|
Response to the Freakonomics study
Unfortunately, many parents have mistakenly put their trust in the economists Steven Levitt & Stephen Dubner, co-authors of the popular book Freakonomics, rather than following the advice of pediatricians and the medical community when it comes to protecting their children in the car. In 2005 the Freakonomics authors wrote an article in the NYTimes Magazine entitled "The Seat-Belt Solution" which came to the sensational conclusion that "there is no evidence that car seats do a better job than seat belts in saving the lives of children older than 2." But fatalities are just the tip of the iceberg; for every death there are 19 injuries requiring hospitalization (some leading to permanent disability) and 300 requiring medical attention.While Dubner & Levitt have "softened" their stance over the past 5 years to say that "car seats are a little better..." than seat belts and advised parents "don't throw out the car seats" The Car Seat Ladies feel like the damage has been done - and we want to try and undo it by providing you with the whole story. More people heard and remember the sensational message than Freakonomics' weak efforts to bring their message more in line with what we know to be best practice. Therefore, we at The Car Seat Lady want to provide you with the evidence so that you can come to your own conclusions and make the best decisions regarding your child's safety. As an interesting side note, both Dubner & Levitt admit to using car seats and boosters for their own children beyond the age of 2; they are willing to endanger the lives of other people's children to sell their books, but aren't willing to make their own children be the guinea pigs for their own misguided hypothesis.
Dr Dennis Durbin & Dr Flaura Winston are pediatricians at the Children's Hospital of Philadelphia and co-principal investigators for the Partners for Child Passenger Safety study, which is the largest study ever done of children in crashes. Data from this ongoing study has led to the publication of dozens of papers in some of the most highly regarded peer-reviewed medical journals including JAMA, Pediatrics, Archives of Pediatrics, Journal of Trauma, and Injury Prevention.
Drs Durbin & Winston wrote a letter to the editor in response to the 2005 NYTimes article.
"As pediatricians, scientists and leaders of the world's largest study on children in crashes, we think that overinterpretation of findings from a single source of data led Stephen J. Dubner and Steven D. Levitt (July 10) to claim that child safety seats are no more effective than seat belts for 2- to 6-year-olds. They examined children in fatal crashes (about 1,200 per year) while ignoring the equally informative data on those in nonfatal crashes (450,000 per year). Our research, which includes over 25,000 in-depth interviews and over 800 crash investigations, consistently shows that child safety seats and booster seats significantly lower the risk of serious injury compared to seat belts alone. Their conclusions stand in stark contrast to the existing body of scientific data that support current child restraint recommendations, and are, in our opinion, irresponsible and dangerous. Learn the facts at www.chop.edu/carseat. We hope that this misleading article does not cost a child his life."
In August 2008 Dubner & Levitt published their study concluding that seat belts are equally effective as child restraints for kids 2-6 in the journal Economic Inquiry. Refuting it, a 2009 article from the Partners for Child Passenger Safety study published in Pediatrics showed that 4-8 year olds using boosters seats were 55% less likely to be injured in a crash than 4-8 year olds wearing seat belts alone - or said another way, for every 100 children injured in a crash wearing only a seat belt, 55 of them would have been injury-free if they'd been in a booster seat.
The Car Seat Lady feels that car seats (with a 5 point harness) are the best protection for kids until they are at least 4 years old AND at least 40 pounds and that boosters are the best protection for school age children until the vehicle's seat belt fits them properly without the booster (i.e. when they can pass the 5-step test).
UPDATE (18 Jan 2007): Consumer Reports has issued a retraction of their article rating Infant Car Seats: CONSUMER REPORTS WITHDRAWS INFANT CAR SEAT REPORT
Many of you have likely heard about the recent Consumer Reports article article "Safety Alert: What if this were your child?" (Consumer Reports, February 2007) In this report, Consumer Reports (CR) claims that most infant car seats on the American market fail to protect children in side impact crashes. The Car Seat Ladies question the scientific validity of CR’s conclusions. Amongst the 3 Car Seat Ladies (Debbi, Alisa, and Emily) we have installed at least 20,000 car seats over the past nearly 20 years. Our experience indicates that car seats, especially when used properly, are extremely effective at preventing injury and death - in even the worst of crashes. We have seen first hand numerous of "our babies" (those whose seats we helped their parents install) come away from highway speed crashes involving severe rollovers without even a bruise. Were the infant seats as unsafe as Consumer Reports purports, we would have seen this reflected in real-world experience -- but, we haven't.
