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Child Passenger Safety

   Motor vehicle crashes are the leading cause of death among children in the United States. In the United States during 2002, 1,543 children age 14 years or younger died as occupants in motor vehicle crashes and about 227,000 were injured.  That’s an average of 4 deaths and 622 injuries each day (NHTSA 2003a). Of the children age 4 years and younger who were fatally injured in 2002, 50% were unrestrained (NHTSA 2003a).

   Most of these injuries could have been prevented. Placing children in age-appropriate restraint systems reduces serious or fatal injuries by more than half (NHTSA 2003b). However, restraint use among young children often depends upon the driver's restraint use. Almost 40% of children riding with unbelted drivers are also unrestrained (Cody et al. 2002).  In addition, many children who ride in child safety seats are improperly secured.  A survey of more than 17,500 children found that only 15% of children in safety seats were correctly harnessed into correctly installed seats (Taft, Mickalide, and Taft 1999).

   Children ages 12 years and younger also should ride in the back seat, the safest place in a vehicle in the event of a crash.  This is especially important for vehicles with front passenger side airbags. Riding in the back seat is associated with at least a 30% reduction in the risk of injury in cars without front passenger side airbags (Braver, Whitfield, and Ferguson 1998).

   An important risk factor for injuries to child passengers is drinking and driving: one in four crash-related deaths among child passengers 0 to 14 years involves alcohol (NHTSA 2003a).Among child passengers 14 years and younger who were killed in drinking driver-related crashes from 1997 through 2002,68% were riding in the vehicle with the drinking driver (Shults 2004).

Programs

A boost for children ages 4 to 8 —
    CDC funded state health departments in Colorado, Kentucky, and New York to develop, implement, and evaluate community-based programs to increase booster seat use among children ages 4 to 8.  From 2000 through 2003, grantees implemented and evaluated community awareness campaigns and school-based programs, aired public service announcements, posted billboards, and conducted booster seat distribution events and car seat checkpoints.  Evaluation data from Colorado showed a significant increase in booster seat use in target communities when compared with control communities.  Evaluation activities continue in New York and Kentucky. Results from these intervention evaluations will help guide future efforts to increase booster seat use.

Research

Research identifies effective interventions to increase child restraint use —
   CDC and the Task Force on Community Preventive Services published systematic reviews of interventions designed to increase child safety seat and safety belt use.  The reviews revealed strong evidence of effectiveness for laws mandating the use of child safety seats and safety belts and programs that distribute child safety seats and educate parents about proper use (Zaza et al. 2001;Dinh-Zarr et al. 2001).