INCREASES IN CRASH INVOLVEMENT AND FATALITIES AMONG MOTOR-VEHICLE OCCUPANTS YOUNGER THAN 5 YEARS OLD

Objective. To determine whether increased exposure as car occupants co uld be a major contributor to increases observed in deaths of young ch ildren in car crashes. Design and setting. Crash data from police repo rts for Maryland, Michigan, Pennsylvania, and Washington for various y ears from 1982 through 1990 were examined to compare annual age mix of injured and uninjured occupants in crashes involving at least two pas senger vehicles. Aggregate national data from the Fatal Accident Repor ting System were also examined over the same time period and compared to population estimates for children younger than 5 years old to asses s temporal trends in number of occupants in this age group who were in volved in motor vehicle crashes in which a fatality occurred in fatal crashes and the number of them killed in passenger vehicles. Results. In regression analyses for each state, the number of car occupants you nger than 5 involved in crashes increased during the years studied; th eir percentage among nondriver occupants involved also increased. At a national level, similar analyses showed increases in the number of oc cupants younger than 5 involved in crashes in which a fatality occurre d. Conclusions. Despite overall increases in the use of restraint devi ces (ie, both child safety seats and adult restraints), fatalities amo ng restrained children have increased. Given that exposures to crash e nvironments are increasing, clinicians need be aware of the importance of child restraints as a means of reducing the likelihood of injury.