We feel that the current frontal crash test mandated by NHTSA (National Highway Traffic Safety Administration) is adequate – since it is more severe than approximately 98% of recorded frontal impact crashes nationwide.
We support side-impact testing of car seats, which is currently not required in the U.S. However, we feel that the CR test at 38mph is likely not the best test; in Australia the side-impact test for car seats is performed at 20mph. Redesigning the seats to pass the 38 mph CR side-impact test may not make seats safer in real-world crashes—and may even make the situation worse. Both NHTSA and the University of Michigan Traffic Research Institute agree that the design changes necessary to meet a higher crash speed may lead to the production of seats that are less effective in lower speed collisions – which are the most frequent type of crashes – and/or are more difficult to properly install, leading to a net decrease in safety for the majority of crashes.
The CR claim that seats perform worse when attached with LATCH is so far not borne out by real-world data. Currently, the largest available source of information on children in real world crashes comes from the Partners for Child Passenger Safety study (www.chop.edu/injury). Less than one percent of crashes reported to PCPS involved infants in rear-facing seats in side-impact crashes – with a risk of injury of less than one-half of one percent. There was no evidence of a difference in risk of injury whether the seat was attached by the vehicle seat belt or LATCH. It is important to note that injuries sustained by these children were not necessarily caused by a child restraint that came loose, as was seen in the tests conducted by Consumer's Union.
The fact remains that child restraints are highly effective at reducing death and serious injury in the real world. To the extent that the Consumer Reports story undermines confidence in use of these restraints, it does the public a disservice.
The Car Seat Ladies feel comfortable continuing to recommend the infant seats that CR found "unsafe" – including the Graco Safe Seat amongst others. We do not see a need for parents to stop using their infant seats - or to go out and purchase a Graco Snug Ride with EPS or Baby Trend Flex Loc as CR recommends doing.
Nonetheless, every parent must make their own decision based on what they feel to be the best for their child. For those who still remain concerned, it's likely best to switch to a rear-facing convertible seat - which a baby can use from the day he/she is born. The convertible seat offers no risk of separation since it is all one piece (unlike an infant seat with a base). Another option is to use the infant carrier without the base (making sure that you properly install the carrier every time you use it).
Key Points for continued safety:
For All Kids:
For kids in rear-facing seats:
- Keep your child rear-facing as long as possible. Kids who are rear-facing are up to 4 times safer than those who are forward-facing. While most kids outgrow their infant seats around 6-9 months (exception: Graco Safe Seat or Cosco Opus 35), most kids will not outgrow their convertible seat rear-facing until 2-3 years of age.
- If you are using an infant seat with a base, make sure to check that the carrier has fully locked into the base by pulling up on the carrier - once on each side. Do not rely on simply hearing the carrier click in.
For kids in forward-facing car seats:
- Use the tether strap on your car seat - ALL forward facing car seats have a tether strap. Using the tether will decrease how far your child's head moves forward by as much as 8 inches! If your vehicle is a 2000 or newer the tether anchors are factory installed - check the owner's manual to your vehicle for information on where they are located in your vehicle. If your vehicle is pre-2000, you can get the tether anchor installed either for free or for a minimal cost (usually $15).
- Keep your child in a car seat until they are AT LEAST 40 pounds AND 3-4 years old AND mature enough to sit still in a booster seat.
For kids in booster seats:
- Use a booster seat until your child can pass the 5-step test.
- High back boosters offer 59% more protection in side impact crashes than backless boosters - so if possible use a high back booster whenever possible. (Backless boosters still offer great protection, so if you need a seat for travel, a backless booster is a great choice.)
