Wheelchair Securement Systems and Seat Belts in Vehicles: A Comprehensive Guide

 Wheelchair securement systems typically consist of three parts, the occupant securements, the wheelchair securements, and floor anchors to assist in securing the wheelchair and rider in place. In this article we will break down every aspect of a complete wheelchair securement system, to hopefully provide a helpful guide on what is required to keep passengers safe while staying compliant with current laws and regulations. While we will be mostly referring to USA specific regulations as mandated by the NHTSA (National Highway Traffic Safety Administration) and the DOT(Department of Transportation) per the ADA (Americans with Disabilities Act), countries around the world often adhere to, or contain similar language to ISO 10542-1:2012, a guide for WTORS (wheelchair tie-down and occupant restraint systems) to ensure safety in transit. You should always to refer to the specific regulations as outlined in your country or region, but the following article will provide a good reference for any regions that have similar language to ISO 10542-1:2012 including the USA, Canada, the EU, Japan, Australia, New Zealand, Brazil, South Korea, and more. First we will outline the requirements as written in regulations and guidelines, then we can dive into specific options and what safely securing a wheelchair user should look like in practice. 

1. Requirements
   1. Occupant Securements: To secure wheelchair users, both a lap belt and shoulder belt are required. Wheelchair tie-downs can't be used as an occupant securement, so separate tie-downs must be used to secure the wheelchair itself, and the wheelchair user. Postural belts can be used to provide support and comfort to the rider, but they should not be used in lieu of a lap and shoulder belt. They do not meet requirements as outlined by the NHTSA guidelines for seat belt assemblies, and will not properly secure the wheelchair user in the event of a crash. Below is specific text from the ADA accessibility guidelines for buses and vans, for more reading click here to view the "Guides to the ADA Guidelines for Transportation Vehicles". 

      T212 Seat Belts and Shoulder Belts

      T212.1 General. Non-rail vehicles shall provide seat belts and shoulder belts complying with T605 at each wheelchair space.

      T605 Seat Belts and Shoulder Belts

      T605.1 General. Seat belts and shoulder belts provided for passengers who use wheelchairs shall comply with 49 CFR 571.209. Seat belts and shoulder belts shall not be used in place of wheelchair securement systems complying with T603.

   2. Wheelchair Securements: Wheelchair securement systems must be able to restrain a longitudinal force of 5000 lbf (22,000N) for each wheelchair. Movement must be limited to a maximum of 2 inches in any direction. The securements must also be compatible for a range of wheelchair sizes and types. As a result of these standards, the only universally accepted method of securement that meets all requirements is the 4-point securement system. This uses four tie-downs, two in the front, two in the rear, attached to solid structural components of the wheelchair, as opposed to the wheels. This setup limits movement in all directions while helping to evenly distribute forces during a sudden stop.
      
      The international standard ISO 10542-1:2012 describes performance and testing criteria for 4 point WTORS (wheelchair tie-down and occupant restraint systems). Manufactures follow these criteria to ensure their products meet performance standards around the globe. Other wheelchair tie-down systems can also meet the requirements below, like a wheelchair docking station. These require modifications of a wheelchair, meaning they aren't universal, and are often used in personal vehicles as opposed to public transit. Again below is specific text from the ADA accessibility guidelines for buses and vans, for more reading click here to view the "Guides to the ADA Guidelines for Transportation Vehicles".

      T211 Wheelchair Securement Systems

      T211.1 General. Non-rail vehicles shall provide wheelchair securement systems complying with T603 at each wheelchair space. 

      T602 Wheelchair Spaces

      T602.4 Size. Wheelchair spaces shall be 30 inches (760 mm) minimum in width and 48 inches (1220 mm) minimum in length. 

      T603 Wheelchair Securement Systems

      T603.2 Orientation. Wheelchair securement systems shall secure the wheelchair so that the occupant faces the front of the non-rail vehicle.

      T603.3 Design Load. Wheelchair securement systems shall comply with the design loads specified in T603.3.1 or T603.3.2, as applicable.

      T603.3.1 Non-Rail Vehicles with Gross Vehicle Weight Rating Equal to or Greater than 30,000 lbs. On non-rail vehicles with a gross vehicle weight rating equal to or greater than 30,000 pounds (13,608 kg), wheelchair securement systems shall restrain a force in the forward longitudinal direction of 2,000 lbf (8,800 N) minimum for each wheelchair.

      T603.3.2 Non-Rail Vehicles with Gross Vehicle Weight Rating Less than 30,000 lbs. On non-rail vehicles with a gross vehicle weight rating less than 30,000 pounds (13,608 kg), wheelchair securement systems shall restrain a force in the forward longitudinal direction of 5,000 lbf (22,000 N) minimum for each wheelchair.

