RFing Stats?

[gwenvet]

On another thread Wendy mentioned this statistic: "Kids RFing are four times less likely to be seriously injured or killed." I don't question it but know that my husband, ever the realist, is going to say "Well what are the numbers? You can't just rely on the overall statistics. Four times 100 kids is definitely alot more significant than four times one injured kid." (I can just hear him!) Now we all agree that one more severely or fatally injured kid isn't good but he does have a point. (Always does, unfortunately! ) I looked on this websit and on cpsafety but no details. Anyone know where to find them so that we can back up our statements and be more informed?

 

[wendytthomas]

I think this is where I read it.

http://www.msnbc.msn.com/id/9916868

And another.

http://www.cpsafety.com/articles/StayRearFacing.aspx

Wendy

 

[SafeDad]

Good point. It is meaningless to just say, "Kids RFing are four times less likely to be seriously injured or killed." You really need to see the study that produced that statistic. Does it apply only to kids under 12months/20 pounds? Does it apply only to kids who are improperly restrained? Does it compare fatality rates of kids restrained RF vs. all kids, many of whom are unrestrained?

Without the details, who knows?

As a side note, you can look at the number of children who die each year as a result of motor vehicle crashes. From 2003, the most recent year available, here are the number of deaths attributed to unintentional motor vehicle traffic injuries and their ranks among all causes of death for kids that age:

Age, number, rank

<1, 144, >20
1, 129, 4 (After Congenital Anomalies, Drowning and Homicide)
2, 116, 4 (After Drowning, Congenital Anomalies and Homicide)
3, 143, 1
4, 117, 2 (After Malignant Neoplasms)
5, 133, 1
6, 119, 1
7, 110, 1
8, 116, 1

For 5 years 1999-2003:

<1, 744, >20
1, 680, 4 (After Congenital Anomalies, Drowning and Homicide)
2, 714, 2 (After Drowning)
3, 689, 1
4, 637, 1
5, 663, 1
6, 651, 1
7, 683, 1
8, 693, 1

Only the top 20 causes were listed; motor vehicle crashes just miss the top 20 for babies under 1 year old.

It's hard to draw conclusions from such general statistics, but it's clear that the number of fatalities for kids 1 year and up (mostly FF) are not 4x greater than for those under 1 year old (mostly RF). In fact, the number of motor vehicle related fatalities drop slightly after the first year, though the totals are pretty similar for each year of age. They are pretty consistently between 100 and 150 deaths for each age, every year. Plus, over half of those deaths are to kids who were completely unrestrained and many more due to misuse. The overall rank for cause of death quickly goes up to #1 after the first year, but only because medical causes and drownings decrease significantly after the first few years.

I would be very surprised to find any study showing that properly restrained kids RF who are above both 1 year and 20 pounds are significantly safer than properly restrained kids FF who are above both 1 year and 20 pounds. That's not to say RF isn't any safer. I'm sure there is a very real advantage if only because the laws of physics clearly benefit the RF child, but it isn't anywhere near 4x or even 2x.

On the other hand, for kids under 1 year of age or under 20 pounds, I could easily believe the 4x safer number. Infants are less well developed than toddlers and so they benefit more from being RF. Plus, RF seats tend to be more tolerant than FF seats and that is an advantage since most kids are improperly restrained for one or more types of misuse of their child restraint.

So, the real question is, "Kids RFing are four times less likely to be seriously injured or killed than what?"

 

[SafeDad]

That 4x number was a preliminary study and was in regard to injuries (not fatalities) to children under age 2 in side impacts. That's still a good reason to keep kids RF as long as possible, but it's certainly not as impressive as when someone says that kids RFing are four times less likely to be seriously injured or killed.

 

[gwenvet]

Wow! I have to spend some more time mulling over these numbers when my brain isn't in mommy mode! I wonder if Steve Wallen (sp?) from Safeguard will chime in, I bet he knows some of this data like the back of his hand! Other than him, I don't know of any industry professionals who lurk here.

 

[SafeDad]

Also, when you talk about injuries, it is important to know how severe they are. No one wants to have their child scraped or bruised, of course. Still, those things and even some more serious injuries like simple fractures do heal. To me at least, it is the injuries that can cause life-threatening, prolonged or life-long effects that would concern parents the most. Injury severity information is usually included in most respectable studies.

