Airbags May Increase Risk of Injury in Children Up to Age 14
Automobile accidents are the leading cause of death among children in the United States, killing over 90,000 children under age 20 in the 1990s. Many of these deaths could have been prevented if the children were properly placed in car seats, wearing seatbelts and/or positioned in age-appropriate locations in the car. But, while airbags significantly reduce the risk of crash-related death and injury in adults, they may be more harmful than beneficial for some children.
Since 1999, the federal government has required automobile makers to install driver and passenger front-impact airbags in all cars, light trucks, and vans. Although there is a risk of serious injury and death as a result of airbag deployment, it is clear that the benefits of airbags outweigh the risks for adults. From 1990 to 2003, the National Highway Traffic Safety Administration (NHTSA) estimated that while 230 deaths were caused by airbag inflation, 14,000 lives were saved by airbags.
But these safety benefits don’t necessarily apply to children. In 2001, the NHTSA demonstrated that passenger-side airbags may cause serious injuries and deaths to children seated in the right front seat. As a result, since 1997, the NHTSA has required the warning label, “Children 12 and under can be killed by an air bag,” in all passenger vehicles with airbags. But researchers are not sure that age 12 is the appropriate cutoff age, and some speculate that a height and/or weight cutoff may be more appropriate.
In a new study in the June 6, 2005 issue of Pediatrics , researchers set out to determine the specific age, height, and/or weight cutoffs that determine when the benefit of being seated in front of an airbag outweighs the risk. They found that while height and weight did not affect the risk, children up to age 14 were at increased risk of serious injury or death when seated in front of a passenger airbag.
About the Study
Researchers used data from a nationally representative database that contains information on people involved in motor vehicle crashes. This study included 3,790 children aged 0-18 who had been seated in the right front seat during a motor vehicle crash from 1995 through 2002. Front passenger airbags were present in 1,433 of these crashes.
By constructing a model that compared children of different ages, heights, and weights, the researchers were able to determine whether one or a combination of these factors affected the risk of serious injury or death associated with a passenger airbag.
Sixty children (1.6%) in this study were seriously injured, with 10 of these injuries resulting in death.
Surprisingly, height and/or weight did not affect the children’s risk of serious injury or death when seated in front of an airbag.
The researchers did, however, determine an age cutoff that consistently differentiated children at increased risk when seated in front of an airbag from those whose risk was decreased. Specifically, children aged 0-14 years who were seated in front of airbags that deployed during crashes were more than six times as likely to have serious injury or death than when airbags did not deploy. This finding, however, did not reach statistical significance, an important consideration. Among the children aged 15-18, airbag deployment was associated with a 69% decrease in risk of serious injury or death.
Interestingly, the use of seatbelts did not affect the association between serious injury or death and the presence of an airbag.
It is important to point out that this study was limited because the number of children with serious injury or death was not large enough to identify an association between height and/or weight and airbag-related risk.
How Does This Affect You?
These findings suggest that children up to age 14, regardless of their body size, may be at increased risk of serious injury or death when seated in front of a passenger airbag. On the other hand, children ages 15-18 were significantly safer when seated in front of a passenger airbag.
Why did age and not body size affect the association between passenger airbags and risk of serious injury or death? Although this study could not say for sure, the researchers speculate that it may have to do with the changes in body composition that coincide with puberty. At about age 11 in girls and age 13 in boys, children experience increases in lean body mass, bone mineral content, and bone density. One or more of these factors may help decrease the children’s susceptibility to injury from airbags. More research is needed to confirm this theory.
Despite this study’s limitations, it seems reasonable to encourage parents to have their children up to age 14 sit in the backseat with age-appropriate restraints (e.g., car seats, seatbelts). Parents will have to decide whether this change in policy is worth the predictably loud protests from their 13 and 14 year-olds who have finally gained the privilege of sitting up front. For children over age 14, airbags seem to be protective in addition to seatbelts.
Advocates of Highway and Auto Safety
National Highway Traffic Safety Administration
Child passenger safety. National Transportation Safety Board website. Available at: http://www.ntsb.gov/Surface/highway/childseat.htm . Accessed June 6, 2005.
Newgard CD, Lewis RJ. Airbags may increase risk of serious injury in children age 14 and younger. Pediatrics . 2005;115(6):1579-1585.
Q&A: airbags. Insurance Institute for Highway Safety website. Available at: http://www.iihs.org/safety_facts/qanda/airbags.htm . Accessed June 6, 2005.
Last reviewed Jun 10, 2005 by ]]>Richard Glickman-Simon, MD]]>
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