This content is not included in
your SAE MOBILUS subscription, or you are not logged in.
Factors Affecting Child Injury Risk in Motor-Vehicle Crashes
Technical Paper
2019-22-0008
This content contains downloadable datasets
Annotation ability available
Sector:
Language:
English
Abstract
Current recommendations for restraining child occupants are based on biomechanical testing and data from national and international field studies primarily conducted prior to 2011. We hypothesized that analysis to identify factors associated with pediatric injury in motor-vehicle crashes using a national database of more recent police-reported crashes in the United States involving children under age 13 where type of child restraint system (CRS) is recorded would support previous recommendations. Weighted data were extracted from the National Automotive Sampling System General Estimates System (NASS-GES) for crash years 2010 to 2015. Injury outcomes were grouped as CO (possible and no injury) or KAB (killed, incapacitating injury, non-incapacitating injury). Restraint was characterized as optimal, suboptimal, or unrestrained based on current best practice recommendations. Analysis used survey methods to identify factors associated with injury. Factors with significant effect on pediatric injury risk include restraint type, child age, driver injury, driver alcohol use, seating position, and crash direction. Compared to children using optimal restraint, unrestrained children have 4.9 (13-year-old) to 5.6 (< 1-year-old) times higher odds of injury, while suboptimally restrained children have 1.1 (13-year-old) to 1.9 (< 1-year-old) times higher odds of injury. As indicated by the differences in odds ratios, effects of restraint type attenuate with age. Results support current best practice recommendations to use each stage of child restraint (rear-facing CRS, forward-facing harnessed CRS, belt-positioning booster seat, lap and shoulder belt) as long as possible before switching to the next step.
Recommended Content
Technical Paper | Trauma to Children in Forward-Facing Car Seats |
Technical Paper | Cervical Spine Loads Induced in Restrained Child Dummies |
Technical Paper | Assessment of Injury Risk to Children From Side Airbags |
Authors
- Marco Benedetti - University of Michigan Transportation Research Institute
- Kathleen D. Klinich - University of Michigan Transportation Research Institute
- Miriam A. Manary - University of Michigan Transportation Research Institute
- Carol A. C. Flannagan - University of Michigan Transportation Research Institute
Citation
Benedetti, M., Klinich, K., Manary, M., and Flannagan, C., "Factors Affecting Child Injury Risk in Motor-Vehicle Crashes," SAE Technical Paper 2019-22-0008, 2020, https://doi.org/10.4271/2019-22-0008.Data Sets - Support Documents
Title | Description | Download |
---|---|---|
Unnamed Dataset 1 | ||
Unnamed Dataset 2 | ||
Unnamed Dataset 3 | ||
Unnamed Dataset 4 | ||
Unnamed Dataset 5 | ||
Unnamed Dataset 6 |
Also In
References
- Baratta , R. , Solomonow , M. 1991 The effect of tendon viscoelastic stiffness on the dynamic performance of isometric muscle Journal of Biomechanics 24 2 1647 1652
- Goldstein , S. , Frankenburg , E. , and Kuhn , J. 1993 Biomechanics of bone Accidental Injury: Biomechanics and Prevention A.M. Nahum and J.W. Melvin 198 223 Springer-Verlag New York
- Letournel , E. , and Judet , R. 1993 Fractures of the acetabulum Springer-Verlag New York
- Reber , J.G. 1978
- Shreiber , D.I. , Bain , A.C. , and Meaney , D.F. 1997 In vivo thresholds for mechanical injury to the blood-brain barrier Proc. 41st Stapp Car Crash Conference 277 292 Warrendale, PA
- Stitzel , J.D. , Duma , S.M. , Cormier , J.M. , and Herring , I.P. 2002 A nonlinear finite element model of the eye with experimental validation for the prediction of globe rupture Stapp Car Crash Journal 46 81 102
