Testimony of
Stephanie Davies
National Transportation Safety Board
before the
Committee On Judicial Proceedings
Maryland Senate
In Support Of
State Bill 789
Child Passenger Safety Legislation
Annapolis, Maryland
March 11, 2008

Good afternoon Chairman Frosh and members of the Judicial Proceedings Committee.  It is my pleasure to be here in Annapolis 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 safety recommendations to prevent their recurrence.  The recommendations that arise from our investigations and safety studies are our most important product.  The Safety Board cannot mandate implementation of these recommendations.  However, in our 40-year history, organizations and government bodies have adopted more than 80 percent of our recommendations.

The Safety Board has recognized for many years that motor vehicle crashes are responsible for more deaths than are crashes in all other transportation modes combined.  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 in the 6-to-8 age range remains high because these children are often unrestrained or restrained in systems too advanced for their physical development.  According to data from the Fatality Analysis Reporting System (FARS), from 1996 through 2005, more than 1,800 children age 6 to age 8 were killed while riding in motor vehicles.  More than 90 percent of child passengers in this age group who died had been unrestrained or placed in an adult seat belt.

Restraining a child makes it three times less likely that the child will be injured in a crash.  Placing a child in the rear seat makes it an additional two times less likely that the child will be injured.  But the best protection for children in the 4-to-8 age range is to place the child in the rear seat with a belt-positioning booster seat.

Maryland recognized the positive effect legislation has on proper restraint use when the State revised its child restraint law to require child restraints through age 5.  Since Maryland enacted that law in 2002, however, many States have implemented more comprehensive laws. 

Today I will discuss two key issues.  First, belt-positioning booster seats are necessary to ensure proper seat belt fit for children ages 4 to 8.  Second, a successful child passenger safety 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 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 fatally injured children was a child who had been placed in the appropriate restraint and who had used it properly.  Children inappropriately restrained by seat belts had higher overall injury severity, including five fatal injuries, 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.  Because such shoulder belt positioning 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 Safety,(1) 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 only 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.

The Safety Board found in the 1996 study that a lap/shoulder belt would not properly fit a child less than 54 inches tall; children under this height would be safer in a booster seat.  The general opinion among law enforcement has been that age is a better enforcement criterion than height.  At the time of the Board’s 1996 study, the American Academy of Pediatrics age, height and weight guidelines indicated that the average 8-year-old child was 54 inches tall.(2)  Therefore, the Board recommended enacting legislation that ensures children up to 8 years of age are required by the State’s mandatory child restraint use law to use child restraint systems and booster seats.

A Successful Child Passenger Safety Program Requires Legislation

Although education is an important factor in increasing booster seat use, it is not sufficient by itself for attaining higher booster seat use levels.  A 2003 survey conducted by NHTSA 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 had traveled on at least one occasion in a booster seat.  Among the State Farm insured population participating in the ongoing Partners for Child Passenger Safety study, 62 percent of children between the ages of 4 and 8 were placed only in adult seat belts.(3)

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, however, costs as little as $15.  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.

Maryland requires child safety seats and booster seats for children under     age 6.  Children remain at risk, however, because Maryland’s law does not fully implement the Safety Board’s recommendation.  From 1997 through 2006, 117 children age 6 and 7 were involved in crashes while riding in motor vehicles in Maryland; 80 percent were unrestrained or improperly restrained in adult seat belts. 

Senate Bill 789 fully satisfies the Safety Board’s recommendation on the use of child restraints and complies with best practices by requiring children to use child restraints until they are 8 years old.

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 Senate Bill 789 will save lives and reduce serious injuries for Maryland’s youngest citizens.

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.

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