed a video
that law enforcement officers distributed to motorcycle clubs across the
state. The video takes an educational and informational approach to
emphasize the importance of wearing a compliant helmet. Also, New York
officials told us New York has used safety checkpoints to verify
compliance with safe motorcycle-operating practices, including use of


54
  Rebecca Naumann and Ruth A. Shults, Ph.D, “ Helmet Use Among Motorcylists Who
Died in Crashes and Economic Cost Savings Associated With State Motorcycle Helmet
Laws—Unite States, 2008-2010,” Morbidity and Mortality Weekly Report, Division of
Unintentional Injury Prevention, National Center for Injury and Prevention and Control,
Centers for Disease Control and Prevention, June 15, 2012.
 The National Occupant Protection Use Survey is the only survey that provides
55

probability-based data on helmet use by motorcycle drivers and passengers in the U.S.
and is conducted annually by NHTSA’s National Center for Statistics and Analysis. The
survey observes helmet use as it actually occurs at randomly selected roadway sites. See
National Highway Traffic Safety Administration, Traffic Safety Facts: Motorcycle Helmet
Use in 2011—Overall Results (Washington, D.C.: 2012).




Page 29                                                      GAO-13-42 Motorcycle Safety
                                      compliant helmets. State officials told us that these checkpoints combine
                                      education with enforcement. Officers distribute information about safety
                                      practices but enforce state laws if violations are found. 56 A challenge that
                                      law enforcement officers face in states with universal helmet laws is that it
                                      can be difficult to identify and cite riders wearing non-compliant helmets.
                                      A Governors Highway Safety Association survey of state motorcycle
                                      programs found that in 2007, nine states with universal helmet laws
                                      provided training to law enforcement officers to help them identify non-
                                      compliant helmets.

Figure 6: Examples of Non-Compliant and DOT-Compliant Helmets




                                      Note: DOT-compliant helmets have an energy-absorbing layer between the comfort liner and outer
                                      shell and include a chin strap with sturdy rivets; furthermore, they generally weigh about 3 pounds.


                                      Promoting voluntary helmet use. In states that have a partial helmet
                                      law or no helmet law, finding ways to encourage riders to wear helmets
                                      can be challenging. According to the NHTSA survey mentioned above, in



                                       The use of checkpoints is controversial. Officials in some states told us that that they are
                                      56

                                      prohibited from using checkpoints to enforce motorcycle laws.




                                      Page 30                                                               GAO-13-42 Motorcycle Safety
                            2011, use of DOT-compliant helmets was much lower in these states than
                            in states with universal helmet laws: 50 percent versus 84 percent.
                            Officials in some states try to promote helmet use through education. For
                            example, officials in Iowa—a state with no helmet law—told us that they
                            host an annual conference for motorcycle riders to discuss motorcycle
                            safety issues. One of the recent conference themes was centered on the
                            use of proper protective gear, including helmets. Officials in several other
                            states, however, told us that there was such strong sentiment from
                            motorcyclists in their state about their right to choose whether to wear a
                            helmet that they do not promote helmet use.


Effectiveness of Most       We found, based on our review of studies, that the effectiveness of most
Strategies Used by States   of the strategies used by states in reducing motorcycle crashes and
Is Unclear                  fatalities is unclear. Although helmet laws are controversial and some
                            states have repealed their universal helmet laws in recent years, such
                            laws are the only strategy proven, by a number of studies, to be effective
                            in reducing motorcyclist fatalities. The effectiveness of most other
                            strategies on reducing motorcycle crashes or fatalities is uncertain or
                            unknown because evidence is limited, mixed, or not of a high quality. 57 In
                            identifying studies to include in our research review, we used selection
                            criteria aimed at ensuring that we included only high quality studies that
                            provided valid results. 58

                            Some newer strategies and strategies that have been proven to be
                            effective in addressing other highway safety issues, such as teen driver
                            safety, may hold promise for improving motorcycle safety. However, while


                            57
                              NHTSA and the Transportation Research Board of the National Academies have also
                            reported on limitations of existing research on motorcycle safety strategies. See National
                            Highway Traffic Safety Administration, Countermeasures That Work, (2011) and David F.
                            Preusser, Allan F. Williams, James L. Nichols, Julie Tison, and Neil K. Chaudhary,
                            National Cooperative Highway Research Program, Transportation Research Board,
                            NCHRP Report 622: Effectiveness of Behavioral Highway Safety Countermeasures,
                            (Washington, D.C.: Transportation Research Board, 2008).
                            58
                               We included studies that (1) were conducted in the U.S., (2) were peer-reviewed or
                            prepared by or for federal or state agencies, (3) included an original analysis of data,
                            using an experimental or quasi-experimental design, (4) addressed either motorcycle
                            crashes or motorcycle fatalities as an outcome, and (5) were published in the last 10
                            years. In some cases, older studies were included if more recent studies of a particular
                            strategy were not available. We did not include strategies related to road infrastructure,
                            emergency response, or vehicle safety. For further details on our methodology, see app.
                            I.




                            Page 31                                                       GAO-13-42 Motorcycle Safety
                            some of the states that we included in our review are trying innovative
                            approaches, few of these states have conducted their own evaluations of
                            these approaches. Some state officials noted that their state had not
                            conducted evaluations of its motorcycle safety strategies because of
                            resource constraints or the difficulty in carrying out such studies. Some
                            state officials expressed concerns to us over gaps in knowledge about the
                            effectiveness of motorcycle safety strategies. Some noted that this
                            knowledge gap makes it difficult to decide how to target safety resources
                            given state budget constraints.

Strategies for Preventing   Licensing. Although licensing is an important component of a state’s
Crashes                     motorcycle safety program and lack of a valid license by many
                            motorcyclists is a problem, we found that limited research has been done
                            on the effectiveness of specific types of licensing strategies on preventing
                            motorcycle crashes or fatalities. Randomized controlled studies of
                            Maryland’s and California’s efforts to increase motorcycle licensing by
                            comparing vehicle registration and driver licensing files found that this
                            method did increase the number of licensed motorcyclists in both states,
                            but most (almost 90 percent) unlicensed motorcyclists remained
                            unlicensed. 59 Also, the strategy did not appear to have an effect on crash
                            risk. 60 We identified only one study that evaluated the effect of motorcycle
                            licensing laws on motorcycle driver mortality in the United States. Results
                            of this study, which covered the years 1997 through 1999, suggested that
                            some stricter licensing requirements used by states, such as those that
                            require a skill test for obtaining a permit, were associated with lower
                            motorcyclist fatality rates compared to other states that did not have these
                            requirements. 61 NHTSA has noted in its 2011 Countermeasures That
                            Work report, which summarizes current research on the effectiveness of
                            various strategies for addressing major highway safety problems, that the




                            59
                              Braver et al, “Persuasion and licensure: A randomized controlled intervention trial to
                            increase licensure rates among Maryland motorcycle owners,” Traffic Injury Prevention,
                            Vol. 8, No. 1, 2007, pp. 39-46; Braver et al, Understanding and Addressing the Problem of
                            Unlicensed Motorcycle Operators in Maryland (2007): and Limrick and Masten,
                            Preliminary Evaluation of a Pilot Program to Increase Licensure Among Improperly
                            Licensed California Motorcycle Drivers, (October 2011).
                             Limrick and Masten, Preliminary Evaluation, 2011.
                            60


                            61
                              G. McGwin, J. Whatley, J. Metzger, F. Valent, F. Barbone, L.W. Rue. “The effect of state
                            motorcycle licensing laws on motorcycle driver mortality rates,” Journal of Trauma, Injury,
                            Infection, and Critical Care, Vol. 56, No. 2, Feb. 2004, pp. 415–419.




                            Page 32                                                       GAO-13-42 Motorcycle Safety
effectiveness of current licensing approaches on motorcycle crashes has
not been evaluated. 62

According to NHTSA’s Countermeasures that Work report, research has
found that graduated licensing systems can be highly effective in reducing
teen driver crashes and fatalities. 63 Based on these results, NHTSA has
identified graduated driver’s licensing as a promising strategy for
motorcycle safety. Graduated driver’s licensing is a three-phase system
for beginning drivers, consisting of a learner’s permit allowing driving only
under supervision, an intermediate license allowing unsupervised driving
with restrictions, and a full license. While 49 states have such systems in
place for licensing to operate motor vehicles, according to NHTSA
officials no state currently has such a system in place for licensing
motorcyclists.

