Risk of Injury to Child Passengers in Sport Utility Vehicles
PEDIATRICS Vol. 117 No. 1 January 2006, pp. 9-14
Lauren Daly, MD, Michael J. Kallan, MS, Kristy B. Arbogast, PhD and Dennis R. Durbin, MD, MSCE
FROM ABSTRACT:
OBJECTIVE.
The popularity of sport utility vehicles (SUVs) is growing, and they are increasingly being used as family vehicles. Because of the large size of SUVs, relative to passenger cars, parents may perceive that they are safer family vehicles. The objective of this study was to determine the relative risk of injury to children involved in crashes in SUVs, compared with those in passenger cars.
DESIGN.
These researchers looked at a sample of 3,922 child occupants 0 to 15 years of age. Injuries were defined as concussions and other brain injuries, spinal cord injuries, facial fractures and lacerations, internal organ injuries, extremity fractures, and scalp lacerations. [These injuries are not seen in our typical patients]
Logistic regression modeling was used to compute the odds ratio (OR) of injury for children in SUVs versus passenger cars, both unadjusted and adjusted for several potential confounders, including differences in child seating position, restraint use, vehicle weight, exposure of the child to a passenger airbag, and whether the vehicle rolled over.
RESULTS.
Among all children in the study, those restrained appropriately were less likely to be injured (75% less) and those in the front seat were more likely to be injured (106% more). In both vehicle types, children exposed to a passenger airbag were more likely to be injured than were those who were not (370% more). Rollover crashes increased the risk of injury in both vehicle types (increased by 229%) and occurred more than twice as frequently with SUVs compared with passenger cars. After adjustment for all of the aforementioned factors, the risk of injury was not significantly different.
Especially detrimental for children in SUVs was being unrestrained versus restrained in a rollover crash (2400 % increased risk with a range between 568% to 9253%). [WOW! Look at these numbers. If you have an SUV, make sure your children are properly restrained].
CONCLUSIONS.
Despite the greater vehicle weight of SUVs, the risk of injury for children in SUVs is similar to that for children in passenger cars.
The potential advantage offered by heavier SUVs seems to be offset by other factors, including an increased tendency to roll over.
Age-appropriate child restraint and rear seat positioning are important, particularly for children in SUVs, given the very high risk of injury for children restrained inappropriately in rollover crashes.
THESE AUTHORS ALSO NOTE:
“Sport utility vehicles (SUVs) are growing in popularity in the United States and increasingly are being used as family vehicles.”
“The number of SUV registrations rose 250% between 1995 and 2002.”
“This may be attributable, in part, to a perception that SUVs are safer than other passenger vehicles because of their larger average size.”
“Any potential safety advantage of the SUVs' increased size and weight is offset by their increased likelihood of rolling over in a crash, compared with passenger cars.”
“Data from the National Highway Traffic Safety Administration indicate that SUVs are 4 times more likely to roll over in a crash than passenger cars.”
“The propensity for SUVs to roll over has been brandished as a warning to consumers that SUVs are unsafe vehicles to buy.”
In this study, all vehicles were insured by State Farm, were of model year 1998 or newer, and were involved in a crash with 1 child occupant less than 16 years of age.
RESULTS
In this study, SUVs had a higher rate of rollover crashes than did passenger cars.
There was a substantial difference in vehicle weight between SUVs and passenger cars, with the average SUV being more than 1300 lbs. heavier than the average passenger car.
“Children who were restrained appropriately were less likely to be injured than were unrestrained children.” (75% less likely to be [seriously] injured) Children in the front seat were more likely to be injured than were those in the rear (106% more likely to be [seriously] injured). After adjustment for variables (weight, restraint use, seating position), children in SUVs had a 62% elevated risk of injury compared to children in passenger cars.
In both SUVs and passenger vehicles, “children exposed to a passenger air bag were more likely to be injured than were those who were not.” (Increased risk by 370% with a range between 136% to 837%) “Rollover contributed significantly to the risk of injury in both vehicle types, with children in rollover crashes being more than 3 times more likely to be injured, compared with children in nonrollover crashes.”
