SAFETY STUDY
Adopted: September 7, 1983
CHILD PASSENGER PROTECTION
AGAINST DEATH,, DISABILITY, AND DISFIGUREMENT
IN MOTOR VEMCLE ACCIDENTS

NTSB NUMBER: SS-83/01
NTIS NUMBER:  PB83-917005


SYNOPSIS
Motor vehicle accidents are the number one killer and crippler of children in the United States. Infants and small children riding as passengers in motor vehicles are especially vulnerable to death, disability and disfigurement even in minor accidents and noncrash incidents, such as sudden stops. Although it is estimated that most fatalities and injuries to infants and small children in motor vehicles could be prevented by the proper use of child safety seats, safety seat use remains low, and most children continue to be transported in motor vehicles without proper protection.

In 1982, because of its increasing concern about the continuing high levels of highway fatalities and injuries, the National Transportation Safety Board began a study of child passenger protection as part of an expanded effort to concentrate its highway accident investigations and its other activities on safety problems having high potentials for success in reducing fatalities and Injuries.

In mid-1982, the Safety Board launched a series of detailed investigations of accidents involving infants and small children. Fifty-three investigations were conducted in 19 States by highway accident investigators in four field offices located in Los Angeles, New York, Kansas City, and Atlanta, and In the Safety Board's Washington, D.C., headquarters The investigations examined the use and crash performance of child safety seats as well as accident consequences to infants and small children who were not traveling In child safety seats. The accident investigations were not intended to produce statistically representative accident data. The Safety Board selected each accident individually to obtain cases which would permit Investigation of potentially significant safety issues in motor vehicle transportation of infants and small children.

The 53 accidents were identified with the assistance of State and local law enforcement agencies, State highway safety agencies, and other organizations, including Physicians for Automotive Safety, the American Academy of Pediatrics, the American Association for Automotive Medicine, the National Child Passenger Safety Association and some of its State and local chapters, the Highway Safety Research Center of the University of North Carolina, the University of Michigan Transportation Research Institute, the Rehabilitation Institute of Chicago, the National Safety Council and some State and local safety councils, and some of the National Accident Sampling System teams of the National Center for Statistics and Analysis of the National Highway Traffic Safety Administration, U.S. Department of Transportation.

On December 7, 1982, based on the preliminary results of its initial investigations, the Safety Board issued Safety Recommendations H-92-59 and -60 to the Governors or Governors-elect of 31 States and the Mayor of the District of Columbia. (See appendix A.) Safety Recommendation H-82-59 urged the adoption of child passenger protection laws requiring the proper use of child safety seats, and Safety Recommendation H-82-60 urged the adoption of comprehensive, statewide child passenger safety programs. When the recommendations were issued, 19 States had passed child passenger protection laws requiring safety seat use. In the next 7 months, 22 more laws were enacted, bringing the nationwide total to 41 child passenger protection laws in 40 States and the District of Columbia. (Additionally, Pennsylvania enacted a law on November 1, 1983. Data hereinafter do not reflect this additional law.)

In early 1983, the Safety Board held regional public hearings in Dallas (January 13, 1983), Philadelphia (February 4, 1983), and St. Louis, (March 24, 1983), on the problem of child passenger safety. The hearings were held to gather information for the public record and to increase public awareness of the problem of child motor vehicle deaths and injuries and the importance of proper child passenger protection. Testimony was received from 54 witnesses, Including families of children involved in crashes, accident investigators and law enforcement officials, pediatricians and other medical personnel, highway safety and accident prevention specialists, and State legislators. (See appendix B.)

This report presents the findings and recommendations of the Safety Board's child passenger protection study. The report presents investigative results; illustrates the problem of deaths and injuries of infants and small children in motor vehicle accidents and the benefits of proper use of child safety seats; identifies misuse of child safety seats as A significant problem in accidents; Identifies other problems and issues developed in the accident investigations; identifies a need for improvements In child passenger safety laws and programs; identifies elements for inclusion in an effective child passenger protection law; and includes further recommendations to reduce child passenger fatalities and injuries.