Training. Although motorcycle training is important for teaching riding
skills needed to operate a motorcycle safely and a number of
stakeholders we interviewed cited lack of training or skills as a factor
contributing to crashes, results of studies on the effectiveness of
motorcycle training programs in reducing crashes and fatalities are
uncertain. For example, findings of a 2008 study that examined the
effects of various alcohol and traffic policies—including mandatory rider
education programs—on motorcycle safety in the continental U.S. from
1990 to 2005 suggested that mandatory rider education programs were
associated with a significant reduction in non-fatal injury rates, but did not
find these programs to influence fatality rates. 64 A 2007 study of




 See NHTSA, Countermeasures That Work, 2011.
62


63
  See NHTSA, Countermeasures That Work, 2011. We have also reported that research
has shown graduated licensing systems to be associated with improved teen driver safety.
See GAO, Teen Driver Safety: Additional Research Could Help States Strengthen
Graduated Driver Licensing Systems, GAO-10-544 (Washington, D.C: May 27, 2010).
64
  See M.T. French, G. Gumus, and J.F. Homer, Public policies and motorcycle safety.
Journal of Health Economics, 28(2009) 831-838. Non-fatal injury data in this study are not
available for all years from all states and are from different sources across states, and
thus, results may be biased to the extent that the effect of these factors on measurement
of injury rates is systematically correlated with policy changes over time.




Page 33                                                      GAO-13-42 Motorcycle Safety
motorcyclist training in Indiana 65 and a 1998 study of such training in
California 66 both found that trained riders did not have lower crash rates
than untrained riders. Various methodological limitations of evaluations,
which we and others 67 have reviewed, make it difficult to determine the
effectiveness of training programs. 68 In addition, effectiveness of training
can vary across states, and even within states.

NHTSA has also reported that based on existing research, the
effectiveness of motorcycle training is uncertain. According to NHTSA
officials, the reason why studies have not been able to link basic
motorcyclist training with crash involvement may be because the training
often teaches riders how to operate their vehicle; it does not necessarily
produce the good judgment that would lead to safe riding behavior. Also,
the officials pointed out that studies of teen drivers have found that some
teens actively choose to drive in an unsafe manner, contrary to their
driver education. 69

Enforcing alcohol-impairment and speed-limit laws. Overall, there has
been little research on the effectiveness of strategies focused on


65
  P. Savolainen and F. Mannering, “Effectiveness of Motorcycle Training and
Motorcyclists’ Risk-Taking Behavior,” Transportation Research Record: Journal of the
Transportation Research Board, No. 2031, (Washington, D.C., 2007), pp. 52–58. The
study found that beginning motorcyclists who took a basic training course were more likely
to be involved in a motorcycle crash than those who did not take the course. The authors
offered possible explanations including that riders who take the course might be less
skilled than those who do not, or their risk perception might change from taking the
course, or that the course might be ineffective.
 J.W. Billheimer,” Evaluation of California Motorcyclist Safety Program,” Transportation
66

Research Record: Journal of the Transportation Research Board, vol. 1640,
Transportation Research Board (1998), pp. 100–109. The study found no significant
differences in crash rates between trained and untrained riders 6 months, 1 year, and 2
years after training.
 See, for example, A. Daniello, H.C. Gable, and U.A. Mehta, “Effectiveness of Motorcycle
67

Training and Licensing,” Transportation Research Record: Journal of the Transportation
Research Board, vol. 2140 (2009), 206-213; and J. Brock, A. Robinson, B. Robinson, and
J. Percer, “Approaches to the Assessment of Entry-Level Motorcycle Training: An Expert
Panel Discussion,” Traffic Safety Facts. DOT HS 811 242.
68
  For example, evaluations have 1) not accounted for important differences between
individuals who take motorcycle training and those who do not, 2) not accounted for other
factors that may have affected crash rates, and 3) relied on self-reported data.
69
  We have previously reported that research on driver education has produced mixed
results regarding its effectiveness in reducing crashes. See GAO-10-544.




Page 34                                                       GAO-13-42 Motorcycle Safety
enforcement of alcohol-impairment or speed-limit laws on motorcycle
safety specifically. However, according to NHTSA’s report
Countermeasures that Work, research has shown that enforcement and
sanctions—such as sobriety checkpoints, extensive patrolling of certain
locations for a set period of time, and impounding vehicles—are effective
for reducing instances of impaired driving and crashes for motor vehicles
generally. Also, automated enforcement—such as cameras that detect
speeding and crossing red lights—has been shown to be effective in
reducing crashes because of speeding and aggressive driving by all types
of motor vehicles. 70 We identified six studies on motorcycles that met our
selection criteria and examined the association between different types of
laws and sanctions related to impaired driving or speeding and
motorcyclist fatalities. 71 These studies provided mixed levels of evidence
on the effectiveness of these approaches. For example, findings from a
2003 study of alcohol impairment laws suggest that these laws are
associated with lower overall motorcycle fatality rates, 72 but findings from
another study did not show this association. 73 An additional study
examined the effect of state speed limits and found that speed limits on




70
  Specifically, according to NHTSA, summary reviews of research conclude that red-light
cameras reduce side-impact crashes and overall crash severity, but increase rear-end
crashes. The reduction of side-impact crashes (the target group of crashes and of higher
severity) are slightly offset by increases in rear-end crashes (which are generally of lower
severity), thus, red-light cameras were found to be more effective at intersections with a
higher ratio of side-impact to rear-end crashes. National Highway Traffic Safety
Administration, Countermeasures That Work, 2011.
71
  Villaveces et al, “Association of alcohol-related laws with deaths due to motor vehicle
and motorcycle crashes in the United States, 1980-1997,” American Journal of
Epidemiology, 2003: French et al, “Public policies and motorcycle safety,” Journal of
Health Economics, 2009; Houston and Richardson, “Motorcyclist fatality rates and
mandatory helmet-use laws,” Accident Analysis & Prevention, 2008; Houston and
Richardson. “Motorcycle safety and the repeal of universal helmet laws,” American
Journal of Public Health, 2007; and Houston; “Are helmet laws protecting young
motorcyclists?” Journal of Safety Research, 2007. The latter three studies by Houston use
the same data over the same time period to examine the effect of universal helmet laws
and other state policies on motorcyclist fatalities. These studies vary only in the type of
analyses carried out, and in one case, the population examined (i.e., motorcyclists 15 to
20 years of age).
72
     Villaveces et al, “Association of alcohol-related laws”, 2003.

 Houston and Richardson, “Are helmet laws protecting,” 2008.
73




Page 35                                                               GAO-13-42 Motorcycle Safety
rural interstates were associated with lower rates of non-fatal motorcycle
injuries. 74

NHTSA’s Countermeasures That Work report states that some
enforcement and sanction strategies to reduce alcohol-impaired driving
may be especially effective for motorcyclists, while other strategies may
be less effective. According to NHTSA officials, law enforcement activities
for motorcycles are analogous to those for passenger vehicles, so high
visibility enforcement, which has been shown to be effective for
passenger vehicles, should work for motorcycles. High visibility
enforcement combines intensive enforcement of a specific traffic safety
law—such as using sobriety checkpoints to enforce the 0.08 BAC limit—
with extensive communication, education, and outreach informing the
public about the enforcement activity. We have previously reported that
high visibility enforcement campaigns have been found effective in
reducing two primary risk behaviors—not using safety belts and impaired
driving—associated with fatal vehicle crashes. 75 NHTSA has also noted
that vehicle impoundment as a sanction for impaired driving is a
promising strategy based on a study that showed that motorcyclists are
highly concerned about the safety and security of their motorcycles.

Efforts to increase motorcyclist safety awareness and motorist
awareness of motorcyclists. Our research review did not identify any
studies of the effectiveness of strategies to increase motorcyclist safety
awareness that met our selection criteria. We also did not identify any
studies of the effectiveness of strategies to increase other driver
awareness of motorcycles that met our criteria. 76 NHTSA has also found,
as noted in its Countermeasures That Work report, that these areas have
not been evaluated. NHTSA officials told us that based on prior studies
on efforts in other highway safety areas—such as efforts to increase seat
belt use—to influence driver behavior through education alone, the


74
     French et al, “Public policies,” 2009.

 See GAO, Traffic Safety: Improved Reporting and Performance Measures Would
75

Enhance Evaluation of High-Visibility Campaigns, GAO-08-477 (Washington, D.C: Apr.
25, 2008).
 In 2011, NHTSA did sponsor several studies on the effect of daytime running lights on
76

motorcycle conspicuity. See, for example, James Jenness et al, Motorcycle Conspicuity
and the Effect of Auxiliary Forward Lighting, NHTSA (Washington, D.C.: 2011). However,
since these studies dealt with enhancements to vehicles to improve safety, they were
outside of our scope.




