Injury implications of inappropriate use of adult seatbelt systems for children aged 2-8

Current Australian child restraints offer excellent protection to child occupants under the age of four.  While booster seats and adult seatbelts have also been shown to offer some level of protection to young children involved in crashes, the level of protection is somewhat lower than provided by dedicated child restraint systems. It is likely that the level of protection is even lower for children who graduate to such systems prematurely. Early graduation to seat belts is often called inappropriate restraint use. The focus of this study is to investigate the role of restraint misuse and inappropriate use on injury outcome for 2-8 year old motor vehicle occupants. The study is a prospective crash investigation study, involving children aged 2-8 who present to the emergency department following a motor vehicle crash. Detailed injury and crash data are collected. Preliminary results suggest that an overwhelming proportion of children in this age group are restrained by adult seatbelt systems rather than the more appropriate dedicated child restraints or booster seats. Common serious injury mechanisms have been observed in children inappropriately restrained. These injury mechanisms include abdominal injuries due to poor lap belt fit, neck injuries due to poor sash belt fit and head injuries due to poor control of head excursion. In addition, restraint misuse appears to be a factor in several of the more serious cases involving restrained children.  Together, this data suggests that reducing the instances of inappropriate restraint use and restraint misuse are potential countermeasures for reducing the severity of injuries sustained by child motor vehicle occupants. Further examination of the potential for injury prevention by changes to restraint system design is underway using a complementary program of sled tests.