The Performance and Use of Child Restraint Systems, Seatbelts, and Air Bags for Children in Passenger Vehicles Volume 1: Analysis

According to the National Highway Traffic Safety Administration (NHTSA), U.S. Department of Transportation, child restraints have been shown to be 69 percent effective in reducing the risk of death to infants and 47 percent effective for children between the ages of 1 and 4. NHTSA also estimates that lap/shoulder belts reduce the risk of fatal injury by 45 percent and moderate to critical injury by 50 percent for passenger car occupants who are older than 5 years. Despite the effectiveness of child restraints and lap/shoulder belts to reduce the likelihood of severe and fatal injuries, accidents continue to occur in which restrained children are being injured and killed.

According to NHTSA’s 1994 Fatal Accident Reporting System (FARS) data, 5,972 children younger than age 11 were passengers of motor vehicles in transport involved in accidents that resulted in at least one fatality. About 20 percent of the child passengers (1,203 of 5,972) were fatally injured. Restraint use was known for 1,114 of the 1,203 fatally injured children; about 54 percent of the fatally injured children (647 of 1,203) were unrestrained. Further, about 40 percent of all the children (2,402 of 5,972) involved in the fatal accidents were unrestrained; only 12 percent of these unrestrained children were not injured. These data show that the percentage of unrestrained children who were killed (26.9 percent) was almost double that of the percentage of restrained children who were killed (14.7 percent).

The National Transportation Safety Board, therefore, conducted this study to examine the performance and use of occupant protection systems for children—child restraint systems, vehicle seatbelts, and air bags. The study also examines the adequacy of relevant Federal Motor Vehicle Safety Standards, the comprehensiveness of State child restraint and seatbelt use laws, and the adequacy of public information and education on child passenger protection. In order to fully discuss the performance of air bags and children, the Board examined the accident experience with passenger-side air bags in general.

The Safety Board selected for study accidents involving at least one vehicle in which there was a child passenger younger than age 11 and in which at least one occupant was transported to the hospital. The Safety Board used a sampling strategy designed to obtain a predetermined number of children in specified age ranges and in certain types of restraint systems to ensure equal representation of ages and restraint categories in the sample. The Safety Board investigated a total of 133 accidents. A total of 13 accidents were omitted from the study: 12 because data required for this study could not be obtained, and 1 because the restraint system used in the vehicle was not designed for automobiles. The study, therefore, analyzes data from 120 vehicle accidents. Volume 1 (NTSB/SS-96/01) of the report contains the Board’s analysis of the data, its conclusions, and safety recommendations; volume 2 (NTSB/SS-96/02) of the report contains case summaries of the 120 vehicle accidents.

The safety issues discussed in this study include the following:

• the dangers that passenger-side air bags pose to children;
• factors that affect injury severity, including the use of an inappropriate restraint for a child’s age, height, and weight, the improper use of the restraint, accident severity, and seat location;
• the adequacy of Federal standards regarding the design and installation of child restraint systems;
• the need to improve seatbelt fit for children;
• the adequacy of public information and education on child passenger protection; and
• the adequacy of State child restraint use laws.

Prior to the completion of this study and as a result of the accidents involving children who were fatally injured by passenger-side air bag deployment, urgent recommendations were issued to NHTSA, the domestic and international automobile manufacturers, the child restraint system manufacturers, and other organizations and agencies associated with the distribution of educational material regarding child passenger protection. As a result of the completed study, additional recommendations were issued to NHTSA; the Governors and legislative leaders of the 50 States and the U.S. Territories, the Mayor and Chairman of the Council of the District of Columbia; the domestic and international automobile manufacturers; and the child restraint manufacturers.