Good morning Chairman Ciotto, Chairman Guerrera, and members of the Committee on Transportation. It is my pleasure to be here in Hartford, Connecticut to talk about child passenger safety.
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 cause, 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 has neither regulatory authority nor grant funds. However, in our 37-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 nation’s 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 age 4 through 7 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 1994 through 2003, more than 3,900 children in this age group were killed while riding in motor vehicles. Over 95 percent of child passengers in this age group who died had been unrestrained or placed in an adult seat belt. For this age group in Connecticut, all the children who died while riding in motor vehicles were unrestrained or in an adult seat belt.
Restraining a child makes it 3 times less likely that the child will be injured in a crash. Placing a child in the rear seat makes it an additional 2 times less likely that the child will be injured. But the best protection for children age 4 through 7 is to place them in the rear with belt-positioning booster seats.
Today I want to discuss two key issues. First, belt-positioning booster seats are necessary to ensure proper seat belt fit for children age 4 through 7. 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 person’s 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 between 8 and 9 years old, the age at which the child’s thigh is long enough for the child to sit against the seat back, the child’s hips are sufficiently developed to anchor the belt, and the child’s 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 children who had been placed in the appropriate restraint and who used it properly died in the subsequent crash. Children inappropriately restrained by seat belts had higher overall injury severity 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 child’s stomach and the shoulder belt can cut across a child’s neck. As this position 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 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 and seat belt use, it is not sufficient by itself. 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 are traveling at least on occasion in a booster seat. Even among the State Farm insured population participating in the ongoing Partners for Child Passenger Safety study, only 49 percent of children between the ages of 3 and 8 are placed in child restraints. 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 and may be available at no cost through community programs, automobile dealers, or other groups. As a nation, what value do we want to place on a child’s 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 his seat belt and the vehicle, even though his seat belt remained buckled. Ms. Skeen’s 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 States’ child passenger safety laws.
Our investigation shows that children are safer if placed in booster seats up to age 8. Therefore, in our 1996 safety study, the Safety Board recommended enacting legislation that ensures children up to 8 are required by the State’s mandatory child restraint use law to use child restraint systems and booster seats. Twenty-eight States (Arkansas, California, Colorado, Delaware, Georgia, Illinois, Indiana, Iowa, Louisiana, Maine, Maryland, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia, Washington, and Wyoming) and the District of Columbia have mandated that children age 4 and above use booster seats. At least 7 other States are considering similar legislation.
FARS data from 1994 through 2003 show that 108 children (age 4 through age 7) were riding in motor vehicles on Connecticut’s roads when they were involved in a fatal crash. Thirty-six percent of the 108 children died or suffered incapacitating injuries; 89 percent of those children who died or suffered incapacitating injuries were not in child restraints. Only 6 children, or 6 percent, involved in fatal crashes were using any form of child restraint.
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 75 percent.
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. Passing House Bill 6660 will save lives and reduce serious injuries for Connecticut’s youngest citizens. It would also reduce both public and private expenditures for medical care and other support that would otherwise be incurred for as long as the injured child lives.
Thank you again for inviting the Safety Board to testify about this important problem. I would be happy to answer any questions you may have.
 The 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 children’s lives by increasing the fund of knowledge about children in motor vehicle crashes.