Child-safety seats have lifesaving potential
That is, Berkeley researchers say, if adults would learn how to use them

By Sarah Yang, Public Affairs

25 September 2002 | A new study of adult drivers and their child passengers conducted by Berkeley researchers found that most of the children were not properly restrained in child-safety seats. Moreover, it reveals that a significant number of children were not secured at all.

The study, released on Tuesday by the campus’s Traffic Safety Center, was conducted to collect baseline data on child-safety-seat use as part of a larger child-passenger-safety initiative at several public hospitals and health-care systems in California.

Researchers surveyed 515 adults who were leaving a public hospital or clinic in California for the first time with a new baby, or who were coming to the hospital or clinic for routine pediatric exams for children ages six and under. They then accompanied the adults to their cars to observe how they secured the children in child-safety seats. In all, researchers observed 463 children from October 2001 to June 2002.

Among their findings:
• Fourteen percent of children observed were not secured at all in a child-safety seat.

• Eighty-four percent of adults surveyed reported knowledge of a new state law that specifies the use of booster seats for children ages four to six, or who weigh between 40 and 60 pounds. However, only 54 percent reported using booster seats consistently.

• Even when children were secured in a car safety or booster seat appropriate for their age and weight, there were other significant errors in how the children were restrained, including: not positioning the harness clip at the child’s armpit level (62 percent), not securing the safety seat tightly enough to the vehicle by the safety belt (69 percent), and not fastening the harness strap tightly enough (60 percent).

The percentage of children using a child-safety seat in this study is in line with results from statewide surveys. The rate of child-safety seat misuse in the study also closely mirrors national statistics, which show that four out of five such seats are used incorrectly.

“It is clear from this survey that there is more need for training and resources for helping people keep children safe as passengers,” says David Ragland, adjunct professor of epidemiology at UC Berkeley’s School of Public Health, director of UC Berkeley’s Traffic Safety Center and co-author of the report. “Parents and caregivers are having a hard time figuring out how to correctly use child-safety seats. This report shows where the gaps in knowledge are.”

Educating low-income families is essential
Through the initiative, seven public hospitals and health systems in California are establishing child-passenger-safety education efforts that specifically address the needs of underserved populations, such as low-income families, people of color, and non-English speakers.

“Prior studies have shown that the majority of patients in public hospitals have certain barriers to using child-safety seats properly,” says Jill Cooper, program manager of Berkeley’s Traffic Safety Center and lead author of the report. “Child-safety seats can be expensive, especially for low-income people. People who don’t speak English may also face barriers to information about their proper use.”

“Patients treated at public hospitals are primarily low-income people of color,” adds Wendy Jameson, director of the California Health Care Safety Net Institute and co-author of the report. “We felt that the health-care system would be a natural vehicle to reach populations who may otherwise not have opportunities to learn about child passenger safety.” According to figures from the California Association of Public Hospitals and Health Systems, 76 percent of the patients in the state’s public hospitals are people of color, and 70 percent are low-income or uninsured.

The initiative to improve child-passenger safety includes parent education, training programs for pediatric-health-care providers to counsel parents and caregivers, distributing free or low-cost car seats to low-income families, and providing car-seat check-ups to parents.

In 1999, as many as 3,000 children who had been injured in motor-vehicle collisions were treated at California’s public hospitals. Statewide in 2000, 7,473 passengers ages six and under were injured, and 75 child passengers died from motor-vehicle crashes and collisions. More than half of the children who died were not restrained.

Most new cars sold in the United States are now equipped with a restraint system that makes it easier for parents to properly install child-safety seats. The system, known as LATCH (Lower Anchors and Tethers for Children), was designed and tested by the National Highway Traffic Safety Administration. As of Sept. 1, new child-safety seats, with the exception of booster seats, have to be compatible with the LATCH system.

The Berkeley Traffic Safety Center will release a final report late next summer to determine whether the initiative made a difference in knowledge and correct usage of child-passenger safety restraints.