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 of the report (NTSB/SS-96/01) contains the Board's analysis of the data, its conclusions, and safety recommendations; volume 2 of the report (NTSB/SS-96/02) contains case summaries of the 120 vehicle accidents.
The safety issues discussed in this study include:
- 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 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, the Safety Board issued urgent recommendations 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, to the Governors and legislative leaders of the 50 States and the U.S. Territories, to the Mayor and Chairman of the Council of the District of Columbia, to the domestic and international automobile manufacturers, and to the child restraint manufacturers.
As a result of this safety study, the National Transportation Safety Board made the following safety recommendations:
To the Governors and Legislative Leaders of the 50 States and U.S. Territories, and to the Mayor and Chairman of the Council of the District of Columbia:
Emphasize the importance of transporting children in the back seat of passenger vehicles through educational materials disseminated by the State. Consider setting aside one-tenth of 1 percent from all motor vehicle insurance premiums for policies written to establish a highway safety fund to be used for this and other safety efforts. (Urgent) (H-96-13)
Review existing laws and enact legislation, if needed, that would:
- (a) Ensure that children up to 8 years old are required by the State's mandatory child restraint use law to use child restraint systems and booster seats. (H-96-14)
- (b) Eliminate exemptions for children to substitute seatbelts in place of child restraint systems. (H-96-15)
- (c) Require children 8 years or older to use seatbelts in all vehicle seating positions. (H-96-16)
To the National Highway Traffic Safety Administration:
Immediately evaluate passenger-side air bags based on all available sources, including National Highway Traffic Safety Administration's recent crash testing, and then publicize the findings and modify performance and testing requirements, as appropriate, based on the findings of the evaluation. (Urgent) (H-96-17)
Immediately revise Federal Motor Vehicle Safety Standard 208, "Occupant Crash Protection," to establish performance requirements for passenger-side air bags based on testing procedures that reflect actual accident environments, including pre-impact braking, out-of-position child occupants (belted and unbelted), properly positioned belted child occupants, and with the seat track in the forward-most position. (Urgent) (H-96-18)
Evaluate the effect of higher deployment thresholds for passenger-side air bags in combination with the recommended changes in air bag performance certification testing, and then modify the deployment thresholds based on the findings of the evaluation. (H-96-19)
Establish a timetable to implement intelligent air bag technology that will moderate or prevent the air bag from deployment if full deployment would pose an injury hazard to a belted or unbelted occupant in the right front seating position, such as a child who is seated too close to the instrument panel, a child who moves forward because of pre-impact braking, or a child who is restrained in a rear-facing child restraint system. (H-96-20)
Determine the feasibility of applying technical solutions to vehicles currently on the road equipped with passenger-side air bags, and those to be manufactured until new standards become effective, to prevent air baginduced injuries to children in the passenger-side seating position. (H-96-21)
Review, through your Blue Ribbon Panel comprising child passenger safety advocates, automobile and child restraint manufacturers, and automobile insurance providers, the various efforts that promote child passenger safety, and then develop and implement a plan to ensure coordinated, comprehensive, continuing programs and stable funding for these programs. (H-96-22)
Evaluate, in conjunction with the child restraint manufacturers, the design of child restraint systems, with the goal of simplifying placement of a child in a restraint system. (H-96-23)
Revise the necessary Federal Motor Vehicle Safety Standards to provide for the secure and uniform installation of child restraint systems. (H-96-24)
Revise Federal Motor Vehicle Safety Standard 213, "Child Restraint Systems," to establish performance standards for booster seats that can restrain children up to 80 pounds. (H-96-25)
Revise Federal Motor Vehicle Safety Standard 208, "Occupant Crash Protection" to require adjustable upper anchorages at all outboard rear seating positions of a vehicle. (H-96-26)
Revise Federal Motor Vehicle Safety Standard 213, "Child Restraint Systems," to include performance requirements for seatbelt adjusters. (H-96-27)
Require installation of center rear lap/shoulder belts in all newly manufactured passenger vehicles for sale in the United States. (H-96-28)
To the domestic and international automobile manufacturers:
Install enhanced warning labels on all passenger vehicles equipped with passenger-side air bags on the road or to be manufactured prior to the effective date of the requirements proposed by the National Highway Traffic Safety Administration on August 6, 1996. The labels should be similar to those to be required for installation in newly manufactured vehicles. (H-96-29) (Supersedes H-95-19)
Develop and implement a program to reduce the misuse of child restraint systems that would include elements such as technical training for dealership personnel in the proper use of child restraint systems and promotional events at dealerships to provide parents and caregivers with information on proper use. (H-96-30)
Offer integrated restraints in passenger vehicles for sale in the United States. (H-96-31)
Voluntarily install adjustable upper seatbelt anchorages at all outboard rear seating positions in all newly manufactured passenger vehicles for sale in the United States. (H-96-32)
Voluntarily install center rear lap/shoulder belts in all newly manufactured passenger vehicles for sale in the United States. (H-96-33)
To the child restraint manufacturers:
Evaluate, in conjunction with the National Highway Traffic Safety Administration, the design of child restraint systems, with the goal of simplifying placement of a child in a restraint system. (Urgent) (H-96-34)
Simplify the written and visual instructions provided to consumers regarding the installation of child restraint devices. (H-96-35)
Also as a result of this safety study, the National Transportation Safety Board reiterated the following recommendation to the Governors of the 39 States that have secondary enforcement of mandatory seatbelt laws, the State of New Hampshire that has no mandatory seatbelt use law, and the Mayor of the District of Columbia:
Enact legislation that provides for primary enforcement of mandatory safety belt laws. Consider provisions such as adequate fine levels and the imposition of driver license penalty points. (H-95-13)