A small child driving a motorcycle without a helmet in heavy traffic

In related news: nearly 300 Indians die daily on roads.

Motor vehicle crashes are the leading cause of death for children older than age 2. A total of 1,045 children younger than age 13 died in motor vehicle crashes in 2008; nearly 700 of these deaths were children riding in passenger vehicles. The number of child passenger deaths has declined by half since 1975. The rate of child passenger deaths per million children also has fallen dramatically, reaching a record low of 13 deaths per million children in 2008. Proper restraint use can help reduce deaths even more. The proportion of fatally injured children who were restrained rose from 15 percent in 1985 to 50 percent in 2008. Still, more than 260 fatally injured child occupants were unrestrained in 2008, and others were improperly restrained.

…it is still strange to hear that only 50% of fatally injured children in 2008 were in a child restraint of some kind.

Among the questions answered are “Are children safer in the rear seats?” (Yes) and “Which type of child safety seat should I use for my child?”.

The project will be tested in four sites in Europe, including North (Sweden), Central (Austria), South (Italy) and Eastern (Poland) Europe; to evaluate their usability, efficiency, user acceptance and market viability; taking into account the very different children’s transportation to/from school systems across the different European regions as well as key cultural and socio-economic aspects.

The project starts 1 of September 2009 and is scheduled to end in August 2012. For more information see the website http://safeway2school.eu/

The effect of a helmet on head injury

Wearing a helmet considerably reduces the risk of head injury in a crash. In the early 1980′s researchers Huijbers and Van Kampen estimated the effect of wearing a helmet: the risk of being killed was 40% lower and that of severe injury went down with 30%.

More recent studies confirm this positive effect. For example, an Italian study among scooter riders from 2003 showed that after helmet use was made compulsory, the risk of head trauma was three to four times smaller. A WHO study from 2006 states that the risk of head injury and its severity is 72% less when wearing a helmet.

This, obviously, requires the helmet to be worn correctly.

Types of helmets

There are mainly three types of helmets today:

1. the integral helmet: this is a helmet that completely encloses the entire head and is equipped with a fixed jaw guard.
2. the jet helmet; this helmet does not have a jaw guard but only a usually hinged visor in front.
3. the system helmet; this is an integral helmet with a hinged jaw guard.

Studies have been carried out of any differences in effectiveness between the various helmet types, particularly the integral helmet and the jet helmet. It is clear that an integral helmet with a fixed jaw guard considerably reduces the risk of chin and facial injury. The jet helmet lacks this protection. This should be considered when choosing a helmet.

Does helmet color matter? According to a study by Wells et al. (2004), the color of the helmet can be important in preventing crashes. Wearers of a white helmet even have a 24% lower crash rate than those wearing a black helmet. The increased visibility makes motorcycle riders easy to spot by other trafficants.

For more information see information from the Dutch Institute for road safety research, SWOV.

The three collisions in a crash

When a crash occurs, a car occupant without a seat-belt will continue to move at the same speed at which the vehicle was travelling before the collision and will be catapulted forward into the structure of the vehicle – most likely into the steering wheel if they are driving, or into the back of the front seats if they are rear seat passengers.

There are three collisions that occur in every crash where a person isn’t wearing a seat-belt. The first collision involves the vehicle and another object, e.g. another vehicle, tree, signpost, ditch or or animal. The second collision occurs between the unbelted person and the vehicle interior, e.g. the driver hits his chest on the steering wheel or his head on the window. Finally, the third collision occurs when the internal organs of the body hit the chest wall or the skeleton. It is the second collision that is most responsible for injuries, and can be reduced significantly by the use of seat-belts and child restraints. The most serious injuries in a car crash are to the head, followed by the chest and the abdomen.

Seat-belts to the rescue

The use of seat-belts and child restraints is one of the most important actions that can be taken to prevent serious injury in a car  crash. While seat-belts and child restraints do not prevent crashes from taking place, they play a major role in reducing the severity of injury to vehicle occupants involved in a collision. An occupant’s chance of survival increases dramatically when appropriately restrained.

Since the 1960s studies  throughout the world have shown that seat-belts save lives.  A review of research on the effectiveness of seat-belts found that their use reduces the probability of being killed by 40–50% for drivers and front seat passengers and by about 25% for passengers in rear seats. The impact on serious injuries is almost as great, while the effect on slight injuries is smaller at 20–30%.

Therefore, the Swedish National Road and Transport Research Institute, VTI, together with the Swedish National Society for Road Safety, NTF has developed an additional standard that tests how force to the neck is handled in accident situations. The standard will be called “Plus test” and will be voluntary as an addition to the European E-standard.

In Sweden there was a previous testing standard for car seats called the T-standard, but it had to be removed due European competition regulations (sounds like “you’re standard is too strict, other European manufacturers can’t enter the market, please lower them”).

In my, (and other people’s) experience, when you look for a car seat, safety is the most important factor. The plus-standard is a welcome addition to the previous tests. Car seats that passed the test will be allowed to use the following sticker on their products:

The plus test has been developed in cooperation between insurance companies, Volvo, the research organizations mentioned above and manufacturers of car seats. More information at the (auto translated) page on ntf.se.

The seats that performed best were (with the highest score first):

1. Maxi Cosi Cabriofix + Easyfix base
2. Britax Römer Babysafe Plus + Isofixbas
3. Volvo Baby seat, Isofix
4. Acta Graco Logico S
5. Brio Primo + bas installed with Isofix
6. Britax Römer BabySafe Plus + bas
7. Recaro Young Profi Plus + Isofix bas
8. Britax Römer BabySafe Sleeper
9. Peg Perego Primo Viaggio Tri-Fix
10. Akta Graco Logico S + bas

The worst performers were these (with the lowest score first):

1. Recaro Start
2. Emmaljunga First Class 0+ bas
3. Emmaljunga First Class 0+ isofixbas
4. Brio Zento
5. Recaro Polaric

Videos of the Emmaljunga tests can be viewed here (page in swedish). This shows the importance of making sure the car seat is properly installed. In the first video you can see how the seat and child is thrown forward.

After the test was performed the manufacturer of the Emmaljunga seats have improved he construction and offered consumers a free upgrade of older seats.

In the 1980s there were many studies that showed that up to half of all child seats were partially or completely installed in the wrong way. At the same time child safety was beginning to gain momentum in the car industry. The idea of creating a simple and well defined interface for child restraints in cars was born in Sweden and swedish car manufacturers together with research institutions formed an ISO committee to develop the standard. The development was completed in 1996 and was named ISOFIX. The same year the Volkswagen group decided to introduce ISOFIX in the entire range.

The system is known as LATCH, Lower Anchors and Tethers for Children, in the United States and LUAS, Lower Universal Anchorage System, in Canada. It has also been called the “Universal Child Safety Seat System”.

Most cars sold in Europe today come with ISOFIX mounts installed by default and they are very simple to use. It is also very easy to find child restraints/seats that use ISOFIX. The only problem is that ISOFIX mounts can’t be used for children above 18 Kg which means you will have to fit the child restraint the ordinary way if you intend to have them rearward-facing up to 4 years of age or longer.

What is the situation like in your country? Is it easy to find cars and seats that use ISOFIX?

Here is one video that explains the danger and risk of serious injury if you are using a forward-facing child restraint:

There are other benefits as well:

• The front seat provides more leg room. This makes it possible to use a rearward-facing car seat for up to a year longer.
• Less distraction for the driver. A test showed that when placing infants in the back seat drivers were distracted much more often than when placing them in the front seat.

Read more at the Folksam website: Child safety tips (automatically translated from swedish).