Child Passenger Safety

Abstract

Despite significant reductions in the number of children killed in motor vehicle crashes over the past decade, crashes continue to be the leading cause of death for children 4 years and older. Therefore, the American Academy of Pediatrics continues to recommend inclusion of child passenger safety anticipatory guidance at every health-supervision visit. This technical report provides a summary of the evidence in support of 5 recommendations for best practices to optimize safety in passenger vehicles for children from birth through adolescence that all pediatricians should know and promote in their routine practice. These recommendations are presented in the revised policy statement on child passenger safety in the form of an algorithm that is intended to facilitate their implementation by pediatricians with their patients and families. The algorithm is designed to cover the majority of situations that pediatricians will encounter in practice. In addition, a summary of evidence on a number of additional issues that affect the safety of children in motor vehicles, including the proper use and installation of child restraints, exposure to air bags, travel in pickup trucks, children left in or around vehicles, and the importance of restraint laws, is provided. Finally, this technical report provides pediatricians with a number of resources for additional information to use when providing anticipatory guidance to families.

Hospital-Based Program to Increase Child Safety Restraint Use among Birthing Mothers in China

“…A 2012 survey in the large city of Shanghai found that only 5.1% of children under the age of 7 were restrained while traveling in a car [3]. Our 2012 observational survey in the middle-sized city (and therefore less influenced by international trends) of Shantou found that fewer than 1% of children were restrained [4].Correct use of a child safety restraint in the proper seating position can reduce the risk of fatality by up to 71% and the risk of serious injury up to 67% [5]. With rapidly increased motorization in China, there is a great need to develop and test intervention strategies that could effectively increase child safety restraint usage in China [6], since Chinese parenting customs coupled with low safety awareness could serve as barriers to CSS use.…”

Situational Use of Child Restraint Systems and Carpooling Behaviors in Parents and Caregivers

“…This previous study was conducted in 2010, prior to the American Academy of Pediatrics Child Passenger Safety Policy Statement and Technical Report in 2011 [1,2], yet even with these new guidelines, inconsistent booster seat use in carpooling still exists. Even among those who typically use booster seats, only 71.7% reported always using a booster seat for their own child when carpooling other children, and only 67.5% reported always asking others to have their child ride in a booster seat when others are driving them.…”

“…Suboptimal compliance with child restraint system (CRS) recommendations [1,2] can increase risk for injury or death if a crash does occur [3,4,5]. After children grow out of harness systems, booster seats help to adequately restrain children in the years they are not yet ready for the seat belts outfitted in vehicles.…”

Biofidelity Evaluation of a Prototype Hybrid III 6 Year-Old ATD Lower Extremity

“…2,6,13,14,19 While it has been observed that upwards of 70-90% of 4-7 year-olds are using some sort of restraint, many in this age group are not using the appropriate restraint type. 7,22,26 Even when children are riding in an age-appropriate BPB seat, an estimated 64% are using the seat incorrectly. 25 The seating position of the pediatric occupant also plays a large role in the child's risk of injury.…”

“…When riding in the front seat, the child is at a greater risk for severe injury or death compared to a child seated in the second row. 7,9,14,17,27 Although many states recommend that children age 13 and under ride in the second row, the NHTSA reports 8% of 4-7 year-old passengers were riding in the front passenger seat in 2011. 26 The consequences of pediatric lower extremity interactions with front row features such as the dashboard and airbags are not well documented.…”