Written Testimony of Mark V. Rosenker
Acting Chairman, National Transportation Safety Board
before the
Kansas House Judiciary Committee
House Bill 2611 -- Child Passenger Safety Legislation
Topeka, Kansas
January 25, 2006


Good afternoon Chairman O'Neal and members of the Judiciary Committee.

I want to commend you for focusing on this issue that will so easily save children from crash-related deaths and injuries.

The National Transportation Safety Board is an independent Federal agency charged by Congress to investigate transportation accidents, determine their probable causes, and make recommendations to prevent their recurrence. The recommendations that arise from our investigations and safety studies are our most important product. The Safety Board cannot mandate implementation of these recommendations. However, in our 38-year history, organizations and government bodies have adopted more than 80 percent of our recommendations.

The Safety Board has recognized for many years that traffic crashes are this nationís most serious transportation safety problem. More than 90 percent of all transportation-related deaths each year result from highway crashes. Traffic crashes are also the leading cause of death to children, and data indicate that nearly half of crashes involving children occur within 7 minutes from home. The number of injuries and deaths for children in the 4-to-8 age range remains high because these children are often either unrestrained or restrained in systems too advanced for their physical development. According to data from the Fatality Analysis Reporting System (FARS), from 1995 through 2004, more than 3,800 children in this age group were killed while riding in motor vehicles. Over 86 percent of child passengers in this age group who died had been unrestrained or placed in an adult seat belt. For this age group, during the same time period, 55 children died in Kansas while riding in motor vehicles; 79 percent of these were unrestrained or had been restrained only by an adult seat belt.

Restraining a child makes it three times less likely that the child will be injured in a crash. Placing a child in the rear seat makes it an additional two times less likely that the child will be injured. But the best protection for children in the 4-to-8 age range is to place the child in the rear seat with a belt-positioning booster seat.

Today I will discuss two key issues. First, belt-positioning booster seats are necessary to ensure proper seat belt fit for children ages 4 to 8. Second, a successful booster seat program requires legislation.

Seat Belts Do Not Provide Sufficient Protection for Children Ages 4 to 8

Because seat belts are designed to provide optimal protection for adults, they do not provide sufficient protection for children. To operate properly, seat belts depend on a personís bone structure, spreading the forces of a crash over the hips, shoulders, and chest, keeping the occupant in place so that the head, face, and chest are less likely to strike the inside of the vehicle. Correct seat belt fit is not usually achieved until a child is 9 years old, the age at which the childís thigh is long enough for the child to sit against the seat back, the childís hips are sufficiently developed to anchor the belt, and the childís height is sufficient for the shoulder belt to fit properly over the shoulder and sternum.

In 1996, the Safety Board examined the performance and use of occupant protection systems for children. The Safety Board reviewed 120 crashes in which at least one vehicle contained a child passenger younger than age 11 and in which at least one occupant was transported to the hospital. This sample included 46 children who were restrained in child restraint systems, 83 children restrained in seat belts, and 65 children who were unrestrained, for a total of 194 children. The Safety Board found that none of the fatally injured children was a child who had been placed in the appropriate restraint and who had used it properly. Children inappropriately restrained by seat belts had higher overall injury severity, including five fatal injuries, than children properly restrained. Among the unrestrained children, almost 30 percent suffered moderate or worse injuries, including five fatalities. Children in high severity accidents tended to sustain injury, which makes proper restraint even more important in such accidents.

Using a seat belt without a booster seat can result in serious injury to children. Without a booster seat, the lap belt can ride over a childís stomach and the shoulder belt can cut across a childís neck. Because such shoulder belt positioning is uncomfortable, children frequently remove the shoulder portion of the adult seat belt, increasing their risk of head injury. According to a study by Partners for Child Passenger Safety1, children inappropriately restrained in seat belts suffered injuries to all body regions, while there were no reported abdominal, neck/spine/back, or lower extremity injuries among children who were restrained in booster seats. Children restrained only in seat belts are 3.5 times more likely to suffer abdominal injury than children appropriately restrained with booster seats. When children use booster seats, the odds of injury are 59 percent lower than when children use only seat belts.

