Child Restraint Research Articles

Rear-facing child car seats: are laws requiring them effective?

INTRODUCTION: Motor vehicle crashes are a leading cause of death in children aged ≤ 2 years in the U.S. The American Academy of Pediatrics advised that children should remain in rear-facing child car seats to mitigate injury from the most common type of severe collision (frontal). Several states have passed laws following these recommendations. Methods: In 2013 publicly available statutes and comprehensive motor vehicle fatality data from the National Highway Traffic Safety Administration's Fatality Analysis Reporting System database were used to investigate whether there is a relationship between motor vehicle crash fatality rates for children under 1 year of age and state laws regulating the direction of car seat placement. States with known rear-facing car seat laws in place were analyzed in a two-step approach in 2014. Simple fatality rates per 100 million vehicle miles were calculated with 95% Poisson CIs. A negative binomial count model for infant deaths was calculated, with state fixed effects, adjusted for the exposure of vehicle miles in each state by year. Results: Unadjusted models showed a protective mortality effect for rear-facing car seat laws, while adjusted models demonstrated no beneficial effect. Implications: This preliminary study suggests that state rear-facing child restraint laws may be having an impact on infant motor vehicle mortality; however the current model is unable to determine their relative contribution given the overall decline in traffic mortality. Language: en

Evaluation of ISO CRS Envelopes Relative to U.S. Vehicles and Child Restraint Systems

Objectives: The objectives of this study are to use computer simulation to evaluate the International Organization for Standardization (ISO) 13216-3:2006(E) child restraint system (CRS) envelopes relative to rear seat compartments from vehicles and CRSs in the U.S. market, investigate the potential compatibility issues of U.S. vehicles and CRSs, and demonstrate whether necessary modifications can be made to introduce such a system into compatibility evaluations between U.S. vehicles and CRSs.Methods: Three-dimensional geometry models for 26 vehicles and 16 convertible CRS designs developed previously were used. Geometry models of 3 forward-facing and 3 rear-facing CRS envelopes provided by the ISO were built in the current study. The virtual fit process closely followed the physical procedures described in the ISO standards.Results: The results showed that the current ISO rear-facing envelopes can provide reasonable classifications for CRSs and vehicles, but the forward-facing envelopes do not represent products currently in the U.S. market. In particular, all of the selected vehicles could accommodate the largest forward-facing CRS envelope at the second-row seat location behind the driver seat. In contrast, half of the selected CRSs could not fit within any of the forward-facing ISO CRS envelopes, mainly due to protrusion at the rear-top corner of the envelope. The results also indicate that the rear seat compartment in U.S. vehicles often cannot accommodate a large portion of convertible CRSs in the rear-facing position. The increased demand for vehicle fuel economy and the recommendation to keep children rear-facing longer may lead to smaller cars and larger CRSs, which may increase the potential for fit problems.Conclusions: The virtual classifications indicated that contact between the forward-facing CRSs and the head restraints in the rear seats as well as that between the rear-facing CRSs and the back of the front seats is a main concern regarding the compatibility between the vehicles and the CRSs. Therefore, modification of the current ISO forward-facing CRS envelopes will likely to be necessary to ensure that they are useful for the U.S. market.

Epidemiology and Patterns of Transport-Related Fatalities in Austria 1980–2012

Objectives: Transport-related accidents remain the largest single cause of death among people aged 15 to 29 in the European Union, and despite the decrease in number of fatalities from 1990 onwards they remain a significant public health problem. The aim of this article was to analyze the long-term trends and patterns of transport-related fatalities, identify the anatomic distribution of most significant injuries in different road users, and identify the primary populations at risk of transport-related death in Austria between 1980 and 2013.Methods: Data on transport-related fatalities based on death certificates were obtained from Statistics Austria for the analyzed period. Crude and age-standardized mortality rates per 100,000 were calculated and broken down by age, gender, and month of death, and the anatomic distribution of most significant injuries were identified. Potential years of life lost before age 75 (PYLL-75) were used as a measure of public health impact.Results: A total of 39,709 transport-related fatalities were identified for the studied years; 74% were males and the mean age was 42.1 years (range 0–103). A decrease in the number of fatalities (from 2018 in 1980 to 554 in 2012), mortality rates (from 26 in 1980 to 7 in 2012), and PYLL-75 (from 68,960 in 1980 to 14,931 in 2012) was observed. Introduction of major prevention milestones (compulsory use of seat belts or child restraints) may have contributed to this decrease. Men 16–24 years old were at the highest risk of transport-related death. Pedestrian victims were more likely to be women and car drivers and motorcyclists were more often men. Most fatal transport accidents occurred between the months of May and October and prevailingly in towns of fewer than 20,000 inhabitants. Injuries to the head were the most significant injuries in all user groups (>50% of cases in all road user types). Reduced mortality rates could translate into higher prevalence of long-term disabilities in survivors of transport accidents.Conclusions: Despite the decreasing trend observed, transport-related fatalities remain a serious public health issue in Austria. An increase in the mortality of motor vehicle drivers warrants more preventive action in this group. Further research is needed on other outcomes of transport accidents such as long-term disabilities to elucidate the true public health burden of transport accidents.