RECOMMENDATIONS

As a result of its Safety Study of Child Passenger Protection Against Death, Disability, and Disfigurement in Motor Vehicle Accidents, the National Transportation Safety Board made the following recommendations:

--to the Governors and legislative leaders of Alaska, Idaho, Iowa, Louisiana, South Dakota, Texas, Utah, Vermont, Wyoming, American Samoa, Guam, Puerto Rico, and the Virgin Islands:

Enact legislation requiring the proper protection of children traveling in motor vehicles, following as closely as possible the elements set forth by the National Transportation Safety Board in its Safety Study, "Child Passenger Protection Against Death, Disability, and Disfigurement in Motor Vehicle Accidents." (Class II, Priority Action) (H-83-49)
Include, as part of a statewide child passenger safety program, public information and education activities specifically aimed at combating misuse of child safety seats. (Class II, Priority Action) (H-83-50)

--to the Governors and legislative leaders of Alabama, California, Connecticut, Delaware, Florida, Illinois, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, New York, North Carolina, Ohio, Rhode Island, Tennessee, Virginia, West Virginia, and Wisconsin:

Include, as part of a statewide child passenger safety program, public information and education activities specifically aimed at combating misuse of child safety seats. (Class II, Priority Action) (H-83-51)

--to the Governors and legislative leaders of Arizona, Arkansas, Colorado, Georgia, Hawaii, Indiana, Maine, Maryland, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, North Dakota, Oklahoma, Oregon, South Carolina, Washington, and the Mayor and Chairman of the Council of the District of Columbia:

Include, as part of a statewide child passenger safety programs public information and education activities specifically aimed at combating misuse of child safety seats. (Class II, Priority Action) (H-83-52)

--to the National Highway Traffic Safety Administration:

Expedite the issuance of a final rule requiring that newly-manufactured vehicles under 10,000 pounds gross vehicle weight be equipped with tether anchorages or predrilled holes for the installation of such anchorages at all rearmost seating locations. (Class II, Priority Action) (H-83-53)

Examine the consequences in accidents of nonuse and misuse of tether straps with safety seats requiring use of tether straps to determine whether such safety seats should be required to meet all the requirements of Federal Motor Vehicle Safety Standard 213, Child Restraint Systems, without the tether strap attached. (Class II, Priority Action) (H-83-54)

Examine the incidence of nonuse and misuse of a tether strap with child safety booster seats when used in a rear vehicle seat and the consequences in accidents of such nonuse or misuse to determine whether the advantages offered by such booster seats outweigh the disadvantages. (Class II, Priority Action) (H-83-55)

Amend Federal Motor Vehicle Safety Standard 213, Child Restraint Systems, to require that child safety seats and other child restraint systems include on their certification labels, information for obtaining a replacement copy of the manufacturer's detailed instructions for use. (Class II, Priority Action) (H-83-56)

Conduct research and developmental crash testing to explore the feasibility and desirability of developing abdominal and neck load criteria, anthropomorphic dummies, and test procedures for child safety seats and other child restraint systems. (Class II, Priority Action) (H-83-57)
Conduct research to examine the potential for other restrained or unrestrained vehicle occupants to sustain injuries in accidents from contact with a child safety seat when used in a motor vehicle and to determine whether additional safety requirements may be necessary and practicable to prevent or minimize potential injuries. (Class II, Priority Action) (H-83-58)
Conduct crash tests and accident research to examine the use and accident performance of safety belts with children at various ages to better identify the benefits and limitations of such use. (Class II, Priority Action) (H-83-59)

--to Child Safety Seat Manufacturer:

Review and revise instructions for use of child safety seats and other child restraint devices as needed to improve the clarity of the instructions and to establish specific height, weight, or other thresholds for required actions which depend on a child's physical characteristics (such as conversion between forward and rear-facing modes and harness rerouting on convertible child safety seats). (Class II, Priority Action) (H-83-60)

Attach permanent labels to safety seats to identify correct safety belt routing points, harness routing points, and correct recline positions for use in motor vehicles. (Class II, Priority Action) (H-83-61)

--the International Association of Chiefs of Police:

Coordinate and promote the development of training programs for State and local law enforcement officers on the use and misuse of child safety seats and safety belts for law enforcement and accident investigation purposes. (Class II, Priority Action) (H-83-62)

Promote the use of statewide traffic accident data systems to correct and analyze specific data identifying the use and misuse of child safety seats and safety belts in motor vehicles involved in accidents and the consequences of such use and misuse. (Class II, Priority Action) (H-83-63)

-to the National Child Passenger Safety Association:

Assist the States in developing effective programs to implement child passenger protection laws. (Class II, Priority Action) (H-83-64)