Wednesday, October 28, 2015

CDC Study Reveals Medical Outcomes and Hospital Charges Among Children in a Crash

A new CDC surveillance summary highlights that proper car seat, booster seat, and seat belt use among children prevents injuries, decreases deaths, and reduces hospital charges. It also confirmed that parents often transition children to the next, less protective, stage of child passenger restraint too soon. With every transition to the next stage of restraint (e.g., rear-facing seat to forward-facing seat, forward-facing seat to booster seat, and from booster seat to seat belt), children are less protected in a crash and the cost of injury increases.

This surveillance summary examined the following:

Restraint use at the time of a crash:

Seating position at the time of a crash:

A higher percentage of children (aged 1-7) who were restrained using a car seat or booster seat were also sitting in a back seat. There was a significant decrease in the percentage of children sitting in a back seat from age 7 years (95%) to age 8 years (77%), and only 55% of restrained children aged 12 years were sitting in a back seat. Among the children who were unrestrained, 25% to 32% of children aged 8-12 years were in the front seat.

Type of injury:

The use of a car seat or booster seat among children aged 4-7 reduced the risk for neck, back, or abdominal injuries, traumatic brain injuries, and hospitalization compared with seat belt use alone. Unrestrained children in a crash had approximately 7 times the percentage of traumatic brain injury compared with children buckled in age- and size-appropriate restraints. Regardless of age, contusions and other superficial injuries were the most prevalent type of injury; and unrestrained children had the highest percentage of each type of injury.

Hospital charges:

Among all age groups, the average hospital charges incurred during motor vehicle crashes varied based on restraint use and seating position, showing a decrease (in 2008 dollars) with the use of age- and size- appropriate restraint use in a back seat.

Characteristics of drivers:

Drivers with risky driving behaviors (including those who were driving unrestrained, driving with suspected alcohol or drug use, driving while distracted, or in a speed-related crash) had a higher percentage of unrestrained child passengers. Male drivers were more likely to have unrestrained child passengers than female drivers. Drivers aged ≤20 years had the highest percentage of unrestrained child passengers, followed by drivers aged 50-59 years and aged ≥60 years. The youngest and oldest drivers also had the highest percentage of children riding in a front seat.

What Can Be Done?

Parents and caregivers are the first line of defense for children in a crash; therefore, strategies for improving child passenger safety should focus on helping parents and caregivers learn how to properly buckle their children in and use age- and size-appropriate car seats, booster seats, and seat belts in the back seat on every trip, no matter how short. Effective interventions, including child passenger restraint laws (with child safety seat/booster seat coverage through at least age 8 years) and child safety seat distribution plus education programs, can increase restraint use and reduce child motor vehicle deaths. In addition, enforcement and implementation of effective interventions intended for adults to increase restraint use and prevent impaired driving, distracted driving, and speeding can reduce the risk of motor vehicle crashes and in turn also might reduce the risk for injury to child passengers.