Kids and car safety

University of Michigan Health System
Tuesday, 1 June 2004

University of Michigan expert gives tips on how to keep children safe while in the car this summer

We depend on cars everyday to drive the kids to school, soccer practice, and friends' houses. But many people underestimate the dangers of motor vehicles. More than just modes of transportation, cars are potential weapons that kill thousands of people each year, but we can make efforts to keep children safer.

Motor vehicle accidents

The first and greatest danger is motor vehicle crashes, which kill between 200 and 300 children in Michigan each year. But according to Elaine S. Pomeranz, MD, medical director of the Child Protection Team at the University of Michigan Hospital System, it is possible to reduce the chance of fatalities from motor vehicle accidents by taking necessary precautions.

The first way to protect children is using proper child restraints. All seats should be placed in the rear of the car because of the potential dangers of airbags, especially in newer vehicles with airbags on the passenger side. "Children should really not sit in the front seat until they are at least 12 years old," recommends Pomeranz.

It is also important that children's sizes are taken into account. Infants, classified as less than one year and under 20 pounds, should be secured in an appropriate rear facing carrier in the backseat of the vehicle. When children surpass the 20 pound weight recommendation, a forward-facing toddler seat should be used, also placed in the backseat. These transition toddler seats secure children with a Y-shaped latch belt system. The five-point restraint system should fit snugly.

From about 40 pounds to 80 pounds, children should ride in booster seats. "Booster seats elevate children high enough that they are able to safely use the shoulder harness belt systems already installed in cars," explains Pomeranz. The belt should go safely across the chest, rather than the neck. Children can usually forego booster seats at age 8. At age 12, children can also ride in the front seat.

Safe and Secure

Properly buckling children in car seats is also important. Only 25% of children killed in Michigan car crashes in a one year period were properly secured. The National SAFE Kids campaign also reports that 86 % of child restraints are used incorrectly.

Pomeranz notes that properly securing children includes two parts: how the child is buckled in the car seat and how the child's car seat is attached to the motor vehicle. Each car seat has specific qualifications for proper use. Many child safety organizations sponsor free car seat inspection sites across the country to make sure that the seat is being used correctly that parents can find via the web and take advantage of, such as National Safe Kids Coalition:

Pomeranz also stresses the importance of children staying in car seats at all times when vehicles are moving. This is a common problem, especially for toddlers once they become able to undo their car seats on their own. She recommends several strategies to keep kids buckled up. First, parents, as well as everyone else in the car, should set an example. Rather than singling out children with reminders to stay buckled up, encourage them to take on the job of reminding others. Parents can also reward children by making certain toys, books, or music available to children when buckled up and should stop the car if children refuse to stay buckled in.

Children not buckled up pose other dangers as well. Besides not being best positioned in the event of a crash, children have been known to get burned from cigarette lighters; parents may also have other objects in the car that they have forgotten about which could injure children. Children moving around can also interfere with the driver's visibility.

Heating up

In addition to the children who die from motor vehicle crashes, many children die every summer from heat exposure when left in cars. From 1996 to 2000, more than 120 children– most three and younger–died from heat stroke after being trapped in cars. Even children who survive serious heat exposure often have severe disabilities as a result of irreversible brain damage from lack of oxygen.

Studies show that regardless of the color of the car, its seats, or if the windows are cracked, interior temperatures can rise from 96 degrees to 150 degrees in a matter of 20 minutes, with a sharp rise in the first 10 minutes. With such hot temperatures, a few moments can have drastic consequences.

Infants and young children in hot cars can experience heat stroke within only a matter of minutes. Heat stroke causes children's skin to become red and dry. They become unable to produce the sweat needed to reduce their core body temperature; the heart rate quickens and they eventually become confused and lose consciousness before the organ systems fail. When there is not enough oxygen in the car for a long enough period of time, children die of asphyxiation, as well as heat exposure.

Pomeranz also stresses that children have a lower tolerance for heat than adults do. "Children exhaust their ability to sweat more quickly than adults," she says. In fact, parents should not leave children alone even for a few minutes with the air conditioning running because it is never safe to leave children alone in cars. Pomeranz says that toddlers can climb out of car seats and disengage the car's break, shift the car into neutral, or even turn on the ignition if the key has been left.

More tips for keeping kids safe in cars:

  • Teach children not to play in, on, or around cars.

  • Always lock car doors and trunks, even at home, and keep keys out of reach.

  • When cars have been parked in the heat, check that car seats and buckles aren't overly hot.

  • Safety seats are often recalled, so stay informed.

  • Make sure your car is equipped with a trap resistant trunk– and if not, see your car dealer.

For more information, visit the following websites:

U-M Your Child: Motor Vehicle Safety

U-M Women's Health Topics: Car Safety Seats

National Safe Kids Coalition

Kids and Cars

Safety Belt Safe USA

American Academy of Pediatrics: Care Safety Seats

For more information, or to contact University of Michigan Health System, see their website at:

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