Program fidelity measures associated with an effective child restraint program: Buckle-Up Safely.

We sought to identify the program fidelity factors associated with successful implementation of the Buckle-Up Safely program, targeting correct use of age-appropriate child car restraints. In 2010, we conducted a cluster randomized controlled trial of 830 families with children attending preschools and long day care centers in South West Sydney, New South Wales, Australia. Families received the Buckle-Up Safely program in the intervention arm of the study (13 services). Independent observers assessed the type of restraint and whether it was used correctly. This detailed process evaluation showed that the multifaceted program was implemented with high fidelity. Program protocols were adhered to and messaging was consistently delivered. Results from multilevel and logistic regression analyses show that age-appropriate restraint use was associated with attendance at a parent information session hosted at the center (adjusted odd ratio [AOR]=3.66; 95% confidence interval [CI]=1.61, 8.29) and adversely affected by the child being aged 2 to 3 years (AOR=0.14; 95% CI=0.07, 0.30) or being from a family with more than 2 children (AOR=0.34; 95% CI=0.17, 0.67). Findings highlight the importance of parents receiving hands-on education regarding the proper use of age-appropriate child restraints.

Recurring tragedy of road traffic accidents in India: Challenges and opportunities.

Sir, Road traffic accident (RTA) is an emerging epidemic; it is the eighth leading cause of death and most important cause of death among young people (15–29 years) globally. Every year, 1.24 million people die prematurely in RTA and moreover, 20–50 million people suffer from nonfatal injuries worldwide.[1] India recorded more number of deaths from RTA than any other countries in the world. According to National Crime Records Bureau Report, there was 17.6% increase in deaths due to RTA from 2008 to 2012.[2] Without immediate action, this tragedy will continue to increase, posing a major threat to the country. RTA poses a major burden in health care system in terms of prehospital care, emergency care, and rehabilitation. India spends 12.5 billion dollars on average, toward RTA, which excludes the economic burden of accident survivors with a permanent disability.[2] It is estimated that 3% gross domestic product lost due to RTA in India.[3] India differs from developed countries in road use patterns, with mixed traffic of slow and fast-moving vehicles, pedestrians and animals sharing the same roads.[4] India is currently experiencing a rapid increase in vehicles especially two-wheelers. As of 2009, combined two and three wheelers constitute about 71.6% of total registered vehicles in India.[3] Risk factors are broadly classified as human and environmental factors. Human risk factors are younger age (15–29 years), male sex, drunken driving, fatigue, nonobservance of traffic rules, inadequate use of helmets and safety belts, medical conditions (sudden illness, myocardial infarction, impaired vision), psychological factors (risk taking, impulsiveness), defective judgment, delayed decisions, aggressiveness, poor perceptions, family dysfunction, and distraction while driving (using mobile phones). Environmental risk factors may be related to roads (defective and narrow roads, defective layout of crossroads, poor lighting, and lack of familiarity) and vehicles (excessive speed, poorly maintained vehicles, large number of vehicles, low driving standards and overloaded buses).[4,5] Even though, there are laws and policy regulating RTA, it has been found that the enforcement of regulations is weak [Table 1].[3] According to World Health Organization report on India, enforcement of speed limit and drink law both scored 3 on a scale of 0–10. Enforcement of wearing seat belts for car occupants and helmet law enforcement both scored 2 on a scale of 0–10.[3] Factors that need to be addressed are road safety infrastructure development, appropriate vehicle designs for Indian roads, setting vehicles standard, regular inspection of vehicles, minimizing exposure by segregation of vulnerable road users such as pedestrians and cyclist, removal of encroachments on footpath, strict enforcement of legislation, adequate training of drivers, educating public about road safety, improving postcrash emergency care for the victims and better rehabilitation services, strengthening of accident research and injury surveillance system for accurate database on RTA.[4,5] Table 1 Status of road safety measures in India To reduce the alarming trend of RTA, legal reforms are necessary, it includes adoption of newer regulation regarding child restraint, apply blood alcohol concentration limits of 0.02 g/dl or less among young and novice drivers, reducing speed limit for newer and younger drivers, disqualification and cancellation of license for repeat offenders. Setting a national target to reduce the incidence of accidents proved to be successful in improving the road safety.[5] So far, India has not set a target, such national target should be set and revised at regular interval. Since there is no program, there is an urgent need for appropriate and exclusive national program to combat RTA. To conclude, RTAs are easily predictable and preventable. It requires strong political commitment and multipronged strategies to address the current demands and needs of six E's of road safety such as education, engineering (roads), engineering (vehicles), enforcement, emergency care and enactment. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Research on the Optimization of Intelligent Child Restraint Systems Based on Children of Different Ages

