Child Restraint Systems in Side Impact Crashes: Injury Patterns and Causation (Multiple Year Project)

Principal Investigator: Kristy Arbogast, PhD, Children's Hospital of Philadelphia

This study proposes to delineate injury causation scenarios for rear-seated, CRS-restrained children in side-impact crashes and create a contact map for each vehicle interior involved.

The objective of this study is to further understand side impact protection for child restraints through an analysis of the structural interaction between the child restraint system and the vehicle. 

Below is an executive summary of this line of research. Please note that each summary describes results and interpretation that may not be final. Final interpretation of results will be in the peer-reviewed literature.

childrestraintsystem

Although side impact crashes account for only 25 percent of all motor vehicle crashes (MVCs), they represent more than 40 percent of all MVC-related injury costs. Due to this fact, increased attention has been placed on better protecting children in child restraint systems (CRS). The aim of this study was to delineate injury causation scenarios for children placed in CRS involved in side-impact MVCs and to document probable contact points in the vehicle interior.

2009-2010

Two in-depth crash investigation databases, the Crash Injury Research and Engineering Network and the Partners for Child Passenger Safety Study, were queried for rear-seated, CRS-restrained children ages 0 to 8 in side impact crashes who sustained Abbreviated Injury Scale 2+ injury. These cases were reviewed by a multidisciplinary team of physicians and engineers to describe injury patterns, injury causation, and vehicle components contributing to the injuries; 41 occupants met the inclusion criteria (average age 2.6 years), with 24 seated near the side of the crash, 7 seated on the far side, and 10 seated in the center. The most common injuries were to the skull and brain, with a greater proportion of skull fractures occurring in older children. Lung contusions and spinal injuries were also reported.

Near-side head and face contact points were along the rear vertical plane of the window and the horizontal plane of the windowsill. Head and face contact points for center- and far-side occupants were along the edges of the front seat back and front seat head restraint.

These findings have implications for the future design of child restraints with side wings and energy management features on vehicle door interiors to reduce injuries from MVCs involving children placed in CRS.

2008-2009

The researchers identified the causes of clinically significant injury (an injury which scored 2 or greater on the Abbreviated Injury Scale) in children seated in a rear-facing CSS, forward-facing CSS, or booster, all in the rear of vehicles. The multidisciplinary team of physicians and engineers reviewed 41 case studies from the Crash Injury Research and Engineering Network (CIREN) and Partners for Child Passenger Safety (PCPS) databases to determine how the injuries occurred and what vehicle components may have directly or indirectly contributed. Probable contact points were transferred to generic vehicle interior diagrams to provide a visual representation of interactions that may cause injury.

The researchers found that the most common injuries occurred to the skull and brain, with a growing proportion of fractures to the skull occuring with increased child age. The children also suffered several lung contusions but no rib fractures, noticeably different than the experience of adult crash victims who commonly fracture their ribs in similar crashes. Occupants seated on the side of the impact (“near- side”) typically experienced head and face contact along the rear vertical plane of the window and the horizontal plane of the windowsill. Occupants seated in the center or side of the vehicle away from the crash (“far-side”) typically experienced impact along the edges of the front seat back and front seat head restraint closest to the side of the crash.

A growing body of research is investigating ways to prevent head injury in children in child-restrained systems who were passengers in side impact crashes. This study adds to this useful knowledge to help scientists and industry develop both educational and technological interventions to reduce the burden of injury to restrained children in side impact crashes.

IAB Mentors

Pankaj Amesar, formerly with Britax (Year 2); Uwe Meissner, Volkswagen (Year 2); Rajiv Menon, Dorel (Year 2); Stephen Oltman, Dorel (Year 2); Hiromasa Tanji, Takata (Year 2); Steve Ridella, National Highway Traffic Safety Administration (Year 1)