Page 36                                                    GAO-13-42 Motorcycle Safety
                              effectiveness of motorcycle safety strategies using outreach and
                              communications alone is likely to be low.

Strategies for Reducing the   Helmet laws. In contrast to the lack of information on the impacts of
Severity of Crashes           strategies to prevent crashes, a number of studies have demonstrated
                              that universal helmet laws are an effective strategy for mitigating the
                              severity of crashes when they do occur. Such laws have been shown to
                              be associated with lower motorcycle fatality rates. We identified nine
                              studies that met our selection criteria and examined the association
                              between motorcycle helmet laws and motorcyclist fatalities. All nine
                              studies provided evidence that universal helmet laws significantly
                              decrease the rate of motorcyclist fatalities, 77 for example:

                              •    One nationwide study for 1975-2004 found that universal helmet laws
                                   were associated with at least a 22 percent reduction in motorcyclist
                                   fatalities. 78
                              •    A study, using data from the 48 contiguous states for 1988 to 2005,
                                   found that state laws mandating helmets reduced fatalities by 27
                                   percent. 79
                              Research has also shown universal helmet-use laws to effectively
                              increase the rate of helmet use among motorcyclists. In states without
                              universal use helmet laws or where such laws were repealed, helmet use
                              rates were lower than in states with universal helmet-use laws. Studies



                              77
                                M.T. French, G. Gumus, J.F. Homer, “Public policies and motorcycle safety,” Journal of
                              Health Economics. 28(2009); D.J. Houston and L.E. Richardson. “Motorcycle Safety and
                              the Repeal of Universal Helmet Laws,” American Journal of Public Health. Vol. 97, No.11.
                              2007; D.J. Houston. “Are helmet laws protecting young motorcyclists?” Journal of Safety
                              Research. 38(2007); T.M. Pickrell and M. Starnes. “An Analysis of Motorcycle Helmet
                              Use in Fatal Crashes,” National Highway Traffic Safety Administration, Technical Report.
                              DOT HS 811 011. (August 2008); C.C. Morris. “Generalized linear regression analysis of
                              association of universal helmet laws with motorcyclist fatality rates,” Accident Analysis and
                              Prevention.38(2006); G. McGwin, et al, “The Effect of State Motorcycle Licensing Laws
                              on Motorcycle Driver Mortality Rates,” The Journal of Trauma Injury, Infection, and Critical
                              Care. 56(2004); A. Villaveces et al, 2003: D.J. Houston and L.E. Richardson,
                              “Motorcyclist fatality rates and mandatory helmet-use laws,” Accident Analysis and
                              Prevention. 40(2008); and T.S. Dee, “Motorcycle helmets and traffic safety,” Journal of
                              Health Economics. 28(2009) 398-412.
                              78
                                D.J. Houston and L.E. Richardson, “Motorcyclist fatality rates and mandatory helmet-use
                              laws,” Accident Analysis and Prevention. 40 (2008).
                              79
                                T.S. Dee, “Motorcycle helmets and traffic safety,” Journal of Health Economics. 28
                              (2009) 398-412.




                              Page 37                                                        GAO-13-42 Motorcycle Safety
we reviewed of observed helmet use rates in four states that repealed
their universal helmet laws estimated helmet use of 90 percent or higher
when helmet-use laws were in effect, compared to 66 percent or lower
following the repeals.

Enforcing Use of DOT-Compliant Helmets and Promoting Voluntary
Helmet Use. We did not identify any studies of the effectiveness of
enforcement efforts aimed at increasing the use of compliant helmets or
of programs to promote motorcycle helmet use in states without universal
helmet laws. NHTSA has also noted in its Countermeasures That Work
report that these strategies have not been evaluated.

Sound evaluations of motorcycle safety strategies are challenging to carry
out, a situation that may help explain why research on some strategies
has been limited and why results of some studies have been mixed or
uncertain. NHTSA officials told us that evaluating the effects on crashes
and fatalities of strategies other than helmet laws has been challenging,
particularly since there are fewer motorcycles than passenger cars or
trucks. Also, the complexity of the relationship between various factors
and existing strategies that may affect crashes and fatalities makes it
difficult to isolate the effects of a single strategy. Although limited
evidence exists on the effectiveness of particular strategies states are
using for addressing motorcycle safety and the results of studies are
sometimes mixed or uncertain, the use of a range of strategies is
important. As we discuss in the next section, major studies on motorcycle
safety issues and NHTSA have emphasized that states should approach
motorcycle safety with a comprehensive range of strategies to address
the various factors that contribute to crashes and fatalities. 80




 See, in particular, Motorcycle Safety Foundation and National Highway Traffic Safety
80

Administration, National Agenda for Motorcycle Safety (2000); Transportation Research
Board/National Cooperative Highway Research Program, NCHRP Report 500: Volume
22: A Guide for Addressing Collisions Involving Motorcycles (2008); U.S. Department of
Transportation, National Highway Traffic Safety Administration, Uniform Guidelines for
State Highway Safety Programs: Highway Safety Program Guideline No. 3- Motorcycle
Safety. Washington, D.C. (2006).




Page 38                                                     GAO-13-42 Motorcycle Safety
                          NHTSA has provided guidance, outreach, and training to help states
NHTSA Supports            improve their motorcycle safety programs. Although NHTSA provides
States’ Motorcycle        grants for states to use for these programs, Congress imposed limits on
                          the grants, allowing states to use them only for motorcyclist-training and
Safety Programs, but      motorist-awareness activities. NHTSA has also conducted research on
Funding Flexibility       motorcycle safety strategies, but has not researched or developed plans
and New Research          to research certain strategies that it has identified as promising or a high
                          priority for improving motorcycle safety.
Priorities Would
Enhance Efforts

NHTSA Has Provided        NHTSA has provided states with a variety of guidance, including written
Guidance, Outreach, and   guidelines and technical assistance that identifies and promotes
Training to States        strategies states can use to address the key factors contributing to
                          crashes and fatalities. In particular, NHTSA’s 2011 Countermeasures
                          That Work report, discussed previously, provides states with information
                          on various highway safety strategies available to them—including
                          motorcycle safety strategies—and what is known about the effectiveness
                          of these strategies. NHTSA intends this information to help states select
                          safety strategies that have been proved effective through research or that
                          have shown promise. 81 In addition, NHTSA has:

                          •      Issued guidelines for state highway safety programs that recommend
                                 that states adopt a comprehensive approach to addressing
                                 motorcycle safety. 82 Strategies that the guidance encourages include
                                 those discussed in our report. Conducted assessments of individual
                                 state safety programs based on these guidelines, at the request of
                                 individual states. 83
                          •      Developed model standards for states and curriculum developers to
                                 incorporate into motorcycle training courses.
                          •      Developed guidelines for states regarding motorcyclist licensing, in
                                 cooperation with the American Association of Motor Vehicle




                          81
                              National Highway Traffic Safety Administration, Countermeasures that Work, 2011.
                          82
                            National Highway Traffic Safety Administration, Uniform Guidelines for State Highway
                          Safety Programs: Highway Safety Program Guideline No. 3- Motorcycle Safety (2006).
                          83
                              Since 2006, 15 states have had these assessments conducted.




                          Page 39                                                       GAO-13-42 Motorcycle Safety
     Administrators, 84 and is working with the association to revise a
     manual that states can provide to motorcyclists receiving their
     licenses.
•    Conducted campaigns on motorist awareness and impaired-riding
     prevention that make available marketing materials, such as radio
     advertisements and posters that states can use in their motorcycle
     safety programs.