Child restraint systems designed to match child occupant only under one collision condition can't provide effective protection for children under other collision condition. An adaptive child restraint system, which characteristic parameters are adjustable, is used to analyze the optimum parameters of restraint system for child occupants at different ages. The seat height, the cushion length and the force limiter value of the seat belt are chosen as optimization variables, and children's comprehensive damage evaluation I and neck injury threshold Nkm are chosen as optimization objectives. The methods of approximate model of polynomial regression and non-dominated sorting genetic algorithm II are combined to conduct, multi-objective optimization for 3, 6, 10 years old child dummy respectively in both the front impact and rear impact according to GB 27887. The results show that the optimized parameters of restraint system can provide a better protection for children of the three age group in the two collision conditions. The correlation model between optimum parameters and child's height and weight is fitted based on optimization design points of the three age groups. Therefore, good protection effect can be achieved to children with different height and weight.

Rehabilitation of drivers who misapply or do not use child restraint systems in cars in Austria

Risk in traffic is very often related to the kind of driving style, endangering passengers and other road users. Sometimes an accident may occur without too much false behaviour of the driver. Risk for the passenger - often children - then may occur because of the driver not being aware of the sense of passive safety items like safety belts. Causes for this risky behaviour of adults - primarily parents - may lie in lack of knowledge of physical principles, ignorance of existing traffic laws, taking too little time to handle the buckling up or falsely delegating the responsibility to other technical in-car-systems like airbags. This paper will give insight into the Austrian traffic law regarding the correct use of child restraint systems as well as information about the criteria which have to be taken into consideration while conducting rehabilitation courses with traffic offenders. The psychological treatment will be discussed under consideration of underlying psychological theories regarding behaviour modification.

Roadside observation of child passenger restraint use

Background: Despite legislation and research evidence supporting the use of childhood vehicle restraints, motor vehicle crashes remain the leading cause of injury, death and disability among Canadian children. Methods: Working in collaboration with trained car seat specialists and police officers, roadside checks were conducted to observe correct use of child restraints. Results: Of the 1323 child vehicle restraints inspected, 99.6% of the children were restrained, 91% were in the correct seat, and 48% of restraints were correctly installed. The seat/restraint types most used incorrectly used were booster seats (31%) and seat belts (53%). The majority of incorrectly installed or fitted seats (55%) were forward facing. Common errors in installation and fit included the seat not being secured tightly enough to the vehicle, incorrect tether strap use, the harness not being tight enough, and/or the chest clip being in the wrong place. Conclusions: The greatest proportion of incorrect seat use was among those children who transitioned to a seat belt too soon. The greatest proportion of installation and fit errors were among forward facing seats. Researchers recommend: 1) targeting parents with older children (ages 3 and above) regarding transitioning too soon from forward facing seats to booster seats, and from booster seats to seat belts; 2) targeting parents with younger children regarding correct installation of rear facing and forward facing seats; 3) collaborating with police officers to review the most common errors and encourage observation at roadside checks; and 4) creating community awareness by way of roadside checks.

Advocacy for booster seat legislation in Florida: a lesson in politics and policy formation.