A Successful Booster Seat Program Requires Legislation

Although education is an important factor in increasing booster seat use, it is not sufficient by itself for attaining higher booster-seat use levels. A 2003 survey conducted by the National Highway Traffic Safety Administration revealed that 85 percent of parents and caregivers had heard of booster seats, but only 60 percent of those who knew about booster seats had used them at some point. The survey also revealed that just 21 percent of children ages 4 to 8 had traveled on at least one occasion in a booster seat. Among the State Farm insured population participating in the ongoing Partners for Child Passenger Safety study, 62 percent of children between the ages of 4 and 8 were placed only in adult seat belts.2

Much of the opposition to mandating booster seats concerns the inconvenience and cost to adults to comply with booster seat laws. A backless belt-positioning booster seat costs less than $20. As a nation, what value do we want to place on a childís life? In her testimony before the U.S. Senate, Autumn Skeen, a mother who lost her son because he was not in a booster seat, stated that she had relied on Washington State statutes in deciding to use a seat belt for her 4-year-old son. In June 1996, Anton Skeen died when he was ejected out of both his seat belt and the vehicle, even though his seat belt remained buckled. Ms. Skeenís reliance on State law to determine the necessary safety requirements for her child is common among concerned parents. In focus groups conducted by Partners for Child Passenger Safety, many parents who used seat belts to restrain their children justified their actions with their Statesí child passenger safety laws.

In the 1996 safety study, the Safety Board found that a lap/shoulder belt would not properly fit a child less than 54 inches tall; children under this height would be safer in a booster seat. The general opinion among law enforcement has been that age is a better enforcement criterion than height. At the time of the Boardís 1996 study, the American Academy of Pediatrics age, height, and weight guidelines indicated that the average 8-year-old child was 54 inches tall. Therefore, in our 1996 safety study, the Safety Board recommended enacting legislation that ensures children up to 8 are required by the Stateís mandatory child restraint use law to use child restraint systems and booster seats.

The value of legislation is apparent when considering the advances made in child restraint and seat belt use after legislation was passed. Child restraint use went from 15 percent to 51 percent between 1979 and 1985 and is now above 90 percent. Seat belt use went from 14 percent to 59 percent between 1984 and 1991, and is now about 82 percent. Thirty-three States (Arkansas, California, Colorado, Connecticut, Delaware, Georgia, Idaho, Illinois, Indiana, Iowa, Louisiana, Maine, Maryland, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia, Washington, West Virginia, and Wyoming) and the District of Columbia mandate that children age 4 and above use booster seats. At least 6 other States are considering booster seat legislation.

FARS data from 1995 through 2004 show that 297 children were riding in motor vehicles on Kansas roads when they were involved in a fatal crash. Eighty-two percent of the 297 children died or suffered injuries; 94 percent of those children who died or suffered injuries were not in child restraints. Only 24 children, or 8 percent, involved in fatal crashes were using any form of child restraint.

Parents want to protect their children, but many parents do not understand that seat belts do not provide sufficient protection for children in this age range. Belt-positioning booster seats ensure proper seat belt fit, which means that children get the optimum level of protection from the seat belt without the risk of head or abdominal injuries. House Bill 2611 fully satisfies the Safety Boardís recommendation on the use of child restraints and complies with best practices by requiring children to use child restraints until they are 8 years old. Passing this bill will save lives and reduce serious injuries for Kansasí youngest citizens.

Thank you again for inviting the Safety Board to testify about this important problem.

1The Children's Hospital of Philadelphia and the University of Pennsylvania, with support from the State Farm Insurance Companies, has undertaken a 5-year research project to study child occupant protection. The central goal of this project is to save childrenís lives by increasing the fund of knowledge about children in motor vehicle crashes.

2Partners for Child Passenger Safety, CPS Issue Report, July 2004.