NHTSA also partnered with the Motorcycle Safety Foundation and others
to produce a key report, the National Agenda for Motorcycle Safety, in
2000 and has produced subsequent guidance based on this report. 85 The
report contained 82 recommendations aimed at improving motorcycle
safety, about half of which applied to states and communities. 86 In 2006,
NHTSA produced a guide to provide states with specific steps for
implementing the recommendations that applied to the state. 87 NHTSA is
currently updating this guide. In 2010, in response to a National
Transportation Safety Board 2007 recommendation, NHTSA prioritized
the recommendations based on impact, cost, time, and obstacles and
produced a set of 22 high priority recommendations, including 10 aimed
at states and communities. The agency is in the process of developing an
action plan for states based on these 10 recommendations. 88



84
  National Highway Traffic Safety Administration, A Guideline Document for Motor Vehicle
Administrators On Motorcycle Operator Licensing (2009).
 Transportation Research Board/National Cooperative Highway Research Program,
85

National Agenda for Motorcycle Safety (2000).
86
  The other recommendations were made to national agencies, such as NHTSA, and
organizations. These recommendations addressed research, program evaluation, data
collection, regulation, motorcycle design and manufacture, and motorcycle operator
insurance.
87
 U.S. Department of Transportation, National Highway Traffic Safety Administration. DOT
HS 810 680. Implementation Guide: National Agenda for Motorcycle Safety. Washington,
D.C (2006).
88
  The 10 recommendations, in order of priority, are to 1) use effective strategies to
increase use of DOT-compliant helmets; 2) educate police and judges on motorcycle
safety issues; 3) educate police on alcohol-related behavior of motorcyclists; 4)
discourage mixing alcohol or other drugs with motorcycling; 5) provide training to all who
need or seek it; 6) provide additional education/training on proper braking techniques; 7)
merge rider education/training and licensing into one-stop operations; 8) encourage states
to issue motorcycle endorsements immediately upon course completion; 9) encourage
motorcyclists to increase conspicuity; and 10) communicate helmet use benefits and work
toward greater voluntary use of DOT-compliant helmets.




Page 40                                                      GAO-13-42 Motorcycle Safety
In addition to guidance, NHTSA has provided outreach to states.
According to NHTSA officials, staff in NHTSA’s regions work with the
states daily, helping them to identify highway safety problems and
countermeasures, such as enforcing individual state laws or finding ways
to increase helmet use. However, according to NHTSA officials, some
motorcyclist advocacy groups have been critical when NHTSA has
promoted helmet use. NHTSA regional officials told us that they do not
actively seek the passage of universal helmet laws by states, but they do
appear before state legislatures to discuss the benefits of helmet use,
when invited to speak. 89 Some NHTSA regions have collaborated on
motorcycle safety conferences. For example, in 2010, three regions held
a conference for their states to discuss motorcycle safety issues.
Additionally, NHTSA regional officials we met with told us that they
periodically hold conference calls or meet with states in their respective
regions to discuss motorcycle safety issues and share information.

Finally, NHTSA has provided motorcycle safety-related training courses
for state officials and law enforcement agencies. One such course is for
state highway safety staff responsible for setting up and managing state
motorcycle-safety programs. This course is currently available
electronically and, according to state officials, has provided insights and
tools to help them better understand their responsibilities. NHTSA also
developed and provided training on motorcycle safety for instructors at
law enforcement training academies in 2011 and 2012. State law
enforcement officials stated that this training helped educate law
enforcement personnel on motorcycle safety and their role in reducing
motorcycle crashes. NHTSA expects to deliver the law enforcement
training electronically in fiscal year 2013 to increase its availability to law
enforcement personnel.

In general, state and local officials told us that they were satisfied with the
assistance they receive from NHTSA. Officials we interviewed in 11 of the
16 states we covered noted that NHTSA efforts—including guidance,
outreach, and training—were helpful.




 DOT, like all federal agencies, is prohibited from lobbying using appropriated funds
89

without express congressional authorization. In addition, under 23 U.S.C. § 402(c), no
state highway safety program may be approved by the Secretary if it requires the state to
adopt or enforce adult safety helmet requirements.




Page 41                                                      GAO-13-42 Motorcycle Safety
NHTSA’s Motorcyclist        Although NHTSA provides funding to states through the Motorcyclist
Safety Grants May Only Be   Safety Grant Program, the funding can only be used for limited purposes.
Used for Training and       As noted previously, this program, established under SAFETEA-LU,
                            provides grants to states that can be used to support (1) motorcyclist
Motorist Awareness          training and (2) motorist awareness efforts. Specifically, states can use
Strategies                  grant program funds to improve training curricula, deliver training, and
                            recruit or retain motorcycle safety instructors, as well as for public
                            awareness and outreach programs to improve motorist awareness. The
                            new surface transportation legislation, MAP-21, continued the program
                            with similar requirements, but at a reduced annual amount. States were
                            awarded a total of $45.9 million from fiscal years 2006 through 2012,
                            including $7 million in both fiscal years 2011 and 2012. 90 The funding
                            awarded to individual states during these fiscal years ranged from
                            $100,000 to just over $500,000, although most states were awarded from
                            $100,000 to $200,000. Under MAP-21, the total grant amount exclusively
                            authorized for motorcycle safety has been reduced by almost 50 percent,
                            to roughly $4 million annually.

                            To pursue strategies other than motorcyclist training and motorist
                            awareness, states can use other sources of funding, including other
                            federal grants. In particular, states have used some State and Community
                            Highway Safety Grant Program funds for motorcycle safety efforts and, as
                            noted previously, may continue to do so under MAP-21. 91 According to
                            NHTSA funding data, however, states used a small portion of this grant
                            funding—about $16.5 million of the total of $1.13 billion states received
                            (about 1.5 percent)—on motorcycle safety efforts from fiscal years 2006




                            90
                              Originally, $25 million was authorized under SAFETEA-LU through fiscal year 2009.
                            MAP-21 eliminated individual safety grant programs, including motorcycle safety, and
                            incorporated them together under an overall highway safety program, as National Priority
                            Safety Grants, at 23 U.S.C. § 405. Section 405 provides for a series of grants that are
                            similar to other preexisting individual grant programs. The amounts an individual state
                            received under SAFETEA-LU and that they will receive under MAP-21 are determined by
                            formula and cannot exceed 25 percent of the amount a state receives under the State and
                            Community Highway Safety grant program.
                             See 23 U.S.C. § 402, discussed in footnote 13.
                            91




                            Page 42                                                     GAO-13-42 Motorcycle Safety
through 2011. 92 Officials in five states told us that they are reluctant to
use State and Community Highway Safety Grant funding within their state
for motorcycle safety efforts because allocating such funding for
motorcycle safety would reduce the amount available for their state’s
other highway safety program priorities, such as teen driver safety,
aggressive and distracted driving, and safety belt enforcement. Officials in
two states noted that competition for the use of these grant funds is
rigorous; consequently officials would prefer not to use the moneys to
fund some desired motorcycle safety activities, such as training police
officers on motorcycle safety issues. Officials in another state indicated
that although they do use these grant funds for motorcycle-related
enforcement, they must prioritize their limited resources and cannot
provide this funding at the level they believe is needed. Officials in one
state said the state has elected not to use State and Community Highway
Safety Grant funding for programs specifically targeted to motorcyclists.

States may also use state funding to pursue motorcycle safety strategies
although this funding can also be limited. Officials in eight states told us
that state resource constraints limit the ability to fund motorcycle safety
activities in their states. Additionally, officials in two NHTSA regional
offices as well as a highway safety association and an association
representing state motorcycle-safety agencies told us that limited state
funding for motorcycle safety efforts is a problem. In particular, they noted
that obtaining funding for enforcement efforts is challenging for states.
Some states do have dedicated funding available for motorcycle safety;
however, much of this funding is devoted to training. State officials in 13
of the states that we included in our review told us that their motorcycle
safety programs receive funding from fees for motorcycle-related
registration or licensing, training, or penalties. For example, according to
officials in Florida, New Hampshire, and Utah, amounts ranging from $1
to $5 from each motorcycle registration are directed toward training
programs as well as other motorcycle safety purposes.



92
  States have also used other NHTSA grant programs for motorcycle safety, such as the
Safety Belt Grant Program and the Impaired Driving Program, but to a lesser extent.
Based on NHTSA’s funding data, states used about $800,000 of the safety belt grant
funds on motorcycle safety from fiscal years 2006 to 2011. States with a primary safety
belt law received this funding, which could be used for any other highway safety effort,
including motorcycle safety. NHTSA’s grant system does not track how states spend
Impaired Driving Program funding but, according to NHTSA officials, the amounts used for
motorcycle safety are likely even smaller. Under MAP-21, states may also continue to use
certain non-motorcycle grant funds for motorcycle safety.