MVCs are a major contributor to child injury and death. Infant restraint seats and child booster seats have been shown to reduce the odds of severe injury or death when used correctly. While all states have mandated the use of these restraint systems, the age at which a child can be legally restrained using an adult seat belt varies from state to state. Efforts to strengthen Florida's weak child restraint laws have failed for more than a decade; in the 2014 legislative session, advocates succeeded in raising the state's age requirement from 3 years to 5 years. While many factors contributed to this year's success, some key elements included efficient communication of supporting data, a strong and broad advocacy network and the leveraging of election year political rivalries. Efforts to further strengthen the law will continue into future legislative sessions.

Factors affecting tether use and correct use in child restraint installations

IntroductionField studies show that top tethers go unused in half of forward-facing child restraint installations. MethodIn this study, parent volunteers were asked to use the Lower Anchors and Tethers for Children (LATCH) to install child restraints in several vehicles to identify tether anchor characteristics that are associated with tether use. Thirty-seven volunteers were assigned to four groups. Each group tested two forward-facing child restraints in four of 16 vehicle models. Logistic regression models were used to identify predictors of tether use and correct use. ResultsSubjects used the tether in 89% of the 294 forward-facing child restraint installations and attached the tether correctly in 57% of the installations. Tethers were more likely to be used when the anchor was located on the rear deck as typically found in sedans compared with the seatback, floor, or roof. Tethers were less likely to be attached correctly when there was potentially confusing hardware present. No vehicle tether hardware characteristics or vehicle manual directions were associated specifically with correct tether routing and head restraint position. ConclusionThis study provides laboratory evidence that specific vehicle features are associated with tether use and correct use. Practical applicationsModifications to vehicles that make tether anchors easier to find and identify likely will result in increases in tether use and correct use.

The Prevalence of Child Restraint System Use among Children in Vehicles Equipped with Front Passenger Airbag in Kajang, Malaysia

New cars are being introduced with front passenger airbags (PAB) as a standard safety feature. Airbags are designed to reduce vehicle occupant injury in the event of a collision. In order for airbags to be effective, occupants must be restrained while travelling in vehicles. Children are often seen unrestrained while travelling in vehicles throughout Malaysia. Studies have shown that unrestrained children are exposed to higher risk of injury in a crash involving PAB deployment, compared to those who are restrained. The intended life saving benefit of PAB may be negated if child occupants remain mostly unrestrained. The objective of the study is to determine the prevalence of child restraint system (CRS) use in vehicles, especially those equipped with PAB. To realise this, an observational survey was conducted at selected day care centres in Kajang, to determine the use of child restraints among children aged six and below, child seating position, driver seatbelt use and availability of PAB. The study was performed in the first half of 2012. A total of 537 children aged 6 and below were observed. 51.4% of the children were seated in the front passenger seat, 45.3% were seated in the rear and 3.3% were seated on the driver’s lap. 13.3% of children seated in front seats were restrained, compared to 4.9% of those seated at the rear. Children were 4 times more likely to be restrained if the drivers were belted compared to those who were not. In vehicles equipped with PAB, 11.2% of children seated on the front seats are restrained, while in vehicles without, 17.1% were restrained. The restraint use among children is low and the presence of PAB does not have a significant effect on the use of CRS. There was a significant association between belted drivers and restrained children. The low CRS use is expected as the current legislation does not specifically mention the requirement for children to use CRS while travelling in vehicle, even if the vehicle is equipped with PAB.

Effects of Increasing Child Restraint Use in Reducing Occupant Injuries Among Children Aged 0–5 Years in Japan

Objectives: In Japan, child restraint use among preschool children started to increase before compulsory child restraint use for children aged 0–5 years was introduced by legislation in April 2000. This study determined the effects of increased child restraint use in reducing motor vehicle occupant injuries among children aged 0–5 years.Methods: We obtained monthly police data of child vehicle occupant injuries from 1990 to 2009. We calculated monthly ratios of morbidity rates per population of children aged 0–5 years to those of children aged 6–9 years. Time trends of the morbidity rate ratios were analyzed using a joinpoint regression model to determine whether there were trend changes in child occupant injuries and when they occurred if there were trend changes.Results: The morbidity rate ratios showed a slightly increasing trend of 0.03% per month (95% confidence interval [CI], −0.02% to 0.09%) until the change-point in December 1997 (95% CI, July 1996 to January 1999), which then changed to a decreasing trend of −0.14% per month (95% CI, −0.16 to −0.11), with an overall trend change of −0.17% (95% CI, −0.23 to −0.11). No change-point was identified in or around April 2000 when compulsory restraint use was introduced.Conclusions: The present study used comparative indicators relative to age groups that were not covered by the legislation and showed that a decreasing trend of occupant morbidity among children aged 0–5 years started before the introduction of compulsory restraint use. This change probably reflects the prelegislative voluntary increase in child restraint use.