      T603.4 Movement. Wheelchair securement systems shall limit the movement of an occupied wheelchair to 2 inches (51 mm) maximum in any direction when secured in accordance with the manufacturer’s instructions and when the non-rail vehicle is operating in normal conditions.

   3. Other Considerations: Other guidelines when it comes to wheelchair securement systems include keeping the surfaces slip resistant and safe as a walking surface and for wheelchairs. Openings in the surface can be a result of floor anchorage systems. We will go over the multiple types of floor anchorage below, with L-Track (also called airplane track or logistic track) being the most common. Uncovered L-Track can cause a trip hazard as a walking surface or can cause the wheels of a wheelchair to become stuck. It is recommended to use L-Track filler strip on unused parts of L-track to both ensure compliance with regulations, and to keep it in good condition.
      
      It is also required to stow away wheelchair securements not in use. Wall mounted wheelchair bags are a good choice to store both wheelchair and occupant securements when not being used. 

      T302 Walking Surfaces

      T302.1 General. Walking surfaces in non-rail vehicles shall comply with T302.

      EXCEPTION: Walking surfaces on lifts shall not be required to comply with T302.

      T302.2 Slip Resistant. Walking surfaces shall be slip resistant.

      T302.3 Openings. Openings in walking surfaces shall not allow the passage of a sphere more than 5/8 inch (16 mm) in diameter. Elongated openings shall be placed so that the long dimension is perpendicular to the dominant direction of travel.

      T604 Stowage

      T604.1 General. When wheelchair securement systems are not in use, the systems shall not protrude into the wheelchair space except as provided in T603.5, and shall not interfere with passenger movement or pose a hazard. Wheelchair securement systems shall be reasonably protected from vandalism, and shall be readily accessed then needed for use.

2. Occupant Securement Guide
   1. Requirements: As stated above it is required to have both a lap and a shoulder belt to properly secure wheelchair users during transit. They should be accommodating to a range of body types while providing comfortable positioning for the users. They are required to meet the Federal Motor Vehicle Safety Standards (FMVSS) as outlined by the NHTSA  here. This is to ensure they are capable to withstand the forces generated in a crash.
   2. Lap Belts: Lap belts are intended to distribute forces across the pelvic region, as opposed to the abdomen. In other words, belts should rest across the users pelvic and hip bones, not pulling on the stomach. They should be independently anchored, meaning looping it around a wheelchair isn't sufficient. The most common anchoring method used by major brands in WTORS is an integrated lap belt system. In this system, the two rear wheelchair tie-down retractors also contain a securement point for the lap belts. This means the retractor serves a dual purpose in securing both the wheelchair and the occupant. These integrated WTORS are designed and crash tested to exert different forces on the wheelchair than the occupant, while utilizing the same anchor point in the rear. This is however not a requirement. Retractable lap belts that are independently anchored from the wheelchair securements are slightly more expensive, but are easier to use and don't require manually attaching the lap belt to the rear retractors.
      
   3. Shoulder Belts: Lap belts should always be used in tandem with a shoulder belt when securing a wheelchair user. Shoulder belts reduce the risk of head and other upper body injuries, whiplash, or forward ejection in the event of a crash. To properly secure a shoulder belt ensures that it rests between the neck and shoulder, while not touching the neck nor falling off the shoulder. Manual shoulder belts common in the industry anchor to the wall at one point, and attach the lap belt at another. Retractable shoulder belts are another good option, offering ease of use and anchor points less prone to operator error. While the wheelchair uses a 4-point restraint system, occupant securements tend to use a 3-point system. This means the lap belt anchors at 2 points behind the wheelchair, while the shoulder belt anchors at another point. 
   4. Proper Securement: Proper securement is vital to ensure occupant securement systems work in the manner intended. Improper securement can lead to serious injury or death. It is vital all drivers are trained on how to properly secure a passenger. Lap belts should rest across the pelvic and hip bones, not pulling on the stomach or abdomen. In the event of a crash Improper securement of can lead to internal organ damage, spinal injuries, or sliding under the belt. Shoulder belts should rest between the neck and shoulder, not touching the neck nor falling off the shoulder. Shoulder belts should attach to the lap belt all the way across the body, not in the middle of the lap. All belts should be tight as to have no slack, but not too tight as to cause discomfort for the occupant. Ensuring belts have no twists or slack is vital to ensure they work as intended, as any tie-down system is only as strong as its weakest link. Properly securing a passenger is important for safety and comfort of the rider even during regular transit, as sudden stops or belts pulling on the neck can cause discomfort in what would otherwise be pain free travel. 
   5. FAQ: 
      1. Q: Can I use a postural belt in place of a lap belt?
         
         1. A: No, postural belts are not a suitable replacement for a lap belt as they do not meet the standards set to ensure safety. Postural belts will not keep a rider safe in the event of a crash or sudden stop. A postural is used to support sitting posture and cannot legally or safely replace a lap belt.
      2. Q: Is a shoulder belt required?
         