Page 43                                                     GAO-13-42 Motorcycle Safety
The limitations on spending Motorcyclist Safety Grant funds affect states’
ability to pursue a range of strategies or try new approaches to
motorcycle safety. GAO has reported on the potential benefits of allowing
states more flexibility in using NHTSA’s safety incentive grant programs.
Specifically, we reported that the structure of highway safety grants since
SAFETEA-LU did not always allow states sufficient flexibility to direct
funding toward safety priorities as identified in highway safety plans. 93 We
also reported that flexibility could become a key issue in the future as
emerging issues become more critical. 94

Furthermore, as previously noted, major studies on motorcycle safety
issues as well as NHTSA have identified the need for states to approach
motorcycle safety with a comprehensive range of strategies. In particular,
the highest-priority recommendations of the National Agenda for
Motorcycle Safety recently identified by NHTSA recommend a range of
strategies states should pursue to improve motorcycle safety. These
recommendations include

•    using effective strategies to increase use of DOT-compliant helmets,
•    improving motorcyclist training and licensing,
•    educating police about motorcycle safety issues in order to strengthen
     enforcement,
•    increasing the safety awareness of motorcyclists (including
     discouraging them from mixing alcohol and other drugs with
     motorcycling and encouraging them to increase conspicuity), and
•    promoting voluntary helmet use.

Guidelines for states on addressing motorcycle safety prepared by
NHTSA and the Transportation Research Board also recommend various
strategies to address motorcycle safety. 95 Additionally, both the National



93
  GAO, Traffic Safety: Grants Generally Address Key Safety Issues, Despite State
Eligibility and Management Difficulties, GAO-08-398 (Washington, D.C.: March 2008).
 GAO, Traffic Safety Programs: Progress, States’ Challenges, and Issues for
94

Reauthorization, GAO-08-990T (Washington, D.C.: July 16, 2008).
95
  National Highway Traffic Safety Administration, Uniform Guidelines for State Highway
Safety Programs: Highway Safety Program Guideline No. 3- Motorcycle Safety (2006);
and National Highway Traffic Safety Administration, Countermeasures That Work, 2011;
Transportation Research Board/National Cooperative Highway Research Program,
NCHRP Report 500: Volume 22: A Guide for Addressing Collisions Involving Motorcycles
(2008).




Page 44                                                    GAO-13-42 Motorcycle Safety
Transportation Safety Board and CDC have highlighted increasing the
use of DOT-compliant helmets as a high priority for saving lives on the
nation’s highways. 96

The restrictions in how states can use their motorcyclist safety grants may
impede states’ ability to fund some motorcycle safety activities they
believe are needed. In fiscal year 2013 budget estimates, NHTSA
proposed amending the Motorcyclist Safety Grant Program to provide
states additional flexibility. Specifically, NHTSA proposed amending the
program so that states could use these funds to promote the use of DOT-
compliant motorcycle helmets, increase efforts to reduce impaired riding,
and reduce the number of improperly licensed motorcyclists. According to
a NHTSA official, expanding the possible uses for the grants would allow
states to develop and implement additional countermeasures specific to
the motorcycle safety-related problems in their states. Officials we
interviewed in 14 of the 16 states said that the grant program is too
restrictive. State officials cited a variety of activities that they would
enhance or undertake in order to improve motorcycle safety in their state
if they could use the grant funding for those purposes. These include
activities related to enforcement as well as alcohol impairment, training
law enforcement officers, increasing safety awareness through outreach
to motorcyclists, 97 enforcing the use of compliant helmets, and promoting
voluntary helmet use. One state with a universal helmet law explained
that the state needs more funding to train police officers about motorcycle
safety issues, especially how to work with motorcyclists to increase safety
awareness or how to recognize non-compliant helmets. According to a
highway safety association official, each state’s motorcycle safety efforts
would benefit greatly from convening a summit of stakeholders to develop
a state strategic plan for motorcycle safety, but funding for such an
activity is generally not available.




96
  National Transportation Safety Board, NTSB Most Wanted List: Critical Changes Needed
to Save Lives (2011); U. S Department of Health and Human Services, Centers for
Disease Control, National Center for Injury Prevention and Control, Motorcycle Safety,
How to Save Lives and Save Money, (Atlanta, GA). CDC’s report emphasizes universal
helmet laws as the only approach proven to be effective in reducing motorcycle fatalities.
 The types of motorcyclist outreach efforts envisioned by state officials included those
97

emphasizing the importance of riding unimpaired and of wearing safety gear and
conspicuous clothing, accomplished through various mechanisms such as conferences,
bumper stickers, or public service announcements.




Page 45                                                      GAO-13-42 Motorcycle Safety
NHTSA Has Conducted          NHTSA has conducted motorcycle safety research on various topics and
Some Studies on              has used the results to provide states and others with information on
Motorcycle Safety            factors that contribute to motorcycle crashes and fatalities, the
                             effectiveness of existing strategies, and new strategies that may have
Strategies, but Gaps Exist   potential to improve motorcycle safety. Funding allocated to motorcycle
                             safety research from fiscal years 2007 to 2012 totaled $7.3 million, of
                             which $2.5 million was for research conducted in fiscal year 2012. 98
                             Conducting research is part of NHTSA’s overall mission. According to
                             NHTSA officials, states do not have sufficient resources to evaluate the
                             strategies they are using and expecting them to do so is not realistic.

                             Some of NHTSA’s research addresses the factors that contribute to
                             motorcycle crashes and fatalities. In fiscal years 2008 through 2011,
                             NHTSA’s research on factors included studies on the effects of alcohol on
                             motorcycle-riding skills and on motorcycle rider braking control behavior,
                             among other topics. One study currently under way—the Instrumented
                             On-Road Study of Motorcycle Riders—will use instrumentation mounted
                             on motorcycles to record information about motorcyclists’ riding
                             behaviors, such as acceleration, position in lane, and braking. According
                             to NHTSA officials, participants will also provide information about their
                             attitudes, personality, and risk-taking behaviors before the
                             instrumentation is installed. According to NHTSA officials, this study could
                             result in a broad range of findings that could provide additional
                             information on factors that could contribute to motorcycle crashes and
                             fatalities and possibly identify improvements needed in strategies, such
                             as training, rider conspicuity, road infrastructure, or the design of
                             motorcycles. NHTSA also plans to use this information to determine
                             relationships between riders’ attitudes and crash involvement as well as
                             other riding behaviors. NHTSA expects to complete this study in the fall of
                             2015.

                             Other NHTSA research focuses on strategies that states currently use or
                             on new strategies being considered. In fiscal years 2008 through 2011,
                             NHTSA’s research on strategies included a study on youth motorcycle-
                             related brain injury by helmet law type, an expert panel on evaluating
                             motorcycle training and a demonstration program to educate
                             motorcyclists about the dangers associated with operating a motorcycle



                              These funds came out of NHTSA’s behavioral safety research budget, which totaled $9.9
                             98

                             million in fiscal year 2012.




                             Page 46                                                   GAO-13-42 Motorcycle Safety
while under the influence of alcohol. 99 NHTSA’s research on strategies in
fiscal year 2012 could help to address some of the current limitations in
knowledge, discussed previously, about the effectiveness of motorcycle
safety strategies that states have used or could use. This research
emphasized identifying ways to improve law enforcement efforts, training,
licensing, and promotion of helmet use (see table 3). According to
NHTSA officials, this research should produce new information about the
effectiveness of high visibility enforcement, which NHTSA has identified
as a promising strategy. It should also produce new information on an
innovative method to increase licensing among motorcyclists that
includes outreach to law enforcement and the motorcyclist community.
Additionally, NHTSA’s research should provide information that may lead
to improvements in training for motorcyclists. Finally, NHTSA recently
initiated a research project to determine whether there are states without
universal helmet-use laws that have higher helmet-use rates than other
states without such laws and to identify factors and programs that may be
related to higher helmet use in these states. Such information could help
identify ways to promote voluntary use of helmets in the 31 states that do
not have universal helmet laws.




99
   NHTSA also funded several studies on the effects of daytime running lights (on both
motorcycles and motor vehicles) on motorcycle conspicuity. These focused on vehicle-
based strategies rather than strategies that could be implemented by states.