Motor Vehicle Crash–Related Injury Causation Scenarios for Spinal Injuries in Restrained Children and Adolescents

Objective: Motor vehicle crash (MVC)-related spinal injuries result in significant morbidity and mortality in children. The objective was to identify MVC-related injury causation scenarios for spinal injuries in restrained children.Methods: This was a case series of occupants in MVCs from the Crash Injury Research and Engineering Network (CIREN) data set. Occupants aged 0–17 years old with at least one Abbreviated Injury Scale (AIS) 2+ severity spinal injury in vehicles model year 1990+ that did not experience a rollover were included. Unrestrained occupants, those not using the shoulder portion of the belt restraint, and those with child restraint gross misuse were excluded. Occupants with preexisting comorbidities contributing to spinal injury and occupants with limited injury information were also excluded. A multidisciplinary team retrospectively reviewed each case to determine injury causation scenarios (ICSs). Crash conditions, occupant and restraint characteristics, and injuries were qualitatively summarized.Results: Fifty-nine cases met the study inclusion criteria and 17 were excluded. The 42 occupants included sustained 97 distinct AIS 2+ spinal injuries (27 cervical, 22 thoracic, and 48 lumbar; 80 AIS-2, 15 AIS-3, 1 AIS-5, and 1 AIS-6), with fracture as the most common injury type (80%). Spinal-injured occupants were most frequently in passenger cars (64%), and crash direction was most often frontal (62%). Mean delta-V was 51.3 km/h ± 19.4 km/h. The average occupant age was 12.4 ± 5.3 years old, and 48% were 16- to 17-year-olds. Thirty-six percent were right front passengers and 26% were drivers. Most occupants were lap and shoulder belt restrained (88%). Non-spinal AIS 2+ injuries included those of the lower extremity and pelvis (n = 56), head (n = 43), abdomen (n = 39), and thorax (n = 36). Spinal injury causation was typically due to flexion or lateral bending over the lap and or shoulder belt or child restraint harness, compression by occupant's own seat back, or axial loading through the seat pan. Nearly all injuries in children <12 years occurred by flexion over a restraint, whereas teenage passengers had flexion, direct contact, and other ICS mechanisms. All of the occupants with frontal flexion mechanism had injuries to the lumbar spine, and most (78%) had associated hollow or solid organ abdominal injuries.Conclusions: Restrained children in nonrollover MVCs with spinal injuries in the CIREN database are most frequently in high-speed frontal crashes, of teenage age, and have vertebral fractures. There are age-specific mechanism patterns that should be further explored. Because even moderate spinal trauma can result in measurable morbidity, future efforts should focus on mitigating these injuries.

Comparative Performance of Forward-Facing Child Restraint Systems on the C/FMVSS 213 Bench and Vehicle Seats

