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Pediatricians in Chile, U.S. work to make cars safer for kids :

March 16, 2017
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Child passengers in Chile are much safer now, thanks in part to Chilean and AAP pediatricians who collaborated to help shape a new automobile safety law.

All children up to age 12 now must sit in the back seat. In addition, child restraint systems are required for children up to age 9, and children ages 9-12 must wear seat belts. Like in the U.S., the Chilean law also bases the type of restraint system to use on the child’s height and weight. The new regulations will result in an estimated 30% reduction in deaths.

The Academy has been collaborating with the Sociedad Chilena de Pediatria (SOCHIPE, Chilean Pediatric Society), as it advocated for the stronger laws to protect children.

The regulation for children up to age 12 to sit in the back seat took effect last year, and the seat restraint regulation was enacted last month. Violating these regulations carries big consequences. Drivers are subject to a hefty fine (66,000 to 132,000 pesos, or about U.S. $100 to $200) and suspension of driving privileges for up to 45 days.

“For safety, following these regulations will be a huge improvement. Children sitting in the back seat are much less likely to be injured,” said Marilyn J. Bull, M.D., FAAP, who consulted with Chilean pediatricians. A transportation safety expert, Dr. Bull has represented the Academy as liaison to the National Child Passenger Safety Board.

Road traffic incidents are the leading cause of death for children ages 1-14, according to Chile’s Traffic Safety Commission (CONASET). The rate of child mortality due to road traffic injuries in Chile is almost three times higher than the U.S. and 27 times higher than Sweden.

“Many of these deaths and injuries in crashes are preventable,” Dr. Bull said.

The previous law only required children ages 8 or under to ride in the back seat and those ages 4 and under to be seated in child restraint systems.

Despite the law, eight in 10 parents did not use safety restraints on daily trips, according to a SOCHIPE statement. This behavior could be attributed to the lack of regulation, awareness and knowledge about the importance of safety seats for protection, according to Sergio Rendich, M.D., of Santiago, Chile, SOCHIPE transportation safety committee chair and collaborator with CONASET.

Some families are not happy with the law because they must buy new car seats, and large families face challenges with working out safe seating arrangements, said Dr. Rendich.

“As SOCHIPE, we want to help in this area, teaching health professionals the proper installation, so they can check out how the parents installed them and eventually correct any mistake,” he said. “We must help parents to fulfill the law with education, understanding and comprehension as a way to make them understand the risks about transporting their children not tied or fastened, and the advantages from transporting them protected by a child safety device.”

To help address these issues, Gary A. Smith, M.D., Dr.P.H., FAAP, a member of the AAP Council on Injury, Violence and Poison Prevention (COIVPP) and Kyran P. Quinlan, M.D., M.P.H., FAAP, COIVPP chair, also have met with government traffic safety representatives and pediatricians. They presented AAP information on evidence and training, and lent the Academy’s support to Chile to help motivate parents to comply with the changes.

Chile has launched a national awareness campaign to educate parents (http://www.conaset.cl/sillas-infantiles/). Transportation safety experts and SOCHIPE are working to bring pediatricians up to speed on how to incorporate child passenger safety education into child visits.

Although the new laws do not specifically address safety for children with disabilities, Dr. Bull said the needs of these children are on their radar.

The Academy continues to work with SOCHIPE on improving child passenger safety and common goals. Other Latin American countries have expressed interest in the Academy’s assistance to duplicate Chile’s efforts.

“We know that to implement a successful occupant protection program, it takes engineering, which is the car seat; it takes education, which is the training we do for families, community and culture; and it takes enforcement,” said Dr. Bull. “These all must work in concert for the optimal outcome.”

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