NHTSA, for the first time, is keeping track of “not-in-traffic” injuries and deaths. In its first year of data, 2007, the system estimated that there were 262 child fatalities and approximately 115,000 injuries related to not-in-traffic incidents.
    The Not-In-Traffic Surveillance System (NiTS) is a virtual database that tracks incidents of vehicular death and injury on private property. Prior to the establishment of NiTS, the federal government only kept statistics for crashes that occurred in traffic on public roads, streets, and highways, which neglected incidents that occurred in moving or parked vehicles on private property, such as private roads, driveways, and parking lots.
    NiTS was required as a component of the Cameron Gulbransen Kids Transportation Safety Act, which was signed by the president in February 2008. The June 2009 issue of NHTSA’s publication Crash*Stats gives a brief statistical study of a subset of the data involving children under 14. The study found the vast majority of child fatalities (210) were due to frontover or backover incidents with children standing, walking, or on bicycles near vehicles. Hyperthermia caused 27 deaths and was the leading cause of noncrash fatalities.
    The study can be found at http://www-nrd.nhtsa.dot.gov/Pubs/811116.pdf. NHTSA has also developed a new website section, “Keeping Kids Safe: Inside & Out,” that can be accessed at www.safercar.gov. The site alerts visitors to the main types of NiT dangers and provides prevention tips.
    Prior to the development of NiTS, private organizations were the primary keepers of noncrash, nontraffic statistics, most notably the nonprofit KidsAndCars.org. KidsAndCars.org is responsible for the initiation and successful passage of the Cameron Gulbransen Kids Transportation Safety Act.  In a June press release, Janette Fennell of that organization commented that, although the NiTS system is a welcome tool for establishing the importance of these issues, some counts appear to be incomplete. In particular, her data confirms an average of 40 annual hyperthermia deaths, far more than the 27 reported by NiTS.

Private organizations continue to provide a wealth of educational information and support on the subject of not-in-traffic incidents:

• KidsAndCars.org — Information regarding statistics, incident details, policy, prevention products and tips, survivor advocacy, and links. In May, Janette Fennell of KidsAndCars.org spoke before the House Subcommittee on Commerce, Trade and Consumer Protection during a hearing entitled “Auto Safety: Existing Mandates and Emerging Issues.” A copy of her written testimony, which outlines the key issues and challenges facing the CPS industry, can be viewed at www.saferidenews.com.
• Harrison’s Hope — Harrison’s Hope, dedicated to the safety of children in and around cars, has developed the “Zero Seconds Program,” an educational approach to spreading the word about prevention of nontraffic tragedies. A DVD and a CD-ROM with printable educational materials is available for $17.25 at www.harrisonshope.org.
• Golden Gate Weather Services — Adjunct Professor of Meteorology Jan Null of San Francisco State University maintains vehicular hyperthermia incident data and details by state, including links to newspaper articles for each incident. Go to http://ggweather.com, and click on “weather links.”
• SafeKids USA — SafeKids offers a free web-based course called “In and Around Cars” which is geared toward parents, caregivers, and the general public. A set of 35 slides identifies dangers, gives tips to reduce risk, and points learners to related resources. Go to www.safekidswebinars.org.

Safe Ride News July/August 2009

 

     Over the past thirty years, the rate of obesity has doubled for children ages 2-5 and 12-15, and tripled for kids ages 6-11. Kim Hermann, Safe Kids USA, discussed how obesity presents challenges for child passengers. 
    Obesity in children is not specific to gender or socioeconomic group, but is overrepresented among Hispanics, Native Americans, and children receiving WIC benefits.  Obesity is more prevalent in the southeastern states compared with other areas of the U.S. 
    Aside from the many other health concerns related to this trend, there are serious implications for CPS.  A study published in the December 2008 Injury Prevention found that obese children had a 2 ½ times greater risk of injury in a crash than children of normal weight.
    While this makes it even more important that these children ride in age-appropriate CRs, many families can’t find one with a suitable upper weight limit.  Therefore, some parents feel forced to begin forward-facing use or move their child out of a harness or BPB before he or she is developmentally ready.
    Using data from the National Center for Health Statistics and the 2000 U.S. Census, growth curve projections have suggested that by 2005, parents of over 280,000 kids would have trouble finding a height/weight-appropriate CR on the U.S. market, with the worst problem being for 3-year-old children.  In response to this, CR manufacturers have developed many CRs with expanded harness capacity, both in the rear-facing and forward-facing modes.  In 2008, 15 conventional CRs with harnesses and two vests were available for kids weighing more than 40 pounds, compared with only four in 2005. 
    Challenges to the use of available products still exist, however.  Higher prices, lack of awareness, and attitudinal issues (i.e., preferring to move through stages of CR use too quickly) all pose problems. Since these CRs are larger in overall size, fit in smaller vehicles is also an issue.
    In addition to CR limitations, the upper weight limits of lower LATCH anchors, tether anchors, and LATCH connectors of CRs must be considered.  Many parents are unaware that these attachment options cannot be used when a child exceeds the weight specified by the CR or vehicle manufacturer.  The owner’s manuals and the LATCH Manual provide guidance as to when installation must be done with a seat belt rather than LATCH due to weight restrictions.
Resources: 
Pollack, KM; Xie, D; Arbogast, KB; and Durbin, DR. “Body mass index and injury risk among US children 9-15 years old in motor vehicle crashes.” Injury Prevention. 1 December 2008; 14(6): 366 - 371.
Trifiletti, LB; Shields, W;Bishai, D; McDonald, E; Reynaud, F; and Gielen, A. “Tipping the Scales: Obese Children and Child Safety Seats.” Pediatrics. April 2006,117(4): 1197-1202.