Page 47                                                     GAO-13-42 Motorcycle Safety
Table 3: NHTSA Research and Development on Strategies to Improve Motorcycle Safety, Fiscal Year 2012

                                                                     Actual or planned
Title                                                                completion                       Type of strategy studied
Motorcycle High Visibility Enforcement Demonstrations                Spring 2013                      Law enforcement related to alcohol
(Partnership with Georgia State Patrol)                                                               impairment, licensing, and use of DOT-
                                                                                                      compliant helmets
                                          a
Study to Improve Crash Avoidance Skills                              Winter 2013                      Training
Effect of Sight Distance Training on Motorcycle Skills               Winter 2013                      Training
Examination of Washington State’s Vehicle Impoundment                Winter 2013                      Law enforcement related to licensing
Law for Motorcycle Endorsements
                                                                                      b
Examine the Puerto Rico .02 BAC for Motorcycle Riders                Winter 2013                      Law enforcement related to alcohol
                                                                                                      impairment
Examination of the Feasibility of Alcohol Interlocks for             Fall 2013                        Law enforcement related to alcohol
Motorcycles                                                                                           impairment
Demonstration to Increase the Number of Properly                     Fall 2013                        Licensing
Endorsed Motorcyclists (Partnership with Commonwealth
of Massachusetts)
High Visibility Impaired Riding Crackdown Demonstration in Fall 2013                                  Law enforcement related to alcohol
Four States                                                                                           impairment
                                                                                  c
Study on Influential Factors for Helmet Usage in States              Uncertain                        Promotion of voluntary helmet use
Without Universal Helmet Laws
The Effect of Entry-Level Motorcycle Rider Training on               Spring 2015                      Training
Motorcycle Crashes
                                              Source: GAO analysis of NHTSA information,
                                              a
                                               This study is evaluating the impacts of motorcyclist training over time to assess its effectiveness.
                                              b
                                               According to NHTSA officials, this study has been completed ,but insufficient data were available to
                                              draw meaningful conclusions from the analysis. Consequently, NHTSA does not plan to issue a
                                              report.
                                              c
                                                According to NHTSA officials, the estimated completion date for this project is uncertain at this time
                                              because of the nature of the project and could range from Spring 2013 through Fall 2015.


                                              This research could increase knowledge about which motorcycle safety
                                              strategies would be effective or promising for states to use. However,
                                              NHTSA has not researched two strategies it has identified as a high
                                              priority or promising. In particular, NHTSA has not researched how to
                                              encourage motorcyclists to increase their conspicuity to motorists. The
                                              agency has identified this strategy as a high priority, based on its recent
                                              assessment of the recommendations of the National Agenda for
                                              Motorcycle Safety. Furthermore, among the high priority National Agenda
                                              for Motorcycle Safety recommendations identified by NHTSA is a
                                              recommendation for the federal government to develop and evaluate a




                                              Page 48                                                                 GAO-13-42 Motorcycle Safety
graduated-licensing model for motorcyclists. Although NHTSA and the
American Association of Motor Vehicle Administrators have developed
such a model, 100 an evaluation of the model has not been performed. As
noted previously, NHTSA considers graduated licensing a promising
strategy for improving motorcycle safety.

NHTSA officials pointed out that the agency’s highway safety research
budget is limited, and the agency must prioritize its investments in
research. According to NHTSA officials, they have prioritized their
research efforts based on problems identified through crash data and the
factors on which the agency can have the most impact. The officials
explained that they have not studied how to increase motorcyclists’ safety
awareness, including encouraging riders to increase their conspicuity,
because experience in other highway safety areas has shown the
effectiveness of public education alone, without enforcement, to be low. 101
Nevertheless, in the report on its prioritization of the National Agenda for
Motorcycle Safety recommendations, the agency reported that efforts to
increase motorcyclist conspicuity could have an impact if they were well-
researched and supported by rider groups. 102 NHTSA officials also
explained that they have not evaluated a model graduated-licensing
system for motorcyclists because no states are currently using the
approach the officials have proposed. They noted that they are
considering the possibility of conducting a demonstration project to
evaluate such a model-licensing system, but would need to identify a
state that would be willing to participate.

As previously noted, some states have expressed concerns about gaps in
knowledge regarding the effectiveness of motorcycle safety strategies
and have noted that these gaps make it difficult to decide how to target



 See National Highway Traffic Safety Administration, A Guideline Document for Motor
100

Vehicle Administrators On Motorcycle Operator Licensing, 2009.
  Officials also explained that NHTSA has not researched motorist awareness strategies
101

for similar reasons.
  National Highway Traffic Safety Administration, Prioritize Recommendations of the
102

National Agenda for Motorcycle Safety, Final Report (2010). NHTSA determined the
potential impact of motorist awareness campaigns in addressing the problem of multi-
vehicle motorcycle crashes to be lower than that of increasing motorcyclist conspicuity,
noting that such campaigns share many characteristics of traffic safety communications
campaigns that have been found to be ineffective. In particular, they promote a passive
message (“be aware”) rather than focus on changing behaviors.




Page 49                                                      GAO-13-42 Motorcycle Safety
              constrained resources. While helmet laws have been proved effective in
              reducing motorcyclist fatalities and NHTSA’s current research could help
              to broaden the range of strategies that are shown to be effective, further
              research on high priority strategies or promising strategies that have been
              proved successful in other highway safety areas could help states make
              more informed choices as they make decisions about what motorcycle
              safety strategies to pursue.

              NHTSA does not have a current comprehensive plan for motorcycle
              safety to guide its research efforts in this area. In 2007, DOT issued a
              plan to reduce motorcyclist fatalities that identified research NHTSA had
              under way as well as research that it planned to conduct in the future.
              According to NHTSA officials, the 2007 plan is still relevant as they are
              working on items identified in that plan. They do, however, intend to begin
              developing a new plan for motorcycle safety in spring 2013. According to
              NHTSA officials, this plan will cover a range of NHTSA initiatives,
              including research on motorcycle safety strategies, but NHTSA officials
              have not yet decided what types of research to include. Given NHTSA’s
              limited resources for research, developing and publishing a new plan
              provides an opportunity for NHTSA to identify research priorities for
              motorcycle safety, based on gaps in knowledge about the effectiveness of
              motorcycle safety strategies and the types of strategies that have been
              identified as high priorities. NHTSA officials agreed that the new plan
              provided this opportunity.


              Motorcycle crashes can result not only in serious injuries or death but
Conclusions   also can impose significant costs that are borne by the victims and their
              families as well as by society, including the government, employers,
              private insurers, and healthcare providers. While universal helmet laws
              are the only strategy proved to be effective in reducing motorcyclist
              fatalities, such laws can be controversial and it is uncertain whether the
              number of states with such laws, currently 19, will increase or decrease in
              the future. It is important that states approach motorcycle safety in a
              comprehensive manner, in order to address the various factors that
              contribute to crashes as well as fatalities. By providing states with greater
              flexibility in how they can use their Motorcyclist Safety Grants, Congress
              could increase states’ ability to pursue the combination of strategies
              states believe is needed to prevent crashes and reduce fatalities.
              Furthermore, the gaps in knowledge about the effectiveness of various
              types of strategies other than universal helmet laws impede states’ ability
              to make informed decisions about what combination of strategies to
              pursue with their limited resources. NHTSA has researched a variety of


              Page 50                                             GAO-13-42 Motorcycle Safety
                  motorcycle safety strategies. Given its limited funding for research,
                  however, NHTSA could better fulfill its role as a leader in identifying
                  strategies states can use to address motorcycle safety by reexamining its
                  research priorities in light of the factors that contribute to crashes and
                  fatalities and gaps in knowledge regarding motorcycle safety strategies.
                  In particular, by focusing on researching high priority and promising
                  strategies that it has identified, NHTSA could better assist states in
                  targeting their resources and prioritizing their efforts to improve
                  motorcycle safety.


                  In order to provide states with greater flexibility to pursue a range of
Matter for        strategies to address the various factors contributing to motorcycle
Congressional     crashes and fatalities, Congress should consider allowing states to use
                  the Motorcyclist Safety Grants for purposes beyond motorcyclist training
Consideration     and raising motorist awareness of motorcycles.


                  To provide the states with information that could better enable them to
Recommendations   effectively address the factors that contribute to motorcycle crashes and
                  fatalities, NHTSA should

                  •   as part of its expected comprehensive plan for motorcycle safety,
                      identify research priorities that address these factors as well as gaps
                      in knowledge about the effectiveness of state strategies, particularly
                      those that it has identified as a high priority or promising.
                  •   in addition to setting these research priorities, conduct research on
                      the following strategies that it has identified as a high priority or
                      promising:
                      •   encouraging motorcyclists to increase their conspicuity, and
                      •   implementing a graduated-licensing model for motorcyclists.