In rollover crashes involving SUVs, the risk of injury was 25-fold greater for unrestrained versus appropriately restrained children. (Range was 7-fold to 94-fold increased risk)
DISCUSSION
Children in SUVs had a similar risk of injury compared with children in passenger cars. “Contrary to public perception, SUVs do not provide superior protection to child occupants, compared with passenger cars.”
“The potential safety advantage of SUVs resulting from their heavier weight seems to be offset by other factors, including the greater tendency of SUVs to roll over in a crash.”
Results of this study also confirm the importance of age-appropriate restraint and rear seating for children in either type of vehicle, as well as the elevated risk of injury to children who are exposed to a deploying passenger air bag. This study showed a 25-fold increased risk of injury to unrestrained child occupants in an SUV rollover crash. Unrestrained children in SUV crashes (with and without rollover) fare worse than unrestrained adults.
National Highway Traffic Safety Administration data indicates that in rollover crashes, 50% of unrestrained occupants were ejected from the vehicle; only 4% of restrained occupants were ejected. “Of those ejected, 62% were killed.”
One is more than four times more likely to be injured in a rollover SUV accident if one is unbelted as compared to those who are belted. These authors cite research that documents 83% to 99% for restraint use among children less than 8 years of age.
CONCLUSIONS
“Our findings suggest that, despite the larger size of SUVs and the consequent perception of improved safety, children riding in SUVs have a similar risk of injury, compared with children riding in passenger cars.”
“The protective effect of increased vehicle weight offered by SUVs is tempered by their higher risk of rollover crashes.”
In either SUVs or passenger cars, “age-appropriate child restraint and rear seat positioning are critically important for reducing the risk of injury in a crash.” Because of the higher risk of rollover, there is strong importance for the use of age-appropriate restraint for all children who ride in SUVs.
The increased risk of injury posed by deploying passenger air bags in any vehicle “reinforces the importance of continued education of parents to never place children less than 13 years of age in the front seat of a passenger air bag-equipped vehicle.”
KEY POINTS FROM DAN MURPHY
1) This study only looked at seriously injured children, including brain injuries, spinal cord injuries, facial fractures and lacerations, internal organ injuries, extremity fractures, and scalp lacerations. Consequently, most of the patients we would see in the clinical setting were not included.
2) Children who are properly restrained are 75% less likely to be [seriously] injured compared to unrestrained children.
3) Children in the front seat are 106% more likely to be [seriously] injured than children sitting in the back seat.
4) In any vehicle, children exposed to a deploying passenger airbag were 370% more likely to be [seriously] injured than were those who were not.
5) SUVs are 4 times more likely to roll over in a crash than passenger cars.
6) Rollover crashes increased the risk of [serious] injury by 229%.
7) Risk of [serious] injury increased 2,400% with a range between 568% to
9,253% for unrestrained children in SUV rollover crashes. [If you have an SUV, make sure your children are properly restrained].
8) Despite the greater vehicle weight of SUVs, the risk of injury for children in SUVs is similar to that for children in passenger cars, primarily because of the increased tendency for the SUV to roll over.
9) “Any potential safety advantage of the SUVs' increased size and weight is offset by their increased likelihood of rolling over in a crash, compared with passenger cars.”
10) In this study, children in SUVs had a 62% elevated risk of [serious] injury compared to children in passenger cars.
11) In both SUVs and passenger vehicles, children exposed to a passenger air bag were more 370% likely to be [seriously] injured than were those who were not.
12) In rollover crashes involving SUVs, the risk of injury was 25-fold greater for unrestrained versus appropriately restrained children. (Range was 7-fold to 94-foldincreased risk).
13) There is a 25-fold increased risk of injury to unrestrained child occupants in an SUV rollover crash.
14) In rollover crashes, 50% of unrestrained occupants are ejected from the vehicle, and 62% of those ejected will die.
15) Only 4% of restrained occupants are ejected in rollover crashes.
16) Because of the higher risk of rollover, there is strong importance for the use of age-appropriate restraint for all children who ride in SUVs.
17) The increased risk of injury posed by deploying passenger air bags in any vehicle “reinforces the importance of continued education of parents to never place children less than 13 years of age in the front seat of a passenger air bag-equipped
vehicle.”
