Safety First

By Nancy Molina, DC

As any parent knows, keeping young children safe is a full-time job. Danger seems to lurk around every corner; everything from sharp objects and choking hazards when they're very young to broken limbs and bullies when they're a bit older. And what about every time you load them into a car and drive somewhere; how do you protect them from potential harm? It's all about safety first.

Injury is the number-one killer of children in the United States. In 2004, injury accounted for 59.5 percent of all deaths in children younger than 18 years of age.  The financial burden to society of children who survive childhood injury with disability also continues to be enormous. According to a study in the April 2008 issue of Pediatrics, "Only the comprehensive cooperation of a broadly diverse group of people will have a significant effect on improving the care and outcome of injured children." That starts with parents, grandparents and adults in general  ensuring children are as safe as they can possibly be every time they go anywhere in a motor vehicle.

 - Copyright – Stock Photo / Register Mark Sobering Statistics

Motor vehicle crashes are the leading cause of death for children 2 to 14 years old, based on 2004 figures, which are the latest data currently available from the National Center for Health Statistics. In 2006, an average of five children ages 14 and younger were killed and 568 were injured every day in motor vehicle crashes. Injures suffered while riding in cars are the number-one preventable cause of death in young children. We all must make every effort to ensure children ages 0-16 are properly restrained in the correct restraint system for their age and size every time they travel in a motor vehicle. While great progress has been achieved in recent years in preventing child occupant deaths and injuries - and increasing the correct use of child safety seats, booster seats and safety belts - more work needs to be done to protect child occupants who remain at heightened risk.

Focus on Prevention

The magnitude of this problem demands that parents educate themselves as to the dangers children face, particularly the high-risk group of  young children. Young children have delicate bodies and bone structures, and because they are light, may be easily thrown upon impact. In a low-speed crash, an infant or small child can smash into the windshield with the same force as if you dropped them from a third-story window.

Research has shown that lap/shoulder seat belts, when used, reduce the risk of fatal injury to front-seat occupants (ages 5 and older) of passenger cars by 45 percent and the risk of moderate-to-critical injury by 50 percent. For light-truck occupants, seat belts reduce the risk of fatal injury by 60 percent and the risk of moderate-to-critical injury by 65 percent. In 2006, 6,983 passenger vehicle occupants ages 14 and younger were involved in fatal crashes. For those children whose restraint use was known, 25 percent were unrestrained; among those who were fatally injured, 45 percent were unrestrained.

One of the best ways to prevent an injury is for infants and children to always ride in car safety seats. For older children, a proper restraint system must be used each and every time they ride. For example, a safety seat can hold the child securely in the car and even help absorb some of the forces of violent car crashes. And of course, as a rule, every child should be buckled up for every ride.

Using the safety seat correctly does make a difference. The child must be held securely in the safety seat - harness, straps and a shield.  Just a little mistake in the way the seat is secured in a car can make even the safest seat fail in a crash.  If children are less than 4'9" tall, they must be in a booster seat. This is vital, yet too many people ignore the rule. "Only an estimated 10 to 20 percent of children ages 4 to 8 are placed in booster seats by the adults who care for them," asserts J. Robert Galvin, MD, MPH, commissioner of the Department of Public Health.

Why is this so important? A study by Children's Hospital of Philadelphia indicates that children in this age group who use booster seats are 59 percent less likely to be injured in a car crash than children restrained by a seat belt alone. Every year, children suffer preventable injuries and deaths in motor vehicle crashes because they are not riding in an appropriate child safety seat or booster seat. Booster seats help to correctly position lap-shoulder safety belts for children who have outgrown their child safety seats.

 - Copyright – Stock Photo / Register Mark For maximum child passenger safety, parents and caregivers need to remember and follow the 4 Steps for Kids:

  1. Use rear-facing infant seats in the back seat from birth to at least 1 year of age and at least 20 pounds.
  2. Use forward-facing toddler seats in the back seat from age 1 and 20 pounds to about age 4 and 40 pounds.
  3. Use booster seats in the back seat from about age 4 to at least age 8, unless the child is 4' 9" or taller, and use safety belts in the back seat at ages 8 or older (or when your child is taller than 4' 9").
  4. All children under the age of 13 should ride in the back seat.

Remember, as parents, it's your responsibility to keep your children safe and provide an environment that is secure - and it's my responsibility as a health care provider to do the same. For more information about child seat safety, talk to your doctor. Another good resource is the National Highway Traffic Safety Administration Web site: www.nhtsa.dot.gov.


Nancy Martin-Molina, DC, QME, MBA, CCSP, is a doctor of chiropractic and certified chiropractic sports physician practicing in San Juan Capistrano, Calif. She can be contacted via her Web site, www.molinachiropractic.com.


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