So, it will be very interesting to see the fine details in the final study referenced in the MSNBC article, after it has been peer-reviewed and published. It sounds like it may be another year. Here is an update from last month, including some A/V files:

http://www.seas.virginia.edu/enews/enews_sep06/sherwood.html

 

[Chris Sherwood]

RF benefits

Hello,
My name is Chris Sherwood and I work as a research scientist at the University of Virginia. The focus of most of my research is on child passenger safety. I was e-mailed by a poster asking to comment on some our research, as it relates to the benefit of Rear Facing restraints for children past the standard 1 year AND 20 pound guideline.

We began looking into this topic because in Sweden it is common to keep children rear facing up to the ages of 3 and 4. But in Sweden very few children use forward facing restraints. They typically transition directly from RF to booster seats. Their research shows that RF restraints have clear benefits over the forward facing boosters. Given their findings, we wanted to learn if children in the US would benefit from remaining in RF restraints past 1 year AND 20 pounds.

We are about 2 years into a 3 year project which uses several different methods to try to answer this question. Some of the information mentioned above stems from a presentation I gave at the AAP conference last year. It was not a formal presentation, and I showed some preliminary results that showed a clear benefit for children under the age of 24 months when seated in RF restraints rather than FF. We have completed the rest of the work on that paper, and it is currently in its final stages before submitting it to a journal.

I am always unsure how to discuss this type of data, i.e. prior to an official publication. On the one hand, I obviously have confidence in the findings and want people to use the safest restriant possible. On the other hand, there is a reason that scientific publications use a peer review process. (Which is one of my complaints with the methods used by the Freakonomics authors). So I don't think it is appropriate for me to quote any specific findings until the research is published, I will give an idea of our findings.

Overall, RF restraints were significantly safer than FF restraints. But what was an interesting finding, was the fact that the benefit was the greatest in side impact crashes. We will continue to study this finding, but our initial thoughts are that this is due to the fact that most side impact crashes have a frontal component (meaning that all occupants will move to the side of the vehicle as well as forward). For children in RF restraints, this means that their bodies (particularly their heads) will move farther INTO the restraint, likely getting added protection from any side wings. Children in FF restraints will move forward and away from the side wings.

Trying to answer the questions of how much safer are RF restraints, and at what age should they be switched to FF are practically impossible to answer. But our group believes that children benefit from staying in RF restraints at least until the age of 2.

Hope I addressed some of your questions.

Sincerely,
Chris Sherwood

 

[SafeDad]

Welcome- and thank you for your comments!

As with many areas of Child Passenger Safety, it's very difficult to get good statistics- especially when you only want to know the results for properly restrained children, for example. RF vs. FF, top-tether vs. no tether, rear seat center vs. rear-seat outboard, LATCH vs. seatbelt and many other comparisons are usually left without any data to support one being significantly superior to the other. Studies like yours will be a great help to child passenger safety advocates. Thanks again!

 

[skaterbabs]

welcome Chris, and thank you!

 

[gwenvet]

Thanks Chris for taking the time to share the latest info on the topic. When your data is published I hope you will come back and post a link to the online paper. And if you happen to lurk here, please feel welcome to chime in!

Darren: I thought a bit about the numbers of auto deaths you listed for 2003. Do you know if those numbers were adjusted or totals? If they are totals than, if I remember correctly, it would be impossible to say that 116 two year old deaths was really less than 143 three year old deaths because if there were say (hypothetically) twice as many three year olds as two year olds driving around then the comparative number of 3 year old deaths would actually be 71.5. Does that make ANY sense? Statistics never was my strong suit but we need to make sure we are comparing apples to apples!! Thanks for finding that data!

Wendy, I hope that my using your quote didn't hurt your feelings any! It certainly wasn't intended, on the contrary it was a statement that I found really compelling and the topic is such an important one. I think your comments are always highly regarded here! Hope I didn't offend you and if I did, my apologies!

 

[SafeDad]

I don't know if the numbers are adjusted or not. I wouldn't think the population would vary by more than a percent or two from year-to-year, so I bet it doesn't matter so much even if they aren't.

You can find the data and information here:

http://webappa.cdc.gov/sasweb/ncipc/leadcaus.html