PEDIATRICS Vol. 117 No. 1 January 2006, pp. 9-14
Lauren Daly, MD, Michael J. Kallan, MS, Kristy B. Arbogast, PhD and Dennis R. Durbin, MD, MSCE
FROM ABSTRACT:
OBJECTIVE.
The popularity of sport utility vehicles (SUVs) is growing, and they are increasingly being used as family vehicles. Because of the large size of SUVs, relative to passenger cars, parents may perceive that they are safer family vehicles. The objective of this study was to determine the relative risk of injury to children involved in crashes in SUVs, compared with those in passenger cars.
DESIGN.
These researchers looked at a sample of 3,922 child occupants 0 to 15 years of age. Injuries were defined as concussions and other brain injuries, spinal cord injuries, facial fractures and lacerations, internal organ injuries, extremity fractures, and scalp lacerations. [These injuries are not seen in our typical patients]
Logistic regression modeling was used to compute the odds ratio (OR) of injury for children in SUVs versus passenger cars, both unadjusted and adjusted for several potential confounders, including differences in child seating position, restraint use, vehicle weight, exposure of the child to a passenger airbag, and whether the vehicle rolled over.
RESULTS.
Among all children in the study, those restrained appropriately were less likely to be injured (75% less) and those in the front seat were more likely to be injured (106% more). In both vehicle types, children exposed to a passenger airbag were more likely to be injured than were those who were not (370% more). Rollover crashes increased the risk of injury in both vehicle types (increased by 229%) and occurred more than twice as frequently with SUVs compared with passenger cars. After adjustment for all of the aforementioned factors, the risk of injury was not significantly different.
Especially detrimental for children in SUVs was being unrestrained versus restrained in a rollover crash (2400 % increased risk with a range between 568% to 9253%). [WOW! Look at these numbers. If you have an SUV, make sure your children are properly restrained].
CONCLUSIONS.
Despite the greater vehicle weight of SUVs, the risk of injury for children in SUVs is similar to that for children in passenger cars.
The potential advantage offered by heavier SUVs seems to be offset by other factors, including an increased tendency to roll over.
Age-appropriate child restraint and rear seat positioning are important, particularly for children in SUVs, given the very high risk of injury for children restrained inappropriately in rollover crashes.
THESE AUTHORS ALSO NOTE:
“Sport utility vehicles (SUVs) are growing in popularity in the United States and increasingly are being used as family vehicles.”
“The number of SUV registrations rose 250% between 1995 and 2002.”
“This may be attributable, in part, to a perception that SUVs are safer than other passenger vehicles because of their larger average size.”
“Any potential safety advantage of the SUVs' increased size and weight is offset by their increased likelihood of rolling over in a crash, compared with passenger cars.”
“Data from the National Highway Traffic Safety Administration indicate that SUVs are 4 times more likely to roll over in a crash than passenger cars.”
“The propensity for SUVs to roll over has been brandished as a warning to consumers that SUVs are unsafe vehicles to buy.”
In this study, all vehicles were insured by State Farm, were of model year 1998 or newer, and were involved in a crash with 1 child occupant less than 16 years of age.
RESULTS
In this study, SUVs had a higher rate of rollover crashes than did passenger cars.
There was a substantial difference in vehicle weight between SUVs and passenger cars, with the average SUV being more than 1300 lbs. heavier than the average passenger car.
“Children who were restrained appropriately were less likely to be injured than were unrestrained children.” (75% less likely to be [seriously] injured) Children in the front seat were more likely to be injured than were those in the rear (106% more likely to be [seriously] injured). After adjustment for variables (weight, restraint use, seating position), children in SUVs had a 62% elevated risk of injury compared to children in passenger cars.
In both SUVs and passenger vehicles, “children exposed to a passenger air bag were more likely to be injured than were those who were not.” (Increased risk by 370% with a range between 136% to 837%) “Rollover contributed significantly to the risk of injury in both vehicle types, with children in rollover crashes being more than 3 times more likely to be injured, compared with children in nonrollover crashes.”
