MONDAY, Nov. 6, 2006 (HealthDay News) -- The number of American kids injured in nonfatal school bus accidents each year is between double and triple previous estimates, a new study finds.
Among the nation's 23.5 million children and teens under the age of 19 who currently ride school buses, roughly 17,000 head to hospital emergency rooms each year because of injuries sustained either while riding or getting on or off a school bus, the researchers report.
"This number is huge," said study lead author Jennifer McGeehan, a researcher at the Center for Innovation in Pediatric Practice with the Columbus Children's Research Institute at Columbus Children's Hospital in Ohio. "And it means these injuries are occurring much more frequently than previously thought, and parents need to be aware of that."
The study tally far exceeds the 6,000 school bus injuries figure cited by the preeminent nonprofit independent federal advisory group, the Transportation Research Board (TRB). It's also twice as many as the 8,500 injuries cited by the federal National Highway Traffic Safety Administration (NHTSA).
In the study, McGeehan and her team reviewed statistics on children under the age of 19 who were injured in a bus-related accident between 2001 and 2003. All of these children were treated at an emergency room in one of 99 hospitals across the U.S.
The information was collected by the U.S. Consumer Product Safety Commission as part of its routine surveillance system, in effect since 1978.
Nonfatal ER-treated bus-related injuries were included if the patient had been riding on a bus, getting on or off a bus, or standing near a bus when they experienced an accident.
The authors point out that, unlike prior TRB efforts looking at injuries during the September-through-June academic term, the current study included injuries sustained over a full 12-month year.
The research team found approximately 51,000 children had been treated during the study period, averaging about 17,000 per year.
Accidents were split almost evenly between boys and girls, and nearly all the patients were treated and released from the hospitals they attended. A little more than 46 percent of the patients were white and about 28 percent were black.
A large proportion of injuries, more than 42 percent, resulted from car crashes. About 24 percent of injuries occurred while children and teens were getting on or off a bus.
The highest injury rate was observed among the 11-to-14-year-old group, which accounted for 43 percent of all injuries. Lower-extremity injuries were the most common type of injury among this group and older teens.
The next most-injured segment was the 5-to-9-year-old group. In this group, head injuries accounted for more than half of all injuries. Teens aged 15 to 19 years old were slightly less prone to experiencing an accident than the youngest group.
Among all the patients, strains and sprains were the most commonly encountered injury. This was followed in frequency by contusions and abrasions in more than 28 percent of cases, and lacerations (mostly to the head) in 15 percent of cases.
The authors emphasized that, since they focused only on patients who attended an ER after their accident, the high injury rate might still miss many incidents. Children who went untreated or were treated by their parents, school doctors or pediatricians were not incorporated into the final totals.
Based on the high numbers, the researchers believe that children would benefit from the presence of a second adult on the bus -- in addition to the driver -- who would be dedicated solely to supervising children.
And what about seatbelts? School buses typically do not require passengers to buckle up. The researchers said they could draw no firm conclusions on their potential benefit based on the current data.
However, they called for further research and statistical analysis on the subject, and said they supported the idea of including seat belts on buses.
"We absolutely advocate for the addition of safety belts to new school buses at a minimum," said McGeehan. "If I had children riding a bus I would personally want them in restraints."
"We do know that school buses still are one of the safest modes of travel," McGeehan added. "So we aren't saying school buses are dangerous. But we think they may be providing incomplete protection that might not safeguard kids in the case of lateral crashes or rollover crashes."
Terry Williams, a spokesman for the Washington-D.C.-based National Transportation Safety Board, said his group declined to comment on the new study.
However, Alan Ross, president of the nonprofit National Coalition for School Bus Safety in Torrington, Conn., strongly agreed that school bus safety belts are long overdue.
"In this day and age for these vehicles to lack that additional protection is ridiculous," said Ross. "It's just common sense. And today the kids coming to us in kindergarten are already pre-trained from riding in their parents' car, so they can buckle and unbuckle faster than I can."
This new data also point to the need for a major overhaul of school buses and school bus safety, he said.
"The school bus is a vehicle that has basically not been redesigned, with the exception of some added seat padding, in over 40 years, so we're dealing with a 40-year-old antique in terms of its body, its being prone to rollover, and its lack of traction control," Ross said. "They also allow the use of very flammable urethane material in the seating that is now barred from use in cars, boats and planes; there are inadequate emergency exits; and a poor two-way communication system between drivers and the outside world. All of these things need to be addressed."
More information
Theres more on school bus injury at the National Coalition for School Bus Safety.
