Motor vehicle accidents are the number one killer and crippler of children in the United States. Infants and small children riding as passengers in motor vehicles are especially vulnerable to death, disability and disfigurement even in minor accidents and non-crash incidents, such as sudden stops. Although it is estimated that most fatalities and injuries to infants and small children in motor vehicles could be prevented by the proper use of child safety seats, safety seat use remains low, and most children continue to be transported in motor vehicles without proper protection. In 1982, because of its increasing concern about the continuing high levels of highway fatalities and injuries, the National Transportation Safety Board began a study of child passenger protection as part of an expanded effort to concentrate its highway accident investigations and its other activities on safety problems having high potentials for success in reducing fatalities and Injuries. In mid-1982, the Safety Board launched a series of detailed investigations of accidents involving infants and small children. Fifty-three investigations were conducted in 19 States by highway accident investigators in four field offices located in Los Angeles, New York, Kansas City, and Atlanta, and In the Safety Board's Washington, D.C., headquarters The investigations examined the use and crash performance of child safety seats as well as accident consequences to infants and small children who were not travelling In child safety seats. The accident investigations were not intended to produce statistically representative accident data. The Safety Board selected each accident individually to obtain cases which would permit Investigation of potentially significant safety issues in motor vehicle transportation of infants and small children. The 53 accidents were identified with the assistance of State and local law enforcement agencies, State highway safety agencies, and other organizations, including Physicians for Automotive Safety, the American Academy of Pediatrics, the American Association for Automotive Medicine, the National Child Passenger Safety Association and some of its State and local chapters, the Highway Safety Research Center of the University of North Carolina, the University of Michigan Transportation Research Institute, the Rehabilitation Institute of Chicago, the National Safety Council and some State and local safety councils, and some of the National Accident Sampling System teams of the National Center for Statistics and Analysis of the National Highway Traffic Safety Administration, U.S. Department of Transportation. On December 7, 1982, based on the preliminary results of its initial investigations, the Safety Board issued Safety Recommendations H-92-59 and -60 to the Governors or Governors-elect of 31 States and the Mayor of the District of Columbia. (See appendix A.) Safety Recommendation H-82-59 urged the adoption of child passenger protection laws requiring the proper use of child safety seats, and Safety Recommendation H-82-60 urged the adoption of comprehensive, statewide child passenger safety programs. When the recommendations were issued, 19 States had passed child passenger protection laws requiring safety seat use. In the next 7 months, 22 more laws were enacted, bringing the nationwide total to 41 child passenger protection laws in 40 States and the District of Columbia. (Additionally, Pennsylvania enacted a law on November 1, 1983. Data hereinafter do not reflect this additional law.) In early 1983, the Safety Board held regional public hearings in Dallas (January 13, 1983), Philadelphia (February 4, 1983), and St. Louis, (March 24, 1983), on the problem of child passenger safety. The hearings were held to gather information for the public record and to increase public awareness of the problem of child motor vehicle deaths and injuries and the importance of proper child passenger protection. Testimony was received from 54 witnesses, Including families of children involved in crashes, accident investigators and law enforcement officials, pediatricians and other medical personnel, highway safety and accident prevention specialists, and State legislators. (See appendix B.) This report presents the findings and recommendations of the Safety Board's child passenger protection study. The report presents investigative results; illustrates the problem of deaths and injuries of infants and small children in motor vehicle accidents and the benefits of proper use of child safety seats; identifies misuse of child safety seats as A significant problem in accidents; Identifies other problems and issues developed in the accident investigations; identifies a need for improvements In child passenger safety laws and programs; identifies elements for inclusion in an effective child passenger protection law; and includes further recommendations to reduce child passenger fatalities and injuries.
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