In rollover crashes involving SUVs, the risk of injury was 25-fold greater for unrestrained versus appropriately restrained children. (Range was 7-fold to 94-fold increased risk)
DISCUSSION
Children in SUVs had a similar risk of injury compared with children in passenger cars. “Contrary to public perception, SUVs do not provide superior protection to child occupants, compared with passenger cars.”
“The potential safety advantage of SUVs resulting from their heavier weight seems to be offset by other factors, including the greater tendency of SUVs to roll over in a crash.”
Results of this study also confirm the importance of age-appropriate restraint and rear seating for children in either type of vehicle, as well as the elevated risk of injury to children who are exposed to a deploying passenger air bag. This study showed a 25-fold increased risk of injury to unrestrained child occupants in an SUV rollover crash. Unrestrained children in SUV crashes (with and without rollover) fare worse than unrestrained adults.
National Highway Traffic Safety Administration data indicates that in rollover crashes, 50% of unrestrained occupants were ejected from the vehicle; only 4% of restrained occupants were ejected. “Of those ejected, 62% were killed.”
One is more than four times more likely to be injured in a rollover SUV accident if one is unbelted as compared to those who are belted. These authors cite research that documents 83% to 99% for restraint use among children less than 8 years of age.
CONCLUSIONS
“Our findings suggest that, despite the larger size of SUVs and the consequent perception of improved safety, children riding in SUVs have a similar risk of injury, compared with children riding in passenger cars.”
“The protective effect of increased vehicle weight offered by SUVs is tempered by their higher risk of rollover crashes.”
In either SUVs or passenger cars, “age-appropriate child restraint and rear seat positioning are critically important for reducing the risk of injury in a crash.” Because of the higher risk of rollover, there is strong importance for the use of age-appropriate restraint for all children who ride in SUVs.
The increased risk of injury posed by deploying passenger air bags in any vehicle “reinforces the importance of continued education of parents to never place children less than 13 years of age in the front seat of a passenger air bag-equipped vehicle.”
KEY POINTS FROM DAN MURPHY
1) This study only looked at seriously injured children, including brain injuries, spinal cord injuries, facial fractures and lacerations, internal organ injuries, extremity fractures, and scalp lacerations. Consequently, most of the patients we would see in the clinical setting were not included.
2) Children who are properly restrained are 75% less likely to be [seriously] injured compared to unrestrained children.
3) Children in the front seat are 106% more likely to be [seriously] injured than children sitting in the back seat.
4) In any vehicle, children exposed to a deploying passenger airbag were 370% more likely to be [seriously] injured than were those who were not.
5) SUVs are 4 times more likely to roll over in a crash than passenger cars.
6) Rollover crashes increased the risk of [serious] injury by 229%.
7) Risk of [serious] injury increased 2,400% with a range between 568% to
9,253% for unrestrained children in SUV rollover crashes. [If you have an SUV, make sure your children are properly restrained].
8) Despite the greater vehicle weight of SUVs, the risk of injury for children in SUVs is similar to that for children in passenger cars, primarily because of the increased tendency for the SUV to roll over.
9) “Any potential safety advantage of the SUVs' increased size and weight is offset by their increased likelihood of rolling over in a crash, compared with passenger cars.”
10) In this study, children in SUVs had a 62% elevated risk of [serious] injury compared to children in passenger cars.
11) In both SUVs and passenger vehicles, children exposed to a passenger air bag were more 370% likely to be [seriously] injured than were those who were not.
12) In rollover crashes involving SUVs, the risk of injury was 25-fold greater for unrestrained versus appropriately restrained children. (Range was 7-fold to 94-foldincreased risk).
13) There is a 25-fold increased risk of injury to unrestrained child occupants in an SUV rollover crash.
14) In rollover crashes, 50% of unrestrained occupants are ejected from the vehicle, and 62% of those ejected will die.
15) Only 4% of restrained occupants are ejected in rollover crashes.
16) Because of the higher risk of rollover, there is strong importance for the use of age-appropriate restraint for all children who ride in SUVs.
17) The increased risk of injury posed by deploying passenger air bags in any vehicle “reinforces the importance of continued education of parents to never place children less than 13 years of age in the front seat of a passenger air bag-equipped
vehicle.”