Mother & Baby, October 2004
Seat belt safety
Two years ago when the popstar Michael Jackson dangled his six month old child, Prince Michael, from a fourth floor hotel balcony most people questioned whether he was fit to be a parent. But CIAN MOLLOY reports that thousands of Irish people put children in a similar danger every day of the week by not restraining them properly with seat belts when travelling by car.
An unrestrained child sitting in a car travelling at 30 mph that breaks sharply will be thrown forward with a force of 30 to 60 times their own body weight. That force is similar to dropping a child from a fourth story window, says Brian Farrell, communications officer with the National Safety Council.
According to Dr Peter Keenan, a consultant paediatrician in the accident and emergency department of Temple Street Children's Hospital if an unrestrained child is involved in a head-on collision between two cars travelling at 30 mph, it is almost certain that death is inevitable. He says having an unrestrained child in a front seat or standing in the back between the driver and the front passenger seats is akin to putting your child in a rocket launcher ready to be fired out the front window should an accident occur.
Despite the risks, many drivers do not secure children properly in their cars. According to a survey carried out by Dr Alf Nicholson of the Lourdes Hospital in Drogheda last year, less than a quarter of cars with child passengers had those children properly restrained. This is despite the fact that nearly eight out of every 10 children involved in a car crash will survive the accident if they are restrained in the right size car seat or wearing a properly fitting seat belt.
Rules of the road
According to law, with the exception of taxi-drivers and bus drivers, all drivers are responsible for ensuring that front and rear seat passengers aged under 17 must wear a seat belt if it is fitted in the car and, if the child is aged under four, the driver must ensure that the child is secured with an appropriate child restraint.
If you are a mum with a newborn baby, your maternity hospital will not allow you to take your child away in a car, if it doesn't have an appropriate rear-facing child seat. However, for insurance reasons, no nurse will put the child into the seat for you - you will have to do it yourself first time. If dad is picking you and your child up, its a good idea for him to practice fitting the child seat in place before arriving to collect you both to take you home.
However, while it is recommended that children over the age of four are appropriately restrained, the use of child car seats or booster seats are not mandatory.
"What the law says is different to what the National Safety Council say is safe to do," says Farrell. "At the moment the emphasis in law is on ensuring that children are restrained full stop. Any restraint is better than no restraint at all."
Thanks to a series of campaigns run by the National Safety Counci the level of seat-belt use in Ireland is improving - according to annual surveys for drivers and front seat passengers the total number wearing seat belts has increased from 51 per cent in 1991 to 72 per cent in 2002. However, the 1999 survey showed that rear-seat belt wearing rates were about 20 per cent. The rate for wearing rear-seat belts in 2002 couldn't be determined in the NSC survey, because there were too few records in the survey of vehicles with more than one occupant!
At present under the recently launched Road Safety Strategy, it's hoped to increase the rear-seat belt wearing rates to 60 per cent by the end of 2006. One of the chief ways of reaching this target is that the Garda’ have agreed to include an inspection of seat belt wearing in any dealings with motorists.
There is some confusion about how the law stands regarding taxis, partly due to a misleading instruction that was issued to Garda’ about a year ago, which saw taxis being stopped for carrying children that weren't in child seats. Since then the law has been clarified, according to Tommy Gorman, president of the National Taxi Drivers Union, who says the onus is on adult passengers to ensure that the children travelling with them are secured properly.
According to Gorman, the usual practice with very small children is for them to be placed on an adults lap with the seatbelt around them. However, Farrell says this in itself is dangerous. "Jesus, absolutely no way should you put a seat belt around you and a child on your lap," the NSC spokesman told Mothers and Babies. "In the event of an accident that child would end up being crushed to death between the adult and the seat belt."
However at the Royal Society for the Prevention of Accidents (ROSPA), spokesman Roger Vincent says that while having a rear seat belt around both an adult and a child on their lap could cause death by crushing, the alternative of having the child on your lap without a seat belt is only slightly less dangerous. "In an accident, the force of the impact could cause the child to be torn from your arms," he says. "Really, where possible in a taxi the child should be in a child car seat where apropriate."
Having a child seat doesn't necessarily mean that your child will be safe, Vincent points out. "A whole series of studies have revealed that on average 70 per cent of child seats are incorrectly fitted," he said. "There would be quite a variety in the mistakes people make - some would be minor, some would be quite serious. The problem is that people will often not be aware that the seat is not fitted properly. The commonest mistakes are that either the seat is not secured enough or the child is not firmly secured enough in the seat. If there is room for movement, the child will be thrown about in a crash and is likely to be injured."
The surgeon's view
As someone dealing with the devastating injuries caused to those children involved in road accidents, Dr Keenan is firmly of the view that the laws on seat belts should be vigorously enforced. He echoes the view that any restraint is better than no restraint at all, but he has had to deal with many cases where children were injured because they were wearing inappropriate adult seat belts, which are designed for those who are at least five foot tall. He said: "A lap seat belt is better than no seat at all, but in a collision having only a lap seat belt on may result in flexion injuries to the spine and trauma to internal organs. Where children wear adult seat belts, the shoulder strap often comes to close to the neck causing injury there in a collision."
Amazingly, the rules on child seats are covered by a UN regulation, which among other things specifies that when the seat is sold it must come with clear installation instructions in the language of that country. In the UK, ROSPA have identified the lack of a requirement to provide instructions in ethnic minority languages such as Urdu or Gujarati as a problem with the regulations and, given Ireland's growing number of immigrants, it is a growing problem in this country. Another drawback in the UN regulations is that when a hired car comes with child seats, there is no requirement to provide installation instructions or guidance on use at all.
"We recommend that people use new child seats rather than second hand seats or seats handed down through the family, because second hand seats often come without instructions," says Vincent. "An additional problem with older child seats is that they may not fit properly in more modern cars. Indeed, this is a problem with a lot of incorrectly fitted child seats - often its the wrong seat for the wrong model car. People should think carefully when buying child seats and not just buy a seat where the trim matches the material of the cars seat upholstery. If you can't fit the seat properly, go back to the retailer and have them show you how to fit it. If it doesn't fit properly, its not fit for purpose and you should ask for your money back and buy the correct seat elsewhere if such a seat is not available in that particular shop."
If you are looking for further advice on child seats, restraints and bolster seats, visit ROSPA's website at www.childcarseats.org.uk.
At the Lourdes Hospital in Drogheda, advice on car seats is given as part of ante-natal care. As a result, it has been found that fewer children are being treated in accident and emergency for serious injury in car crashes as a proportion of the total number of car crash victims who are treated at the hospital.
"The car safety information is usually given when the women are about 32 to 36 weeks pregnant, a time when most mothers wouldn't have already bought a car seat," says Mary McGann a midwife working in the hospitals Parentcraft department. "We make the parents aware of their responsibilities under the law and what the recommendations are.
"Personally, I think there is a need for greater awareness of this particular issue. There has been a very good television advertisement about the dangers of not wearing a seat belt in the back seat, but I really think there should be a television advertisement commissioned that focuses particularly on children. Our children are very precious and we have a responsibility to keep them safe. No one wants to put their child in danger, but too many people travel with children who aren't properly restrained. It's something that needs to change."