- American Academy of Pediatrics, Committee on Injury, Violence, and Poison Prevention 2001 Policy Statement: Child passenger safety Pediatrics 127 788 793
- Arbogast , K.B. , Durbin , D.R. , Cornejo , R.A. , Kallan , M. F. , Winston , F. K. 2004 An evaluation of the effectiveness of forward facing child restraint systems Accident Analysis and Prevention 36 4 585 589
- Arbogast , K.B. , Jermakian , J.S. , Kallan , M.F. , Durbin , D.R. 2009 Effectiveness of belt positioning booster seats: an updated assessment Pediatrics 124 1281 1286
- Arbogast , K.B. , Kallan , M.J. , Durbin , D.R. 2005 Effectiveness of high back and backless belt-positioning booster seats in side impact crashes Association for the Advancement of Automotive Medicine Proceedings 49 201 213
- Bae , J.Y. , Anderson , E. , Silver , D. , Macinko , J. 2014 Child passenger safety laws in the United States, 1978-2010: Policy diffusion in the absence of strong federal intervention Social Science and Medicine 100 30 37
- Benedetti , M. , Klinich , K.D. , Manary , M.A. , Flannagan , C.A. 2017 Predictors of restraint use among child occupants Traffic Injury Prevention 1 4 10.1080/15389588.2017.1318209
- Bondy , N. and Glassbrenner , D. 2001
- Compton , C.P. 2005 Injury severity codes: a comparison of police injury codes and medical outcomes as determined by NASS CDS investigators Journal of Safety Research 36 5 483 484
- Daly , L. , Kallan , M.J. , Arbogast , K.B. , Durbin , D.R. 2006 Risk of injury to child passengers in sport utility vehicles Pediatrics 117 1 9 14
- Durbin , D.R. , Chen , I. , Smith , R. , Elliott , M.R. , Winston , F.K. 2005 Effects of seating position and appropriate restraint use on the risk of injury to children in motor vehicle crashes Pediatrics 115 3 e305 e309
- Durbin , D.R. , Jermakian , J.S. , Kallan , M.J. , McCartt , A.T. , Arbogast , K.B. , Zonfrillo , M.R. , Myers , R.K. 2015 Rear seat safety: variation in protection by occupant, crash and vehicle characteristics Accident Analysis and Prevention 80 185 192
- Eichelberger , A.H. , Chouniard , A.O. , Jermakian , J.S. 2012 Effects of booster seat laws on injury risk among children in crashes Traffic Injury Prevention 13 6 631 639 10.1080/15389588.2012.660663
- Elliott , M.R. , Kallan , M.J. , Durbin , D.R. , Winston , F.K. 2006 Effectiveness of child safety seats vs seat belts in reducing risk for death in children in passenger vehicle crashes Archives of Pediatric and Adolescent Medicine 160 6 617 621
- Farmer , C.M. 2003 Reliability of police-reported information for determining crash and injury severity Traffic Injury Prevention 4 1 38 44
- Farmer , P. , Howard , A. , Rothman , L. , Macpherson , A. 2009 Booster seat laws and child fatalities: a case-control study Injury Prevention 15 5 348 350 10.1136/ip.2008.021204
- Flannagan , C.A. 2013
- Greenland , S. and Thomas , D.C. 1982 On the need for the rare disease assumption in case-control studies American Journal of Epidemiology 116 3 547 553
- Henary , B. , Sherwood , C.P. , Crandall , J.R. , Kent , R. W. , Vaca , F.E. , Arbogast K.B. , Bull , M.J. 2007 Car safety seats for children: rear facing for best protection Injury Prevention 13 398 402 10.1136/ip.2006.015115
- Isaksson-Hellman , I. , Jakobsson , L. , Gustafsson , C. , Norin , H. 1997
- Jakobsson , L. , Wiberg , H. , Isaksson-Hellman , I. , Gustafsson , J. 2007 Rear seat safety for the growing child––a new 2-state integrated booster cushion Proceedings of the Enhanced Safety of Vehicles Conference National Highway Traffic Safety Administration
- Jones , L.E. , Ziebarth , N.R. 2017 U.S. child safety seat laws: are they effective, and who complies? Journal of Policy Analysis and Management 36 3 584 607
- Kallan , M.J. , Arbogast , K.B. , Elliott , M.R. , Durbin , D.R. 2009 Non-fatal and fatal crash injury risk for children in minivans compared with children in sport utility vehicles Injury Prevention 15 1 8 12
- Kelley-Baker , T. , Romano , E. 2014 Child passengers killed in reckless and alcohol related motor vehicle crashes Journal of Safety Research 48 103 110
