How to best protect children in side-impact crashes

Researchers from The Children’s Hospital of Philadelphia say restraints, other passengers in rear seat reduce risk

Researchers at The Children’s Hospital of Philadelphia will present today a series of findings aimed at enhancing protection for children in side-impact car crashes at the Scientific Conference of the Association for the Advancement of Automotive Medicine (AAAM). The findings demonstrate that children fare better in side-impact crashes if they are restrained and if they are seated with other occupants in the back seat, and they emphasize the protective benefits of high back booster seats in these crashes for 4-to 8-year-olds.

The original findings are based on real-world crash data from Partners for Child Passenger Safety (PCPS), a research partnership of Children’s Hospital and State Farm Insurance Companies. In addition to the new findings, PCPS research being presented at the conference confirms that children riding in passenger cars and light truck vehicles, such as SUVs, are at increased risk of injury in a side-impact crash when their vehicle is struck by a light truck.

“Side impacts are the second most common fatal crash type after frontal crashes and require focused attention from the safety community,” says Kristy Arbogast, Ph.D., Associate Director of Field Engineering, TraumaLink, The Children’s Hospital of Philadelphia. “Most importantly, we need to focus on the most vulnerable occupants– children.”

According to the National Highway Traffic Safety Administration (NHTSA), 42 percent of child fatalities to rear-seated children ages 0 to 8 years occur in side-impact collisions. Overall, side-impact crashes kill about 300 American children under age 8 each year and result in more severe injuries at lower crash severities than frontal collisions.

The Children’s Hospital researchers hope the new findings provide NHTSA and the auto industry with information that can be used to enhance performance testing and safety design that take into account the unique safety needs of child occupants. The recently passed SAFETEA (Safe, Accountable, Flexible, and Efficient Transportation Equity) Act of 2005 requires NHTSA to upgrade its side-impact standard by July 1, 2008.

“In addition to providing new insights into child occupant safety in side-impact crashes, our findings demonstrate the effectiveness of using age- and size- appropriate restraints and rear seating in preventing injuries in this crash direction,” said Kristy Arbogast. “Correct restraint use and rear-seating for children, this is the message we need to convey to parents.”

Key findings from the PCPS research study that were presented at the AAAM Conference:

“Effectiveness of High Back and Backless Belt-Positioning Booster Seats in Side impact crashes”

• Belt-positioning booster seats provided a 58 percent overall reduction in risk of injury to 4-to 8-year-olds in side-impact crashes as compared with seat belts alone. (These findings support prior PCPS research, which shows booster seats to be 59 percent effective in reducing injury risk to 4-to 8-year-olds in crashes of all impact directions.)
• The risk reduction provided by booster seats in side-impact crashes varied by booster seat type: 4-to 8-year-olds riding in high back booster seats were at a 70 percent reduction in injury risk, while those in backless boosters did not experience a statistically significant risk reduction as compared with seat belts alone.
• However, both types of booster seats provided significant protection from “seat belt syndrome” injuries to the internal abdominal organs and lumbar spine. Most of the injuries to children seated in backless booster seats were head injuries.
• Possible explanations for non-significant reduction in injury risk for backless booster seats are that parents may be less likely to use to use the shoulder belt- positioner that comes with backless booster seats and that high back boosters have a contoured back that may better contain the occupant in side-impact crashes.

“Effect of Increased Rear Row Occupancy on Injury to Seat Belt Restrained Children in Side impact Crashes”

• Seat belt restrained children aged 4 to 15 who were riding in the rear row of passenger cars reduced their risk of injury by up to 58 percent in side-impact crashes if they were riding with another seat-belted passenger in the rear row. The data suggests that development of a restraint system that limits side-to-side motion would be effective in reducing injury during side-impact crashes.
• Initial analyses showed that head injuries were the most frequent injury in all seating positions, with struck-side and center-seated occupants having similar risks of injury and non-struck side occupants at the lowest risk of injury.

“Effect of Vehicle Incompatibility on Child Occupant Injury Risk”

• Children riding in passenger cars and light trucks are at a significantly greater risk for serious injury when struck by a light truck than by a passenger car and when seated on the struck side of a side-impact crash.
• Overall risk for serious injury was more than twice as high for children sitting on the struck side of the vehicle than for children seated in the center and non-struck side seating positions in side-impact crashes.

For more information about safe practices for restraining children when traveling in a motor vehicle, including interactive videos on how to choose and install a child safety seat, visit www.chop.edu/carseat.