Optimal Restraint and Seating Position Play a Big Role in Reducing Risk of Injury to Children in Car Crashes

BOSTON, Oct. 20 -- Real-world crash data reinforce evidence that child safety seats play a major role in reducing the risk of significant injury to children involved in car crashes. Sitting in the back seat also plays a major role in protecting young passengers. Researchers see a need for improved education efforts and improved state child restraint laws so that parents understand the benefits of child safety seats versus the risks of inappropriate restraint. Original research findings from Partners for Child Passenger Safety, a research collaboration of The Children's Hospital of Philadelphia and State Farm Insurance Companies, will be presented to members of the American Academy of Pediatrics (AAP) at its conference on Sunday, October 20 and Monday, October 21.

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. The research project produces robust findings that are frequently published in scientific journals and shared with regulatory and industry groups.

PCPS research that will be presented at the AAP National Conference includes:

-- The Effect of Optimal Restraint and Seating Position on the Risk of Injury to Children. Findings/ Conclusions: 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. Presenter: Dennis R. Durbin, M.D., M.S.C.E., Co-Principal Investigator of Partners for Child Passenger Safety and Director of Research for TraumaLink, the Center for Interdisciplinary Pediatric Trauma Research at The Children's Hospital of Philadelphia.

-- Factors Associated with Front Row Seating of Children in Motor Vehicle Crashes Findings/ Conclusions: 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 children. Presenter: Dennis R. Durbin, M.D., M.S.C.E.

-- Sub-optimal Restraint is Associated with an Increase in Abdominal Injury in Children Involved in Motor Vehicle Crashes Findings/ Conclusions: 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. Prevention and education efforts must continue to reinforce the necessity of age appropriate restraint in all children. Presenter: Michael Nance, M.D. Associate Director of Trauma and Pediatric Surgeon at The Children's Hospital of Philadelphia.

-- Sub-optimal Restraint Affects the Pattern of Abdominal Injuries in Children Involved in Motor Vehicle Crashes Findings/ Conclusions: 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. Presenter: Nicolas Lutz, M.D., Senior Trauma Fellow and Pediatric Surgeon at The Children's Hospital of Philadelphia

-- Using Crash-based Data to Effectively Advocate for Appropriate Child Occupant Restraint Findings/ Conclusions: PCPS turns research into action by generating crash-based pediatric injury data and providing it in variety of disciplines to target audiences. In particular, data regarding the inappropriate restraint and injury of 3-to-8-year-old children have proven valuable to safety advocates and state/ federal legislators initiating the amendment of statewide child restraint and seat belt laws. This session shows how resource tools, backed by scientific data, can be successfully incorporated into educational initiatives and legislative advocacy. Presenter: Flaura Koplin Winston, M.D., Ph.D., Principal Investigator of Partners for Child Passenger Safety and Director of TraumaLink, the Center for Interdisciplinary Pediatric Trauma Research at The Children's Hospital of Philadelphia

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.

Founded in 1855 as the nation's first pediatric hospital, The Children's Hospital of Philadelphia 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.