Mr. Chairman, I have undertaken to define in general terms the interests, objectives, and programs of the Service in the field of accident prevention because that as we interpret it is the principal purpose of the chairman's bill, H.R. 133.

As was pointed out in our Department's report on the bill, H.R. 133, as written, adds no substantial new program authority to that already available to the Service under existing statutory provisions. I would however, add specificity to some general authorities, thus underscoring and focusing public attention-and the attention of research workers in the health sciences on the particular needs and objectives of accident-prevention research.

We believe that such action by the Congress could contribute in this field, as it has in other fields of research, to the further advancement of programs already authorized and established.

We have also pointed out in our report several provisions of H.R. 133, as introduced, which would require substantial revision. The only point that we believe requires reiteration and emphasis in this statement today is the need for revision or clarification of those provisions of the bill which might be so construed as to limit or subordinate the accident-prevention research interests and responsibilities of other Federal departments and agencies.

As I indicated earlier in this statement, the field of accident prevention, including accident-prevention research, is very broad and diversified. It requires the resources of many agencies and individuals, and particularly many agencies and individuals in the Federal Government.

No one organization or agency could possibly conduct an allembracing program of its own or undertake the central planning and coordination of the efforts of other agencies.

Therefore, whole Public Health Service activities in this field could be strengthened through specific legislative emphasis along the lines of H.R. 133, with the amendments proposed, any such legislation should give due recognition to the parallel interests and programs of other agencies in the field.

This concludes my general statement, Mr. Chairman. I shall be glad, however with the assistance of the Surgeon General, Dr. Terry, and Dr. Paul V. Joliet, the Chief of our Division of Accident Prevention to answer any questions your committee may have regarding our present and projected activities in this important field, which your bill deals with.

Mr. ROBERTS. Thank you, Mr. Secretary.

We appreciate your statement on this bill. I want to congratulate you too on the charts which you presented for the benefit of the committee.

I was particularly impressed with the fact that it seems that when our youngsters begin to drive automobiles, that is when the curve takes its upward swing, and I wondered if you would agree with that, that apparently when they start to drive automobiles this onset of terrific loss of life seems to make itself known.

Mr. COHEN. Mr. Chairman, you are raising a problem which is very close to my heart. I have three teenagers driving a car at the present time and, of course, as a parent, I am well aware of the anxiety and distress that both my wife and I have each time one of our children drives the car.

As parents we have tried to instill in our children the sense of responsibility in having this death defying vehicle in their hands.

On the other hand, I must admit that not everything is under the control of the particular driver because there are other drivers on the road and there are other obstructions, and so on. I am sure all parents are concerned about this. It is so tragic, as I said, to have children reach the age of 18 or 20 and then see their life snuffed out just as they are ready to embark on their life's work after society has spent years in educating them and their parents have invested so much.

I think it certainly is an area that we ought to do a lot more in. Leaving out the matter of the love and affection for our children, just from the standpoint of economics to the country, a great deal of additional research could be justified in preventing this tremendous loss.

If this driving simulator that we have been talking about in an accident research prevention center could just simply reduce a small part of that loss, I think the return on the investment would be very great.

Perhaps the Surgeon General would like to say something on that. Dr. TERRY. Mr. Chairman, I think one is struck on repeated occasions by incidences which occur, and just in this morning's paper I think you may have noticed an article about the death of five teenage girls in Baltimore in an automobile accident.

We realize that we will never make automobiles completely safe, but, for instance, in reading this article in the paper, without having any more specific information about it, I was struck with wanting to know what had happened.

The driver was not killed. I believe he was the only occupant of the car who was not killed and after the accident, according to the report in the paper, related that his brakes failed.

Of course, I do not know whether the brakes actually did fail or whether this was a human failure, whether this individual had something wrong with him and he should not have been driving, or whether this was an automobile that had mechanical defects and should not have been allowed on our streets and highways.

I think this is an example of the sort of tragic incidences which occur every day and I think that our experience has shown very well in so many instances, many of them can be prevented by proper studies and application of existing information in the field.

Mr. ROBERTS. Actually, from the standpoint of physical alone, the teenager should be the best driver we have. Wouldn't you agree with that?

Dr. TERRY. That is right, sir. At that age their reflexes are better and from the pure physical standpoint, they should be the best, once they have learned to drive.

Mr. ROBERTS. Doctor, would you think that this type of prevention center would cost a great deal of money, or do you have any cost estimates?

Dr. TERRY. Yes, sir. We have some cost estimates, Mr. Chairman. I think it all depends on what one thinks of in terms of the actual things which are to be incorporated into such a center. For instance, the type of the center that we are thinking of in the research laboratory estimates, it is estimated that such a building would cost in the neighborhood of $8,500,000. This would be facilities to include laboratories for study, an area in which the simulator would be placed.

As I think you are aware, Mr. Chairman, we have received the support from the Congress already to begin the early stages of development and acquisition of a driving simulator. This is a complicated device that has to be developed and it will take several years yet before it will be available, but at the same time through the support of the Congress we have been able to get funds to start on this program, and this would be included in a part of this, as well as track facilities about the building which would be used for studies of the reaction of individuals to practice actual circumstances in driving.

Mr. ROBERTS. Do you contemplate that the simulator would be a part of the Accident Prevention Research Center?

Dr. TERRY. Yes, sir. It would be a very key part, but it would by no means be the entire Center. In other words, there would be many other laboratories of physiological, chemical, and other types which are necessary to support the work around the simulator and to support studies in other areas, such as home accidents, in which one would be able to mockup certain situations and study within such a center. Mr. ROBERTS. Dollarwise, what do we spend per capita in this field of automotive highway research?

Dr. TERRY. I don't have the exact figures, Mr. Chairman, on the automotive.

Mr. ROBERTS. Do you have them overall?

Dr. TERRY. I have them overall for accident prevention, and, as you realize, this year our budget is $3,660,000 in this area of accident prevention, which represents

Mr. ROBERTS. About $2. Is it not, per capita?

Dr. TERRY. About 2 cents per capita.

Mr. ROBERTS. Two cents, I mean.

Dr. TERRY. This is in comparison, for instance, to the area of the heart where we are spending 85 cents; cancer, 88 cents; in terms of research, development, and application in those fields.

Mr. ROBERTS. As pointed out, I believe by the Secretary, this field which we are talking about, the field covered in H.R. 133, is now the leading cause of death in the teenage group. You used the figures of what? Fifteen to twenty-four?

Mr. COHEN. Yes; 15 to 24. The motor vehicle was 67.7 percent. Is that the one you had reference to, Mr. Chairman?

Mr. ROBERTS. Yes.

This is a group, I believe, you mentioned, as the group that we will have to look to to draw our future leadership?

Mr. COHEN. That is certainly true. I recall when I was teaching at the University of Michigan that it would appall me, that at the end of the school year after the students had graduated, there would always be three or four traffic deaths that grew out of some kind of celebration or some other event just after these students had graduated, just on the embarkation of their work.

There are many aspects that I think need more research. true that there needs to be continuous work on highway safety.

It is

I think another area is the question of the use of alcohol and the kinds of laws that we have with regard to accidents when people are driving under the influence of alcohol.

That is an area of research that needs further work. Studies of the door locks on automobiles has been productive. You can reduce the extent of deaths and injuries by a number of things, including, as