 

     In its January 2009 edition, SafetyBeltSafe News, published by SafetyBeltSafe U.S.A. (SBS USA), called attention to two recent tragic cases where children were strangled by their shoulder belts. They are only the latest of a string of incidents that first came to light in 2005 and have been reported since by SBS USA, where children wrapped a shoulder belt around their necks in play or curiosity without realizing that the belt’s switchable retractor had been activated. In the most recent cases, a 5-year-old Maryland boy died in December and a 13-year-old Texas boy died last October. In most of the other cases collected so far, the child has been rescued by the quick action of cutting the seat belt webbing.
    This topic is covered in the 2009 LATCH Manual, Chapter 3, due to its occasional connection to unused shoulder belts where CRs are installed with LATCH.  The manual also addresses the guidance suggested by SBS USA that is being adopted by some vehicle and CR manufacturers. Note that this problem is not related to specific brands or models.
    Such infrequent but serious incidents are due to shoulder belts with switchable retractors that children inadvertently pull out all the way and then wrap around their necks. Such seat belt retractors have been in most vehicles since the 1996 model year, when they were introduced as an effective method to improve installation of child restraints. Because of the many scenarios that have occurred and the wide range of ages involved, this is mainly a behavioral issue. SBS USA Executive Director Stephanie Tombrello points out that the involved parents she has spoken with have all said they were completely unaware of how shoulder belts lock and the potential hazard if their children play with the belts. Parents need this information in order to teach their children how and why not to play with any seat belt.    This kind of incident can happen in cars with switchable retractor-equipped lap-shoulder belts when:
•    an unused shoulder belt is within reach of the child—either because the child’s CR is installed with LATCH or the child is seated next to a position with an unused lap-shoulder belt. The lap-shoulder belt may be dangling unused from the ceiling in cases where a vehicle seat has been removed or when the center-rear shoulder belt is separate.
• the lap-shoulder belt is being used by the child with or without a booster.

•    Provide age-appropriate entertainment for children, such as soft toys, music, or a story on tape or CD.  While driving, be as aware as possible of children’s behavior in the back seat.
•    Make sure that the harness on the car seat is snug so that a fidgety or curious child cannot reach or pull out an unused shoulder belt.
•    When the LATCH system is being used, keep the unused shoulder belt out of reach. General Motors brands, Chrysler brands, Honda/Acura, and Ferarri recommend fastening the seat belt behind the CR before installing it, so long as the belt buckle does not interfere with the LATCH installation. If the seat belt buckle or the LATCH attachments interfere with each other, unbuckle the seat belt after the LATCH system is tightened so the belt is trapped behind the CR. (See LATCH Manual, Appendix B.)
•    If a child can reach an adjacent shoulder belt, it may be possible to buckle the belt and lock its retractor so the webbing can’t be pulled out. 
•    For children using belt-positioning boosters who are prone to playing with the belt, the switchable retractor can be engaged by the caregiver to keep the belt snug.
• Older children using lap-shoulder belts should be shown how the belt locks and made aware of the very serious nature of the potential problem. Make them part of the solution so they can educate their friends.

SRN, SafetyBeltSafe U.S.A., and KidsAndCars.org are collaborating to collect data on cases of entanglement in vehicle seat belts, whether fatal or not.  This will help us learn more about the extent and circumstances of such incidents and may lead to better interventions.  We are working on a questionnaire that will be available on our websites to simplify integrating reports into the KidsAndCars.org database, which includes many other types of parked car and nontraffic- related incidents.  Meanwhile, if you learn of a case, please send as much information as possible to:

KidsAndCars.org
E-mail (preferred):
email@KidsAndCars.org
Fax: (913) 327-0014

 

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Recent research results from real crashes shows that a child under age 4 has a 43-percent lower risk of injury riding in a car seat in the center of the back seat than in a side position.  If space is available in the center seat and a car seat can be tightly installed there, that’s the best place.  However, even if a child must ride in the center, a correctly used car seat offers very good protection.

The details and answers to parents’ questions follow.

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