         1. A: Yes, shoulder belts are required to ensure the safety of riders. In rare cases there are documented medical or behavioral exemptions, in which case reasonable other accommodations should be made. If a rider has a legitimate medial or behavioral reason, operators should follow 49 CFR §37.169 the "reasonable modification" policy. It's important to remember that these rules and regulations are meant to ensure safety and equitable accommodation. 
      3. Q: Can I attach the seat belts to the wheelchair?
         1. A: No, seat belts must attach to either an anchor point on the vehicles floor or side-walls, or to a retractor as part of an integrated wheelchair tie-down and occupant restraint system (WTORS).
            
      4. Q: Can the belts route around trays, joysticks, or armrests?
         1. A: No, belts should route directly against the body of the rider. Not doing so can result in "submarining" or the occupant sliding out from under the belts. 
      5. Q: How often should belts be replaced?
         1. A: It's good practice to regularly inspect belts before use and during the securement process. Belts should be replaced if the webbing is torn, cut, or fraying. Buckles can wear down over time, so if they are damaged, loose, or not buckling properly you should replace the belt. Any tie-down system is only as strong as its weakest link. 
   6.  Crash Test Videos - Below are four videos produced by the University of Michigan Transportation Research institute showing the dangers of not properly following the guidelines outlined above. They show 30MPH crash tests while using only a postural belt, while not using a shoulder belt, while routing the belt around an armrest, and finally with proper securement. These visuals speak for themselves on the necessity of taking occupant securement seriously as a safety measure. 
      
      
      
      

        3.  Wheelchair Securement Guide

1. 1. Requirements: The requirements for wheelchair securements include withstanding a longitudinal force of 5000 lbf (22,000N), limiting movement to 2 inches in any direction, and being able to accommodate a wide range of wheelchair types and sizes. 
   2. Floor Anchorage: A big consideration in securing wheelchairs is how to anchor to the floor of your vehicle. The common options in the industry include L-Track, A-Track, 360° movement fittings (Slide-N-Click, Smart Fitting), or a floor mount.
      
   3. 4-Point Securement Systems: The leaders in 4-point securement systems are Q'straint, Sure-Lok, and AMF Bruns. Q'Straint and Sure-Lok are popular options in the US and Canada, while AMF Bruns is more common in Europe, with a growing presence in North America. The most popular option is to use 4 retractable straps that attach to the mobility device from both the front and back. These retractors are designed to pair with their occupant securements to create an integrated WTORS system. This integrated system is the most common and practical way to secure a wheelchair user while in transit. In vehicles with limited space electrical retractors are often used for the front two securement positions. They connect directly to the cars electrical system, and make the process from ramp to proper securement in the vehicle easier for both the driver and the wheelchair user. Manual tie-downs are also available, although these lack the hardware to attach occupant restraints, meaning a separate floor anchorage would be required for both.  
   4. Other Options: While 4-Point Securement Systems are the cheapest and most common way to secure a wheelchair and rider while in transit, other options do exist. For independent or personal use, a wheelchair docking station is a common replacement. In this setup, a docking is station is permanently secured to the floor of the vehicle in the desired seating position. The wheelchair is then given a compatible bracket that will lock into the docking station when moving into position. While these are expensive, and require potentially difficult installation, they are the fast, extremely easy, and non-intrusive in comparison to the 4-Point Securement System. Brands with a docking station include the QLK from Q'Straint and EZ Lock docking stations. These are crash tested systems that meet and exceed safety standards for wheelchair securement. 
   5. FAQ: 
      1. Q: What is a 4-Point Securement System?
         1. A: A 4-Point Securement System utilizes 4 anchor points, 2 in the front, 2 in the rear to properly secure a wheelchair in place. It is the most common system used to secure wheelchairs during transit.
            
      2. Q: Do I need both wheelchair and occupant securements?
         1. A: Yes, wheelchair securement is not a replacement for securing a rider in place.

     4.  Other Accessories to Consider

1. 1. L-Track Filler Strip: In order to maintain L-Track, filler strip is recommended to keep dirt and other objects out of the openings in the track. Filler strip can help decrease time spent cleaning L-Track, and ultimately extend its life. 
   2. Wheelchair Bags: Wheelchair bags can attach to the sidewall of a vehicle to give a space to store wheelchair and occupant restraints when not in use. 
   3. Belt Cutters: Belt cutters are a good backup safety tool to quickly and easily free a passenger in the event of an emergency.
   4. Secure Loops: A secure webbing loop creates a securement point on a wheelchair when other anchor points are too large or hard to reach for the wheelchair securement. Simply wrap the loop around a secure point on the wheelchair frame and create a consistent and strong anchor point.