Bryan Whitaker

Injury Prevention

Working Upstream Part 2: Motor Vehicle Accidents for Children Occupants

Risk Factors and Protective

Factors

Risks-

Black and Hispanic populations have a higher rate of unbuckled

children than White ones according to the Centers for Disease Control

(2016). This disparity is believed to existed because of the higher

poverty rates within these communities, and access to restraint items

are scarce (Sauber-Schatz, West, Bergen, 2014).

Older children have a higher chance of being unbuckled than younger

ones (Centers for Disease Control, 2016).

Incorrect use of restraint devices (Center of Disease Control, 2016).

Driving with an intoxicated driver can increase the risk of not only

getting in a car crash, but also not being properly restrained. 65% of

children died, who were a passenger in a car with an intoxicated driver,

and were 61% of the time were found not properly restrained (Center

for Disease Control, 2016).

Prevention-

Using booster car seats properly, can greatly reduce the chance of a

child occupant younger than one from dying by 71%, according to the

Center of Disease Control (2016). In 2014, 252 children deaths were

prevented because of restraint utilization (National Highway and Traffic

Safety Administration, 2016).

Seat belt use for children that have out grown child booster seats (8

years of age) reduces risk of dying in a crash by 50% (Centre for

Disease Control, 2016)

Education Strategies

Restraint for children occupants is one of the most effective way to prevent

childhood death from a car crash. As mentioned earlier, car seats can reduce

the chance of a child one year or younger from dying in a car crash by 71%

(National Highway and Traffic Safety Administration, 2016). Similarly, booster

seats reduced the risk of death for children ages 4-8 by 45%, as stated by

Center for Disease Control (2016). Although car and booster seats are
essential in averting early childhood death, there needs to be an increase

effort in educating the public about proper car and booster seat installation.

A study done by the National Highway Traffic Safety Administration in 2015,

showed an overall misuse rate for all forms of child restraint use was 46%,

the most frequently misused restrain device was the forward-facing car

seats, which reported at a misuse rate of 61%.

Education programs are effective in teaching parents on how to accurately

install a booster and car seat, but education programs can also give

participants incentives and access to car seats to promote use (Center for

Disease Control, 2015). Not only that, but there is evidence that proposes

that education programs can also increase the use of restraint devices. 5

different studies with 3,070 participants measuring the restraint use of 4 to 8

year olds, showed that when education programs and incentives with

distribution services were put into place, there was a positive and beneficial

outcome, which was an increase use of parents using booster and car seats

when in moto vehicles (Ehiri, Ejere, Magnussen, Emusu, King, Osberg, 2006).

Environmental

One environmental component that can be controlled to prevent children

occupant death, is speed reduction. Speed has an effect in 1/3 of all fatal

road crash deaths in high income countries (World Health Organization,

2015). The World Health Organization (WHO) suggests that road

infrastructure change to lessen the speed a driver can go. This can be done

by installing more traffic lights, so drivers dont have open road to speed on.

WHO also recommends roundabouts and speed humps for obstacles that will

make the roadway environment harder to speed on.

WHO (2015) also proposes that roadway infrastructure needs to be changed

with the consideration of safety and passenger protection. This approach is

about implementing more traffic lights, speed humps, over passes, median

strips, and increasing lighting on streets with a lot of traffic.

Finally, WHO (2015) advises that car designs become remodeled so that

when a crash does occur, it will have the least amount of impact as possible.

This can be achieved by requiring car companies to install more absorbent

crumble zones, so when impact does occur, it is not as severe. A feature that

should also be installed on all cars, are camera and alarm systems for when

the car is put into reverse, so that the driver knows that there is an object

behind them.

Enforcement

In order to prevent death for children occupants in motor vehicle crashes, experts

suggest that laws be put into place that enforce restraint use of car and booster

seats. Restraint laws demand that children in the car be properly secure in a moving

vehicle. Research confirms that when restraint laws are put into place, the amount

of child restraint use goes up. A study looking at 5 different states that did not have

restraint laws showed that once the laws were put into place, child restraint device

usage nearly tripled (Eichelberger, Chouinard, Jermakian, 2012). Not only that, but
that same study showed that increasing the age range from 4-8, instead of 4-6,

decreased the rate of injury by 17%.

References

Centers for Disease Control and Prevention. (2016). Injury prevention & control:
motor vehicle safety. Child passenger safety: get the facts. Retrieved from
http://www.cdc.gov/motorvehiclesafety/child_passenger_safety/cps-
factsheet.html

Centers for Disease Control and Prevention. (2015). Injury prevention & control:
motor vehicle safety. What works: strategies to increase car and booster seat
use. Retrieved form
http://www.cdc.gov/motorvehiclesafety/child_passenger_safety/strategies.ht
ml

Ehiri, Ejere, Magnussen, Emusu, King, Osberg. (2006). Interventions for promoting
booster seat use in four to eight year olds traveling in motor vehicles.
Cochrane Database Syst Rev, 25(1). doi: 10.1002/14651858.CD004334.pub2

Eichelberger, Chouinard, Jermakian. (2012). Effects of booster seat laws on injury

risk among children in crashes. Traffic Inj Prev, 13(6), 631-9. doi:
10.1080/15389588.2012.660663.

National Highway Traffic Safety Administration. (2016). Traffic safety facts. Occupant
protection. Retrieved from
https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/812262
 Vital signs: restraint use and motor vehicle
Sauber-Schatz, West, Bergen, (2014).
occupant death rates among children aged 012 Years United States,
20022011. Morbidity and Mortality Weekly Report, 63(05),113-118.
Retrieved from
https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6305a8.htm

World Health Organization. (2015). Road safety. Ten strategies for keeping children
safe on the road. Retrieved from
http://www.who.int/roadsafety/week/2015/Ten_Strategies_For_Keeping_Childre
n_Safe_on_the_Road.pdf