Analysis of Injury Potential of Three-year-old Child Occupants Caused by Inappropriate Installation of Enhanced Child Restraint System with Top Tether in Frontal Crash Accidents

Objective: Frontal crash accidents remain a significant factor in causing the preventable injury and fatality for child occupants aged 3 in China. Despite the increased public awareness and utilization of child restraint system (CRS), inappropriate installations still exist and lead to a potential to result in injuries of head, thorax and abdomen regions of child occupants, especially when it comes to enhanced child restraint system (ECRS) with top tether. The current study focuses on the influence of top tether upon safety performance of ECRS with top tether in dynamic tests with different set-ups and explores the relationship between inappropriate installation of ECRS with top tether and the injury potential of child occupants aged 3 in a frontal crash. Methods: A testing scheme including 4 dynamic tests was devised to ascertain the extent to which the top tether affected the accelerations of thorax, the abdominal penetration and the head displacements. Different kinds of acceleration curves were employed to conduct the tests and to simulate the real status and situation of child occupants aged 3 in the CRS installed with top tether and without top tether respectively. Parameters of accelerations, abdominal penetrations, and head displacements were measured to analyze quantitatively the influence of inappropriate installations of ECRS with top tether under different conditions. Results: The safety performance of ECRS with the use of top tether was found better than that of ECRS without the use of top tether either in the normal condition or in the extreme condition. The test using the acceleration curves defined by regulations, the accelerations of thorax, abdominal penetrations, and head displacements of P3 manikin in the ECRS with the top tether connected to the anchor point revealed results that all met the requirements. While in the test using acceleration curves of the same kind, and when the top tether was not connected, the parameters measured displayed that the safety performance of the sample was worse than the former one. As for the tests using the more severe acceleration curves defined at will, it was more obvious that top tether could affect the function and safety performance of ECRS greatly, and the functional failure and severe damages occurred to the ECRS without the use of top tether. ECRS with the use of top tether was partly qualified even under the more severe conditions. Conclusions: Inappropriate installation of ECRS such as omitting the step of connecting top tether to anchor point could cause severe injuries and fatalities in frontal crash accidents. Effective measures should be taken to minimize the chances of inappropriate installations of ECRS.

The rate of child restraint system use among children aged under six years in China

Aims: The child restraint system (CRS) for vehicles is designed to provide specialized protection for children in the event of a crash. The aim of the study was to investigate the rate of CRS use and analyze the factors associated with CRS use among children aged under six years in China, and to provide further insight into developing strategies for promoting public health education. Methods: This is a cross-sectional study. The study sites were 36 primary healthcare institutions in 12 provinces across China, and the participants were 34,503 guardians of children aged 0–6 years. Guardians who owned private cars were included and completed surveys about their experience using CRS. Odds ratios and 95% confidence intervals were calculated using multivariate logistic regression models. Results: The overall rate of CRS use among children aged under six years in China was 17.3%. Multivariate logistic regression analysis revealed that living in an urban area, low age of the child, guardians having higher education and being looked after by parents had a significant positive association with CRS use among children aged under six years. Conclusions: This study confirms that there is a low rate of CRS use among children aged under six years in China, highlighting the considerable need for CRS use education, advocacy and promotion of increasing use.

Systematic review of child passenger safety laws and their associations with child restraint system use, injuries and deaths

Background and objectiveMany countries and all US states have legislation that mandates how children of certain ages and/or sizes should be restrained in vehicles. The objective of the current systematic review was to describe the associations between legislation and three outcomes: child restraint system use, correct child restraint system use and child passenger injuries/deaths.MethodsIncluded studies were published between 2004 and 2020 and evaluated associations between child passenger safety laws and the outcomes described above. Three literature searches using three search terms (child passenger safety, car seat use, booster seat use) were completed in PubMed and PsycINFO, with the last search occurring in January 2021. Studies are presented based on the outcome(s) they evaluated. The original protocol for this review is registered with PROSPERO (ID: CRD42019149682).ResultsEighteen studies from five different countries evaluating a variety of different types of legislation were included. Overall, positive associations between legislation and the three outcomes were reported. However, there were important nuances across studies, including negative associations between booster seat legislation and correct child restraint use. Further, there were also negative associations between various types of legislation and outcomes for populations with less formal education and lower incomes, and for racial and ethnic minorities.ConclusionOverall, child passenger safety legislation appears to be positively associated with child restraint system use, correct child restraint use and child passenger injuries/deaths. However, there is a need to more comprehensively characterise how different types of legislation influence child passenger safety outcomes to promote equitable effects across populations.

Rideshare use among parents and their children

Motor vehicle crashes are the leading cause of death for young children. Millions of ridesharing trips are taken each day, and use of these services is predicted to increase. Therefore, it is important to examine the safety of children in these vehicles. We conducted a survey of a nationally representative sample of U.S. adults aged 18 years or older (N = 2017). Of the total sample, 450 respondents reported being a parent or legal guardian of children below the age of 10. Of these, 307 or 68% had ever used ridesharing. Among those who had used ridesharing, a total of 253 or 82% reported using ridesharing with their children below the age of 10 years. Among this group, rideshare use was significantly higher among individuals with college education, and in higher income households. Given that the majority of U.S. states have legislation exempting rideshare vehicles from child restraint system law coverage, our finding of high rates of rideshare use among parents suggests that a large number of children could be at risk of injury due to a lack of appropriate restraint use.

Laboratory studies of the influence of the working position of the passenger vehicle air suspension on the vibration comfort of children transported in the child restraint system

The article presents the results of laboratory tests on the influence of the choice of the vehicle suspension position and the method of mounting child seats on the vibration comfort of children transported in them. Two child seats were used in the work. The B seat was attached to the vehicle with the ISOfix system, while the A seat was attached in the classic way (with seat belts). During the tests, the values of vertical vibrations were recorded on the seats of child seats, the rear seat of the vehicle and on the basis of ISOfix. The analyzed systems, depending on the method of mounting a child seat, may be characterized by two different vibration transmission chains. They depend on the method of fixing the child seat (the classic way of fixing the seat and the ISOFIX system). The article presents the results of empirical tests carried out at the EUSAMA SA.640 stand, which in these tests acted as a vibration generator with a frequency of 0 to 25 Hz. The analysis of the obtained results confirmed the observations published in previous articles about the negative impact of the use of the ISOfix base on the vibrational comfort of children.