October 21, 2002

Study shows importance of proper child restraints in reducing crash injuries

Boston, Massachusetts – Real-world crash data reinforces evidence that child safety seats play a major role in reducing the risk of significant injury to children involved in car crashes, says a study by Partners for Child Passenger Safety, a research collaboration of The Children’s Hospital of Philadelphia and State Farm Insurance Companies.

Partners for Child Passenger Safety (PCPS) is a child-specific crash surveillance system that links insurance claims data to telephone survey and crash investigation data. Since 1998, PCPS has collected information on 173,000 crashes involving more than 260,000 children. Until PCPS was established, little information was available on children in real-world car crashes.

PCPS research that was presented at the American Academy of Pediatrics (AAP) National Conference this past weekend includes:

  • In the PCPS study population, only 54 percent of
    children were restrained optimally for their age according to AAP
    guidelines: 74 percent of 0-to-3-year-olds used child safety seats, 9
    percent of 4-to-8-year-olds used booster seats, and 79 percent of 9-to-
    15-year olds used lap/shoulder belts. Twenty-three percent of children
    were seated in the front seat.

  • Within each age group researchers noted a consistent pattern
    demonstrating the incremental benefits of age appropriate restraint and
    rear-seating for each age group of children. Increases in risk of
    injury were observed as children became less optimally restrained and
    move to the front seat.

  • Front row seating is known to increase a child’s
    risk of injury in a crash. Several characteristics of children, drivers
    and vehicles affect the likelihood that a child will sit in the front
    seat. Older children and children riding as the sole passenger in the
    vehicle were more likely to sit in front. Children riding in older
    vehicles, as well as pickup trucks and vehicles without passenger
    airbags, were more likely to sit in front. These factors varied
    somewhat with the age of the child passenger. Educational efforts and
    interventions to promote rear seating should target these groups of

  • It has been established that sub-optimal
    restraint (SOR) of children involved in motor crashes is associated
    with an increased risk of head injury. The risk of abdominal injury
    related to SOR has not previously been determined in real-world
    crashes. PCPS researchers found that SOR more than doubled the risk of
    abdominal injury compared to optimal restraint.

  • Among restrained children with intra-abdominal
    injuries, those who were in SOR were four times more likely to have a
    hollow organ (stomach, intestine, bladder) injury when compared to
    those who were optimally restrained. This suggests that the mechanism
    of injury for hollow organs may be directly related to the inadequate
    position of the lap portion of the seat belt on the abdomen. These
    results may be used to improve the design of crash test dummies to be
    able to evaluate abdominal injuries in children.

The Children’s Hospital of Philadelphia recently launched a multimedia Web site to address many questions people have about appropriate restraint and correct installation of child restraint systems. Parents can view brief videos, listen to helpful instructions and browse quick tips at www.chop.edu/carseat.

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