                  We provided a draft of this report to DOT for review and comment. DOT
Agency Comments   officials agreed to consider our recommendations and provided technical
                  comments, which we incorporated as appropriate. DOT also noted that,
                  while additional research focus by NHTSA on motorcycle safety
                  strategies may be useful in the future, state universal helmet laws are the
                  one strategy that has been proved to be effective in saving lives, as
                  stated in our report.




                  Page 51                                             GAO-13-42 Motorcycle Safety
We are sending copies of this report to interested congressional
committees and the Secretary of Transportation. In addition, this report
will be available at no charge on GAO’s Web site at http://www.gao.gov.

If you or your staff have any questions about this report, please contact
me at (202) 512-2834 or flemings@gao.gov. Contact points for our
Offices of Congressional Relations and Public Affairs may be found on
the last page of this report. GAO staff who made major contributions to
this report are listed in appendix II.




Susan Fleming
Director, Physical Infrastructure Issues




Page 52                                            GAO-13-42 Motorcycle Safety
Appendix I: Scope and Methodology
             Appendix I: Scope and Methodology




             This report addresses: 1) what is known about the costs of motorcycle
             crashes; 2) the factors that contribute to motorcycle crashes, and to
             fatalities when crashes occur, and strategies states are pursuing to
             address these factors; and 3) the extent to which NHTSA assists states in
             pursuing strategies that address these factors.

             To determine what is known about the costs of motorcycle crashes we
             reviewed research related to the costs of these crashes, including the
             amount and types of costs they impose and who pays them. We included
             studies authored or provided to us by federal and state agencies and
             independent research organizations that we interviewed and other
             relevant studies on this topic published in the last 10 years. In some
             cases, we also included studies published more than 10 years ago when
             there was limited or no research about that topic in the last 10 years.
             Because existing estimates were either for vehicles as a whole or only
             covered specific types of motorcycle crash costs, we developed an
             estimate of the total direct measureable costs specifically for motorcycle
             crashes in 2010. To arrive at this estimate, we used data developed in a
             2002 National Highway Traffic Safety Administration (NHTSA) study,
             which provided estimates of direct measurable costs of all motor vehicle
             crashes in 2000 for each of nine cost categories across various levels of
             crash severity. 1 These categories include medical costs, costs associated
             with emergency services, loss in market productivity and household
             productivity, insurance administration, legal, travel delay, property
             damage, and workplace costs. We reviewed NHTSA’s methodology for
             calculating costs and decided to use NHTSA’s cost estimates for our
             purposes because they provide the most detailed estimates of crash
             costs using the most comprehensive data and are used by the Centers
             for Disease Control and Prevention (CDC) and others to develop and
             report on crash costs.

             Specifically, to develop our 2010 motorcycle safety cost estimate, we first
             updated NHTSA’s 2000 cost estimates for all motor vehicles to 2010
             values by adjusting for inflation using the Bureau of Labor and Statistics’




             L. Blincoe et al, The Economic Impact of Motor Vehicle Crashes, 2000 (Washington,
             1

             D.C.: National Highway Traffic Safety Administration, 2002).




             Page 53                                                   GAO-13-42 Motorcycle Safety
Appendix I: Scope and Methodology




consumer price index. 2 Subsequently, to estimate the costs attributable
solely to motorcycle crashes, we applied these updated motor vehicle
crash cost estimates to NHTSA’s 2010 data on motorcycle crashes. We
obtained the number of fatal motorcycle crashes from NHTSA’s Fatality
Analysis Reporting System (FARS) dataset and obtained the number of
property-damage-only crashes and other non-fatal crashes from NHTSA’s
General Estimates System data. 3 To estimate the number of non-fatal
crashes by injury severity, we constructed an injury profile of these non-
fatal crashes based on findings from NHTSA’s 2009 report on helmet use
and head and facial injuries; 4 the constructed injury profile from that
report contains the proportion of non-fatal crashes in various injury
severity categories for non-fatal crashes, based on the maximum
abbreviated injury scale. 5 This allowed us to estimate the number of non-
fatal crashes by level of injury severity in 2010. The number of fatal
motorcycle crashes, property-damage crashes and non-fatal crashes by
injury severity were multiplied by their specific average per-person costs
(in 2010 dollars), and aggregated to yield the total direct measureable
cost of motorcycle crashes. To check for consistency, we compared
various components of costs that are also covered in other existing
estimates identified in our literature review as these estimates might apply
to some specific costs such as medical costs. We also adjusted for the
time periods under consideration because these existing estimates might
be based on data from time periods different from ours.



2
 This estimate inflates the medical costs estimated in the 2002 study by the general
consumer price index rather than the one for medical costs. According to researchers in
NHTSA and the Pacific Institute for Research and Evaluation who have conducted
analyses of crash costs, even though the medical costs in general have risen faster than
the consumer price index, due to both improvements in injury management and data
collection, the medical costs for crashes have likely not risen as fast as the economy-wide
rise in medical costs. Therefore, for our primary analysis, we use the general consumer
price index to adjust the 2000 costs estimates to 2010 levels. However, one researcher
told us that the same dollar figure used in 2000 may be the best representation of medical
costs for these crashes today—that is, without any adjustment for inflation.
3
 NHTSA’s General Estimates System is part of its National Automotive Sampling System
database. The data comes from a nationally representative sample of police-reported
motor vehicle crashes of all types, from minor to fatal.
4
 NHTSA (2009), Motorcycle Helmet Use and Head and Facial Injuries: Crash Outcomes
in CODES-Linked Data. The report evaluated combined data from 18 states on 89,086
motorcycle crashes and 104,472 motorcyclists between 2003 and 2005.
5
 The maximum abbreviated injury score represents the maximum injury severity level
experienced by the victim and ranges from 0, for no injury, to 5, for critical injury.




Page 54                                                       GAO-13-42 Motorcycle Safety
Appendix I: Scope and Methodology




Our cost analysis uses the following assumptions and has the following
limitations:

•   We assumed that the injury profile of motorcyclists did not change for
    non-fatal crashes from the 2003–05 period to 2010.
•   We assumed the average severity of a particular injury category
    based on the maximum abbreviated injury scale score is the same for
    both motorcyclists and other motor vehicle crash victims. However,
    motorcycle crash victims often suffer very different injuries from other
    motor vehicle crash victims. As a result, the consequence and
    treatment costs could vary significantly even if the resulting injuries
    had the same score 6
•   The abbreviated injury scale scores used in the NHTSA report are not
    always accurate predictors of long-term injury outcomes. Some
    injuries with low scores, such as lower extremity injuries, can actually
    result in serious and expensive long-term outcomes.
    •   The analysis also implicitly assumes that the distribution of costs
        across the category types stayed constant from 2002 to 2010. We
        thus assume all cost components grew at the same rate as the
        general consumer price index.
    •   The analysis does not include costs of unreported crashes and
        environmental costs, because those data were not available.
    •   The analysis does not include other difficult to quantify costs such
        as longer term costs of treatment and intangible costs associated
        with emotional pain and suffering.

To identify the factors that contribute to motorcycle crashes and fatalities
and strategies that states are pursuing to address these factors, we
interviewed NHTSA, the Federal Highway Administration (FHWA), CDC,
the National Transportation Safety Board (NTSB), and key stakeholder
organizations involved in motorcycle safety, including the Motorcycle
Safety Foundation, the Insurance Institute for Highway Safety (IIHS), the
American Association of State Highway and Transportation Officials, the
American Association of Motor Vehicle Administrators, Governors
Highway Safety Association, the National Association of State Motorcycle


6
  For example, a motorcycle crash victim may suffer a brain injury, and a motor vehicle
crash victim may suffer a back injury. While both victims’ injuries might have the same
injury severity score and the same assumed severity, in reality, the medical costs of
treating a brain injury could be higher than treating a back injury of similar severity. As a
result, our estimates of the total costs of motorcycle crashes would underestimate the true
direct measurable costs.




