03:18pm Thursday 14 December 2017

U-M study finds 78 percent of drivers admit to driving with child in improperly fitting seatbelt, creating risk for injury

Though no state laws currently require children older than eight years old to use booster seats in the car, a new study shows that more than half of these children would benefit from using one.

According to the University of Michigan report, 78 percent of drivers admit that on most trips, their child passengers ride with an improperly fitting seat belt, a potentially deadly action that can easily be solved when children use a belt positioning booster seat.

The study, which surveyed 891 drivers, found that many people rely solely on seat belts to protect 4- to 9-year-old passengers, despite the fact that most children in this age range are too short to fit in vehicle seat belts that are designed for adults.

Survey data was obtained from the Motor Vehicle Occupant Safety Survey conducted by the National Highway Traffic Safety Administration in 2007. Results are available online today ahead of print in Academic Pediatrics.

Placing a child in an adult seat belt prematurely can cause shoulder and lap belts to fit improperly, researchers warn.

According to the Insurance Institute for Highway Safety (IIHS), shoulder belts should fit across the middle of the child’s shoulder, not touching their neck. Lap belts should lie flat on top of the thighs, not higher up on the abdomen. Click here to see the IIHS’ recommendations.

“It’s alarming that over 70 percent of drivers admitted that their child’s belt did not meet these standards,” says Michelle Macy, M.D., M.S., a clinical lecturer of emergency medicine at the University of Michigan Medical School and a pediatrician at U-M C.S. Mott Children’s Hospital. “Many parents may not even be aware of proper seat belt positioning and may not understand the serious and potentially permanent injuries that can result from improper belt fit.”

A child’s height is a better indicator than age for when they can be transitioned from a booster seat to seat belt, Macy says. Children should be at least 57 inches in height before they stop using a booster seat.

“Fifty-seven inches is the average height of an 11 year old,” says Macy, the lead author of the study. “Those parents relying on a seat belt to protect children under nine years-old are jumping the gun by two or more years.”

Even at age 9, many children’s thighs are too short to sit in most vehicle seats without slumping, leading to poor lap belt fit. They’re often irritated by the shoulder belt rubbing their neck, and will put the belt behind their back or arm, negating the safety benefits of the shoulder belt.

Pediatricians can play a significant role in making parents aware of the dangers of improper seat belt fit. Demonstrating proper fit during regular doctor’s appointments through visual cues near growth charts and in waiting areas may also be beneficial, the study suggests.

“Clinicians really need to emphasize the 57-inch mark,” says Macy. “Whether it requires creating a special mark on the growth scale or providing handouts to parents, we need to ensure parents are aware that children must reach this benchmark before they can graduate from using a booster seat.”

For the full Academic Pediatrics article, please click here.

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Additional Resources:
Insurance Institute of Highway Safety recommendations for proper seat belt fit.
Insurance Institute for Highway Safety recommended booster seats

Citation: doi: 10.1016/j.acap.2011.08.009

Additional authors: Matthew P. Reed, Ph.D., Gary L. Freed, M.D., M.P.H.

Disclosures: None

About C.S. Mott Children’s Hospital:
The University of Michigan C.S. Mott Children’s Hospital is consistently ranked as one of the best hospitals in the country. It was nationally ranked in all ten pediatric specialties in the U.S. News Media Group’s 2011 edition of “America’s Best Children’s Hospitals” including third in the country for heart and heart surgery. In December, the hospital moves to a new 1.1 million square feet, $754 million state-of-the-art facility that will be home to cutting-edge specialty services for newborns, children and women.

Media Contacts      Lauren McLeod: lemcleod@umich.edu 734-764-2220


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