Objective: The objective of this study was to evaluate the fidelity of the C/FMVSS 213 test bench, by comparing the dynamic performance of forward-facing child restraint systems (FFCRS) mounted on the C/FMVSS 213 sled bench versus mounted on a selection of production vehicle seats.Methods: The C/FMVSS 213 bench or one of 3 second-row original equipment manufacturer vehicle seats was mounted to the deck of acceleration crash sled. An FFCRS with a restrained anthropomorphic test device (ATD) was secured by 3-point belt (3-PT) or LATCH lower anchor (LLA) on the C/FMVSS 213 bench or vehicle seat, with or without a tether. The sled was then exposed to a 48 km/h acceleration pulse. Three unique make and model vehicle seats and FFCRS were tested. Fifty-three sled tests were performed.Results: When FFCRS were secured with LLA and no tether, little difference between the vehicle seats and 213 bench was observed. Similarly, when FFCRS were affixed with 3-PT and no tether, few kinematic variable differences achieved statistical significance; chest resultant acceleration was, on average, 9.1 g (SD = 6.6, P =.006) higher on the vehicle seats compared to the bench, as was CRS seatback excursion (difference [Δ] of 39.8 mm, SD = 32.7, P =.011) and ATD knee excursion (Δ = 36.4 mm, SD = 12.0, P < .001). However, when the tether was added to either the 3-PT or LLA attachment methods, the difference between the bench and vehicle seats was more pronounced. ATD kinematic measures such as head resultant acceleration (Δ = 14.6 g, SD = 7.2, P <.001) and pelvis resultant acceleration (Δ = 8.6 g, SD = 6.0, P =.005) were higher on the vehicle seats compared to the bench, as were the injury metrics for head and chest injury: ΔHIC15 = 162.2 (SD = 87.4, P =.001) and ΔChest 3 ms clip = 5.5 g (SD = 6.2, P =.040). Of note, CRS (Δ = 62.8 mm, SD = 32.7, P =.000) and ATD head (Δ = 66.3 mm, SD = 30.9, P =.000) and knee (Δ = 46.9 mm, SD = 25.8, P =.001) forward excursion were all higher on the vehicle seats compared to the bench in 3-PT with tether condition.Conclusions: Without the tether attached, we observed few kinematic and kinetic differences between the vehicle seat and the C/FMVSS 213 bench, suggesting that the bench is an adequate surrogate for the vehicle seat in this condition. With the tether attached, we found significant differences between the C/FMVSS 213 bench and vehicle seats, suggesting that the fidelity of the bench could be improved in the tethered mode. When differences were statistically significant, excursion and injury metrics were generally greater on the vehicle seats than on the C/FMVSS 213 bench.

A prospective study of children aged

ObjectiveThe implementation of the compulsory wearing of seat belts (SBs) for children and improvements in child restraint systems have reduced the number of deaths and severe injuries among children involved in motor vehicle (MV) collisions (MVCs). Establishing the characteristics predictive of such injuries may provide the basis for targeted safety campaigns and lead to a further reduction in mortality and morbidity among children involved in MVCs. This study performed a multidisciplinary investigation among child occupants involved in MVCs to elucidate injury mechanisms, evaluate the safety measures used and determine the characteristics that are predictive of injury. MethodsA prospective study was conducted of all child occupants aged <16 years involved in severe MVCs in south-eastern Norway during 2009–2013. The exterior and interior of the MVs were investigated and the injured children were medically examined. Supplementary information was obtained from witnesses, the crash victims, police reports, medical records and reconstructions. Each case was reviewed by a multidisciplinary team to assess the mechanism of injury. ResultsIn total, 158 child occupants involved in 100 MVCs were investigated, of which 27 (17%) exhibited Abbreviated Injury Scale (AIS) scores of 2+ injuries and 15 (9%) exhibited AIS 3+ injuries. None of the children died. Of those with AIS 2+ injuries (n=27), 89% (n=24) were involved in frontal impact collisions and 11% (3/27) were involved in side impacts. Multivariate analysis revealed that restraint misuse, age, the prevailing lighting conditions and ΔV were all independently correlated with AIS 2+ injuries. Safety errors were found in 74% (20/27) of those with AIS 2+ injuries and 93% (14/15) of those with AIS 3+ injuries. The most common safety error was misuse of restraints, and in particular loose and/or improperly positioned SBs. ConclusionThe risk of injury among child occupants is significantly higher when the child occupants are exposed to safety errors within the interior of the vehicle. Future campaigns should focus on the prevention of restraint misuse and unsecured objects in the passenger compartment or boot.

Neck Moment Characterization of Restrained Child Occupant at Realistic Nontest Standard Higher Impact Speed of 32.2 km/h

The effects of bullet vehicle crash impact angle, child restraint system design, and restraint harness slack at side impact speed of 32.2 km/h (20 mph) on moments sustained at the neck by a three-year-old child are investigated. Mathematical models are built using the response surface method based on simulation results whereby good fitness is achieved. The singular and cross interactive effect of each predictor on the neck moment are analyzed. The number of significant parameters affecting the neck moment is shown to be the largest for wide impact angles (ϕ≥60°) and the impact angle parameter is largely revealed to be the most sensitive. An ideal safe range for low neck moment has been established to be within ϕ angles 45° and 65°. It is further shown that the nature of all parameters effect on the neck moment is highly dependent on the impact angle range.

