Partners for Child Passenger Safety Announces Science-Based Recommendations for Public Policy
WASHINGTON, May 2 -- Researchers from The Children's Hospital of Philadelphia, who lead a national research project called Partners for Child Passenger Safety (PCPS), today will present a year's worth of published research on children in car crashes and offer recommendations to child passenger safety advocates, legislators and automotive manufacturers. The PCPS research confirms the effectiveness of car and booster seats in preventing injuries to children. The research also confirms the need for improved safety testing criteria and procedures for the automotive industry that take into account the unique biomechanical characteristics of children, like smaller stature and lower sitting height, to better protect them during car crashes.
"As physicians and researchers, we know how important it is to base public policies on sound science," said Flaura Koplin Winston, M.D., Ph.D., director of TraumaLink at The Children's Hospital of Philadelphia and the principal investigator of the Partners for Child Passenger Safety, a study funded by State Farm Mutual Automobile Insurance Company. "Because the study has collected information on nearly 150,000 crashes involving more than 220,000 children, we have been able to conduct several analyses and study multiple mechanisms of injury to children during car crashes. By sharing this information with key groups like Advocates for Highway and Auto Safety, we arm them with scientific evidence upon which they can approach policy makers for child passenger safety improvements."
Among the key findings discussed were:
-- The study found an encouraging rapid rise in booster seat use among
older children between 1998 and 2000 -- particularly among 4-year-
olds.
-- Dr. Winston reported a changing pattern of injury with age for
children in side-impact collisions, demonstrating the biomechanical
differences between a child and an adult that result in different
injury patterns.
-- PCPS data show a heightened risk of facial fractures to children who
are inappropriately restrained in seat belts rather than child
restraint systems.
-- The data also demonstrate a nearly 5 times increased risk of injury to
children riding in the rear seat of compact extended-cab pickup
trucks compared to children riding in the rear seat of any other
vehicle type.
-- Children between the ages of 3 and 9 years are at greatest risk for
seat belt syndrome, due to improper fit of both the lap and shoulder
portions of the adult belt.
"We believe that the risk of injury, identified in the PCPS research, can be minimized by educating parents about appropriate restraint and by encouraging the automotive and restraint manufacturing community to incorporate the biomechanical characteristics of child occupants into their safety design," said Dr. Winston.
Partners for Child Passenger Safety Recommendations follow:
1. FACT: During a two-year period of increased child passenger safety
and booster seat awareness education initiatives, PCPS surveillance
noted a rapid rise in booster seat use during each year of the study.
The 4-year-old age group had the largest increase, from 14 percent in
1998 to 34 percent by the end of year 2000. This rapid rise over a
short period of time indicates a heightened awareness among parents
regarding optimal restraint for older children.
1. RECOMMENDATION: Educational efforts should continue to target older
children to encourage the use of belt-positioning booster seats until
the adult seat belt fits properly. State legislators and federal
policy makers should take notice that parents are more receptive to
booster seat legislation and other educational efforts.
2. FACT: PCPS identified a changing pattern of injury with age in side-
impact collisions. As children age, head and extremity injuries
become more common, while injuries to the thorax and abdomen decrease
in frequency. Biomechanical changes that occur as children age, such
as increases in stature and sitting height, result in different
interactions with a vehicle in a side-impact crash and, thus,
different injury patterns. Children who are properly restrained
suffer less severe injuries than children not properly restrained.
2. RECOMMENDATION: Regulators and manufacturers should incorporate
pediatric-specific injury mechanisms into side-impact test procedures
and safety criteria. Parents should appropriately restrain children
on every ride to lessen the severity of injury to their children in
the event of a side-impact collision.
3. FACT: Inappropriately restrained children are almost twice as likely
to suffer facial fracture than those appropriately restrained due to
increased forward head movement. The combination of rear seating with
age-appropriate restraint provided the best protection against facial
fractures.
3. RECOMMENDATION: Stress the importance of age-appropriate restraint in
the rear seat in all public education curricula in order to prevent
facial fractures. Consider revision of federal safety standards to
account for vehicle interior structures typically contacted by child
occupants. Consider enhancements to pediatric dummies to measure
facial impact forces.
4. FACT: Children riding in the rear seat of compact extended-cab pickup
trucks are nearly five times as likely to be injured as rear-row
seated children in other vehicles. The increased risk is caused, in
part, by unique hazards such as a small rear-occupant compartment,
limitations of the two-point (lap belt) restraints and, likely,
inadequate vehicle padding.
4. RECOMMENDATION: Compact extended-cab pickup trucks are not optimal
transport for families with children. Families with a choice of
vehicles should avoid transporting children in compact extended-cab
pickup trucks. Testing for occupant protection in interior impact is
not currently required by federal regulation for side-facing auxiliary
jump seats. Since data suggest that these seats are being used for
child passengers, this exemption should be reconsidered by the
National Highway Traffic Safety Administration (NHTSA) to encourage
improved safety design of the rear compartments.
5. FACT: Seat belt syndrome is a pattern of intra-abdominal and spinal
injuries caused by improper fit of seat belts. Children between the
ages of 3 and 9 years are at greatest risk for seat belt syndrome, due
to the improper fit of both the lap and shoulder portions of the belt.
5. RECOMMENDATION: While any restraint is better than no restraint at
all, children need to be restrained appropriately according to their
age and size on every ride to reduce their risk of serious injuries
(such as seat belt syndrome) in a car crash.
6. FACT: Premature graduation of children from child safety seats to
adult seat belts occurs for a variety of reasons, including a parent's
perception of a low risk of crash occurrence and/or child injury, and
a parent's lack of knowledge regarding best practices for child
passenger safety and the potential consequences of inappropriate
restraint. Parents perceive situational circumstances (e.g., an extra
person in the car), child behavior, state laws, as well as the
availability of booster seats, as reasons to not use booster seats.
6. RECOMMENDATION: Targeted educational campaigns are needed to teach
parents about the importance of booster seat use. Comprehensive child
restraint laws, which are in alignment with Advocates for Highway and
Auto Safety's Model State Law, would help eliminate parents'
confusion.
Partners for Child Passenger Safety (PCPS) is an ongoing research collaboration between The Children's Hospital of Philadelphia, State Farm Mutual Automobile Insurance Company and the University of Pennsylvania. PCPS compiles and analyzes data on real world crashes involving children by combining State Farm claims information with detailed telephone interviews and on-site crash investigations. Since 1997, PCPS has created a database containing information on nearly 150,000 crashes involving more than 220,000 children. It has become the largest source of data on children in motor vehicle crashes. Through peer-reviewed publication of PCPS findings and consistent communication with targeted audiences (medical providers, automobile and restraint manufacturers, public policy makers, advocates, and parents), PCPS seeks to educate parents and automotive and restraint manufacturers on how to best restrain child passengers to reduce rates of injury and death to children in motor vehicles. PCPS is based at The Children's Hospital of Philadelphia.
Founded in 1855 as the nation's first pediatric hospital, The Children's Hospital is recognized today as one of the leading treatment and research facilities for children in the world. Through its longstanding commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered medical discoveries, innovations and breakthroughs that have benefited children worldwide.
CONTACT: Suzanne Hill of The Children's Hospital of Philadelphia, +1-215-590-1417, or hillsu@email.chop.edu.
Note to Media: PCPS Interim Report 2002 and other supporting materials available at traumalink.chop.edu. Click on News and Events.