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Monday, October 15, 2018

CBC earns an incomplete for seat belt story

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The CBC is making a big deal of its investigation into the need for seat belts in school buses. I can see the argument. I often accompany my oldest granddaughter on school outings. I sit in the school bus with the children and I feel weird not wearing a seat belt. It has never felt right and so I did some research.

Finding the definitive answer is not a quick search. It turns out this is a complex problem and a lot of folk have given it a lot of thought. Heck, even the researcher quoted this morning in the CBC report was once featured in a New York Times piece carrying the headline "Study Rejects Requiring School Bus Seat Belts."

Kathleen Weber, the researcher quoted by the CBC, told the Times that all the members of the committee examining the question of seat belts use in school buses were in agreement: the benefits of requiring seat belts were sufficiently small, and the problem itself sufficiently small, that the committee could not justify the cost.

I don't like that answer. If seat belts work, put them in the school buses. Period. End of discussion. Surely, cost does not enter into the equation. We are talking seat belts. How much can seat belts cost? The present system of making school buses safe, compartmentalization, cannot be cheap.

No, the question is: do seal belts work? Or more accurately, do standard seat belts work with little children? Think carefully before answering. If you do, you'll realize little children do not ride in the backseat of the family car restrained only by the three-point seat belts provided. By law a booster seat is required. Why? For safety.

In Canada, over a two-year period, 28 children were reported to have sustained injuries consistent with seat belt syndrome; seven of these children remained paraplegic. Among the 16 injured children eight years of age and older, four were properly restrained with three-point seat belts.

Booster seats are an attempt at preventing maladjusted seat belts from causing serious injuries and even death to improperly restrained children. Ill-fitting seat belts are a big safety concern. Studies show children are especially vulnerable to suffering a seat belt caused injury. Transport Canada has some well founded concerns.

As I mentioned, I have grandchildren. I own two types of booster seats: one a booster cushion and the other a high-backed booster seat that installs using the Universal Anchorage System (UAS/Latch). Both are legal in Canada but not everyone in the world agrees. The use of booster cushions is restricted to older children in Great Britain and Europe. In those places, my grandchildren would be breaking the law by using booster cushions.

Whenever possible, I use the high-back booster seats which attach firmly to the car's UAS system. I leave the booster cushions at home in the garage. My gut feeling is that the high-backed, anchored boosters deliver improved protection. I think the Europeans are making the right decision. I'd like to see this style of booster seat, paired with properly designed seat belts, used in school buses.

The Fifth Estate did one thing right. They found IMMI in Indiana. This is a company developing innovative seat belts for school buses. One product features a five-point system that appears to deal with the biggest dangers posed by traditional three-point seat belts. Kudos to the Fifth Estate for finding the IMMI company and bringing it to our attention.

An independent study of the IMMI product or products may be necessary but surely it could be done quickly. Let's make school buses, already remarkably safe, safer still.

Lastly, one-sided attacks, like the one launched by the CBC, make for attention-holding television but such attacks don't encourage folk to come to the table for an adult discussion. I'm not surprised the minister refused to meet with the CBC Fifth Estate reporter. It appears on the face of it that the CBC folk had an agenda and it wasn't getting at the whole truth and nothing but the truth. It was attacking a government bureaucracy. It was in telling a good story.
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When writing a post for my blog, an immense amount of information must be found and read. I admit it may overwhelm me. A better system would be for journalists to work together and to work longer, ignoring self-imposed, artificial deadlines, to deliver accurate information. Below, is just a very small sample of the info found and examined.

Sixteen passengers died and 13 were injured in the Humboldt Broncos bus crash. The charter bus company involved in the crash had already installed seat belts without a federal rule, but none of the players were wearing one.

