Motor vehicle collisions (MVCs) remain a leading cause of death in children under 15, and this should not be new knowledge to any of us. We also know that the risk of a crash-related injury goes up if a child is unrestrained in a vehicle and that more than 25 years ago, studies indicated that there was a strong association between being an unrestrained driver and having unrestrained. This is why we now have mandatory seat belt laws in our 50 states yet in 15 states, the seat belt law is a secondary offense, meaning that a police officer cannot stop and ticket solely for not wearing a seat belt. How serious is the problem of unrestrained car passengers today? Roehler et al (10.1542/peds.2018-2507) decided to look at the problem of unrestrained drivers and young passengers (≤19 years) involved in fatal car accidents and evaluate the proportion of unrestrained drivers.
The authors analyzed 5 years’ worth of data from the National Fatality Analysis Reporting System and National Automotive Sampling System to look at characteristics of drivers and young passengers and used logistic regression to determine what factors were the highest predictors for children being improperly restrained in vehicles. Sadly, the unrestrained driver remains a very strong predictor for a child to also be unrestrained in both fatal and nonfatal MVCs. So what does this mean for us and our patients? Do we even ask parents and other caregivers if they wear their seatbelts every time they are in their vehicles, or do we just assume this is happening? The Roehler et al study shows us it is not always happening and will hopefully prompt us to ask or remind our families about the importance of buckling up and properly restraining a child in their vehicle. At a population level, perhaps this study will encourage you to work even harder to convince your state legislature to ensure that there are primary seat belt laws in your state if these laws are not already implemented. Fasten your seatbelts and read this study to learn more.