Injury Prevention Policy
Legislation to Require that Children in Motor Vehicles Are Properly Restrained
Motor vehicle traffic crashes are the leading cause of unintentional injury-related death in the United States for children ages 12 and under. In 1997, 1,096 children 12 years old and younger died as occupants in motor vehicle crashes. Children ages 4 and under accounted for 44 percent of these deaths (1).
All 50 states, the District of Columbia, Puerto Rico and the U.S. Territories have child passenger safety laws. However, many of these laws have serious gaps and exemptions in coverage that diminish the protection of children as motor vehicle occupants. Review the Insurance Institute for Highway Safety's web site (2) to see if your state laws protect children of all ages in all areas of a vehicle.
Policy and Details
1. Enact and enforce laws requiring all children and adolescents to be appropriately restrained.
This legislation should:
- Require child restraint systems (car seats) for children up to 4 years old and 40 lbs. Eliminate exemptions for overcrowded vehicles, and "attending to the personal needs of the child". Many states exempt children if the vehicle or driver is from another state. These exemptions endanger children by reducing the number of situations in which children are required to be properly restrained and they should be eliminated.
- Require booster seats until the child is tall enough for automobile lap/shoulder belts to fit properly. In most cases, lap/shoulder belts will not fit properly until children are at least 4'9" tall and weigh 80 pounds. Usually this means that children 4 to 8 years old should be using a booster seat (3). Only about six percent of children of a size appropriate for booster seats use them (3). Washington State recently became the first state in the nation to pass legislation mandating booster seats. You may view the text of the bill online here.
- Require seat belts for those children who no longer fit the size requirements for safety or booster seats. Require that all passengers use seat belts. This requirement should apply to all areas of the motor vehicle. There should be no exemptions for passengers in the rear seat of a car or van.
2. Enact and enforce legislation that requires children ages 12 and under to be transported in a rear seat.
The safest place for a child in a motor vehicle is in the back seat. The National Transportation Safety Board recommends that states enact legislation to require transporting children age 12 and under in a rear seat of a passenger vehicle if a rear seating position is available (4). Currently, very few states have laws that mandate where a child must sit in a motor vehicle. For example, Louisiana requires that children three years and older must be in a rear seat if available, and Rhode Island requires children 5 years and younger to be in a rear seat if available. However, Louisiana and Rhode Island only require child restraints for children 2 years and younger and 3 years and younger, respectively (2). Although these pioneer laws are an improvement over no legislation, they do not adequately protect children by insuring that all children aged 12 years and under ride in the rear seat if one is available.
Child safety seats are extremely effective when correctly installed and used in passenger cars. Research on the effectiveness of child safety seats has found that they reduce the risk of fatal injury by 69 percent for infants (less than 1 year old) and by 47 percent for toddlers (1-4 years old) (5). If all child passengers ages 5 and under were properly restrained, it is estimated that an additional 183 lives could have been saved in 1997 alone (6).
The enactment and enforcement of laws requiring children to ride in the back seat further enhance child passenger safety. An Insurance Institute for Highway Safety study revealed that properly restrained children in rear seats had death rates lower than children seated in front. In addition, sitting in back reduced children's risk of death, whether or not they were restrained (7). A study by Berg, et al confirms that "sitting in the rear seat during a motor vehicle crash offers a significant protective effect, restraint use enhances this effect, and usage rates of restraint devices are too low" (8). The enactment and enforcement of appropriate child restraint laws will help protect the health and safety of children who may not otherwise use appropriate restraint devices.
David Lawrence, Center Director
Center for Injury Prevention Policy and Practice
San Diego State University
6505 Alvarado Road, Suite 208
San Diego, CA 92120
Phone: (619) 594-3691
Fax: (619) 594-1994
1. Office of Statistics and Programming, National Center for Injury Prevention and Control, CDC. 1997, United States MV traffic, Occupant Deaths and Rates per 100,000. Available ONLINE: http://www.cdc.gov/ncipc/wisqars/, April 11, 2000.
2. Insurance Institute for Highway Safety. Child Restraint, Belt Laws. Available ONLINE: http://www.iihs.org/safety_facts/state_laws/restrain.htm, March 8, 2000.
3. National Highway Traffic Safety Administration. Booster Seat Tips and Talking Points. Available ONLINE: http://www.nhtsa.dot.gov/people/injury/childps/Boosterseat/talking.html, April 4, 2000.
4. National Transportation Safety Board. The State of Child Passenger Safety in America. Remarks by Jim Hall, Chairman of NTSB at the Lifesavers 2000 Conference on March 13, 2000. Available ONLINE: http://www.ntsb.gove/speeches/jhc000313.htm, April 3, 2000.
5. National Highway Traffic Safety Administration. Traffic Safety Facts 1997: Children. DOT HS 808 765.
6. National Highway Traffic Safety Administration. Traffic Safety Facts 1997: Occupant Protection. DOT HS 808 768.
7. Insurance Institute for Highway Safety. With or without airbags, children are safer when they ride restrained in back, Institute study shows. Available ONLINE: http://www.iihs.org/news_releases/1997/pr062797.htm, March 16, 2000.
8. Berg, MD, et al. Effect of Seating Position and Restraint Use on Injuries to Children in Motor Vehicle Crashes. Pediatrics, 105 (4), April 2000: 831-835.
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Last modified: 4-August-2000.