Research link: http://www.who.int/roadsafety/projects/manuals/seatbelt/seat_belt_manual_module_1.pdf

The three-point lap and diagonal seat-belt used by adults is not designed for children’s varying sizes, weights, and the different relative proportions of children’s bodies. For example, a smaller portion of a child’s abdomen is covered by the pelvis and rib cage, while a child’s ribs are more likely than an adult’s to bend rather than break, resulting in energy from a collision being transferred to the heart and lungs.

Consequently three-point lap and diagonal seat-belts may lead to abdominal injuries among children, and will not be optimally effective at preventing ejection and injury among them. Appropriate child restraint systems are specifically designed to protect infants and young children from injury during a collision or a sudden stop by restraining their movement away from the vehicle structure and distributing the forces of a crash over the strongest parts of the body, with minimum damage to the soft tissues.

Child restraints are also effective in reducing injuries that can occur during non-crash events, such as a sudden stop, a swerving evasive manoeuvre or a door opening during vehicle movement.

Seatbelt Syndrome in Children: This is an interesting paper. Seat belts are good but, when it comes to their use with children, proper booster seats are an excellent addition to increase safety. It should be noted that there are a number of opinions on what exactly constitutes a proper booster seat. For instance, look up what is demanded in Great Britain.

http://www.roadsafetyobservatory.com/HowEffective/vehicles/seat-belts
http://www.roadsafetyobservatory.com/HowEffective/vehicles/child-restraints (The researchers found that abdominal injuries mainly occurred in children using only a seat belt, emphasising the need for belt-positioning boosters. (Jakobssen, 2005))

(The main system for safely restraining occupants in vehicles is, of course, seat belts. However, seat belts do not fit children properly, and do not fit babies at all. This means they are less effective in protecting children, and in some circumstances, could even cause injury.

Children are not simply smaller adults; they are proportioned differently, their bones are not fully formed and their skeletal structure does not cover and protect their internal organs in the way it does in adults. All of these things change as children grow older, meaning that the type of restraint system they use also needs to change, until they reach the point where the seat belts can provide the same protection as for adults. (Burdi and Huelke, 1969, WHO, 2009))

Child Car Restraints Compared with Seatbelts
A USA study of 2 to 3 year old rear seat child passengers in crashes that resulted in at least one vehicle being towed away between 1998 and 2004 concluded that the odds of injury were 81.8% lower for toddlers in child seats than for toddlers wearing seat belts. (Zaloshnja, 2007)
Another American study comparing the use of child restraints with seat belts by 2 to 6 year old children involved in vehicle crashes between 1998 and 2003 found that compared with seat belts, child restraints (when not seriously misused) were associated with a 28% greater reduction in the risk for death in children of that age group. When including cases of serious misuse, the effectiveness was slightly lower, at 21%. (Elliot, 2006)

A study of crashes in 15 states in America between December 1998 and May 2002 involving 1,207 children aged 12 and 47 months, seated in the rear of vehicles, found that the risk of serious injury was 78% lower, and the risk of hospitalisation was 79% lower, for children in forward facing child restraints than for those in seat belts. (Arbogast, 2004)

A study of 17,980 children under 16 years old involved in crashes in 15 states between December 1998 and November 2002 found that the risk for inappropriately restrained (defined as using a seat belt rather than a child safety seat or booster seat) children was almost double that of appropriately restrained children. (Durbin, 2005)

An analysis of fatal car accidents in the USA between 1982 and 1987 estimated that children in child safety seats were 50% less likely than unrestrained children to be killed, but those using the car’s adult seat belts were only 36% less likely to be killed. (NHTSA, 1998)

When these estimates were updated in 1996, the estimates for the effectiveness of seat belts on their own had increased to 47% in cars and 48% in light trucks or vans. The effectiveness of child restraints had also increased from 69% to 71% for under one year olds and from 50% to 54% for one to four year olds. (NHTSA, 1996)

https://www.researchgate.net/publication/11366925_Are_seat_belt_restraint_use_effective_in_school_age_children_A_prospective_crash_study