Although it is always safer to ride in a vehicle’s back seat, the relative benefits today decline for children as they age, particularly after they have transitioned out of a CR. This is the overall finding of a Center for Injury Research and Prevention (CIRP) study of the state of science on the safety of children and youth in the rear seats of vehicles. CIRP, a group that is part of The Children’s Hospital of Philadelphia, published the findings in its April 2013 CPS Issue Report. “Optimizing the Rear Seat for Children” includes extensive review of the scientific literature relevant to this subject since 2001.
When considering how long a CR can be used, the tendency is to focus primarily on weight limits. But given the quantity of high-weight-harness (HWH) models on today’s market, most children will outgrow a CR by height before reaching the weight limit—sometimes long before.
It wasn’t always this way. Within recent memory, weight was nearly always the limiting factor, since infant CRs had 22-pound rear-facing limits, and forward-facing harnesses uniformly could be used to 40 pounds. But CRs today have been strengthened and are rated to be used at much higher weights for either mode, so the mind-set must shift to expecting most CRs to be outgrown by height.
In the last two issues, SRN ran articles exploring CR angle situations of following the “level-to-ground” line and considering issues related to touching the back of the front vehicle seat. During our research, we noted a handful of other interesting angle-related issues worth mentioning.
Dr. Winston is a board-certified practicing pediatrician, biomechanical engineer, and clinical researcher. She is the founder and co-scientific director of The Center for Injury Research and Prevention at The Children’s Hospital of Philadelphia (CHOP).
Since 1997, CPSTs have helped families safely navigate occupant protection for children with measurable results. Motor vehicle crashes are no longer the leading cause of death for children under age 4.* We have tracked steady increases in appropriate restraint use and a corresponding drop in fatalities—from about 2,000 per year in the 1990s to fewer than 1,100 in 2009 for children less than 16 years old.
Part one of this series on installation angles for rear-facing CRs, which explored using the level-to-ground line to determine the appropriate angle, ran in the last issue of SRN. This article considers another issue related to rear-facing CR angle: things to consider when the top of the CR contacts the vehicle front seatback. Unlike the issue of understanding how to read the level-to-ground line, which depends solely on the CR manufacturer as the source of guidance, this situation requires considering the advice of both the CR and vehicle manufacturer.
(This article, part one of a two-part series, looks at how proper rear-facing angle is assessed, especially for older children, and how to use “level to ground” lines on labels. In the next issue, SRN will explore issues related to rear-facing CRs touching front seatbacks.)
After many years of knowing, from research and Swedish crash experience, that keeping children rear facing as long as possible is best, the CPS community now has strong support for this best practice from the American Academy of Pediatrics’ April policy statement on child passenger safety. Armed with that respected organization’s advice to keep kids rear facing until at least age 2, if possible, or even longer if they still fit, the community is doubly blessed by the accessibility of numerous CR models that will hold children up to these higher weight limits. Such models are even available in today’s marketplace across all price levels.
In October 2008, NHTSA published the “Federal Motor Vehicle Safety Standards; Seating Systems, Occupant Crash Protection, Seat Belt Assembly Anchorages, School Bus Passenger Seating and Crash Protection” final rule, the last components of which will take effect on October 21, 2011. Important among these is the requirement for new buses of 10,000 pounds gross vehicle weight or less to be equipped with lap-shoulder belts, rather than lap-only belts, in all positions.
Having access to lockable, standardized lap-shoulder seat belts on these smaller buses may make installation of conventional CRs easy on most buses so equipped. However, caregivers and advocates are often surprised to learn that best practice is to NOT use a booster on a school bus, even when a lap-shoulder belt is available and the child would normally ride in a booster in the family vehicle.
All boosters are not created equally, according to a recent report by the Insurance Institute for Highway Safety (IIHS) that rates the belt fit of many booster models. A booster should route the lap belt flat across a child’s upper thighs, position the shoulder belt at mid-shoulder, and consistently fit this way in a variety of vehicles. The IIHS has revised its evaluation system since its prior report from 2008.
An analysis of Partners for CPS (PCPS) data reaffirms that boosters are an important step in providing protection to child passengers. The research input was more complete than previously published studies, and the results still prove that belt-positioning booster (BPB) use is more protective than seat belts alone. Children ages 4 to 8 using BPBs were 45 percent less likely to sustain injuries than those using just the vehicle seat belt.
The problem of head restraints (HRs) interfering with CR installation seems to be growing because HR design improvements for non-CR passengers can actually be at odds with CR installation ease. Injury reduction is more effective when the HR is closer to the back of the head, so the trend is for HR designs to protrude further into the seating area – sometimes preventing the back of a forward-facing CR from being aligned with the seatback. Unfortunately, this mismatch coincides with an increased use of high-weight harness (HWH) seats and higher-backed boosters, which are taller and much more likely to reach the height of the HR.