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Published on: September 21, 2017
Injuries to belted older children in motor vehicle crashes
J Felipe García-España1, Dennis R Durbin
1Center for Injury Research and Prevention at the Children's Hospital of Philadelphia, and The Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. gardajf@email.chop.edu
Insights
Injuries to older children in car crashes are relatively rare, but head injuries are most common. Proper seat belt use, including the shoulder strap, is crucial for reducing risk.
Area of Science:
- Pediatric Safety
- Traffic Accident Analysis
- Injury Prevention
Background:
- Current recommendations advise 8-12-year-olds to use seat belts in rear seats, assuming adequate protection.
- This study examines the effectiveness of these safety measures for older children.
Purpose of the Study:
- To characterize injuries in 8-12-year-olds using seat belts in rear vehicle seats during crashes.
- To estimate injury risk and distribution by body region.
- To identify factors contributing to injury risk.
Main Methods:
- Analysis of 6680 rear-seat occupants aged 8-12 using seat belts in crashes.
- Data collected via driver interviews in 16 US states (1998-2007).
- Injuries defined as Abbreviated Injury Scale (AIS) 2 or greater, reported by parents.
Main Results:
- The overall injury risk for belted 8-12-year-olds in the rear seat was 1.3%.
- Head injuries were most frequent (60%), followed by face, upper extremity, and abdomen.
- Incorrect seat belt usage (shoulder belt not used or misused) was reported in 21% of children, with a slightly higher, though not statistically significant, injury risk.
Conclusions:
- Future injury prevention efforts should focus on head, face, abdomen, and upper extremity protection for children in seat belts.
- Driver and crash characteristics significantly influence injury risk.
- New safety standards mandating lap and shoulder belts in all rear seats may reduce injury risk for older children.
Context:
The American Academy of Pediatrics and the National Highway Traffic Safety Administration currently recommend that, unless they are under 57in. in height, 8-12-year-old children use seat belts and all should ride in the rear seats of vehicles. These recommendations assume that the vehicle seat belt should provide adequate protection for these older children in the event of a crash.
Objectives:
To describe characteristics of older children in the rear seat using seat belts in crashes, to estimate their risk and body region distribution of injury, and to identify risk factors for injury.
Methods:
A representative sample of 6680 seat belt-restrained occupants, 8-12 years of age, seated in the rear seat during crashes involving insured vehicles in 16 US states between December 1998 and December 2007. A telephone interview was conducted with the driver of each vehicle. The main outcome was the parent-reported injury defined as Abbreviated Injury Scale (AIS) 2 or greater injuries.
Results:
The risk of injury for belted 8-12 year olds in the rear seat was 1.3%. Head injury was the most common injury (60%), followed by injuries to the face (9%), upper extremity (9%) and abdomen (9%). One out of five (21%) 8-12 year olds either did not use the shoulder portion of the vehicle seat belt or placed it incorrectly behind their back or under their arm. Bivariate analyses indicated a higher risk of injury for these children (1.8%) as compared to children using both the lap and shoulder portions of the seat belt (1.1%). However, this difference was not statistically significant when other risk factors such as crash severity and characteristics of the driver were considered.
Conclusions:
Injuries to the head, face, abdomen and upper extremity are the most common injuries to target for improved protection among 8-12 year olds in seat belts. Driver and crash characteristics are important risk factors for injury. A recent federal motor vehicle safety standard requiring lap and shoulder belts in all rear seat positions has the potential to further decrease the risk of injury to older children using seat belts.
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