Page 55                                                        GAO-13-42 Motorcycle Safety
Appendix I: Scope and Methodology




Safety Administrators, and the American Motorcyclist Association.
Furthermore, we conducted interviews with and reviewed documentation
from the state agencies that have lead responsibility for motorcycle
safety, generally the Highway Safety Office, in the following 16 states:
Arizona, California, Colorado, Florida, Idaho, Iowa, Maryland, Mississippi,
Missouri, New Hampshire, New Jersey, New York, Texas, Utah,
Washington and Wisconsin. We selected states representing a range of
fatality rates, varying types of motorcycle safety laws and policies, varying
levels of ridership, and that are geographically diverse. For five of these
states—Florida, Iowa, Maryland, Texas, and Wisconsin—we interviewed
additional agencies and organizations responsible for motorcycle safety,
including the applicable NHTSA region, state agencies responsible for
motorcycle licensing and training; state and local law enforcement
agencies; and motorcycle advocacy groups. 7

In addition, we conducted a literature review to obtain information on the
factors that contribute to motorcycle crashes and fatalities as well as to
determine the extent of knowledge about the effectiveness of motorcycle
safety strategies used by states. We identified studies for our review
through a search of numerous bibliographic data bases (including
searched EMBASE, SocialSciSearch, SciSearch, MEDLINE, ProQuest,
Transportation Research International Documentation, BIOSIS, and
National Technical Information Service); interviews with NHTSA, the
FHWA, CDC, NTSB, the Motorcycle Safety Foundation, and IIHS; and
bibliographic references in NHTSA’s Countermeasures that Work report,
as well as other documents reviewed. From this search, we screened the
identified studies for relevance to our report and selected studies that met
the following criteria: (1) conducted in the U.S., (2) peer-reviewed as well
as by or for federal or state agencies, (3) included an original analysis of
data, and (4) published in the last 10 years. In order to assess the
effectiveness of motorcycle helmet laws, we also considered studies
published more than 10 years ago because many changes in helmet laws
occurred and were evaluated more than 10 years ago. In some cases, for
other strategies we also included studies published more than 10 years
ago when there was limited or no research about that strategy in the last
10 years. In such cases, we considered the extent to which factors may
have changed over time that could affect the relevance of their findings.


7
 We did not include states’ motorcycle safety efforts related to road infrastructure or
emergency response in our review. Also, we were unable to schedule an interview with
an advocacy group in Maryland and law enforcement officials in Texas and Florida.




Page 56                                                      GAO-13-42 Motorcycle Safety
Appendix I: Scope and Methodology




In addition, for motorcycle helmet laws, we limited studies to those
including the entire U.S. population (and met the criteria listed above).
This was done in part to limit the scope to larger studies that provided
more power to detect effects of helmet laws while controlling for other
important factors.

Furthermore, for studies of the factors associated with motorcycle
crashes and fatalities, we restricted our review to studies that addressed
either crashes or fatalities. For studies of the effectiveness of strategies,
we restricted our formal review to studies that met the following criteria:
(1) examined the effectiveness of motorcycle safety strategies covered in
our review 8 (2) addressed either motorcycle crashes or motorcyclist
fatalities as an outcome: and (3) used an experimental (e.g.,
randomization of individuals or communities to receive the program) or
quasi-experimental design (e.g., statistically controlling for individual,
community, or state exposure to the program policy) to evaluate the
effects of the strategy. Out of the 117 studies we screened, we identified
20 studies that met these screening criteria, including 18 studies of
motorcycle safety strategies. Each of these studies was evaluated for
relevance and reviewed by social science specialists to ensure that any
findings presented reflected the methodological approaches and
limitations of each study.

Finally, to identify characteristics of crashes we reviewed NHTSA reports
covering calendar years 1991 through 2010 based on their analyses of
data from their FARS database. To identify characteristics that were not
available in NHTSA’s published reports (primarily from 2010 FARS data),
we analyzed data on vehicle fatalities from FARS and data on vehicle
registrations from the FHWA. We reviewed existing documentation about
the data and interviewed officials knowledgeable about the data and their
limitations in order to assess the extent which the data are accurate and
complete. In addition, we conducted data comparisons, logic tests, and
tests for missing data and errors. We estimated missing blood alcohol
concentration (BAC) test results using NHTSA’s method of multiple



8
 We covered the following strategies in our review: licensing, training, enforcement of
alcohol impairment and speeding laws, efforts to increase motorcyclist safety awareness,
efforts to increase motorist awareness of motorcyclists, helmet laws, enforcement of use
of DOT-compliant helmets, and promotion of helmet use. These strategies are generally
aimed at changing the behavior of motorcyclists and motorists. We did not include
strategies related to road infrastructure, emergency response, or vehicle safety.




Page 57                                                      GAO-13-42 Motorcycle Safety
Appendix I: Scope and Methodology




imputation. 9 We found FARS data, vehicle registration data, and
NHTSA’s published reports to be sufficiently reliable for our purposes.

To determine the extent to which NHTSA assists states in pursuing
strategies that address the factors that contribute to motorcycle crashes
and fatalities, we reviewed the Safe, Accountable, Flexible, Efficient
Transportation Equity Act: A Legacy for Users 10 and the Moving Ahead
for Progress in the 21st Century Act 11 and relevant portions of the United
States Code to determine NHTSA’s responsibilities and authority related
to motorcycle safety. We also reviewed reports, studies, and other
documentation and interviewed officials in NHTSA headquarters and
regional offices to determine what NHTSA has done to assist states to
identify and promote motorcycle safety strategies for use by states. We
also analyzed data on Motorcyclist Safety Grant funds awarded to
states 12 and interviewed state officials from states in our selection to
determine how and the extent to which they have used the Motorcycle
Safety and other grant programs to address motorcycle safety and
challenges they have faced in using the grants. We also reviewed
information on NHTSA’s research and development related to motorcycle
safety for the last 5 years to identify the extent to which they addressed
factors that contribute to crashes and fatalities and strategies to address
those factors. In addition, we interviewed the stakeholder groups cited
above and state officials in the 16 states we selected to obtain their views
on NHTSA’s efforts. Finally, we reviewed key reports on motorcycle
safety, such as reports by the Transportation Research Board, and the
Motorcycle Safety Foundation, and pertinent GAO reports, as well as
NTSB recommendations, in evaluating NHTSA’s efforts. We limited our
work to NHTSA’s efforts to identify and promote motorcycle safety
strategies for states to use and did not cover other NHTSA motorcycle


9
  When the alcohol test results are unknown, BAC values have been assigned to drivers
and non-occupants involved in fatal crashes, using NHTSA’s method of multiple
imputation that was revised in 2002 (NHTSA Technical Report DOT HS 809 403,
Transitioning to Multiple Imputation: A New Method to Estimate Missing Blood Alcohol
Concentration (BAC) Values in FARS.)
 Pub. L. No. 109-59, 119 Stat. 1144 (2005).
10



 Pub. L. No. 112-141, 126 Stat 405 (2012).
11


12
  SAFETEA-LU established a Motorcyclist Safety grant program, also known as the
Section 2010 grant program. MAP-21 eliminated individual safety grant programs,
including Section 2010, but established a National Priority Safety Program, which among
other things includes provisions for motorcycle safety grants.




Page 58                                                     GAO-13-42 Motorcycle Safety
Appendix I: Scope and Methodology




safety efforts, such as data collection, research on vehicle safety, or
helmet standards.

We conducted this performance audit from October 2011 to November
2012 in accordance with generally accepted government auditing
standards. Those standards require that we plan and perform the audit to
obtain sufficient and appropriate evidence to provide a reasonable basis
for our findings and conclusions based on our audit objectives. We
believe that the evidence obtained provides a reasonable basis for our
findings and conclusions based on our audit objectives.




Page 59                                             GAO-13-42 Motorcycle Safety
Appendix II: GAO Contact and Staff
                  Appendix II: GAO Contact and Staff
                  Acknowledgments



Acknowledgments

                  Susan Fleming, (202) 512-2834 or flemings@gao.gov
GAO Contact
                  In addition to the contact named above, Judy Guilliams-Tapia (Assistant
Staff             Director), Namita Bhatia-Sabharwal, Leia Dickerson, Sharon Dyer,
Acknowledgments   Lorraine Ettaro, Lynn Filla-Clark, Bert Japikse, Terence Lam, Janet Lee,
                  Stephanie Purcell, and Amy Rosewarne made important contributions to
                  this report.




(541084)
                  Page 60                                           GAO-13-42 Motorcycle Safety
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