Study Finds Few Using Car Child Safety Restraints Correctly

A new study reveals that few are using car child safety restraints correctly, increasing injury risks during motor vehicle accidents. For instance, explained WebMD, when children passengers are sitting in the front seats of cars at inappropriate ages, seat belts might not fit them and they may not be wearing the safety devices. The study found that the issue applies to children riding as passengers in cars, trucks, and vans.

“The most important finding from this study is that, while age and racial disparities exist, overall few children are using the restraints recommended for their age group, and many children over five are sitting in the front seat,” Michelle Macy, MD, said in a news release, wrote WebMD. Macy is a pediatrician who specializes in emergency medicine at the C.S. Mott Children’s Hospital at the University of Michigan in Ann Arbor. “We found that few children remain rear-facing after age one, fewer than two percent use a booster seat after age seven, and many over age six sit in the front seat,” said Macy.

The emerging study also found that more than one in three children, aged 11-12 and one in four children aged eight to 10 were front seat passengers; one in seven of those were aged six and seven, said WebMD. The findings appear, online, in the American Journal of Preventive Medicine.

Researchers reviewed 2007-2009 data from nearly 21,500 American children, nationwide, under the age of 13. Data was received from observations made of drivers with passenger children under the age of 13 when arriving at locations such as gas stations, fast-food chains, recreation centers, and child-care centers, said WebMD. Researchers recorded driver factors such as seat belt use, vehicle type, gender, age, and number of passengers. Children’s age, ethnicity, location in the car, and use and positioning of car safety restraints were also reviewed, said WebMD. The study found that in all age groups, minority children had lower rates of age-appropriate car safety restraint use and older children’s child safety seat use decreased while the incidence of not wearing seat belts increased. Also, in vehicles where the driver was not wearing a seat belt, there was a 23 percent increased likelihood that child passengers would also not be wearing child seat restraints, said WebMD.

Earlier this year, we wrote that, in a change of direction, the American Academy of Pediatrics (AAP) said that children should continue to be secured in rear-facing car seats until they are either two years of age or they grow larger than seat specifications, according to revised guidance. Since 2002, the AAP recommended children be secured in rear-facing car seats for as long as possible. The guidance does not provide a minimum threshold for turning the seats around, said Dennis Durbin, MD, a pediatric emergency physician at the Children’s Hospital of Philadelphia. Prior guidance set minimums at either one-year of age or when the child reaches 20 pounds, said Dr. Durbin, the policy statement’s lead author and author of an accompanying technical report published previously in Pediatrics.

Meanwhile, the National Highway Traffic Safety Administration (NHTSA) released new guidelines for child passenger safety based on age that were considered in line with AAP’s recommendations. In a recent interview, Dr. Durbin said that the AAP’s committee on injury, violence, and poison prevention opted to revise the child passenger safety policy following its 2007 reaffirmation.

In Sweden, children generally remain in rear facing seats until they reach the age of four; new data from Sweden and the United States revealed that there are benefits in reducing serious injury risks in children over the age of one. Durbin pointed out that today’s car seats and restraint systems are easily able to accommodate this new guidance.

In addition to saying that children remain in rear-facing car seats until the age of two or when they outgrow seat height and weight criteria, updated AAP recommendations say:

  • Once they outgrow the seats, children should be placed in forward-facing seats with harnesses until they outgrow those seats’ height and weight specifications.
  • When forward-facing seats are no longer feasible, place children in belt-positioning booster seats until children are able to be fitted in the car’s lap-and-shoulder seat belt so that the lap belt fits low across the hips and pelvis and the shoulder strap fits across the middle of the child’s shoulder and chest. This tends to occur when a child is four-feet nine-inches tall, at around age eight-to-12.
  • When booster seats have been outgrown, children must always wear lap and shoulder straps and all children under the age of 13 must ride in the back seat.


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