TUESDAY, April 6, 2004 (HealthDayNews) -- People take pains to learn how to use their computers, their DVD players and the rest of their high-tech gadgetry.
So why are they so apparently indifferent when it comes to simple devices that can protect their children from injury and death in cars?
Child safety restraints are proven to save lives and reduce the risk of harm in crashes. But parents continue to install and use them improperly. Earlier this year, U.S. transportation officials reported that nearly three in four child safety restraints are used incorrectly, greatly raising young passengers' risk of serious or deadly harm in a wreck.
"Child safety seats are very effective when used properly," Dr. Jeffrey W. Runge, administrator of the National Highway Traffic Safety Administration (NHTSA), says in a statement about the findings. "Parents and caregivers should take time to understand how to better protect children of all ages."
That's a message safety experts hope to spread on April 7, World Health Day 2004. The day's theme: Road safety.
The good news, officials say, is that overall child safety restraint use is rising, up 50 percent since the mid-1990s among children who weigh 60 pounds or less. However, nearly 12 percent of children remain unrestrained while riding in a motor vehicle.
Rae Tyson, a NHTSA spokesman, says parents of newborns seem to be clear on the proper way to install safety seats and how their infants should ride in them. But something happens as the children grow larger.
"When the confusion and the parental diligence drops off is when the child starts to get a little older, when they move from rear-facing to front-facing seats, and when they should move to a booster seat," Tyson says. Many parents apparently skip the booster seat stage and start buckling their children into belts designed for adults.
"That's not a good thing," Tyson says. "Children at that age are not ready to use an adult restraint."
To review:
The American Academy of Pediatrics calls for children under 1 year of age and/or 20 pounds to ride in rear-facing seats designed specifically for infants or that can be converted for infant use. Older children can ride facing forward, as long as their seats are anchored by the vehicle's three-point safety straps.
The NHTSA recommends that children between the ages of 4 and 8 years use a booster seat, unless they are at least 57 inches (4 feet, 9 inches). These seats face forward and should be held in place by both lap and shoulder belts. The lap belt should sit low and tight across the lap and upper thighs, while the shoulder belt should be snug across the chest and shoulder to avoid abdominal injuries.
Children age 12 and under should never ride in the front seat, the agency advises.
Psychologist David Eby, a University of Michigan researcher who studies safety restraint use, says belting a child who should be in a booster seat raises the risk of serious injury in a crash threefold, and quadruples the risk of a serious head injury.
"The whole idea of a booster seat is that the child isn't big enough to fit into an adult belt. It helps the belt fit properly, and when it doesn't, the belt causes injuries."
Lap belts are designed to lie over the hip bones. But on small children not in a booster seat, the belts fit over the soft tissue and organs of the abdomen. "During the crash you have no bony structure but the spine" to absorb the forces of impact, he says.
Adding to the confusion, not all booster seats are equal. For a time, manufacturers produced seats with a "shield" bar intended to provide an extra measure of safety. But Ebel says these devices are less safe than conventional booster seats for two reasons: They're harder to install and children can hit the shield or their knees with their head.
"To me [installing a shield booster] is considered a misuse" of the devices. "It's important for parents to understand that," says Eby, who is launching a study of booster seat use, and misuse, in Michigan that he hopes will identify the reasons parents have so much trouble with child safety restraints.
If you don't trust yourself to properly install a child safety seat, or you want to make sure you've done it right, take your car to an expert. Try car dealers, police and fire stations, or insurance agencies. "There are clinics going on all the time," Tyson says.
More information
The National Highway Traffic Safety Administration's guidelines for proper child restraints can be found on the agency's Web site. You can also try the National Safety Belt Coalition.
