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we have seen, seat belts, and improved door locks. I have reason to believe that if we apply ourselves to this matter, we can do so.

One point, Mr. Chairman, was not made in my statement, but I think should be of interest to your subcommittee. The extent to which the State health departments are working on accident prevention is very spotty in the United States at the present time.

We only have 15 States that have a full-time person in their public health departments that is dealing, in a full-time way, with accident prevention. That gives you some rough idea that we are not yet at the point where the States recognize that you have to have people who are working on this all the time.

In 36 other States, we have part-time personnel, and I think that there is a great deal yet that remains to be done to stimulate and encourage the State health departments to undertake this as a more major function of their responsibility.

Mr. ROBERTS. Do you have any figures as to the number of States which require physical examinations of drivers on renewal?

Dr. JOLIET. The most recent to require this was Pennsylvania, sir. I believe Oregon has such a law. We can get a listing for you. Those are the two that I know of offhand.

Mr. ROBERTS. I would like to have you supply that for the record. (The following material was submitted for the record:)

The accompanying charts indicate:

(a) State physical examination requirements for new applicants for driver licensing and renewals (obtained from International Association of Chiefs of Police), and

(b) State physical examination requirements for special licensing cases (obtained from American Optical Survey of State Requirements for Motor Vehicle Operators).

State physical examination requirements for new applicants for driver licensing and

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1 Pennsylvania periodical physical examination suspended pending legislative review.

Dr. TERRY. Mr. Chairman, I would like to mention in relation to the figures that Mr. Cohen gave you here, you might notice that there were 51-15 that have full time and 36 that have part time, actually amounting to 51 because this includes Guam, Puerto Rico, and the Virgin Islands, which means this: That with 53 in the table for consideration, actually there are two States, and they are not the territories either, that do not have either part-time or full-time personnel at the State level devoted toward accident prevention.

Mr. ROBERTS. I would like to ask the Secretary if he thinks this is a healthy situation for States not to require physical examinations on renewals.

Mr. COHEN. Perhaps Dr. Terry and Mr. Joliet want to comment on this. I feel that it is a matter that we certainly ought to do a great deal more research on before we finally decide what needs to

be done, both with respect to further consideration of the individual and the examination of the automobile.

Those are two areas I think in which there is a great deal of controversy. Some States provide for examination of people over 65. This is interesting to a lot of the State legislators. But in principle, if that is good for people over 65, I think it is good for people under 65, because we all know that the variation in human capacity and performance is very great for people under 65 as well as for people over 65.

Mr. ROBERTS. Actually, we do require, do we not, pilots of planes, and I suppose marine pilots and locomotive engineers, and we require drivers of vehicles in Interstate Commerce, that is trucks that are under the licensure of the ICC to pass certain physical standards?

Mr. COHEN. I would like to say this, and then perhaps Dr. Terry would comment. I think we would all agree with the objective of that, and yet, I think we are at that stage in development of accident prevention that we don't really know what those standards ought to be.

Mr. ROBERTS. We have no place to go. out that they have no place to go for any on scientific research. Isn't that true?

Actually the ICC points information that is based

Mr. COHEN. Yes. Commercial airplane pilots are very much up in arms over this so-called arbitrary ruling that at age 60 they can't fly any more. I wouldn't want to comment for or against it, but the point that I am trying to make is simply that we need to know a lot more about human capacities and how to set standards before we make a final judgment.

We are probably in the accident prevention field today where we were 15 years ago in cancer.

In other words, we have a lot of very fundamental work to do to assemble all this knowledge and information, and once it can be assembled, I think that competent scientific people then can begin to set standards that the States and different people in different

areas can use.

Is that a fair statement, Dr. Joliet?

Dr. JOLIET. That is a very eminently fair statement. You can see the work that has been done in advancing the safety and quality of highways by developing the Interstate System. There is no comparison of these highways with what we knew when we were kids. However, drivers have not improved as the highways have. Nothing like a comparable advance has been made in determining who may or who may not drive cars from the standpoint of physical or mental limitations.

Mr. ROBERTS. I would like also to ask you if in the event of approval of this bill, you would see any infringement on such activity of the Interior Department, as minimum safety, or any infringement on the work of the Federal Aviation Agency, or upon the traditional role of the Department of Commerce through the Bureau of Public Records, or any other Federal agencies whose present jurisdiction would be divested by this bill, that is, with the amendments or suggestions which you have made in your statement.

Mr. COHEN. Mr. Chairman, the way I read the bill it neither is intended nor is there anything explicit which I think infringes on the

jurisdiction of these other areas that the Federal agencies are working on and in which they are doing very fine work.

I would, however, feel that if you were going to pass legislation, in order to avoid that difficulty, the statute should be made very clear that this is not intended to supersede the responsibilities of these agencies which have a specific responsibility in either mine safety, or occupational injury, or pilots, or any such areas. As I read the bill and as I read your hearings before, what you are looking for is a research function in the Federal Government which has already been given to the Public Health Service, which will attempt to pool all of the information available throughout our society and make it available to everyone and thus coordinate research in such a way that it will be more useful to everyone and accelerate the progress we made in this field without any duplication.

I think if the committee report or the statute were to make that clear there would not need to be any concern on the part of those other Federal agencies.

Mr. ROBERTS. Do you see any infringement or interference that could be promoted by this bill in the activities of such organization as the National Safety Council, which is a privately run nonprofit organization?

Mr. COHEN. Mr. Chairman, I think that there is nothing in this bill that interferes with the work of the National Safety Council or any other of the very fine nongovernmental agencies that are working in this field.

This problem is no different from the problem we have in, let us say, setting up a National Cancer Institute and its relationship to the many health agencies concerned with cancer.

We have a very fine working relationship between the public and private agencies. It is no different from setting up the National Heart Institute and giving it the responsibility for research, and it works fine with all the nongovernmental agencies in the heart field.

It is no different from the new institute that you were most responsible in creating last year, the National Institute of Child Health and Human Development, which has just been set up under Dr. Terry's supervision, that is going to work in the whole area of human development.

It works splendidly with all of these private organizations._ I think if you look at all of the National Institutes of Health under Dr. Terry's supervision and guidance, one of the key objectives of his administration and the Department is that the Federal Government shall do those things that are difficult for private groups to do, because of their cost, because of the assemblage of various numbers of scientific personnel that are in shortage, and then make this information available to the voluntary agencies so they can undertake the education, the community action, bringing this knowledge right down to the people in the local community, undertake the safety campaigns, and undertake the dissemination of this knowledge. This bill does not in any way conflict with the work of the National Safety Council or any similar organizations that are working in this field, but rather I think, because of its enactment and highlighting, this would give greater prominence and public support to the fine work that they are doing at the present time.

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