- Klinich , K.D. , Benedetti , M. , Manary , M.A. , Flannagan , C.A. 2016 Rating child passenger safety laws relative to best practices for child occupant protection Traffic Injury Prevention 18 4 406 411 10.1080/15389588.2016.1203427
- Kononen , D. , Flannagan , C.A. , Wang , S. 2011 Identification and validation of a logistic regression model for predicting serious injuries associated with motor vehicle crashes Accident Analysis and Prevention 43 1 112 122
- Lee , L.K. , Monuteaux , M.C. , Burghardt , L.C. , Fleegler , E.W. , Nigrovic , L.E. , Meehan , W.P. , Schultzman , S.A. , Mannix , R. 2015 Motor vehicle crash fatalities in states with primary versus secondary seat belt laws: A time-series analysis Annals of Internal Medicine 163 3 184 190 10.7326/M14-2368
- Li , H. R. , Pickrell , T. M. , and Shova , K.C. 2016
- Little , R.J.A. , Rubin , D.B. 2002 Statistical analysis with missing data. 2 New York John Wiley & Sons
- Mannix , R. , Fleegler , E. , Meehan III , W.P. , Schultzman , S.A. , Hennelly , K. , Nigrovic , L. , Lee , L.K. 2012 Booster seat law and fatalities in children 4 to 7 years of age Pediatrics 130 6 996 1002 10.1542/peds.2012-1058
- Margolis , L.H. , Foss , R.D. , Tolbert , W.G. 2000 Alcohol and motor vehicle-related deaths of children as passengers, pedestrians, and bicyclists Journal of the Ameican Medical Association 283 2245 2248
- McDonald , G. , Davie , G. , Langley , J. 2009 Validity of police-reported information on injury severity for those hospitalized from motor vehicle traffic crashes Traffic Injury Prevention 10 2 184 190 10.1080/15389580802593699
- McMurry , T.L. , Arbogast , K.B. , Sherwood , C.P. , Vaca , F. , Bull , M. , Crandall , J.R. , Kent , R.W. 2018 Rear-facing versus forward-facing child restraints: an updated assessment Injury Prevention 24 55 59
- NASS-FARS 2017
- National Highway Traffic Safety Administration 2011 http://www.safercar.gov/parents/Car-Seat-Safety.htm
- National Safety Council 1996 Manual on the Classification of Motor Vehicle Traffic Accidents Sixth Edition (ANSI D 16.1–1996) Itasca, IL National Safety Council.
- National Highway Traffic Safety Administration 2015 www-nrd.nhtsa.dot.gov/Pubs/812215.pdf
- Pressley , J.C. , Trieu , L. , Barlow , B. , Kendig , T. 2009 Motor vehicle occupant injury and related hospital expenditures in children aged 3 years to 8 years covered versus uncovered by booster seat legislation Journal of Trauma 67 1 Suppl S20 S29 10.1097/TA.0b013e3181951a90
- Quinlan , K.P. , Brewer , R.D. , Sleet , D.A. , Dellinger , A.M. 2000 Characteristics of child passenger deaths and injuries involving drinking drivers Journal of the American Medical Association 283 17 2249 2252
- Sauber-Schatz , E.K. , West , B.A. , Bergen , G.B. 2014 Vital signs: restraint use and motor vehicle occupant death rates among children aged 0–12 years - United States, 2002–2011 Morbidity and Mortality Weekly Report 63 05 113 118
- Sun , K. , Bauer , M.J. , Hardman , S. 2010 Effects of upgraded child restraint law designed to increase booster seat use in New York Pediatrics 126 3 484 489 10.1542/peds.2010-0249
- Watson , A. , Watson , B. , Vallmuur , K. 2015 10.106/j.aap.2015.06.011
- Winston , F.K. , Kallan , M.J. , Elliott , M.R. , Menon , R.A. , Durbin , D.R. 2002 Risk of injury to child passengers in compact extended-cab pickup trucks Journal of the American Medical Association 287 9 1147 1152
- Wolf , L. , Chowdhury , R. , Tweed , J. , Vinson , L. , Losina , E. , Haider , A. H. , Quereshi , F. G. 2017 Factors associated with pediatric mortality from motor vehicle crashes in the United States: A state-based analysis Journal of Pediatrics 187 295 302.e3 10.1016/j.jpeds.2017.04.044
- Zaloshnja , E. , Miller , T.R. , Hendrie , D. 2007 Effectiveness of child safety seats vs safety belts for children aged 2 to 3 years Archives of Pediatric and Adolescent Medicine 161 1 65 68