Car Seat Manufacturers Responses to the Consumer Reports Article
Graco
Britax
Evenflo
Combi
Other Responses
American Academy of Pediatrics
SeatCheck.org and Chrysler Group
Juvenile Products Manufacturers Association
Partners for Child Passenger Safety
This month's issue of Consumer Reports (CR) features an article questioning the performance of certain rear-facing infant car seats, particularly with respect to the use of LATCH to secure the infant seat base to the vehicle's seat. The high-severity frontal and side sled tests conducted by Consumers Union in the lab found that most car seats performed poorly in either one or both of the tests and performed worse when attached to the vehicle using LATCH than they did when attached with the vehicle's seat belt.
The Partners for Child Passenger Safety (PCPS) research team at The Children's Hospital of Philadelphia supports the need for further research into the effectiveness of LATCH to protect children of all ages. As LATCH becomes more prevalent, we will be able to conduct analyses of the effectiveness of LATCH to protect children in real-world crashes. The PCPS team further supports the development of a side impact test procedure for child restraints that accurately simulates real world crash conditions. In the meantime, it is important for parents to place findings such as those reported in CR in perspective: children riding in the correct restraint for their age and size are far safer than if they were not restrained at all, or in a restraint that is inappropriate for their age or size.
The most current data from PCPS, which is the largest available source of information on children involved in real world crashes, shows:
- Less than one percent of crashes reported to PCPS since 1997 involved infants in rear-facing seats in side-impact crashes. Among these cases, the risk of injury was less than one-half of one percent – with no evidence of a difference whether the seat was attached by LATCH or by the vehicle seat belt. It is important to note, however, that injuries sustained by these children were not necessarily caused by a child restraint that came loose, as was seen in the tests conducted by Consumer's Union.
- Previous PCPS analyses indicate that side impact crashes generally have higher injury rates than frontal impacts for allpassengers, including children restrained in child restraints. Children in forward-facing restraints in side-impact crashes showed a few common characteristics of the crashes that resulted in injury: intrusion into the child's occupant space, a frontal component of the crash (rather than a 90-degree side-impact collision); and rotation of the child restraint towards the side of impact. Many of these characteristics are challenging to simulate in a sled test like the one implemented by Consumers Union.
Automotive Coalition for Traffic Safety, Inc.
January 4, 2007
CHILD SAFETY SEATS HIGHLY EFFECTIVE IN REAL WORLD CRASHES ACCORDING TO AUTOMOTIVE COALITION FOR TRAFFIC SAFETY
Consumer Reports Conclusions Not Based on Real World Experience
(Washington, DC) - The Automotive Coalition for Traffic Safety (ACTS) reminds all parents and caregivers to properly secure young children in age and size-appropriate child safety seats whenever they are in a motor vehicle despite media reports that many rear-facing infant seats did not perform well in Consumer Reports tests.
"The Federal Government's research shows that infant seats are highly effective, reducing fatal injuries to infants by 71 percent in passenger cars and by 59 percent in pickup trucks, minivans and SUVs," said ACTS president Phil Haseltine. "While product testing is important, the ultimate test of a safety device is how it performs in a real-world crash." Consumer Reports has apparently not shared details of its test procedures with manufacturers or other researchers.
Safety belts and LATCH system connectors are both effective methods of installing child safety seats in vehicles. Both the child safety seat instructions and the vehicle owner's manual should be carefully followed to ensure a secure installation. LATCH attachments are not available in all seating positions and using safety belts to install the child restraint may result in a tighter installation, depending on the specific child safety seat and vehicle seat in which it is being installed. Parents should try installing a child safety seat in their vehicle before buying it to ensure a proper fit.
"While LATCH attachments are still relatively new to the marketplace, I am not aware of any scientific data identifying problems with LATCH attachments in crashes," Haseltine added. "In fact, anecdotal reports suggest that LATCH is performing well in real world crashes." (LATCH stands for Lower Anchors and Tethers for Children)
ACTS is a nonprofit organization funded by motor vehicle manufacturers that educates the public and policymakers about traffic safety issues, particularly those associated with occupant restraint systems and other vehicle safety technologies. ACTS has long been involved in child passenger safety issues. In 1995, Mr. Haseltine served as moderator of the Blue Ribbon Panel on Child Restraints and Vehicle Compatibility. The panel's recommendations resulted in the development and adoption of the LATCH system. Subsequently, ACTS has led numerous panels and symposia addressing booster seat use and safety belt use by older children and teens.
|