Childhood motor vehicle occupant injuries

Article Abstract:

Motor vehicle accidents are the fourth highest cause of death in all age groups in the United States and the leading cause of death in children beyond the age of one year. Mortality of 15- to 19-year-old occupants of cars involved in accidents is 33 deaths per 100,000 population, more than 10 times that of children less than 10 years of age. Twice as many adolescent males as females die. Mortality of drivers in this age group is the highest among licensed drivers. These high death rates occur because children tend to overload cars, have more single vehicle accidents, and more nighttime and weekend accidents. Data reported were collected by the Fatal Accident Reporting System, which is maintained by the National Highway Traffic Safety Administration. Among children under 20 years of age, motor vehicle-related deaths account for 498,563 years of potential life lost (per year), based on the conventional life expectancy of 65 years. Intervention strategies to reduce mortality of teenaged drivers and occupants are presented. Driver interventions and expected outcomes include: (1) delaying licensure to age 17, thereby reducing fatal crashes in 16-year-olds by 65 to 85 percent; (2) eliminating driver education classes, thereby reducing licensure of 16- and 17-year-olds and decreasing per capita crash involvement; (3) initiating curfews to restrict nighttime teenage driving; and (4) establishing lower blood alcohol levels for teenage divers. Other interventions include mandatory loss of driving privileges for violating curfews, driving under the influence of drugs or alcohol, speeding, and failing to use safety belts. Occupant safety interventions include: (1) comprehensive child safety laws, especially for children under 5 years of age; (2) enforcement of seat belt use at all seat locations; (3) installation of lap-shoulder seat belts for rear seats; and (4) installation of passive restraints in all positions and air bags in both front seat positions. (Consumer Summary produced by Reliance Medical Information, Inc.)

Laws, regulations and rules, Patient outcomes, Mortality, Statistics, Study and teaching, Traffic accidents, Motor vehicles, Child safety seats

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Child passenger safety: past, present and future

Article Abstract:

Motor vehicle safety has improved overall since the 1968 requirement that cars be equipped with seat belts. Preschool children were not required to wear seat belt restraints until 1978, and by 1984 all states required children from birth to age four to be restrained while traveling in cars. In 1984, 49 percent of preschool children were restrained with seat belts while riding in automobiles. A 1989 parking-lot survey revealed an increase in seat-belt use to 82.5 percent. Although seat-restraint use has increased in children under the age of five, many restraints are used incorrectly. In 1984, 15 percent of five- to 13-year-olds used restraints. This increased in 1988 to 39 percent. Among 13- to 19-year-olds, restraint use in 1984 was seven percent, while four years later it climbed to 24 percent. It is estimated that seat-belt use prevented 4,500 deaths and 119,000 injuries in the over-four age group. To improve safe transport of children and adolescents, many changes still need to be made. In the November issue of the American Journal of Diseases and Children, Argran et al. suggest that seat belts do not work as well for older children. Changes should be made to make the current seat belts more uniform and appropriate for older children. It is suggested that seat-belt harnesses be adjustable to accommodate all sizes of children. In addition, the age limit required for child restraint should be raised. To improve car safety for teenagers, air bags, nondetachable restraints, decreased alcohol use and improved law enforcement are suggested. The current laws regarding restraints have improved the situation, but there is still a long way to go. Parents are urged to follow proper safety protocols to help raise a generation of seat-belted children. (Consumer Summary produced by Reliance Medical Information, Inc.)

editorial

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Injuries among 4- to 9-year-old restrained motor vehicle occupants by seat location and crash impact site

Article Abstract:

Children who have outgrown infant car seats use adult seat belts for restraint. However, these seat belts are designed to fit the bodies of adults, not children. The harness often falls over the face and neck of the child and the lap belt may sit over the abdominal organs. In addition, the physical activity and behavior of the children in seat-belt restraints is different than in adults. The severity and type of injuries sustained by seat location and crash site was determined in a group of four- to nine-year-olds who were using seat belt restraints at the time of the accident. Of the 131 children studied, 70 percent had head or face injuries, 12 percent of those were considered serious. Several children hit the windshield or front seat on impact. These injuries occurred in all seat locations and impact sites, particularly from front impacts. Serious injuries from lateral impacts, which cannot be prevented by seat belts, were reported in 41 percent of the restrained children. Less common injuries included lower torso injuries (18 percent) and spinal injuries (15 percent). No children were ejected from the vehicle when seat-belt restraints were used. Thicker doors with better padding are needed to prevent injuries from lateral impacts. Improvements in seat-belt design to accommodate the smaller body proportions of children are also needed. To prevent injuries in the interior of the vehicle, it is suggested that children seated in the front have the seat moved all the way back. Conversely, the front seat should be moved forward if children are seated in the back. Lap and shoulder restraints used in the back seat may prevent head impacts. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Physiological aspects, Collisions (Physics), Impact

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