Don׳t learn safety by accident: A survey of child safety restraint usage among drivers in Dansoman, Accra

ObjectiveThe study surveyed child safety restraints use among drivers transporting children to school in Dansoman, Accra. MethodEmploying a naturalistic observational method, the following were observed: sex of the driver, vehicle model, child characteristics, child location in the vehicle, whether child was restrained and how they were restrained, whether the driver was belted and the presence of other vehicle occupants. In total 126 vehicles were observed. ResultsThe study revealed low child restraints use among the observed drivers; children in new vehicles were more likely to be restrained; children seated in the back seat were more likely to be unrestrained; and child occupants were more likely to be unrestrained where there were other vehicle occupants. ConclusionThe study maintained that a collaborated effort by road safety stakeholders in terms of education/awareness creation and subsequent strict enforcement of child restraints use laws were required.

Fatal head injuries in children under the age of 5 years in Pretoria.

The incidence of fatal injuries in children has been reported to be highest among children aged 1 to 4 years. Major causes of head injury include road traffic accidents, falls, and intentional or inflicted injury (such as nonaccidental injury syndrome). This study reviewed the profile of children (under 5 years of age) who had been admitted to a large urban medicolegal mortuary (in Pretoria, the capital city of South Africa), after having suffered fatal head injuries. This study was conducted over a 5-year period (from January 2004 through December 2008), and a total of 107 cases were identified for inclusion. These cases constituted nearly a fifth of admissions in this age group. The male-to-female ratio was 56%:44%, and the peak age of injury was less than 1 year. Most head injuries were sustained in road traffic accidents (70%) followed by falls (10%) and other types of blunt force injuries (9%). Only 1 case of nonaccidental injury syndrome (child abuse) was found. The great majority of deaths were deemed to have been accidental in nature (91%) with 6 (6%) homicides. Urgent review pertaining to the use of child restraint devices and the safety of pedestrians is required, and the institution of childhood injury registers could aid in reducing childhood fatalities in South Africa.

A study of general aviation accidents involving children in 2011.

General aviation accidents involving children are rare, but when they do happen, little is known about the children involved, including their age, restraint status, and injuries. This lack of information is due to the fact that the National Transportation Safety Board (NTSB) did not always collect detailed data about passengers involved in accidents. Consequently, in 2011, NTSB investigators collected detailed information on children involved in general aviation accidents and this report provides a summary of the outcomes. During 2011, 19 general aviation accidents and incidents included 39 children who were 14 yr old and younger. In total, 26 children sustained fatal injuries, 2 sustained serious injuries, 5 sustained minor injuries, and 6 sustained no injuries. All of the children less than 2 yr old were restrained in a child restraint system and sustained no injuries in the accidents. At least one 4-yr-old child would have benefited from being restrained in a child restraint system. In addition, in two accidents, it was determined that children were likely sharing a single seat belt. This year-long data collection regarding children involved in general aviation accidents provided substantial information concerning age, restraint status, and injuries. In response to issues identified, the NTSB made improvements to its aviation data management system to routinely collect this information for future investigations and enable subsequent evaluation of the data regarding child passengers involved in general aviation accidents over the long term.

Parametric study for head injury criteria response of three-year olds in a child restraint system in oblique and lateral intrusive side impact

A parametric study is undertaken to ascertain the sensitivity of the child restraint system (CRS) design, with respect to oblique side impact at standard velocities in consideration of intrusion. A hybrid model is constructed using a combination of both finite elements and multi-body ellipsoids where a three-year-old Hybrid III child dummy is placed inside a CRS and restrained with a harness system. A prescribed structural motion simulation of a side-impact crash is carried out based on experimental data. Validation is performed and the model is shown to be acceptable for common standard injury responses as well as being greatly economical in terms of computational processing time. A plan of experiments is prepared based on the Latin hypercube sampling for six parameters involving two different crash velocities. The head injury criterion (HIC) is considered as the response in this study. The model is adapted for intrusion and oblique impact. Response surface models are shown to be suitable for the mathematical modelling of the problem and Student's t-test is used to assess the parameter sensitivity both qualitatively and quantitatively. Most of the parameters are seen to have greater significance for wider principle direction of force (PDOF) angles above 60°. In general, a gradual decrease in significance is observed for parameters with increasing impact velocity, with the notable exception of the impact angle. The impact angle is shown to most notably affect the HIC especially from PDOF angles 45°–75°, identified as the critical impact angle range. The far side shoulder harness slack parameter is also found to be significant in reducing the HIC.